Progesterone induces neuroprotection associated with immune/inflammatory modulation in experimental traumatic brain injury.

An imbalance of immune/inflammatory reactions aggravates secondary brain injury after traumatic brain injury (TBI) and can deteriorate clinical prognosis. So far, not enough therapeutic avenues have been found to prevent such an imbalance in the clinical setting. Progesterone has been shown to regulate immune/inflammatory reactions in many diseases and conveys a potential protective role in TBI. This study was designed to investigate the neuroprotective effects of progesterone associated with immune/inflammatory modulation in experimental TBI. A TBI model in adult male C57BL/6J mice was created using a controlled contusion instrument. After injury, the mice received consecutive progesterone therapy (8 mg/kg per day, i.p.) until euthanized. Neurological deficits were assessed via Morris water maze test. Brain edema was measured via the dry-wet weight method. Immunohistochemical staining and flow cytometry were used to examine the numbers of immune/inflammatory cells, including IBA-1 + microglia, myeloperoxidase + neutrophils, and regulatory T cells (Tregs). ELISA was used to detect the concentrations of IL-1ß, TNF-α, IL-10, and TGF-ß. Our data showed that progesterone therapy significantly improved neurological deficits and brain edema in experimental TBI, remarkably increased regulatory T cell numbers in the spleen, and dramatically reduced the activation and infiltration of inflammatory cells (microglia and neutrophils) in injured brain tissue. In addition, progesterone therapy decreased the expression of the pro-inflammatory cytokines IL-1ß and TNF-α but increased the expression of the anti-inflammatory cytokine IL-10 after TBI. These findings suggest that progesterone administration could be used to regulate immune/inflammatory reactions and improve outcomes in TBI.

Dyslipidemia and its associated factors among community adults located in Shangcheng district, Zhejiang province.

Dyslipidemia is highly prevalent and an important modifiable risk factor of cardiovascular disease in China. However, there is little information on the dyslipidemia in Shangcheng district, eastern China. Therefore, this study aims to investigate the prevalence and associated factors of dyslipidemia among community adults in this area. A community based cross-sectional study was conducted from August 1 to November 30, 2020. The study utilized a multi-stage probability sampling method to enroll permanent residents (those who have resided in this region for 6 months or more) who were 18 years old or above. Firstly, five streets were selected randomly, and then two communities were randomly selected from each of the chosen streets, finally, systematic sampling at the household level was conducted. All participants were interviewed by trained investigators and underwent anthropometric and biochemical measurements using standard criteria. LASSO (least absolute shrinkage and selection operator) and multivariate binary logistic regression were employed to identify the factors associated with dyslipidemia. In total, 3153 participants were enrolled into this study, resulting in a response rate of 93.28%. 33 subjects were excluded because of incomplete data. Finally, 3120 participants with a mean age of 55.26 (SD = 17.97) years were included into analysis. The overall prevalence of dyslipidemia was 35.96%. 21 variables were screened to multivariate binary logistic regression through the implementation of LASSO method. The multivariate binary logistic regression analysis revealed that individuals aged 40-49 [adjusted odds ratio (aOR) = 2.197, 95% confidence interval (CI) 1.445-3.341], 50-59 (aOR = 3.213, 95% CI 2.121-4.868), 60-69 (aOR = 4.777, 95% CI 3.169-7.201), and 70 and above (aOR = 5.067, 95% CI 3.301-7.777), with an educational level of junior middle school (aOR = 1.503, 95% CI 1.013-2.229), with an educational level of senior middle school (aOR = 1.731, 95% CI 1.25-2.397), with an educational level of under graduate and above (aOR = 2.125, 95% CI 1.46-3.095), without hypertension (aOR = 0.627, 95% CI 0.517-0.76), without diabetes (aOR = 0.625, 95% CI 0.498-0.785), obesity (aOR = 1.887, 95% CI 1.13-3.154), frequent smoking (aOR = 1.727, 95% CI 1.293-2.308), frequent drinking (aOR = 0.738, 95% CI 0.556-0.981), without family history of CVD (aOR = 0.505, 95% CI 0.342-0.744), and daily seafood intakes between 42.87 and 71.43 g (aOR = 1.31, 95% CI 1.05-1.634) were significantly associated with dyslipidemia. Gender-stratified analyses showed that aged 70 and above (aOR = 2.127, 95% CI 1.195-3.785), without hypertension (aOR = 0.643, 95% CI 0.484-0.854), without diabetes (aOR = 0.603, 95% CI 0.436-0.834), without CVD (aOR = 0.494, 95% CI 0.309-0.791), without stroke (aOR = 1.767, 95% CI 1.036-3.012), frequent smoking (aOR = 1.951, 95% CI 1.415-2.691), former smoking (aOR = 1.703, 95% CI 1.16-2.502) were significantly associated with dyslipidemia in male. Aged 40-49 (aOR = 3.51, 95% CI 1.789-6.887), 50-59 (aOR = 7.03, 95% CI 3.584-13.791), 60-69 (aOR = 15.728, 95% CI 8.005-30.9), and 70 and above (aOR = 12.929, 95% CI 6.449-25.921), with an educational level of senior middle school (aOR = 1.926, 95% CI 1.288-2.881), with an educational level of under graduate and above (aOR = 2.91, 95% CI 1.75-4.837), without hypertension (aOR = 0.592, 95% CI 0.45-0.779), without diabetes (aOR = 0.619, 95% CI 0.443-0.865), without family history of CVD (aOR = 0.429, 95% CI 0.251-0.733), without family history of cancer (aOR = 0.542, 95% CI 0.316-0.929), daily vegetables intakes between 251 and 500 g (aOR = 0.734, 95% CI 0.545-0.99), daily seafood intakes between 42.87 and 71.43 g (aOR = 1.421, 95% CI 1.04-1.942) were significantly associated with dyslipidemia in female. In the age-stratified analyses, it was found that without hypertension (aOR = 0.522, 95% CI 0.375-0.727) or diabetes (aOR = 0.445, 95% CI 0.267-0.744), obesity (aOR = 2.956, 95% CI 1.258-6.942), frequent smoking (aOR = 1.826, 95% CI 1.196-2.787), showed a significant association with dyslipidemia in individuals aged younger than 60 years. Female (aOR = 1.764, 95% CI 1.316-2.366), with an educational level of junior middle school (aOR = 1.793, 95% CI 1.169-2.749), with an educational level of senior middle school (aOR = 2.002, 95% CI 1.406-2.849), with an educational level of under graduate and above (aOR = 2.849, 95% CI 1.791-4.532), without hypertension (aOR = 0.604, 95% CI 0.477-0.764), without diabetes (aOR = 0.63, 95% CI 0.486-0.818), without CVD (aOR = 0.66, 95% CI 0.473-0.921), frequent smoking (aOR = 1.513, 95% CI 1.02-2.245), former smoking (aOR = 1.647, 95% CI 1.089-2.491), without family history of CVD (aOR = 0.406, 95% CI 0.239-0.692), daily seafood intakes between 42.87 and 71.43 g (aOR = 1.376, 95% CI 1.018-1.859) were significantly associated with dyslipidemia among participants aged 60 and above. Dyslipidemia is a prevalent condition observed among adults residing in Shangcheng district. Risk factors such as gender, age, education, hypertension, diabetes, cardiovascular disease, stroke, obesity, smoking, drinking, family history of cardiovascular disease, family history of cancer, daily vegetables intakes, daily seafood intakes were associated with dyslipidemia and varied across population of different gender and age groups. Enhancing education and promoting self-awareness regarding the necessity of behavior modification and regular medication intake would be beneficial in reducing the occurrence of dyslipidemia among adults in the Shangcheng district.

An analysis of the relationship of triglyceride glucose index with gastric cancer prognosis: A retrospective study.

AIMS/INTRODUCTION: Gastric cancer, one of the most common malignant tumors worldwide, is affected by insulin resistance. The triglyceride glucose (TYG) index is considered a surrogate indicator of insulin resistance; however, its prognostic value in patients with gastric cancer remains obscure. This study aimed to determine whether the TYG index could predict the long-term prognosis of patients with gastric cancer after radical resection gastrectomy. MATERIALS AND METHODS: We retrospectively analyzed patients with gastric cancer who underwent radical resection gastrectomy. The preoperative TYG index was calculated using the patients' laboratory data. Patients were divided into two groups based on a high or low TYG index. We observed overall survival and evaluated the clinical application value of the index using Cox proportional hazards regression to calculate independent parameters. A prediction model was also established. RESULTS: In total, 822 patients with gastric cancer were included. The high and low TYG index groups comprised 353 and 469 patients, respectively. The overall survival time was significantly longer in the high-index group than in the low-index group. In the multivariate analysis, TYG index, preoperative age, surgical procedure, tumor node metastasis (TNM) stage, N stage, and postoperative complications (all p < 0.01) were considered independent prognostic predictors. Based on the multivariate analysis, the riglyceride glucose (TYG) index hazard ratio was 0.70 (95% confidence interval, 0.54-0.89, p = 0.004). CONCLUSIONS: We established a model with a high clinical application value and clinical practice relevance to predict the prognosis of gastric cancer. In this model, TYG was an independent protective factor for gastric cancer prognosis.

Inhibition of neutrophil extracellular trap formation attenuates NLRP1-dependent neuronal pyroptosis via STING/IRE1α pathway after traumatic brain injury in mice.

Introduction: Increased neutrophil extracellular trap (NET) formation has been reported to be associated with cerebrovascular dysfunction and neurological deficits in traumatic brain injury (TBI). However, the biological function and underlying mechanisms of NETs in TBI-induced neuronal cell death are not yet fully understood. Methods: First, brain tissue and peripheral blood samples of TBI patients were collected, and NETs infiltration in TBI patients was detected by immunofluorescence staining and Western blot. Then, a controlled cortical impact device was used to model brain trauma in mice, and Anti-Ly6G, DNase, and CL-amidine were given to reduce the formation of neutrophilic or NETs in TBI mice to evaluate neuronal death and neurological function. Finally, the pathway changes of neuronal pyroptosis induced by NETs after TBI were investigated by administration of peptidylarginine deiminase 4 (a key enzyme of NET formation) adenovirus and inositol-requiring enzyme-1 alpha (IRE1α) inhibitors in TBI mice. Results: We detected that both peripheral circulating biomarkers of NETs and local NETs infiltration in the brain tissue were significantly increased and had positive correlations with worse intracranial pressure (ICP) and neurological dysfunction in TBI patients. Furthermore, the depletion of neutrophils effectively reduced the formation of NET in mice subjected to TBI. we found that degradation of NETs or inhibition of NET formation significantly inhibited nucleotide-binding oligomerization domain (NOD)-like receptor pyrin domain containing 1 (NLRP1) inflammasome-mediated neuronal pyroptosis after TBI, whereas these inhibitory effects were abolished by cyclic GMP-AMP (cGAMP), an activator of stimulating Interferon genes (STING). Moreover, overexpression of PAD4 in the cortex by adenoviruses could aggravate NLRP1-mediated neuronal pyroptosis and neurological deficits after TBI, whereas these pro-pyroptotic effects were rescued in mice also receiving STING antagonists. Finally, IRE1α activation was significantly upregulated after TBI, and NET formation or STING activation was found to promote this process. Notably, IRE1α inhibitor administration significantly abrogated NETs-induced NLRP1 inflammasome-mediated neuronal pyroptosis in TBI mice. Discussion: Our findings indicated that NETs could contribute to TBI-induced neurological deficits and neuronal death by promoting NLRP1-mediated neuronal pyroptosis. Suppression of the STING/ IRE1α signaling pathway can ameliorate NETs-induced neuronal pyroptotic death after TBI.

Occurrence, distribution and risk assessment of microplastics and polycyclic aromatic hydrocarbons in East lake, Hubei, China.

The pollution of microplastics (MPs) and polycyclic aromatic hydrocarbons (PAHs) in the environment is a global problem, which has attracted extensive attention of many researchers. In present study, MPs and PAHs are investigated to study the impact of human activities and their possible relationship in China's second largest urban lake, East Lake. The abundance of MPs are 3329.19 ± 2059.26 particles/m3 and 2207.56 ± 1194.04 particles/kg in water and sediment, respectively. MPs are predominantly characterized by fibers, polypropylene (PP) and polyethylene (PE), colorlessness in water and sediment. The abundance of MPs in water with frequent human activities is higher, which is reversed in sediments, indicating that disturbance is not conducive to the enrichment of MPs in sediments. The concentration of 16 PAHs are 36.95 ± 13.76 ng/L and 897.08 ± 232.34 ng/g in water and sediment, respectively. PAHs in water are mainly 2-3-ring, while there are 4-ring PAHs in sediments. The good corresponding relationship between MPs and PAHs indicates that human activities have an important impact on the distribution of pollutants compared to the interaction of pollutants. In addition, the significant positive correlation between lakeshore length and water MPs abundance indicates that surface runoff may be an important source of water MPs. The pollution load index shows that MPs in sediment has reached moderate to severe pollution level, while the water is slightly polluted level. The potential ecological risk assessment results show that more than half of the sediment sites are at dangerous to very dangerous ecological risk level.

Bioavailability and regional transport of PM2.5 during heavy haze episode in typical coal city site of Fenwei Plain, China.

Despite the decrease in anthropogenic emissions, haze episodes were still frequent in the Fenwei Plain, which was identified as one of the three key areas for air pollution control. Herein, PM2.5 samples were collected to investigate the influence of festival effect during the Chinese Spring Festival from February 2rd to 13th, 2019, in Linfen on the Fenwei Plain. The characteristics of element pollution, enrichment factor, source apportionment, regional transport of PM2.5, and health risk assessment were discussed. Meanwhile, the simulated lung fluid method (SLF) was carried out to accurately assess the inhalation risks of heavy metals (HMs). Results indicated that the average concentration of PM2.5 was 195.6 µg·m-3 during the studying period. Road fugitive dust (15.6%), firework burning source (25.6%), industrial emission (30.5%), and coal combustion (28.3%) were identified by positive matrix factorization (PMF) modeling. Using the HYSPLIT trajectory model, air masses from the central Shaanxi, southern Hebei, and northern Henan were the dominant transport paths during the Spring Festival, which contributed 21.9 and 41.2% of total trajectories, respectively. The findings that high PSCF and CWT levels were found in central Shaanxi, southern Hebei, and northern Henan were confirmed. The SLF mean bioaccessibility (%) of the solubility of particulate metals was in order of Mn > Ni > Sb > Ba > Zn > Pb > Cr. However, the carcinogenic risk value of Cr was the highest, exceeding the maximum acceptable risk. The present study provided important information for further analyzing the air pollution cause of Fenwei Plain.

Establish a New Diagnosis of Sarcopenia Based on Extracted Radiomic Features to Predict Prognosis of Patients With Gastric Cancer.

Background: Preoperative sarcopenia is a prognostic risk factor for gastric cancer (GC). This study aimed to determine whether radiomic sarcopenia features on computed tomography (CT) could be used to diagnose sarcopenia preoperatively, and whether they could be used to accurately predict the postoperative survival and complication prognosis of patients with GC. Methods: We retrospectively analyzed data of 550 patients with GC who underwent radical gastrectomy. The patients were divided into training (2014-2016) and validation (2017-2019) cohorts. We established a radiomics-based diagnosis tool for sarcopenia. Thereafter, univariate and multivariate analyses of diagnostic factors were carried out. Receiver operator characteristic (ROC) curves and area under the curve (AUC) were used to compare different diagnostic models. The Kaplan-Meier method was used to estimate the survival curve. Results: Radiomic sarcopenia correlated with complications and long-term survival. Skeletal muscle index, grip strength, and walking speed were correlated with postoperative complications in both cohorts (AUCs: 0.632, 0.577, and 0.614, respectively in the training cohort; 0.570, 0.605, 0.546, respectively, in the validation cohort), and original sarcopenia was more accurate than any of these indicators. However, radiomic sarcopenia has a higher AUC in predicting short-term complications than original sarcopenia in both groups (AUCs: 0.646 vs. 0.635 in the training cohort; 0.641 vs. 0.625 in the validation cohort). In the training cohort, the overall survival time of patients with original sarcopenia was shorter than normal patients (hazard ratio, HR = 1.741; 95% confidence interval [CI], 1.044-2.903; p = 0.031). While radiomic sarcopenia had a greater prognostic significance, the overall survival time of patients with radiomic sarcopenia was significantly worse than normal patients (HR, 1.880; 95% CI, 1.225-2.885, p = 0.003). Conclusion: Extracted sarcopenia features based on CT can predict long-term survival and short-term complications of GC patients after surgery, and its accuracy has been verified by training and validation groups. Compared with original sarcopenia, radiomic sarcopenia can effectively improve the accuracy of survival and complication prediction and also shorten the time and steps of traditional screening, thereby reducing the subjectivity effects of sarcopenia assessment.

Huge quantities of microplastics are "hidden" in the sediment of China's largest urban lake-Tangxun Lake.

Microplastics (MPs) pollution in Tangxun Lake, the largest urban lake in China, was investigated. The average MPs pollution in sediment (1.81 ± 1.75 × 104 items kg-1) is at a high level, while the MPs in lakeshore water (917.77 ± 742.17 items m-3) is in the middle to low level compared with existing studies, which is related to the government's protection. Fragments and fibers are the most common shapes in sediment and water, respectively. MPs size <1 mm dominates in the sediment, while the MPs in water has a larger size. The distribution of MPs in the inner lake shows that pellets tend to "hidden" in sediments. Suspected MPs are randomly selected for polymer detection by Micro-Raman microscopy. Polypropylene (PP), polyethylene (PE) and polyethylene terephthalate (PET) are the most common polymer types in water, sediment and atmospheric deposition MPs samples. The input of wastewater, fishery and surrounding human activities are the main sources of MPs in sediment. Atmospheric deposition has a great impact on the distribution of MPs, while the contribution of surface runoff to lake MPs is not remarkable. In addition, MPs in sediments have exceeded the environmental carrying capacity. More attention should be focused on the sediment, where huge amounts of MPs are "hidden".

Variation of pollution sources and health effects on air pollution before and during COVID-19 pandemic in Linfen, Fenwei Plain.

Stringent pollution control measures are generally applied to improve air quality, especially in the Spring Festival in China. Meanwhile, human activities are reduced significantly due to nationwide lockdown measures to curtail the COVID-19 spreading in 2020. Herein, to better understand the influence of control measures and meteorology on air pollution, this study compared the variation of pollution source and their health risk during the 2019 and 2020 Spring Festival in Linfen, China. Results revealed that the average concentration of PM2.5 in 2020 decreased by 39.0% when compared to the 2019 Spring Festival. Organic carbon (OC) and SO42- were the primary contributor to PM2.5 with the value of 19.5% (21.1%) and 23.5% (25.5%) in 2019 (2020) Spring Festival, respectively. Based on the positive matrix factorization (PMF) model, six pollution sources of PM2.5 were indicated. Vehicle emissions (VE) had the maximum reduction in pollution source concentration (28.39 µg· m-3), followed by dust fall (DF) (11.47 µg· m-3), firework burning (FB) (10.39 µg· m-3), coal combustion (CC) (8.54 µg· m-3), and secondary inorganic aerosol (SIA) (3.95 µg· m-3). However, the apportionment concentration of biomass burning (BB) increased by 78.7%, indicating a significant increase in biomass combustion under control measures. PAHs-lifetime lung cancer risk (ILCR) of VE, CC, FB, BB, and DF, decreased by 44.6%, 43.2%, 34.1%, 21.3%, and 2.0%, respectively. Additionally, the average contribution of meteorological conditions on PM2.5 in 2020 increased by 20.21% compared to 2019 Spring Festival, demonstrating that meteorological conditions played a crucial role in located air pollution. This study revealed that the existing control measures in Linfen were efficient to reduce air pollution and health risk, whereas more BB emissions were worthy of further attention. Furthermore, the result was conducive to developing more effective control measures and putting more attention into unfavorable meteorological conditions in Linfen.

Fluvoxamine Confers Neuroprotection via Inhibiting Infiltration of Peripheral Leukocytes and M1 Polarization of Microglia/Macrophages in a Mouse Model of Traumatic Brain Injury.

Neuroinflammation is an important mediator of secondary injury pathogenesis that exerts dual beneficial and detrimental effects on pathophysiology of the central nervous system (CNS) after traumatic brain injury (TBI). Fluvoxamine is a serotonin selective reuptake inhibitor (SSRI) and has been reported to have the anti-inflammatory properties. However, the mechanisms and therapeutic effects of fluvoxamine in neuroinflammation after TBI have not be defined. In this study, we showed that fluvoxamine inhibited peripheral immune cell infiltration and glia activation at 3 days in mice subjected to TBI. Fluvoxamine treatment promoted microglial/macrophage phenotypic transformation from pro-inflammatory M1-phenotype to anti-inflammatory M2-phenotype in in vivo and in vitro experiments. In addition, fluvoxamine treatment attenuated neuronal apoptosis, blood-brain barrier (BBB) disruption, cerebrovascular damage, and post-traumatic edema formation, thereby improving neurological function of mice subjected to TBI. These findings support the clinical evaluation of fluvoxamine as a neuroprotective therapy for TBI.

Activation of Sigma-1 Receptor Alleviates ER-Associated Cell Death and Microglia Activation in Traumatically Injured Mice.

BACKGROUND: Endoplasmic reticulum (ER) stress and unfolded protein response (UPR) is associated with neuroinflammation and subsequent cell death following traumatic brain injury (TBI). The sigma-1 receptor (Sig-1R) acts as a dynamic pluripotent modulator of fundamental cellular processes at the mitochondria-associated membranes (MAMs). The activation of Sig-1R is neuroprotective in a variety of central nervous system diseases, but its impact on ER stress induced by traumatic brain injury is not known. This study investigated the role of Sig-1R in regulating the ER stress-mediated microglial activation and programmed cell death (apoptosis and pyroptosis) induced by TBI. METHODS: Ten human brain tissues were obtained from The Tianjin Medical University General Hospital. Four normal brain tissues were obtained from patients who underwent surgery for cerebral vascular malformation, through which peripheral brain tissues were isolated. Six severe TBI tissues were from patients with brain injury caused by accidents. None of the patients had any other known neurological disorders. Mice with Sig-1R deletion using CRISPR technology were subjected to controlled cortical impact-induced injury. In parallel, wild type C57BL/6J mice were analyzed for outcomes after they were exposed to TBI and received the Sig-1R agonist PRE-084 (10 mg/kg daily for three days) either alone or in combination with the Sig-1R antagonist BD-1047 (10 mg/kg). RESULTS: The expression of Sig-1R and the 78 kDa glucose-regulated protein, a known UPR marker, were significantly elevated in the injured cerebral tissues from TBI patients and mice subjected to TBI. PRE-084 improved neurological function, restored the cerebral cortical perfusion, and ameliorated and brain edema in C57BL/6J mice subjected to TBI by reducing endoplasmic reticulum stress-mediated apoptosis, pyroptosis, and microglia activation. The effect of PRE-084 was abolished in mice receiving Sig-1R antagonist BD-1047. CONCLUSIONS: ER stress and UPR were upregulated in TBI patients and mice subjected to TBI. Sig-1R activation by the exogenous activator PRE-084 attenuated microglial cells activation, reduced ER stress-associated programmed cell death, and restored cerebrovascular and neurological function in TBI mice.

Preoperative comprehensive malignancy risk estimation for thyroid nodules: Development and verification of a network-based prediction model.

BACKGROUND: In order to avoid excessive treatment of thyroid nodules in the clinic, it is necessary to find a simple and practical analysis method to comprehensively and accurately reflect benign or malignant thyroid nodules. This study aimed to construct and validate a comprehensive and reliable network-based predictive model using a variety of imaging and laboratory criteria for thyroid nodules to stratify the risk of malignancy prior to surgery. METHODS: We retrospectively analyzed data from patients who underwent surgical treatment for thyroid nodules at the Thyroid and Breast Diagnosis and Treatment Center of Weifang Hospital of Traditional Chinese Medicine between January 2018 and December 2020. Binary logical regression analysis was performed to predict whether nodules were malignant or benign. The developmental dataset included 457 patients (January 2018-December 2020). The validation set included separate data points (n = 225, January 2018-December 2020). RESULTS: In this study, criteria that showed significant predictive value for malignant nodules included TI-RADS: 4b (p = 0.065); Bethesda IV, Bethesda V, Bethesda VI (P < 0.0001); BRAFV600E mutation (P < 0.0001); Calcitonin>5 pg/ml (p = 0.0037); and FNA-Tg>30 ng/ml (p = 0.0003). A 10-grade risk scoring system was developed. The risk of malignancy risk ranged from 2.06% to 100% and was positively associated with increasing risk grade. The areas under the receiver-operating characteristic curve of the development and validation sets were 0.972 and 0.946, respectively. CONCLUSION: A simple, comprehensive and reliable web-based predictive model was designed using a variety of imaging and laboratory criteria to stratify thyroid nodules by probability of malignancy.

The Prevalence of Diabetes, Prediabetes and Associated Risk Factors in Hangzhou, Zhejiang Province: A Community-Based Cross-Sectional Study.

Objective: Little information is available on the prevalence and associated risk factors of diabetes and prediabetes in the community located in Hangzhou city, Zhejiang Province, southeast China. This study aims to investigate the prevalence of adult diabetes and prediabetes and their associated risk factors among a community population in Hangzhou. Methods: A multistage sampling method was used in this study. Ten communities located in Shangcheng district of Hangzhou city were selected, and 3096 permanent residents (resident for ≥6 months) aged 18 years and above were enrolled into this study. Finally, a total of 2986 participants were included. A questionnaire interview and physical examination were conducted for all participants by trained investigators in a local medical center. Anthropometric measurements covered height, weight, waist circumference (WC) and blood pressure, while the blood tests included fasting blood glucose, an oral glucose tolerance test and fasting lipid profiles. The American Diabetes Association diabetes diagnosis criteria were used to discriminate among normal blood glucose, diabetes and prediabetes. The Rao-Scott adjusted χ 2 test and complex sampling design-based unconditional multivariate logistic regression analysis were used to evaluate factors associated with diabetes and prediabetes. Descriptive and inferential statistics were calculated in Stata version 15. P-values <0.05 indicate statistical significance. Results: The overall prevalence of diabetes was 13.97%, of which 81.54% had prediagnosed diabetes and 18.46% were newly diagnosed with diabetes in the present study. The prevalence of prediabetes was 18.89%. Multivariable logistic regression analysis showed that age, education, once smoking, family history of diabetes, obesity, central obesity and hypertension were factors associated with diabetes, while age, smoking, drinking, central obesity and hypertension were significant factors related to prediabetes. Conclusion: The prevalence of diabetes and prediabetes in adults in Hangzhou city remains high. Interventions aiming to modify risk factors such as drinking, obesity, central obesity and hypertension are urgently required.

Effect of Short-Term Preoperative Parenteral Nutrition Support for Gastric Cancer Patients with Sarcopenia: a Propensity Score Matching Analysis.

INTRODUCTION: Sarcopenia is well recognized as an unfavorable prognostic marker for gastric cancer (GC) patients. Currently, few nutritional interventions-such as parenteral nutrition-exist for the treatment of patients with sarcopenia. This study aimed to estimate the effectiveness of short-term preoperative parenteral nutrition (PN) in GC patients with sarcopenia. MATERIALS AND METHODS: We collected data on GC patients with sarcopenia who underwent radical gastrectomy at our hospital from 2010 to 2018. A 1:1 ratio propensity score matching (PSM) was applied to establish the PN and control groups. Data were analyzed using the chi-squared, Mann-Whitney U, and Fisher's exact tests. RESULTS: In total, 428 patients met the inclusion criteria, and the propensity scores identified 166 matched pairs of patients with sarcopenia. The overall incidence of postoperative complications between both groups was not significantly different (P = 0.728). The PN group had a lower rate of intra-abdominal infection (P = 0.032) and higher hospitalization costs (P < 0.001) than the control group. Multivariate analysis demonstrated that age, Charlson score, and TNM stage were independent risk factors for postoperative complications. Additionally, subgroup analysis revealed that short-term preoperative PN support is associated with decreased postoperative surgical complications in patients with albumin levels < 35 g/L (P = 0.025). CONCLUSION: Short-term preoperative PN support is not associated with reduction of overall complication rate in patients with GC and sarcopenia. However, those with sarcopenia and hypoalbuminemia benefited from preoperative PN support.

Impact of malnutrition diagnosed using Global Leadership Initiative on Malnutrition criteria on clinical outcomes of patients with gastric cancer.

OBJECTIVE: Our objective is to validate the effectiveness of the Global Leadership Initiative on Malnutrition (GLIM) criteria in malnutrition diagnosis compared with Patient-Generated Subjective Global Assessment (PG-SGA) and assess the impact of malnutrition diagnosed using GLIM criteria on the clinical outcomes of patients with GC. METHODS: We retrospectively analyzed the data of 895 patients who underwent radical gastrectomy at the First Affiliated Hospital of Wenzhou Medical University. Nutrition assessment was performed on all patients according to the GLIM criteria and PG-SGA. The κ statistic was used to evaluate the agreement between two methods. Multivariate logistic regression and Cox regression based on single-factor analysis were used to predict postoperative complications and overall survival rates. RESULTS: Based on the GLIM criteria, 38.3% of the patients were diagnosed as malnourished, including 21.7% Stage I (moderate malnutrition) and 16.6% Stage II (severe malnutrition). GLIM criteria had a moderate agreement with PG-SGA (κ = 0.548). Patients in the Stage II malnutrition group had a higher incidence of complications, a longer postoperative length of stay, and higher hospitalization costs. Logistic regression showed that Stage II malnutrition was an independent risk predictor of postoperative complications (odds ratio, 3.28; 95% confidence interval [CI], 2.18-4.94). Furthermore, Cox regression analysis showed that both Stage I (hazard ratio [HR], 1.52; 95% CI, 1.11-2.07; P = .009) and Stage II (HR, 1.85; 95% CI, 1.34-2.53; P < .001) malnutrition were independent risk predictors of overall survival. CONCLUSION: Diagnosis of malnutrition according to the GLIM criteria is useful in predicting the adverse postoperative clinical outcomes of patients with gastric cancer.

[Characteristics and Health Risk Assessment of Heavy Metals in PM2.5 Under Winter Haze Conditions in Central China: A Case Study of Huanggang, Hubei Province].

To explore the pollution characteristics and potential health risks of heavy metals in PM2.5 on haze days in Central China, PM2.5 samples were collected from the Huanggang monitoring station, a regional observation point in Central China, between January 13 and 24, 2018. The contents of Cr, Mn, Co, Ni, Cu, Zn, As, Cd, Sn, and Pb in PM2.5 were analyzed by inductively coupled plasma mass spectrometry(ICP-MS), and the enrichment factor method was used to determine the potential risk based on the exposure model recommended by the Environmental Protection Administration(EPA). The results showed that during the observation period, the concentrations of Zn in PM2.5 were highest, and the concentrations of the carcinogens As and Cd were higher than the secondary standard limits of China's ambient air quality standard(GB 3095-2012), with 70% of these elemental concentrations accounting for the largest proportion in the middle haze period. The enrichment factor analysis showed that Cd, Sn, Co, Pb, and Zn were the most abundant elements, especially during the middle haze period, and were mostly derived from transportation and coal combustion. The results of the human health risk assessment showed that exposure via hand-mouth feeding was the main non-carcinogenic risk, and the exposure and non-carcinogenic risks of children were significantly higher than those of adults. Pb poses a non-carcinogenic risk to children, while heavy metals in PM2.5 pose no non-carcinogenic risks to adults and carcinogenic heavy metals pose no carcinogenic risks.

Preoperative Fibrosis-4 (FIB-4) Evaluation May Be Helpful to Evaluate Prognosis of Gastric Cancer Patients Undergoing Operation: A Retrospective Study.

BACKGROUND: Liver dysfunction and chronic inflammation influence the prognosis of many tumors and surgical outcomes. This study was performed to determine whether the Fibrosis-4 (FIB-4) index, originally defined as a noninvasive fibrosis marker, can predict the prognosis of patients with gastric cancer undergoing radical gastric cancer surgery. METHODS: We have retrospectively analyzed 594 consecutive patients with gastric cancer who underwent gastrectomy in our database. The FIB-4 index was calculated using laboratory data and age before gastrectomy. The clinical utility of FIB-4 was evaluated by X-tile. Patients were divided into two groups (high and low FIB-4 index groups), and their overall survival (OS) was investigated. Cox regression analysis was used to identify the independent parameters associated with prognosis. Finally, we developed a prognostic prediction model by using R statistical software. RESULTS: A total of 556 patients, including 422 men and 134 women, were enrolled. Of these, 61 (11.0%) and 495 (89.0%) patients had low and FIB-4 indexes, respectively. In addition to the indicators of FIB-4, preoperative age, tumor site, surgical procedure, TNM stage, and postoperative complications were found to be independent predictors of prognosis (P < 0.05). Among patients, the FIB-4 index group had significantly shorter OS (log-rank P = 0.01) than the low FIB-4 index group. This association was also confirmed in the multivariate analysis (hazard ratio, 4.65; 95% confidence interval, 1.07-4.29; P = 0.031). CONCLUSIONS: Preoperative FIB-4 index can predict long-term outcomes of gastric cancer patients who had undergone gastrectomy.

Deposition records of polycyclic aromatic hydrocarbons and black carbon in peat core from Dajiuhu, Shennongjia, Central China: human activity imprint since the industrial revolution.

Polycyclic aromatic hydrocarbons (PAHs) are a kind of organic pollutants with carcinogenic, teratogenic, and mutagenic effects. This study aims to assess the effects of changes in China's socio-economic indicators represented by energy consumption and number of motor vehicles, on PAHs and black carbon (BC) deposition. For this, a 50-cm peat core from Dajiuhu peatland, Central China, was collected and divided into 50 subsamples to establish a sedimentary record of about 200 years with radioactive 210Pb. The Σ16PAH concentration ranged from 212.67 to 830.10 ng·g-1, mainly composed of 2- and 3-ring PAHs, and BC ranged from 7.89 to 36.48%. The deposition characteristics of BC first increased and then decreased from the core bottom to the top. The predominant of the carcinogenic PAHs (C-PAHs) was Dibenzo[a,h]anthracene (DBA) before 1949, and then changed to Benzo[b]fluoranthene (BbF). Ratio of Fla/Pyr, (3+4)-ring/(5+6)-ring PAHs, and BaA/(BaA+Chr), IcdP/(IcdP+BghiP) suggested that long-range atmospheric transmission (LRAT) and pyrogenic were the main PAHs sources, but that local PAH emission contribution gradually increased since 1990, and mixed (petroleum and combustion) sources were the dominant since 2000. The high concentration of Phenanthrene (Phe) and Naphthalene (Nap) were likely from plant product. Furthermore, increased concentrations of 4-, 5-, and 6-ring PAHs showed significant correlations with increased coal and petroleum consumption and the number of motor vehicles, respectively, and this influence has strengthened after 2000. These were caused by rapid urbanization and industrialization following the implementation of the reform and opening up policy in 1978, and a new round of urbanization after 2000.

A new cyst-forming nematode, Cactodera tianzhuensis n. sp. (Nematoda:Heteroderinae) from Polygonum viviparum in China with a key to the Genus Cactodera.

A new cyst-forming nematode, Cactodera tianzhuensis n. sp. was isolated from the rhizosphere soil of Polygonum viviparum L. in Tianzhu county, China. Morphologically, the new species is characterized by lemon-shaped or rounded cysts that have protruding necks and vulval cones. The vulval cone of the new species appeared to be circumfenestrate without bullae and underbridge, vulval denticle present and anus distinct. Second-stage juveniles are vermiform, stylet well-developed with the rounded stylet knobs to slightly concave anteriorly. Lateral field with four incisures. Tail gradually tapering to a finely rounded terminus with a length of ca 54 (47-59) µm, outline of hyaline portion is V-shaped or U-shaped. Egg shells without visible markings or punctations. The phylogenetic analyses based on ITS-rDNA, D2-D3 of 28S-rDNA clearly revealed that the new species formed a separate clade from other Cactodera species, which further support the unique status of C. tianzhuensis n. sp. Therefore, it is described herein as a new species of the genus Cactodera.

Impact of Preoperative Short-Term Parenteral Nutrition Support on the Clinical Outcome of Gastric Cancer Patients: A Propensity Score Matching Analysis.

OBJECTIVES: Nutrition status is of great significance to the clinical outcome after major abdominal surgery. However, the effect of preoperative short-term parenteral nutrition (PN) support among gastric cancer (GC) patients remains unknown and was evaluated in the current study. METHODS: We retrospectively analyzed 455 nutritionally at-risk GC patients after radical resection from 2010 to 2016. We matched patients with 3-7 days of PN support to those without PN support. χ2 And Mann-Whitney U tests were used to compare differences between the PN and control groups. RESULTS: The propensity-matched sample included 368 GC patients (PN group, n = 184; control group, n = 184). The PN and control groups did not differ regarding postoperative complications (P = .528). The incidence of anastomotic leakage in the PN group was lower than in the control group (P = .011), whereas other complications were not found to differ between the groups. The hospitalization cost of the PN group was significantly higher than that of the control group (P < .001), whereas other outcome indicators were similar. Subgroup analysis showed that short-term PN support may have an improved benefit for patients with serum albumin level <35 g/L, but not at the level of statistical significance (P = .17). CONCLUSION: Short-term PN support did not significantly improve the short-term clinical outcomes of nutritionally at-risk GC patients, with the exception of a lower incidence of anastomotic leakage. Considering that short-term PN support increases economic burden, PN should not be the preferred method among these patients.