Correlations of gray matter volume with peripheral cytokines in Parkinson's disease.

INTRODUCTION: Peripheral cytokine levels may affect specific brain volumes. Few studies have examined this possible relationship. OBJECTIVE: In a case-control study, we used magnetic resonance imaging (MRI) voxel-based morphological analysis techniques to examine the relationship between gray matter volume changes and cognitive, motor and emotional dysfunction as well as between gray matter volume changes and peripheral blood cytokine levels. METHOD: A total of 134 subjects, comprising 66 PD patients and 68 healthy controls, were recruited. Peripheral venous blood was collected to measure the concentrations of 12 cytokines, including IL-1ß, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17, IFN-α, IFN-γ, and TNF-α. All the subjects also underwent MRI, where 3D-T1-weighted MR images were used for the analysis. In addition, the Montreal Cognitive Assessment (MoCA), Mini-Mental Status Examination (MMSE), Unified Parkinson's disease Rating Scale (UPDRS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) scores were assessed in PD patients. Statistical parameter mapping 12 software was used for the statistical analysis of the images. RESULT: Compared with control patients, PD patients presented decreased gray matter volume (GMV) in the bilateral frontal lobe, temporal lobe, parietal lobe, occipital lobe, insula, and right cerebellar lobule VIII. Regional GMV in the temporal lobe, parietal lobe, and cerebellum was correlated with MoCA, MMSE, UPDRS, HAMA, and HAMD scores in PDs. In addition, the regional GMV in PDs was correlated with the concentrations of cytokines, including IL-4, IL-6, IFN-γ, and TNF-α. The IL-6 concentration was negatively correlated with the UPDRS-IV score. CONCLUSION: PD patients exhibit gray matter atrophy in a wide range of brain regions, which are symmetrically distributed and mainly concentrated in the frontal and temporal lobes, and these changes may be linked to motor disorders and neuropsychiatric manifestations. Cytokine concentrations in peripheral blood are correlated with regional gray matter volume in PDs, and the IL-6 level affects gray matter volume in the left precentral gyrus and the manifestation of motor complications.

Associations between different body mass index and lung function impairment in Chinese people aged over 40 years: a multicenter cross-sectional study.

OBJECTIVE: The aim of this study was to explore the associations between different body mass index (BMI) levels and different lung function impairment (LFI) in Chinese people aged over 40 years. METHODS: We used a multi-stage stratified cluster random sampling method to investigate 3000 residents aged over 40 years from 5 areas in Hubei province of China in 2019-20. The data on questionnaire, physical measurements, and spirometry of the participants were collected. The associations of different BMI levels with different LFI were analyzed using multivariate logistic regressions after complex weighting. The spirometry data were analyzed using one-factor analysis of variance (ANOVA), and post-hoc was performed using the least significance difference (LSD)-t test. RESULTS: A total of 2860 subjects were included. The prevalence (95%CI) of obstructive lung disease (OLD), restrictive lung disease (RLD), mixed lung disease (MLD), chronic obstructive pulmonary disease (COPD), COPD mild, and COPD moderate/severe/very severe were 24.1% (95% CI: 22.2-26.2), 11.6% (95% CI: 10.3-12.9), 4.0% (95% CI: 3.3-4.8), 12.6% (95% CI: 11.0-14.1), 7.2% (95% CI: 6.0-8.4), and 5.3% (95% CI: 4.3-6.4) respectively. After multivariate adjustment, the risk of OLD, COPD, and COPD mild decreased with the increment of BMI levels (both P for trend < 0.05). When compared to the normal weight group, the overweight group and obese group were at lower risk of experiencing OLD than normal group, the ORs were 0.77 (95% CI: 0.59-0.99) and 0.59 (95% CI: 0.40-0.86) respectively. The obese group was at lower risk for people with COPD mild (OR: 0.42, 95%CI: 0.21-0.85). Participants in underweight group were more likely to experience COPD and COPD moderate/severe/very severe, the ORs were 2.82 (95% CI: 1.07-7.39) and 3.89 (95% CI: 1.28-11.87) respectively. CONCLUSION: Higher BMI levels were associated with an decreased risk of OLD and COPD. Obesity had a protective effect on lung function in OLD patients and COPD patients. However, there was no significant difference in RLD and MLD prevalence between different BMI groups.

Causal effect of gut-microbiota-derived metabolite trimethylamine N-oxide on Parkinson's disease: A Mendelian randomization study.

BACKGROUND AND PURPOSE: It has been suggested that trimethylamine N-oxide (TMAO) is related to Parkinson's disease (PD) in observational studies. However, the direction of this association is inconsistent. An exploratory Mendelian randomization study was conducted to investigate whether TMAO and its precursors have a causal relationship with PD. METHODS: Summary statistics were obtained for single nucleotide polymorphisms related to circulating levels of TMAO, betaine, carnitine and choline, and the corresponding data for the risk, age at onset and progression of PD from genome-wide association studies. Inverse-variance weighting was used as the primary method for effect estimation. The false discovery rate was applied to the correction of multiple testing. A p value of association <0.05 but above the false discovery rate corrected threshold was deemed suggestive evidence of a possible association. A range of robust Mendelian randomization methods were used for sensitivity analysis. RESULTS: Suggestive evidence was observed of an inverse causal effect of TMAO on motor fluctuations (odds ratio [OR] 0.851, 95% confidence interval [CI] 0.731, 0.990, p = 0.037) and carnitine on insomnia (OR 0.817, 95% CI 0.700, 0.954, p = 0.010) and a positive causal effect of betaine on Hoehn-Yahr stage (OR 1.397, 95% CI 1.112, 1.756, p = 0.004), Unified Parkinson's Disease Rating Scale (UPDRS) III score (ß = 0.138, 95% CI 0.051, 0.225, p = 0.002), motor fluctuations (OR 1.236, 95% CI 1.011, 1.511, p = 0.039), and choline on UPDRS IV (ß = 0.106, 95% CI 0.026, 0.185, p = 0.009) and modified Schwab and England Activities of Daily Living Scale score (ß = 0.806, 95% CI 0.127, 1.484, p = 0.020). CONCLUSIONS: Our findings provide suggestive evidence that TMAO and its precursors have a causal effect on the progression of PD. Further investigation of the underlying mechanisms is required.

Understanding the risk factors for adverse events during exchange transfusion in neonatal hyperbilirubinemia using explainable artificial intelligence.

OBJECTIVE: To understand the risk factors associated with adverse events during exchange transfusion (ET) in severe neonatal hyperbilirubinemia. STUDY DESIGN: We conducted a retrospective study of infants with hyperbilirubinemia who underwent ET within 30 days of birth from 2015 to 2020 in a children's hospital. Both traditional statistical analysis and state-of-the-art explainable artificial intelligence (XAI) were used to identify the risk factors. RESULTS: A total of 188 ET cases were included; 7 major adverse events, including hyperglycemia (86.2%), top-up transfusion after ET (50.5%), hypocalcemia (42.6%), hyponatremia (42.6%), thrombocytopenia (38.3%), metabolic acidosis (25.5%), and hypokalemia (25.5%), and their risk factors were identified. Some novel and interesting findings were identified by XAI. CONCLUSIONS: XAI not only achieved better performance in predicting adverse events during ET but also helped clinicians to more deeply understand nonlinear relationships and generate actionable knowledge for practice.

Cystatin C is a potential predictor of unfavorable outcomes for cerebral ischemia with intravenous tissue plasminogen activator treatment: A multicenter prospective nested case-control study.

BACKGROUND AND PURPOSE: The aim of this study was to explore whether cystatin C (CysC) could be used as a potential predictor of clinical outcomes in acute ischemic stroke (AIS) patients treated with intravenous tissue plasminogen activator (IV-tPA). METHODS: We performed an observational study including a retrospective analysis of data from 125 AIS patients with intravenous thrombolysis. General linear models were applied to compare CysC levels between groups with different outcomes; logistic regression analysis and receiver-operating characteristic curves were adopted to identify the association between CysC and the therapeutic effects. RESULTS: Compared with the "good and sustained benefit" (GSB) outcome group (defined as ≥4-point reduction in National Institutes of Health Stroke Scale or a score of 0-1 at 24 h and 7 days) and the "good functional outcome" (GFO) group (modified Rankin Scale score 0-2 at 90 days), serum CysC baseline levels were increased in the non-GSB and non-GFO groups. Logistic regression analysis found that CysC was an independent negative prognostic factor for GSB (odds ratio [OR] 0.010; p = 0.005) and GFO (OR 0.011; p = 0.021) after adjustment for potential influencing factors. Receiver-operating characteristic curves showed the CysC-involved combined models provided credible efficacy for predicting post-90-day favorable clinical outcome (area under the curve 0.86; p < 0.001). CONCLUSIONS: Elevated serum CysC is independently associated with unfavorable clinical outcomes after IV-tPA therapy in AIS. Our findings provide new insights into discovering potential mediators for neuropathological process or treatment in stroke.

Blood routine test is a good indicator for predicting premature rupture of membranes.

OBJECTIVE: To assess the value of blood routine test (blood RT) in order to predict the occurrence of premature rupture of membranes (PROM). METHODS: A retrospective study was conducted to collect blood RT data from 100 cases of preterm premature rupture of membranes (pPROM), 70 cases of full-term premature rupture of membranes (fPROM), and 100 cases of full-term pregnancy (Normal). Nonparametric tests were performed for each blood routine parameter, the ROC curve was established for the parameters with significant difference, and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratios (+LR), and negative likelihood ratios (-LR) were further calculated. RESULTS: The statistical results showed that WBC, NE.%, LY.%, EO.%, BA.%, NE.#, EO.#, RBC, HGB, HCT, and NLR were significantly different between pPROM and fPROM (P < 0.05). There was a significant difference in WBC, NE.%, LY.%, NE.#, MO.#, RBC, HGB, HCT, and NLR between the pPROM and Normal groups (P < 0.05). Between the fPROM and Normal groups, only WBC was statistically significant (P < 0.05). By establishing ROC curve, the results showed that when the cutoff value of WBC was 9.63 and NEU# was 7.12, their combined detection had the best predictive value with a sensitivity of 73% and a specificity of 81%. In addition, Its PPV was 79.3%, NPV was 75%, +LR was 3.84, and -LR was 0.33. CONCLUSION: The patient's blood RT results can be used to predict the risk of premature rupture of membranes, and in order to improve the sensitivity and specificity, multiple parameters can be combined.

Pharmacological approaches promoting stem cell-based therapy following ischemic stroke insults.

Stroke can lead to long-term neurological deficits. Adult neurogenesis, the continuous generation of newborn neurons in distinct regions of the brain throughout life, has been considered as one of the appoaches to restore the neurological function following ischemic stroke. However, ischemia-induced spontaneous neurogenesis is not suffcient, thus cell-based therapy, including infusing exogenous stem cells or stimulating endogenous stem cells to help repair of injured brain, has been studied in numerous animal experiments and some pilot clinical trials. While the effects of cell-based therapy on neurological function during recovery remains unproven in randomized controlled trials, pharmacological agents have been administrated to assist the cell-based therapy. In this review, we summarized the limitations of ischemia-induced neurogenesis and stem-cell transplantation, as well as the potential proneuroregenerative effects of drugs that may enhance efficacy of cell-based therapies. Specifically, we discussed drugs that enhance proliferation, migration, differentiation, survival and function connectivity of newborn neurons, which may restore neurobehavioral function and improve outcomes in stroke patients.

Meta-Analysis on the Association between Brain-Derived Neurotrophic Factor Polymorphism rs6265 and Ischemic Stroke, Poststroke Depression.

BACKGROUND: Ischemic stroke is a multifactorial neurologic injury that causes mortality and disability worldwide. Poststroke depression is the most important neuropsychiatric consequence of stroke. Brain-derived neurotrophic factor is a neurotrophin family member that plays key role in regulating neuron survival and differentiation. Studies found a polymorphism in brain-derived neurotrophic factor gene (rs6265) may associate with the ischemic stroke and poststroke depression risk. However, the results are inconclusive and inconsistent. METHODS: In the present meta-analysis, the database PubMed, Embase, Cochrane Central Register of Controlled Trials, CNKI, and Chinese Biomedical Literature Database were searched until July 9, 2017. RESULTS: Seven studies with 1287 cases and 1032 controls were included for the meta-analysis of ischemic stroke, and five studies with 272 cases and 503 controls were included for poststroke depression. The results indicated that the GG genotype of brain-derived neurotrophic factor is related to a significantly lower risk of ischemic stroke in the homozygous and dominant models (odds ratio = .57 and .80, respectively). No significant relation was found between rs6265 and poststroke depression. CONCLUSIONS: Thus, brain-derived neurotrophic factor rs6265 might be recommended as a predictor of susceptibility of ischemic stroke. However, the results of this meta-analysis should be interpreted with caution because of the heterogeneity between studies and low sample size. Further studies are needed to evaluate the associations between rs6265 and poststroke depression, especially in Caucasians, with large sample size.

Prehypertension and its optimal indicator among adults in Hubei Province, Central China, 2013-2015.

BACKGROUND: Hypertension accounts for 7% of the annual global disease burden, despite great efforts to counter this trend. Thus, interventions targeted at prehypertension might lead to a breakthrough for hypertension prevention. This study focused on the prevalence of prehypertension among adults in Central China and the best indicator of prehypertension, which would provide the basis for future interventions. METHODS: This cross-sectional study was conducted using multistage stratified random sampling in seven counties in Hubei Province. Data from 30,634 survey respondents were analyzed using logistic regression and receiver operating characteristic (ROC) curve statistical tests, for the prevalence of prehypertension and the predictive ability of body mass index (BMI), waist-to-height ratio (WHtR), and waist circumference (WC) for prehypertension. RESULTS: The prevalence of prehypertension in adults was 42.2%. The following factors contributed to the risk of prehypertension: male sex, elder age, divorce/separation, drinking, heavy labor intensity, and high BMI (p < 0.05). Being a farmer and exercise exhibited positive associations with prehypertension (p < 0.05). Compared with BMI and WHtR, WC had a higher predictive value for prehypertension (area under ROC curve, AUC = 0.630, 95% confidence interval: 0.623-0.637, p < 0.0001), especially for men. The optimal cutoffs of WC for prehypertension were 79.95 cm in men and 76.85 cm in women. CONCLUSIONS: The prehypertension rate in adults was high in Central China. Significant factors related to hypertension were identified. More interventions targeting individuals with WC above the cutoff level are needed for timely awareness of prehypertension and early prevention of hypertension.

Hypothermia followed by rapid rewarming exacerbates ischemia-induced brain injury and augments inflammatory response in rats.

Hypothermia followed by slow rewarming is neuroprotective for ischemic stroke. However, slow rewarming causes patients' longer stay in intensive care unit and increases the risk of hypothermic complications. Hypothermia followed by rapid rewarming (HTRR) is more convenient; but it exacerbates intracranial hypertension for patients with massive hemispheric infarcts. The present study aims to investigate in detail how HTRR exacerbates ischemic brain injury and what are underlying mechanisms. Rats subjected to transient focal ischemia by middle cerebral artery occlusion were treated with normothermia or hypothermia followed by rapid rewarming. Neurological outcome, neuronal injury, blood-brain barrier integrity and expressions of inflammatory cytokines were observed. Results showed that HTRR at a rate of 3 °C/20 min increased both neurological deficit score and Longa score, enhanced the loss of neurons and the plasma level of neuron-specific enolase. Rapid rewarmed rats also displayed increased Evans blue dye extravasation, matrix metalloproteinase 9 level and tight junction impairment. Meanwhile, interleukin-1ß, -6, tumor necrosis factor α and cyclooxygenase-2 were markedly elevated in rapid rewarmed rats. Anti-inflammatory agent minocycline suppressed HTRR-induced elevation of inflammatory cytokines and improved neurological outcome. These results indicated that HTRR significantly impaired neurovascular unit and augmented proinflammatory response in stroke.

Prolonged hypothermia exposure diminishes neuroprotection for severe ischemic-hypoxic primary neurons.

This study aimed to identify optimal mild hypothermic (MH) condition that would provide the best protection for neuronal cells undergoing severe ischemia and hypoxia. We also sought to determine if longer exposure to mild hypothermia would confer greater protection to severe ischemia and hypoxia in these cells. We designed a primary neuronal cell model for severe glucose and oxygen deprivation/reoxygenation (OGD/R) to simulate the hypoxic-ischemic condition of patients with severe stroke, trauma, or hypoxic-ischemic encephalopathy. We evaluated the viability of these neurons following 3 h of OGD/R and variable MH conditions including different temperatures and durations of OGD/R exposure. We further explored the effects of the optimal MH condition on several parts which are associated with mitochondrial apoptosis pathway: intracellular calcium, reactive oxygen species (ROS), and mitochondrial transmembrane potential (MTP). The results of this study showed that the apoptosis proportion (AP) and cell viability proportion (CVP) after OGD/R significantly varied depending on which MH condition cells were exposed to (p < 0.001). Further, our findings showed that prolonged MH reduced the neuroprotection to AP and CVP. We also determined that the optimal MH conditions (34 °C for 4.5 h) reduced intracellular calcium, ROS, and recovered MTP. These findings indicate that there is an optimal MH treatment strategy for severely hypoxia-ischemic neurons, prolonged duration might diminish the neuroprotection, and that MH treatment likely initiates neuroprotection by inhibiting the mitochondrial apoptosis pathway.

Inhibitory effect of Aristolochia fruit on Cytochrome P450 isozymes in vitro and in vivo.

The mature fruits of Aristolochia debilis, known in China by the name, "Madouling" has been popularly prescribed in Asia, particularly in China, to treat a range of conditions including gynaecological problems, arthritis and wound healing. This study was aimed to evaluate the potential effect of Madouling on the cytochrome P450 (CYP) isozymes in vitro in microsomal fractions and in vivo in rats. The influence of Madouling on CYPs activity was first explored by an in vitro method of estimating levels of four respective metabolites in rat liver microsomes. The results were re-examined in vivo in rats by using a cocktail approach involving the probe drugs theophylline, tolbutamide, chlorzoxazone and dapsone. Pharmacokinetics of the four substrates was used to analyze the activities of the targeting isozymes. In vitro study revealed that Madouling decreased the activity of CYP1A2, 3A1 and 2E1. However, no significant influence on CYP2C6 was found. These results coincided with those of in vivo study to a great degree except that in vivo estimation the herb didn't inhibit CYP1A2 significantly. From the data obtained, Madouling is suggested as a candidate for clinically significant CYP interactions. Drug co-administrated with Madouling may need dose adjustment.

Determination of newly synthesized lipoic acid-niacin dimer in rat plasma by UPLC/electrospray ionization tandem mass spectrometry: assay development, validation and application to a pharmacokinetic study.

A simple, sensitive and specific ultra-performance liquid chromatography/tandem mass spectrometry (UPLC-MS/MS) method was developed to determine the newly synthesized compound lipoic acid-niacin dimer (N2L) in plasma. Plasma samples were precipitated by methanol using tetrahydropalmatine as internal standard. Chromatographic separation was achieved on an Acquity BEH C18 (2.1 × 50 mm i.d., 1.7 µm) column; the mobile phase contains methanol and buffer solution (water with 0.5% formic acid and 10 mmol/L ammonium acetate). Multiple reaction monitoring (m/z 353.9 → 148.6 for N2L and m/z 356.0 → 192.0 for internal standard) was performed for detection and quantification. The method was validated to be rapid, specific, accurate and precise over the concentration range of 1-750 ng/mL; N2L was not stable on the bench-top or during freeze-freeze-thaw cycles in plasma, but was stable in the stock solution and after preparation in the autosampler for 24 h. The utility of the assay was confirmed by pharmacokinetic study of N2L in rats.

Effect of raw Radix Rehmanniae on the pharmacokinetics of pioglitazone in rats.

Raw Radix Rehmanniae (RRR) is a frequently used traditional Chinese medicine in the treatment of diabetes mellitus according to the statistics on all of the anti-diabetic formulas recorded in New National Traditional Chinese Medicine. Pioglitazone and RRR may be co-administrated for presumably enhanced therapeutic effects because of the common indications. Therefore, the aim of the study was to evaluate the effect of RRR on the pharmacokinetics of pioglitazone in healthy rats and type 2 diabetic rats. The pharmacokinetic effect of RRR on pioglitazone was studied in healthy rats and type 2 diabetic rats. A validated UPLC-MS/MS method was used to analyze the concentration of pioglitazone in blood samples. The pharmacokinetic parameters were calculated using non-compartmental analyses by Winnonlin 5.0.1. In healthy group, the pre-treatment of RRR significantly (P<0.05) reduced the C(max) but enhanced the V/F of pioglitazone; whereas in T2DM group, significant increase of C(max) and decrease of V/F and T½ were found after the rats were pre-treated with RRR. However, AUC(0-t) and CL/F remained unchanged in both healthy group and T2DM group. In conclusion, co-administration with RRR could alter the pharmacokinetic profiles of pioglitazone to statistically significant levels.

Rare Cases of Pseudomonas aeruginosa Meningitis in Children: 10-Year Experience in a Single Center.

OBJECTIVE: The primary objective was to elucidate the epidemiologic characteristics, risk determinants, and clinical outcomes associated with Pseudomonas aeruginosa-induced meningitis. METHODS: All cases of meningitis caused by Pseudomonas aeruginosa that were treated at the hospital between 2012 and 2022 were retrospectively analyzed and detailed. RESULTS: During a 10-year period, only 10 patients satisfied the inclusion criteria. Three patients had previously undergone neurosurgical procedures and 4 patients had leukemia. CONCLUSIONS: Although Pseudomonas aeruginosa meningitis possesses a low incidence rate, the rate of mortality is high. Patients with leukemia or those who have undergone neurosurgery are the most susceptible to diagnosis. Cases of severe neutropenia present only mild or no cerebrospinal fluid pleocytosis. In patients with sensitive Pseudomonas aeruginosa meningitis, the timely use of anti-Pseudomonas carbapenems for intravenous treatment is highly effective. For drug-resistant Pseudomonas aeruginosa meningitis, intrathecal polymyxins administration can be an effective treatment option.

The neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and neutrophil-to-high-density-lipoprotein ratio are correlated with the severity of Parkinson's disease.

Background: Inflammation plays a pivotal role in the pathogenesis of Parkinson's disease (PD). However, the correlation between peripheral inflammatory markers and the severity of PD remains unclear. Methods: The following items in plasma were collected for assessment among patients with PD (n = 303) and healthy controls (HCs; n = 303) were assessed for the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-high-density-lipoprotein ratio (NHR) in plasma, and neuropsychological assessments were performed for all patients with PD. Spearman rank or Pearson correlation was used to evaluate the correlation between the NLR, the LMR and the NHR and the severity of PD. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of the NLR, LMR and NHR for PD. Results: The plasma NLR and NHR were substantially higher in patients with PD than in HCs, while the plasma LMR was substantially lower. The plasma NLR was positively correlated with Hoehn and Yahr staging scale (H&Y), Unified Parkinson's Disease Rating Scale (UPDRS), UPDRS-I, UPDRS-II, and UPDRS-III scores. Conversely, it exhibited a negative relationship with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Furthermore, the plasma NHR was positively correlated with H&Y, UPDRS, UPDRS-I, UPDRS-II and UPDRS-III scores. Moreover, negative associations were established between the plasma LMR and H&Y, UPDRS, UPDRS-I, UPDRS-II, and UPDRS-III scores. Finally, based on the ROC curve analysis, the NLR, LMR and NHR exhibited respectable PD discriminating power. Conclusion: Our research indicates that a higher NLR and NHR and a lower LMR may be relevant for assessing the severity of PD and appear to be promising disease-state biomarker candidates.

Long-term exposure to PM2.5 chemical constituents and diabesity: evidence from a multi-center cohort study in China.

Background: Long-term exposure to PM2.5 is known to increase the risks for diabetes and obesity, but its effects on their coexistence, termed diabesity, remain uncertain. This study aimed to investigate the associations of long-term exposure to PM2.5 and its chemical constituents with the risks for diabesity, diabetes, and obesity. Methods: This cross-sectional study used the baseline data of a multi-center cohort, consisting of three provincially representative cohorts comprising a total of 134,403 participants from the eastern (Fujian Province), central (Hubei Province), and western (Yunnan Province) regions of China. Obesity and diabetes, and diabesity were identified by a body mass index (BMI) ≥28 kg/m2 and fasting plasma glucose (FPG) ≥126 mg/dL. The average concentrations of PM2.5 and five chemical constituents (NO3 -, SO4 2-, NH4 +, organic matter, and black carbon) over participants' residence during the past three years were estimated using machine learning models. Logistic regression models with double robust estimators, Bayesian kernel machine regression, and weighted quantile sum regression were employed to estimate independent and joint effects of PM2.5 chemical constituents on the risks for diabesity, diabetes, and obesity, as well as the differences from the effects on obesity. Stratified analyses were performed to examine effect modification of sociodemographic and lifestyle factors. Findings: There were 129,244 participants with a mean age of 54.1 ± 13.8 years included in the study. Each interquartile range increase in PM2.5 concentration (8.53 µg/m3) was associated with an increased risk for diabesity (OR = 1.23 [1.17, 1.30]), diabetes only (OR = 1.16 [1.13, 1.19]), and obesity only (OR = 1.03 [1.00, 1.05]). Long-term exposure to each PM2.5 chemical constituent was associated with an increased risk for diabesity, where organic matter exposure, with maximum weight (48%), was associated with a higher risk for diabesity (OR = 1.21 [1.16, 1.27]). Among those with obesity, black carbon contributed most (68%) to the joint effect of PM2.5 chemical constituents on diabesity (OR = 1.16 [1.11, 1.22]). Physical activity reduced adverse effects of PM2.5 on diabesity. Also, additive rather than multiplicative effects of obesity on the PM2.5-diabetes association were observed. Interpretation: Long-term exposure to PM2.5 and its chemical constituents was associated with an increased risk for diabesity, stronger than associations for diabetes and obesity alone. The main constituents associated with diabesity and obesity were black carbon and organic matter. Funding: National Natural Science Foundation of China (42271433, 723B2017), National Key R&D Program of China (2023YFC3604702), Fundamental Research Funds for the Central Universities (2042023kfyq04, 2042024kf1024), the Science and Technology Major Project of Tibetan Autonomous Region of China (XZ202201ZD0001G), Science and technology project of Tibet Autonomous Region（XZ202303ZY0007G), Key R&D Project of Sichuan Province (2023YFS0251), Renmin Hospital of Wuhan University (JCRCYG-2022-003), Jiangxi Provincial 03 Special Foundation and 5G Program (20224ABC03A05), Wuhan University Specific Fund for Major School-level Internationalization Initiatives (WHU-GJZDZX-PT07).

Effects of family centered nursing model on children with primary nephrotic syndrome: A systematic review and meta-analysis.

BACKGROUND: Family-centered nursing model has been widely used in the care of children patients, but there is still a lack of research on the care of children with primary nephrotic syndrome (PNS). Therefore, the aim of this study was to comprehensively evaluate the effects of family-centered nursing on children with PNS. METHODS: The electronic databases included China National Knowledge Internet, Wanfang Data Knowledge Service Platform, VIP, PubMed, Web of Science, Cochrane Library, and Embase, were searched to collect randomized controlled trials on family-centered nursing model in the treatment of children with PNS. Fixed effect models or fixed effect models were used to analyze the outcomes. The primary outcomes were length of hospital stay and nursing satisfaction, and the second outcomes were quality of life (QoL) and behavioral problems. RESULTS: A total of 12 studies involving 996 pediatric patients were included, of which 500 children received family centered care and 496 children received routine care. The results showed that family centered nursing model could significantly improve the QoL of children with PNS (P < .05), increase the nursing satisfaction of family members (P < .0001, SMD = 7.37, 95%CI = 4.15-13.08), reduce the time of hospitalization (P < .0001, standard mean difference [SMD] = -2.30, 95%CI = -2.57 to -2.03), and decrease the scores of psychosomatic disorders and impulsivity hyperactivity in children with PNS (P < .0001, SMD = -3.13, 95%CI = -4.12 to -2.15; P < .0001, SMD = -3.29, 95%CI = -4.29 to -2.28). However, there was no significant statistical difference in the impact on the scores of conduct problems, learning problems, anxiety, and hyperactivity (P > .05). CONCLUSION: Family-centered nursing model can improve the QoL of children with PNS, increase the nursing satisfaction of family members and reduce the length of hospital stay, but further research need to verify its impact on behavioral problems.

[Characteristics and Source Apportionment of Atmospheric Fine Particles in Langfang in Autumn and Winter].

In this study, we report observations of various chemical species in PM2.5 samples that were collected between November 25, 2019 and March 31, 2020 in the northern, urban, and southern areas of Langfang, among which the concentrations of PM2.5 followed the order of southern>urban>northern. The abundance and chemical compositions of the particles in this study were temporally and spatially variable, with major contributions from organic matter (25.4%), nitrate (21.5%), sulfate (11.0%), ammonium (13.5%), and crustal matter (13.7%). The contributions of nitrate, sulfate, and ammonium were higher in the urban site compared with that in the southern and northern sites. On the contrary, organic matter and crustal matter exhibited much higher values in the southern and northern sites. In addition, the contributions of organic matter to the particle mass decreased from 27.3% to 23.0%, and the total contributions of sulfate, nitrate, and ammonium ions increased from 38.7% to 51.3% between clean and haze days, respectively. Source apportionment using positive matrix factorization showed five PM2.5 sources: secondary inorganic aerosol (41.9%), traffic emissions (19.9%), coal combustion (12.7%), industrial pollution (9.1%), and mineral dust (9.3%). The contributions of the first two factors followed the order of urban>northern>southern, whereas the contributions of the last three factors followed the order of southern>northern>urban. Further, the contributions of secondary inorganic aerosol, traffic emissions, and coal combustion were higher on haze days, whereas the contributions of industrial pollution and mineral dust were higher on clean days.