Causality Assessment Between Idiopathic Inflammatory Myopathies and Lung Cancer: A Bidirectional 2-Sample Mendelian Randomization.

BACKGROUND: Although observational studies have revealed associations between idiopathic inflammatory myopathies (IIMs) and lung cancer (LC), they have not established a causal relationship between these 2 conditions. METHODS: We used a 2-sample Mendelian randomization approach to examine the bidirectional causal associations between IIMs and LC, using single-nucleotide polymorphisms selected from high-quality genome-wide association studies in the FinnGen database. Sensitivity analyses were conducted to assess potential heterogeneity and pleiotropy impacts on the Mendelian randomization results. RESULTS: Our analysis demonstrated a positive causal effect of genetically increased IIM risk on LC (odds ratio, 1.114; 95% confidence interval, 1.057-1.173; p = 5.63 × 10-5), particularly on the lung squamous cell carcinoma subtype (odds ratio, 1.168, 95% confidence interval, 1.049-1.300, p = 0.00451), but not on lung adenocarcinoma or small cell lung cancer. No causal effect of LC on IIMs was identified. Sensitivity analyses indicated that horizontal pleiotropy was unlikely to influence causality, and leave-one-out analysis confirmed that the observed associations were not driven by a single-nucleotide polymorphism. CONCLUSION: Our findings offer compelling evidence of a positive causal relationship between IIMs and LC, particularly with regard to lung squamous cell carcinoma, in the European population. Conversely, there is no evidence of LC causing IIMs. We recommend that LC diagnosis consider the specific characteristics of IIMs.

Cost-utility analysis of different venous access devices in breast cancer patients: a decision-based analysis model.

BACKGROUND: Venous access devices commonly used in clinical practice for long-term chemotherapy of breast cancer include central venous catheters (CVCs), peripherally inserted central venous catheters (PICCs), and implantable venous access ports (IVAPs). CVCs and PICCs are less costly to place but have a higher complication rate than IVAPs. However, there is a lack of cost-utility comparisons among the three devices. The aim of this study was to assess the cost-effectiveness of three catheters for long-term chemotherapy in breast cancer patients. METHODS: This study used propensity score matching (PSM) to establish a retrospective cohort. Decision tree models were used to compare the cost-effectiveness of three different intravenous lines in breast cancer chemotherapy patients. Cost parameters were derived from data extracted from the outpatient and inpatient charging systems, and total costs included costs of placement, maintenance, extraction, and handling of complications; utility parameters were derived from previous cross-sectional survey results of the research group; and complication rates were derived from breast cancer catheterization patient information as well as follow-up information. Quality-adjusted life years (QALYs) were measured for efficacy outcomes. Incremental cost-effectiveness ratios (ICERs) were used to compare the three strategies. To assess uncertainty in model parameters, sensitivity analyses (univariate sensitivity analysis and probabilistic sensitivity analysis) were performed. RESULTS: A total of 10,718 patients (3780 after propensity score matching) were included. IVAPs had the smallest cost-utility ratio, and PICCs had the largest cost-utility ratio when left in place for more than 12 months. The incremental cost-utility ratio of PICC to CVC was $2375.08/QALY, IVAP to PICC was $522.01/QALY, and IVAP to CVC was $612.98/QALY. Incremental cost-effectiveness ratios showed that IVAPs were more effective than CVCs and PICCs. Model regression analysis showed that the IVAP was recommended as the best regimen regardless of the catheter indwelling time (6 months, 12 months or more than 12 months). The reliability and stability of the model were verified by single-factor sensitivity analysis and Monte Carlo simulation (probabilistic sensitivity analysis). CONCLUSION: This study provides economic evidence for the selection of vascular access in breast cancer chemotherapy patients. In the case of limited resources in China, establishing a decision tree model comparing the cost-effectiveness of three vascular access devices for breast cancer chemotherapy patients determined that the IVAP was the most cost-effective regimen.

Prevalence of Latent Tuberculosis Infection Among Healthy Young Children and Adolescents and a Two-step Approach for the Diagnosis of Tuberculosis Infection in Chengdu, China.

BACKGROUND: China has a high burden of tuberculosis and latent tuberculosis infection (LTBI). The aim of this study was to estimate the prevalence of LTBI among healthy young children and adolescents and test a 2-step approach to explore the threshold for the diagnosis of tuberculosis infection in Chengdu, China. METHODS: Healthy preschool children and school-going children in Chengdu, Sichuan Province, were screened for LTBI using the tuberculin skin test (TST). Preschool children with TST ≥ 5 mm also underwent interferon-γ release assay (IGRA) to explore the threshold of this 2-step approach. RESULTS: In total, 5667 healthy young children and adolescents completed TST test between July 2020 and January 2021 and were included in the present analysis. The age of the participants ranged from 2.4 to 18 years (median 7.25 ± 4.514 years), of which 2093 (36.9%) were younger than 5 years. The overall prevalence of LTBI was 6.37% and 6.64% in children younger than 5 years old. Fourteen of the 341 preschool children with TST ≥5 mm were interferon-γ release assay positive, of which 4 showed a TST result of 5-10 mm, and 6 preschool children received preventive treatment for LTBI. CONCLUSIONS: Healthy young children and adolescents should also be considered as important target populations for LTBI screening. TST can be recommended for first-line screening as part of a 2-step approach for LTBI screening using a positive threshold of 5 mm.

Role of Human Body Composition Analysis and Malnutrition Risk Questionnaire in the Assessment of Nutritional Status of Patients With Initially Diagnosed Crohn's Disease.

Objective: This study was carried out to investigate the role and necessity of human body composition analysis in assessing the nutritional status of initially diagnosed Crohn's disease (CD) patients. Methods: A total of 47 initially diagnosed CD patients were recruited. The skeletal muscle mass index (SMI), fat-free mass index (FFMI), body fat mass, body fat percent, visceral fat area (VFA), and body cell mass were determined with the Biospace Inbody S10 composition analyzer. Results: In 47 patients with initially diagnosed CD, SMI could determine the muscular mass reduction that could not be determined by the body mass index (BMI) (35.3%), albumin (ALB) (65.6%), nutrition risk screening (NRS)2002 (25.0%), and Patient-Generated Subjective Global Assessment (PG-SGA) (55.6%). FFMI could determine the malnutrition that could not be determined by the BMI (58.8%), albumin (90.6%), NRS2002 (50.0%), and PG-SGA (55.6%). VFA in the fistulizing CD patients was significantly higher than in the stricturing and non-fistulizing, non-stricturing patients (P < 0.05). SMI and BMI had the same performance (P = 1.000) and general consistence (Kappa = 0.487, P = 0.001) in the assessment of malnutrition; SMI and ALB had different performance (P < 0.001) and inconsistence was noted (Kappa = 0.069, P = 0.489) in the assessment of malnutrition; the results of the nutrition assessment were different between SMI and NRS2002 (P = 0.002), and inconsistence was observed (Kappa = 0.190, P = 0.071). SMI and PG-SGA had the same performance in the assessment of nutrition (P = 0.143), but there was inconsistence (Kappa = 0.099, P = 0.464). FFMI and BMI had general consistence in the assessment of malnutrition (Kappa = 0.472, P < 0.001), but the positive rate determined by FFMI (85.1%) was markedly higher than that by BMI (63.8%) (P = 0.002). FFMI and ALB had different performance in the assessment of malnutrition (P < 0.001) and there was inconsistence (Kappa = -0.008, P = 0.877). FFMI and NRS2002 had the same performance in the assessment of malnutrition (P = 0.453), but the consistence was poor (Kappa = 0.286, P = 0.039). The results determined by SMI and PG-SGA were consistent (P = 0.727), but the consistence was poor (Kappa = 0.399, P = 0.006). Conclusion: Human body composition analysis can identify the patients with muscular mass reduction that cannot be identified by commonly used nutrition assessment scales/parameters. Thus, it is helpful for the assessment of disease severity and also important for the nutrition assessment in CD patients.

[Ecosystem services of Chongyi Hakka Terraces]. / 崇义客家梯田生态系统服务功能.

An economic evaluation of the main ecosystem services of Chongyi Hakka Terraces can help to demonstrate the contributions of the terrace system to Hakka society, on the basis of which the protection of Hakka Terrace system could be undertaken by the local government. In view of the social and economic characteristics of Chongyi Hakka Terrace ecosystem and its location, an index system was established to evaluate the service function, and a qualitative analysis was conducted for these functions and their importance. Besides, based on the data collected in 2014, with a combination of physical quality and economic value, a quantitative analysis was carried out for its nine ser-vice indicators. The findings were as follows: firstly, among the nine evaluation indicators, the phy-sical quality and the economic value of soil conservation both ranked the highest, the former being 76457 kg·hm-2 and the latter 105033 yuan·hm-2, accounting respectively for 72.2% and 30.0% of the total mass and total value of the Hakka Terrace ecosystem. Secondly, the unique service functions of Hakka Terrace ecosystem could be embodied in its cultural heritage and landscape, the corresponding economic values reaching up to 100000 yuan·hm-2 and 46333 yuan·hm-2 respectively, ranking the second and third highest among the nine indicators. Thirdly, the agricultural pro-ducts from the Hakka Terrace were vital welfare for the local residents, but their physical quality and the economic value only accounted for 6.1% and 10.4% of its total mass and total value respectively. As a result, the service functions of the Hakka Terrace ecosystem would be dramatically undervalued with respect to agricultural products only. These economic figures could reveal the huge contributions which the Hakka Terrace ecosystem had made to the society, not only raising awareness of the necessity to preserve the agricultural heritage by the administrators and the public, but also providing efficient data support for the government when making ecological compensation criteria for the Hakka Terrace system.

[The assessment of hemoperfusion for the treatment of acute methamidophos poisoning].

OBJECTIVE: To explore the effect of hemoperfusion(HP) about the patients of methamidophos poisoning. METHODS: On the basis of comprehensive treatment,15 cases of severe acute methamidophos poisoning patients were treated with HP, Blood samples were collected at 7 time points, before and 5, 15, 30, 45, 60mins following the beginning and the end of hemoperfusion. Blood samples were used for measuring the concentration of methamidophos and perfusion devices were used for measuring the volume of methamidophos adsorbed by the device after hemoperfusion. RESULTS: 15 patients live in 12 cases, 3 cases of death. HP (former) blood Cholinesterase vigor were 662.60 + 632.05, HP (after) blood cholinesterase vigor were 2577.52 + 920.38 IU/L; The difference of blood Cholinesterase vigor between the before and after HP was statistically significant (P < 0.01). The patients' methamidophos concentration of blood when HP treated 45, 60, 120 min were respectively (851 + 672), (680 + 529), (587 + 520) microg /ml, there were significantly lower than that the patients' methamidophos concentration of blood who were before HP (1659 + 1105) microg/ml, a statistically significant difference (P < 0.01). CONCLUSION: HP can be cut down obviously methamidophos poisoning patients serum concentrations of toxic, the experimental method directly prove the clinical application of carbon HP can really adsorption methamidophos.

[Health values and health-related behaviors in ethnic minority groups in Guizhou Province].

OBJECTIVE: To investigate the perceived health values and its impact on health-related behaviors of the ethnic minority people in Guizhou province, with an aim to developing culturally appropriate health education and health promotion strategies. METHODS: A self-designed questionnaire survey was undertaken in 722 Miao, Gelao, Dong and Buyi people aged 15 years or over. The questionnaire contained six items evaluating perceived health values. The health-related behaviors covered smoking, alcohol drinking, safe water drinking, blood pressure check, reading health information, and seeking medical attention for illness. Kruskal-Wallis Test and Spearman correlation analysis were used to test the relationship between health values and health-related behaviors. RESULTS: Smoking and alcohol drinking were more prevalent in the minority men than in the minority women (P<0. 001). The health-related behaviors including smoking, alcohol drinking and reading changed with age and education levels. Those who had less health risk behaviors (except for smoking) tended to put more values on health. Each of the six health value items was associated with at least three health-related behaviors. Blood pressure check and reading were positively correlated with all of the six health values items. CONCLUSION: There is a need to increase perceived values of health in the ethnic minority people through education so that health promotion can be effectively implemented.

[Study on the quality of life and its influencing factors in Miao and Gelao Minority groups in Guizhou province].

OBJECTIVE: To investigate and evaluate the quality of life and its influencing factors in Miao and Gelao Minority groups in Guizhou province with the aim of providing evidence for valid health promotion measures. METHODS: Based on a self-designed questionnaire to evaluate the quality of life on 582 subjects. Kruskal-wallis test and stepwise regression analysis were used to test the quality of life and its influencing factors. RESULTS: There were significant differences among the groups of quality of life and its influencing factors. The quality of life of Miao Minority was the highest and Gelao the lowest. Sex, age, acute disease prevalence of the past two-weeks, prevalence of chronic diseases, drinking unboiled water, tobacco-smoking habit, educational level and the family expenditure on life were correlated with all or most of the domains of quality of life. CONCLUSION: The key steps on quality of life promotion should include: strengthening the basis medical health service, pushing cooperative medical service, enhancing prevention and care of chronic diseases, speeding the development of economics etc.