Diesel exhaust exposure induced squamous metaplasia of corneal epithelium via yes-associated protein activation.

Atmospheric pollution has been demonstrated to be associated with ocular surface diseases characterized by corneal epithelial damage, including impaired barrier function and squamous metaplasia. However, the specific mechanisms underlying the impact of atmospheric pollution on corneal damage are still unknow. To address this gap in knowledge, we conducted a study using a whole-body exposure system to investigate the detrimental effects of traffic-related air pollution, specifically diesel exhaust (DE), on corneal epithelium in C57BL/6 mice over a 28-day period. Following DE exposure, the pathological alterations in corneal epithelium, including significant increase in corneal thickness and epithelial stratification, were observed in mice. Additionally, exposure to DE was also shown to disrupt the barrier functions of corneal epithelium, leading to excessive proliferation of basal cells and even causing squamous metaplasia in corneal epithelium. Further studies have found that the activation of yes-associated protein (YAP), characterized by nuclear translocation, may play a significant role in DE-induced corneal squamous metaplasia. In vitro assays confirmed that DE exposure triggered the YAP/ß-catenin pathway, resulting in squamous metaplasia and destruction of barrier functions. These findings provide the preliminary evidence that YAP activation is one of the mechanisms of the damage to corneal epithelium caused by traffic-related air pollution. These findings contribute to the knowledge base for promoting eye health in the context of atmospheric pollution.

An automated two-stage approach to kidney and tumor segmentation in CT imaging.

BACKGROUND: The incidence of kidney tumors is progressively increasing each year. The precision of segmentation for kidney tumors is crucial for diagnosis and treatment. OBJECTIVE: To enhance accuracy and reduce manual involvement, propose a deep learning-based method for the automatic segmentation of kidneys and kidney tumors in CT images. METHODS: The proposed method comprises two parts: object detection and segmentation. We first use a model to detect the position of the kidney, then narrow the segmentation range, and finally use an attentional recurrent residual convolutional network for segmentation. RESULTS: Our model achieved a kidney dice score of 0.951 and a tumor dice score of 0.895 on the KiTS19 dataset. Experimental results show that our model significantly improves the accuracy of kidney and kidney tumor segmentation and outperforms other advanced methods. CONCLUSION: The proposed method provides an efficient and automatic solution for accurately segmenting kidneys and renal tumors on CT images. Additionally, this study can assist radiologists in assessing patients' conditions and making informed treatment decisions.

Identification of an inflammatory response-related gene prognostic signature and immune microenvironment for cervical cancer.

Background: Cervical cancer (CC) is the fourth most common cancer among women worldwide. As part of the brisk cross-talk between the host and the tumor, prognosis can be affected through inflammatory responses or the tumor microenvironment. However, further exploration of the inflammatory response-related genes that have prognostic value, microenvironment infiltration, and chemotherapeutic therapies in CC is needed. Methods: The clinical data and mRNA expression profiles of CC patients were downloaded from a public database for this study. In the TCGA cohort, a multigene prognostic signature was constructed by least absolute shrinkage and selection operator (LASSO) and Cox analyses. CC patients from the GEO cohort were used for validation. K‒M analysis was used to compare overall survival (OS) between the high- and low-risk groups. Univariate and multivariate Cox analyses were applied to determine the independent predictors of OS. The immune cell infiltration and immune-related functional score were calculated by single-sample gene set enrichment analysis (GSEA). Immunohistochemistry was utilized to validate the protein expression of prognostic genes in CC tissues. Results: A genetic signature model associated with the inflammatory response was built by LASSO Cox regression analysis. Patients in the high-risk group had a significantly lower OS rate. The predictive ability of the prognostic genes was evaluated by means of receiver operating characteristic (ROC) curve analysis. The risk score was confirmed to be an independent predictor of OS by univariate and multivariate Cox analyses. The immune status differed between the high-risk and low-risk groups, and the cancer-related pathways were enriched in the high-risk group according to functional analysis. The risk score was significantly related to tumor stage and immune infiltration type. The expression levels of five prognostic genes (LCK, GCH1, TNFRSF9, ITGA5, and SLC7A1) were positively related to sensitivity to antitumor drugs. Additionally, the expression of prognostic genes was significantly different between CC tissues and myoma patient cervix (non-tumorous) tissues in the separate sample cohort. Conclusion: A model consisting of 5 inflammation-related genes can be used to predict prognosis and influence immune status in CC patients. Furthermore, the inhibition or enhancement of these genes may become a novel alternative therapy.

A Study of the Relationship Between the Severity of Posterior Capsular Opacification Detected by Objective Detection Techniques and Visual Acuity.

PURPOSE: To explore the severity of posterior capsule opacification (PCO) using objective detection techniques and its relationship with visual acuity. SETTING: The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. DESIGN: Prospective cohort study. METHODS: All patients underwent slit-lamp examination, intraocular pressure measurement (IOP), best-corrected visual acuity (BCVA) before neodymium: yttrium aluminium garnet (Nd:YAG) laser capsulotomy, followed by examination after fully dilated, including IOLMaster 700, optical coherence tomography (OCT), Sirius anterior segment analysis system (Sirius), color fundus photography (CFP). Conducting BCVA and IOP post-treatment again. Recording the thickness and density of posterior capsule, color fundus photography quality (CFPQ) and OCT Signal Strength (OCTSS). Analysis using Spearman correlation analysis, heatmaps, and ROC curves. RESULTS: A total of 83 eyes in 78 patients were included in this study. Spearman correlation analysis revealed correlations between pre-treatment BCVA and IOLMaster 700 PCO thickness (MT), IOLMaster 700 cumulative effect (MCE), Sirius PCO thickness (ST), Sirius maximum density (SMD), Sirius cumulative effect (SCE), OCTSS, and CFPQ (correlation coefficients were 0.500, 0.484, 0.465, -0.256, 0.317, -0.442, -0.412, all P＜0.05). The improvement of Vision Acuity (ImpVA) showed correlations with MT, MCE, ST, SCE, OCTSS, and CFPQ (correlation coefficients were -0.452, -0.471, -0.346, -0.278, 0.320, 0.381, all P＜0.05). For ImpVA, the predictive ability of IOLMaster 700 was superior to Sirius, and the joint model was significantly better than single factors. CONCLUSIONS: Posterior capsule thickness and cumulative effect were reliable indicators for evaluating PCO. Compared to Sirius, IOLMaster 700 demonstrates superior predictive ability and higher correlation.

Prediction of hematologic toxicity in luminal type breast cancer patients receiving neoadjuvant chemotherapy using CT L1 level skeletal muscle index.

This study aims to explore the correlation between the CT-L1 and L3 body composition parameters and analyze the relationship between L1 body composition and hematologic toxicity in luminal-type breast cancer patients undergoing neoadjuvant chemotherapy. Data from 140 luminal-type breast cancer patients who underwent surgical treatment after neoadjuvant chemotherapy were analyzed retrospectively. Spearman analysis was used to assess the correlation between CT-L1 and CT-L3 body composition parameters pre-neoadjuvant chemotherapy. Additionally, univariate and multivariate logistic regression analyses were performed to identify factors influencing hematologic toxicity. CT-L1 body composition parameters were positively correlated with CT-L3 body composition parameters in 34 patients. Severe hematological toxicity occurred in 46 cases among the patient cohort. A skeletal muscle index (SMI) of < 32.91 cm2/m2, initial tumor size ≥ 3.335 cm, and a glucose-to-neutrophil ratio (GLR) ≥ 2.88 were identified as independent risk factors for severe hematologic toxicity during neoadjuvant chemotherapy in luminal-type breast cancer patients. The sample size in this study is small, and the predictive capacity of GLR in hematologic toxicity requires further research for comprehensive validation. CT-L1 analysis represents a viable alternative to CT-L3 analysis for body composition assessment. Patients with a low skeletal muscle index were more prone to experiencing severe hematologic toxicity during neoadjuvant chemotherapy.

Assessment and management of constipation in post-operative patients in the spinal surgery ward: a best practice implementation project.

INTRODUCTION AND OBJECTIVE: Constipation is a common complication following spinal surgery that can result in distension, abdominal pain, infection, and even intestinal perforation. This study reports on an evidence-based implementation project to reduce the incidence of constipation in spinal surgery wards. METHODS: The project was conducted in the spinal surgery ward of a general tertiary hospital in Changsha City, China, from March to August 2022. We used the JBI Implementation Framework and the JBI Model of Evidence-Based Healthcare for audits and feedback. Data were collected and analyzed using JBI's Practical Application of Clinical Evidence System (PACES) software. Seven audit criteria were developed based on the best practice recommendations summarized by JBI. A baseline audit was conducted with 20 nurses and 50 patients in the spinal surgery ward, and a follow-up audit was conducted using the same sample size and setting. RESULTS: The baseline audit revealed compliance below 46% for five of the seven criteria. Strategies developed to address poor compliance included educating nurses and patients, developing a post-operative constipation risk assessment sheet, organizing stakeholder focus group meetings, establishing a constipation management routine, and effective empowerment of nurses. The follow-up audit showed positive compliance results, with the highest rate for Criterion 7 (100%) and the greatest increase for Criterion 2 (from 0% to 78%). Furthermore, the incidence of post-operative constipation decreased from 48% to 16%. CONCLUSION: The project improved compliance with audit criteria, reduced the incidence of constipation, and enhanced the efficiency of quality management in the spinal surgery ward. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A186.

Spatio-temporal distribution of cadmium levels in Chinese population and its potential risk factors.

Cadmium (Cd), a ubiquitous heavy metal, exists in numerous environmental matrices and has severe adverse effects on various human organs and tissues. This research evaluates blood and urine Cd levels in the Chinese population through data mining using Monte Carlo simulation (MCS). A total of 168 scientific studies (120 on urine and 48 on blood) published between January 1980 and December 2020, reflecting a population of 109,743 individuals in China, were included in the study. The results indicate that the blood and urine Cd levels in the Chinese population exhibited a peak from 1990 to 1995 and remained stable after 1995, averaging 1.21 µg/L of blood Cd (BCd) and 0.61 µg/L of urine Cd (UCd). The spatial trend of Cd levels varied significantly. Shandong, Zhejiang, Heilongjiang, and Guangdong provinces were identified as the top provinces with high Cd levels, which were related to factors such as tobacco sales, E-waste amounts, and contaminated rice. Additionally, the study highlights that BCd concentrations are highest among preschool-aged individuals, whereas school-age and adolescent groups exhibit the lowest levels. However, no significant difference existed among the different age groups. Males showed significantly higher Cd levels than females in the general population. Moreover, exposure to smoking, drinking, and staple food preferences had an impact on Cd levels. Furthermore, this comprehensive study, using biological monitoring and data mining, provides valuable information on Cd pollution levels in the Chinese population. It presents a statistical analysis that can aid decision-makers in implementing effective measures to control potential Cd pollution and improve the health of vulnerable populations.

Development and Validation of a New High-Performance Liquid Chromatography-Ultraviolet Assay for Quantification of Mitoxantrone in Plasma of BALB/c-nu Mice.

The concentration of mitoxantrone in the blood of mice was determined by a high-performance liquid chromatography-ultraviolet method with aloe-emodin as the internal standard. The separation was performed on a Hypersil BDS2 column (4.6 × 250 mm, 5 µm) as the analytical column, the mobile Phase A was acetonitrile, and B was 20-mM potassium dihydrogen phosphate (adding 1% triethylamine and adjusting the pH to 2.8 with phosphoric acid) and 4.6-mM sodium octyl sulfonate. The flow rate was 1.0 mL·min-1, the detection wavelength was 243 nm, the column temperature is 25 ± 5°C and the injection amount was 20 µL. Finally, the linear range of mitoxantrone was 5-200 µg·mL-1, and the correlation coefficient was r = 0.9999. The recovery rate of the method was 91.93-105.5%, and the extraction recovery rate was 91.45-105.5%. The intraday precision and interday precision were <3.29% (limit of detection = 0.3 µg·mL-1). The HPLC method established in this paper was simple, rapid, sensitive and accurate, and can be used to determine the content of mitoxantrone in mouse plasma after tail vein injection.

Effect of an educational video about ERAS on reducing preoperative anxiety and promoting recovery.

Video propaganda is reported effectively improving patients' understanding of operation. However, whether a video introducing patients' most concerns can reduce preoperative anxiety and promote recovery stays unsealed. In this study, we investigated the effects of complementary therapy of educational video during preoperative visit. The results showed that thirty-five (23.2%) parents in Group Control were diagnosed as anxiety according to SAS, and nineteen (12.3%) patients were diagnosed after video intervention. The APAIs anxiety score and APAIs information score in Group Video were lower than those in Group Control. Compared with Group Control, video visit helped to increase the first-attempt pass rate of the knowledge retention exam and solve the patient's most worried concerns, and decrease incidence of emergence agitation, total cost of hospitalization and length of hospital stay. Moreover, video visit improved satisfaction degrees of patients and their main family members. Briefly, our study demonstrated video visit can improve patients' knowledge of anesthesia and decrease their preoperative anxiety, which may represent an important complementary therapy to routine preoperative visits.

The Treatment of Diffuse Large B-Cell Lymphoma (Triple Expression) Involving the Breast, Spleen, and Bone in a Male Patient with Viral Hepatitis B: A Rare Case Report.

Background: Diffuse large B-cell lymphoma (DLBCL) involving the breast, spleen, and bone in a male patient with hepatitis B virus (HBV) infection is extremely rare in clinical practice. Case Presentation: We report a case of DLBCL involving the breast, spleen, and bone (triple expression of Bcl-2+, Bcl-6+, and 70% positive C-mcy) in a male patient with HBV admitted to our hospital. The patient was treated with EPOCH×4, lenalidomide+EPOCH×2 chemotherapy, intermittent methotrexate intrathecal injections to prevent central invasion, and autologous stem cell transplantation (ASCT). The patient is currently in complete remission, and the follow-up time was 43 months. Conclusion: A patient with DLBCL involving the breast, spleen, and bone can be treated with a combination of multiple regimens. If the patient's economic conditions permit it, ASCT can be considered.

Peptide YY inhibits transcription and replication of hepatitis B virus by suppressing promoter/enhancer activity.

Hepatitis B virus (HBV) infection is a noteworthy cause of liver diseases, especially cirrhosis and hepatocellular carcinomas. However, the interaction between the host and HBV has not been fully elucidated. Peptide YY (PYY) is a 36-amino-acid gastrointestinal hormone that is mainly involved in the regulation of the human digestive system. This study found that PYY expression was reduced in HBV-expressing hepatocytes and HBV patients. Overexpression of PYY could significantly inhibit HBV RNA, DNA levels, and the secretion of HBsAg. In addition, PYY inhibits HBV RNA dependent on transcription through reducing the activities of CP/Enh I/II, SP1 and SP2. Meanwhile, PYY blocks HBV replication independent on core, polymerase protein and ε structure of pregenomic RNA. These results suggest that PYY can impair HBV replication by suppressing viral promoters/enhancers in hepatocytes. Our data shed light on a novel role for PYY as anti-HBV restriction factor.

Fibromyalgia in China: sleep quality is related to symptoms, quality of life and especially mental health.

OBJECTIVES: To investigate sleep quality in patients with fibromyalgia (FM) and to analyse the effect of sleep on FM symptoms and quality of life. METHODS: Patients with FM and healthy subjects were recruited to assess their sleep quality, and patients were further assessed for pain, fatigue, depression, psychological stress and quality of life. The patients were divided into a sleep disorder group as measured by the Pittsburgh Sleep Quality Index (PSQI score >7 points) and a group without sleep disorders (PSQI score ≤7 points). Linear regression analysis was used to explore the effect of sleep quality on FM pain controlling for sex and age, and the effect of sleep quality on FM fatigue, depression, psychological stress and quality of life controlling for sex, age and pain. RESULTS: A total of 450 patients and 50 healthy subjects participated in the study. The number of FM patients with sleep disorders was significantly higher than that of healthy subjects (90% vs. 14%, p≤0.001). In addition to the number of pain sites, the levels of pain, fatigue, depression, stress symptoms and quality of life were significantly impaired in FM patients with sleep disorders (p<0.05). In terms of the effects on quality of life assessed with the 36-item short-form health survey, the decrease in mental health was more substantial than the decrease in physical health (B=-12.10 vs. B=-5.40). CONCLUSIONS: Similar to FM patients in other countries and regions, a decrease in sleep quality is also the core symptom of FM patients in China and is significantly correlated with the severity of pain, fatigue, depression and stress symptoms and reduced quality of life, especially with regard to mental health, suggesting that the treatment of this disease should include sleep disorder interventions.

Association between intraoperative dexmedetomidine and all-cause mortality and recurrence after laparoscopic resection of colorectal cancer: Follow-up analysis of a previous randomized controlled trial.

Background: Dexmedetomidine (DEX) has been widely applied in the anesthesia and sedation of patients with oncological diseases. However, the potential effect of DEX on tumor metastasis remains contradictory. This study follows up on patients who received intraoperative DEX during laparoscopic resection of colorectal cancer as part of a previous clinical trial, examining their outcomes 5 years later. Methods: Between June 2015 and December 2015, 60 patients undergoing laparoscopic colorectal resection were randomly assigned to the DEX and control groups. The DEX group received an initial loading dose of 1µ/kg before surgery, followed by a continuous infusion of 0.3µg/kg/h during the operation and the Control group received an equivalent volume of saline. A 5-year follow-up analysis was conducted to evaluate the overall survival, disease-free survival, and tumor recurrence. Results: The follow-up analysis included 55 of the 60 patients. The DEX group included 28 patients, while the control group included 27 patients. Baseline characteristics were comparable between the two groups, except for vascular and/or neural invasion of the tumor in the DEX group (9/28 vs. 0/27, p = 0.002). We did not observe a statistically significant benefit but rather a trend toward an increase in overall survival and disease-free survival in the DEX group, 1-year overall survival (96.4% vs. 88.9%, p = 0.282), 2-year overall survival (89.3% vs. 74.1%, p = 0.144), 3-year overall survival (89.3% vs. 70.4%, p = 0.08), and 5-year overall survival (78.6% vs. 59.3%, p = 0.121). The total rates of mortality and recurrence between the two groups were comparable (8/28 vs. 11/27, p = 0.343). Conclusion: Administration of DEX during laparoscopic resection of colorectal cancer had a nonsignificant trend toward improved overall survival and disease-free survival. Clinical Trial Registration: http://www.chictr.org.cn/, identifier ChiCTRIOR-15006518.

Vagus innervation in the gastrointestinal tumor: Current understanding and challenges.

The vagus nerve (VN) is the main parasympathetic nerve of the autonomic nervous system. It is widely distributed in the gastrointestinal tract and maintains gastrointestinal homeostasis with the sympathetic nerve under physiological conditions. The VN communicates with various components of the tumor microenvironment to positively and dynamically affect the progression of gastrointestinal tumors (GITs). The intervention in vagus innervation delays GIT progression. Developments in adeno-associated virus vectors, nanotechnology, and in vivo neurobiological techniques have enabled the creation of precisely regulated "tumor neurotherapies". The present review aimed to summarize the mechanisms of communication between the VN and the gastrointestinal TME and to explore the potential and challenges of VN-based tumor neurotherapy in GITs.

Exploring Health Literacy Categories in Patients With Heart Failure: A Latent Class Analysis.

BACKGROUND: Although a growing number of studies have demonstrated that patients' health literacy is associated with health outcomes, the exact relationship between them is not clear. AIMS AND OBJECTIVES: The aim of this study was to explore latent classes of health literacy in patients with heart failure and analyze the differences among different groups. DESIGN AND METHODS: This is a cross-sectional survey. Patients diagnosed with heart failure were selected from 3 tertiary hospitals in Tianjin, China, from March 2019 to November 2019. We measured patients' health literacy using the Health Literacy Scale for Chronic Patients. Latent class analysis was carried out based on the patients' Health Literacy Scale for Chronic Patients scores. Multinomial logistic regression was used to identify the predictive indicators of the latent classes. RESULTS: The health literacy of patients with heart failure was divided into 3 different latent classes, named "high health literacy group," "low literacy high dependence group," and "moderate literacy high willingness group." There were statistically significant differences in gender, age, smoking history, marital status, education level, household income level, and quality of life among different health literacy classes. Low education level and household income level predicted poor health literacy. CONCLUSION: There were 3 latent classes for the health literacy of patients with heart failure. Different health literacy classes exhibited their own distinctive characteristics. Patients in the "moderate literacy high willingness group" had the worst quality of life. Understanding the specific types of health literacy in patients with heart failure facilitates targeted nursing interventions to improve their quality of life.

A Chinese version of the revised Fibromyalgia Impact Questionnaire: A validation study.

OBJECTIVE: The revised Fibromyalgia Impact Questionnaire (FIQR) was developed to measure the quality of life of patients with fibromyalgia in randomized controlled trials and routine care. The purpose of this study was to translate and adapt the FIQR from English to Chinese, and to examine the validity and reliability of the Chinese version of the FIQR (CFIQR). METHODS: Following the translation of the FIQR, fibromyalgia patients from 6 centers were recruited and completed the CFIQR, the validated Chinese version of the Medical Outcome Study Short Form 36 Health Survey (SF-36) and the Beck Depression Inventory (BDI). In this study, Cronbach's alpha coefficient, test-retest reliability and item total correlation were used for evaluating external and internal reliability; and criterion and structural validity were evaluated. RESULTS: A total of 200 fibromyalgia patients completed the study. The internal consistency was excellent (Cronbach's alpha .90, .88, .88 and .93 for function, overall impact, symptoms scales and total score, respectively; item-total correlations from .25 to .83.) Test-retest reliability levels of the CFIQR total and subscale scores were strong correlation (intraclass correlation coefficient >0.75). Furthermore, there were significant correlations between the 3 subscale and the total score of the CFIQR and the SF-36, as well as the CFIQR and the BDI, by criterion validity (P < .01). Confirmatory factor analysis gave an acceptable value for structural validity according to the 3-factor structures of function, overall impact and symptoms. CONCLUSIONS: The CFIQR is a valid and reliable instrument for both clinical practice and research purposes with Chinese speakers globally. [ClinicalTrials.gov: NCT03381131].

Disease burden and risk factors of ischemic heart disease in China during 1990-2019 based on the Global Burden of Disease 2019 report: A systematic analysis.

Objective: The aim of this study was to identify the disease burden and risk factors of ischemic heart disease (IHD) in China, during 1990-2019, through a systematic analysis using the Global Burden of Disease (GBD) 2019 report in order to provide first-hand information for primary and secondary prevention of IHD in China. Methods: Data on the rates of incidence, death, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of IHD were obtained from GBD2019 to determine the disease burden and risk factors of IHD in China. Results: The rates of incidence, death, YLLs, YLDs, and DALYs of IHD in China increased at different levels during 1990-2019. The annual rate of change in incidence, death, YLLs, YLDs, and DALYs of IHD were 1.31%, 1.57%, 0.93%, 1.14%, and 0.94%, respectively. In 2019, the YLDs of IHD in Chinese women were higher, while the rates of incidence and death, YLLs, and DALYs were lower in Chinese women than in Chinese men. The disease burden of IHD had significant age differences, and people aged ≥70 years had the highest disease burden. A total of 24 risk factors were associated with the rates of death and DALYs of IHD, and the five most significant risk factors were high systolic blood pressure, high LDL cholesterol (LDL-C), smoking, ambient particulate matter pollution, and intake of a high-sodium diet. From 1990 to 2019, a high annual rate of change in IHD-related deaths and DALYs was observed due to ambient particulate matter pollution, high body mass index (BMI), and intake of a diet high in processed meat. Conclusion: The results of the study revealed that the disease burden of IHD in China was on the rise, especially in people aged ≥70 years. The main disease burden of IHD in male patients was premature death and that in female patients was disability. Environmental, behavioral, and metabolic factors were considered the three main risks of the disease burden of IHD, with metabolic factors having the greatest impact. Therefore, periodic health check-ups and high-risk factor interventions for key populations should be strengthened from the grassroots level, which are conducive to further reducing the disease burden of IHD in China.