Follow up study of the association between bedroom light at night exposure and body mass index in children / 中国学校卫生

Objective@#To explore the association between bedroom light at night (LAN) exposure and body mass index (BMI) in children at 1 year follow up, so as to provide new strategies for obesity prevention.@*Methods@#From December 2021 to May 2022, cluster random sampling was conducted, involving 648 children from two primary schools in Tianchang, Chuzhou City, Anhui Province, China, to assess bedroom LAN exposure of children during sleep. A questionnaire survey and physical examination were carried out in May 2022. Multivariate linear regression was performed to analyze the correlation between bedroom LAN exposure and BMI variable quantity at 1 year follow up (May, 2023).@*Results@#The median intensity of bedroom LAN exposure during the sleep episode was [1.11(0.35,3.24)lx] in children. The proportion of the sample exposed to an average light intensity of ≥3 lx was 27.5%, while 19.0% was exposed to a LAN intensity of ≥5 lx during the sleep episode. In the multivariable linear regression, after adjusting for covariates, including sex, baseline age, sleep duration, family monthly income, and maternal education level, exposure to a 1 h-average post bedtime LAN intensity of ≥3 lx ( β=0.25, 95%CI =0.05-0.44) and LAN≥5 lx ( β=0.34, 95% CI = 0.12-0.55) was associated with a gain of 0.25 and 0.34 kg/m 2, respectively, in the children s BMI at the 1 year follow up ( P < 0.05).@*Conclusions@#A positive correlation was found between bedroom LAN exposure and BMI variable quantity at 1 year follow up in children. Thus, reduced bedroom LAN exposure might be useful for interventions aimed at obesity prevention.

Predictive Modeling of Chronic Kidney Disease with Hypertension or Diabetes Based on Machine Learning Algorithms / 昆明医科大学学报

Objective To build the early predictive model for chronic kidney disease(CKD)in hypertension and diabetes patients in the community.Methods The CKD patients were recruited from 4 health care centers in 4 urban areas in Kunming.The control group was residents without hypertension and diabetes(n = 1267).The disease group was residents with hypertension and/or diabetes(n = 566).The questionnaire survey,physical examination,laboratory testing,and 5 SNPs gene types in the PVT1 gene.The risk factors,which were filtered with logistics regression,were used to build predictive models.Four machine learning algorithms were built:support vector machine(SVM),random forest(RF),Na?ve Bayes(NB),and artificial neural network(ANN)models.Results Thirteen indicators included in the final diagnostic model:age,disease type,ethnicity,blood urea nitrogen,creatinine,eGFR from MDRD,ACR,eGFR from EPI2009,PAM13 score,sleep quality survey,staying-up late,PVT1 SNP rs11993333 and rs2720659.The accuracy,specificity,Kappa value,AUC of ROC,and PRC of ANN are greater than those of the other 3 models.The sensitivity of RF is the highest among 4 types of machine learning.Conclusions The ANN predictive model has a good ability of efficiency and classification to predict CKD with hypertension and/or diabetes patients in the community.

The related factors of subjective cognitive decline and its relationship with the progression of Alzheimer's disease / 临床神经病学杂志

Subjective cognitive decline(SCD)refers to self-perceived persistent decline in cognitive function,but the relevant neuropsychological tests remain within the normal range.It is a possible earliest preclinical stage that can be identified in the continuous progressive duration of Alzheimer's disease(AD).Many factors are involved in the occurrence of SCD and how to identify the AD progressive SCD to ultra-early intervention is the focus of current research.This paper aims to summarize and analyze the related concepts,clinical characteristics,related influencing factors,and their relationship with the progression of AD,which may provide a reference for subsequent related studies.

The efficacy of artificial(nonbiological)extracorporeal liver support system for primary biliary cholangitis and the effect of this therapy on prognosis / 实用医学杂志

Objective To evaluate the clinical efficacy of plasma exchange(PE)and double plasma molecular absorption system(DPMAS)in the treatment of primary biliary cholangitis(PBC)and the effect of this therapy on prognosis.Methods The clinical data on 526 PBC patients in our hospital from December 2013 to January 2022 were retrospectively analyzed.The patients were divided into different groups according to different therapies and then matched with propensity.The changes in symptoms,laboratory indexes and MELD scores were compared between two groups before and after treatment,and the clinical efficacy of artificial liver treatment for PBC patients was assessed.The effect of this treatment on the survival outcomes in these patients via comparing the cumulative survival rates at 3,6 and 12 months between the two groups.Results The efficiency was better in the group with artificial liver treatment in addition medical therapy than the group with medical treatment alone,the difference was statistically significant(76.7%vs.55.8%,χ2 = 4.214,and P = 0.040).Cox proportional risk regression showed that TBIL was an independent risk factor affecting the 3-,6-,or 12-month survival in PBC patients.Conclusions Artificial liver support system can effectively relieve symptoms,reduce levels of ALT,AST and TBIL,improve blood coagula-tion function,and lower MELD scores in PBC patients.This therapy revealed a trend of improvement in 3-,6-,or 12-month survival outcomes.

Explorationand practice of project management of voluntary service in public hospitals / 现代医院

Voluntary service is an important symbol of social civilization and progress.The project-based operation of volunteer service in public hospitals can accurately enrich the service content,improve the patient's medical experience,and give full play to the social effect of the brand,which is an important implementation process in the institutionalization and stand-ardized development of volunteer service in medical institutions.Starting from the four aspects of project development,implemen-tation,monitoring and evaluation,this paper systematically expounds on how to build the project-based management model of public hospital voluntary service,and analyzes the difficulties and solutions of project-based construction in combination with the actual situation,so as to provide references for the project-based management and brand building of public hospital voluntary serv-ice,and advance the high-quality development of public hospitals.

Status Analysis of Unplanned Reoperation in Cardiac Surgery Department of a Provincial Grade A Tertiary General Hospital / 中国医院管理

Objective To analyze the current situation of unplanned reoperation in cardiac surgery and to discuss the management measures of unplanned reoperation.Methods The information of patients undergoing cardiac surgery in a class A tertiary comprehensive hospital during 2018-2022 was collected to analyze the incidence of unplanned reoperation,major ca uses,disease types,surgica l moda lities and Complications.Results A tota l of 3902 patients underwent surgery,of whom 73(1.87%)underwent unplanned reoperation.The main cause of unplanned reoperation was bleeding(50%).The disease types with the highest unplanned reoperation composition ratio were coronary heart disease(38.4%),and the disease types with the highest incidence were dilated cardiomyopathy(11.1%).The average hospitalization cost,the average length of hospitalization,mortality rate and medical dispute rate of patients who had unplanned reoperation were significantly higher than those who did not have unplanned reoperation,the difference was statistically significant(P=0.001).Conclusion The hospital should strengthen the perioperative management of cardiac surgery,focus on supervising disease types and surgical modalities with high incidence of unplanned reoperation,and strictly implement the system of operation classification and the system of reporting unplanned reoperation to ensure the quality of patient surgery.

Diagnostic value of superb microvascular imaging and CTA combined with serum sdLDL-C for hypertension patients with ACI / 中华老年心脑血管病杂志

Objective To investigate the diagnostic value of superb microvascular imaging(SMI)grading,CT angiography(CTA),and serum small and dense low-density lipoprotein cholesterol(sdLDL-C)in elderly hypertension patients with acute cerebral infarction(ACI).Methods A ret-rospective study was conducted on 180 elderly hypertension patients admitted to our hospital from June 2021 to June 2023,and those admitted due to ACI were assigned into ACI group(95 cases)and those without into non-ACI group(85 cases).The SMI grade,CTA,and serum sdLDL-C level were compared between the two groups.ROC curve was plotted to analyze the diagnostic value of SMI grading and CTA combined with serum sdLDL-C for ACI in patients with hyperten-sion.Multivariate logistic regression analysis was employed to analyze the factors affecting the oc-currence of ACI in the patients.Results The ACI group had significantly larger proportion of hy-perlipidemia,and higher DBP,SBP,and HDL-C,and LDL-C than the non-ACI group(P＜0.05).The proportion of SMI grade 2 and grade 3 and serum sdLDL-C level were also greatly higher[35.79％vs 10.59％,43.16％vs 8.24％,(1.62±0.25)mmol/L vs(1.35±0.19)mmol/L,P＜0.01],and the proportion of SMI grade 0 and grade 1 was lower(11.58％vs 51.76％,9.47％vs 29.41％,P＜0.01)in the ACI group than the non-ACI group.ROC curve analysis showed that the AUC value of SMI grade and CTA combined with serum sdLDL-C in diagnosing ACI in patients with hypertension was 0.934(95％CI:0.897-0.972).Multivariate logistic regression analysis in-dicated that SMI grade,CTA,and sdLDL-C were risk factors for ACI in hypertensive patients(P＜0.01).Conclusion Combination of carotid artery plaque SMI grading,CTA,and serum sdLDL-C has high auxiliary diagnostic value for elderly hypertension patients with ACI.

Exploring the Mechanism of Anti-asthma Effect of Fujiu Patch on Modulation of Th17/Treg Immune Balance Based on IL-6/STAT3 and IL-2/STAT5 Signaling Pathways / 中药新药与临床药理

Objective This study aims to investigate the regulatory effects of Fujiu Patch(composed of Sinapis Semen,Kansui Radix,Corydalis Rhizoma and Asari Radix et Rhizoma)on the CD4+ T helper 17 cell(Th17)/CD4+CD25+ regulatory T cell(Treg)balance in asthmatic rats via the signal pathway of IL-6/signal transducer and activator of transcription 3(STAT3)as well as IL-2/signal transducer and activator of transcription 5(STAT5),and to reveal its anti-asthma mechanisms.Methods An experimental asthma model was constructed by ovalbumin(OVA)combined with aluminum hydroxide sensitization and challenge,and then the rats were administered with Fujiu Patch at Dazhui(DU14),Feishu(BL13)and Shenshu(BL23)points for 4 hours each time,once every other day for 7 times.Immunohistochemistry was used to detect the positive expressions of Th17 specific cytokine(IL-17)and Treg transcription factor(Foxp3)in rat lung tissue.The percentage of Th17 and Treg cells in peripheral blood was examined by flow cytometry analysis,and the expressions of IL-6/STAT3 and IL-2/STAT5 pathway-related proteins in lung tissue were assayed with Western Blot.Results Compared to the model group,IL-17 positive expression in the rat lung showed a significant reduction in the Fujiu Patch group(P＜0.01),while the positive expression of Foxp3 was obviously increased(P＜0.05).Meanwhile,the protein expression levels of IL-6 and phospho-STAT3 were were significantly declined(P＜0.01),and the protein expression levels of IL-2 and phospho-STAT5 were were significantly elevated(P＜0.01).However,there was no significant alteration in the total protein expressions of STAT3 and STAT5(P＞0.05).Furthermore,the proportion of Th17 cells in peripheral blood of rats in the Fujiu Patch group was lower than that in the model group,while the proportion of Treg cells was higher than that in the model group.Statistically-significant differences were observed(all P＜0.01).Conclusion These findings indicate that Th17/Treg immune imbalance occurs in asthmatic rat.Fujiu Patch may exert anti-asthma effects via inhibiting the expression of IL-6,downregulating the expression of phospho-STAT3,diminishing the level of IL-17-producing Th17 cells,as well as increasing the expressions of IL-2-mediated STAT5 phosphorylation,raising the level of Foxp3-expressing Treg cells,promoting Th17/Treg balance and suppressing immune responses in rat with asthma.

Status of parent-child bed sharing and its influences on children / 中国儿童保健杂志

The influence of bed sharing on children′s physical and psychological health has been concerned as one of the main types of sleep arrangements.At present, there are significant differences in bed sharing among children of different ages, groups, regions and races.There are also studies on the impact of bed sharing sleep on children′s health, on the one hand, it is conducive to breastfeeding, where infants get enough security; on the other hand, it leads to an increase in the incidence of sudden infant death syndrome, and an increase in the number of night awakenings.Therefore, it is important to understand the current research situation of bed sharing and its influences on children, thus to better promote children healthy growth.

Spatial-temporal characteristics of drug-resistant tuberculosis in Pudong New Area, Shanghai, in 2016-2021 / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics and spatial-temporal distribution of drug-resistant tuberculosis in Pudong New Area from 2016 to 2021 and to provide scientific basis for the prevention and control of drug-resistant tuberculosis. Methods The data of tuberculosis patients in Pudong New Area from 2016 to 2021 were collected through the Tuberculosis Information Management System of China Disease Prevention and Control Information System. The geographic information database was established by ArcGIS software and the vector map of Pudong New Area for trend surface analysis and spatial autocorrelation analysis . Results From 2016 to 2021, a total of 3916 patients with etiological positive tuberculosis were found to be drug resistant with the drug resistance rate of 13.13%. The drug resistance rate of each year showed a decreasing trend (χ2trend=14.917, P<0.001). The rates of drug resistance of male, retiree, age 50~<60 years old, 60~<70 years old and recurrent patient were higher. From 2016 to 2021, the incidence of drug-resistant TB showed no spatial aggregation.In the south - north direction, the north is higher than the south generally. In the east - west direction, the west is higher than the east generally. Conclusion Drug resistance screening should be strengthened for men, retirees, over 50 years old, and recurrent TB patients,. Prevention and control measures should be strengthened in street towns with dense population and large floating population.

The Association between Educational Attainment and the Risk of Nonalcoholic Fatty Liver Disease among Chinese Adults: Findings from the REACTION Study

Background/Aims@#Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. @*Methods@#A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. @*Results@#Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. @*Conclusions@#In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Dark-Blood Computed Tomography Angiography Combined With Deep Learning Reconstruction for Cervical Artery Wall Imaging in Takayasu Arteritis

Objective@#To evaluate the image quality of novel dark-blood computed tomography angiography (CTA) imaging combined with deep learning reconstruction (DLR) compared to delayed-phase CTA images with hybrid iterative reconstruction (HIR), to visualize the cervical artery wall in patients with Takayasu arteritis (TAK). @*Materials and Methods@#This prospective study continuously recruited 53 patients with TAK (mean age: 33.8 ± 10.2 years; 49 females) between January and July 2022 who underwent head-neck CTA scans. The arterial- and delayed-phase images were reconstructed using HIR and DLR. Subtracted images of the arterial-phase from the delayed-phase were then added to the original delayed-phase using a denoising filter to generate the final-dark-blood images. Qualitative image quality scores and quantitative parameters were obtained and compared among the three groups of images: Delayed-HIR, Dark-blood-HIR, and Dark-blood-DLR. @*Results@#Compared to Delayed-HIR, Dark-blood-HIR images demonstrated higher qualitative scores in terms of vascular wall visualization and diagnostic confidence index (all P < 0.001). These qualitative scores further improved after applying DLR (Dark-blood-DLR compared to Dark-blood-HIR, all P < 0.001). Dark-blood DLR also showed higher scores for overall image noise than Dark-blood-HIR (P < 0.001). In the quantitative analysis, the contrast-to-noise ratio (CNR) values between the vessel wall and lumen for the bilateral common carotid arteries and brachiocephalic trunk were significantly higher on Darkblood-HIR images than on Delayed-HIR images (all P < 0.05). The CNR values were significantly higher for Dark-blood-DLR than for Dark-blood-HIR in all cervical arteries (all P < 0.001). @*Conclusion@#Compared with Delayed-HIR CTA, the dark-blood method combined with DLR improved CTA image quality and enhanced visualization of the cervical artery wall in patients with TAK.

Compliance and correctness of hand hygiene of health care workers in intensive care units of a tertiary first-class hospital / 中国感染控制杂志

Objective To study the compliance and correctness of hand hygiene(HH)of staff in intensive care units(ICUs)of a tertiary first-class hospital,and provide theoretical basis for HH intervention.Methods In April 2023,staff in 17 ICUs of this hospital were performed on-site survey by infection control staff,and monitoring forms about HH compliance and correctness were filled out.Results A total of 874 HH opportunities were ob-served with the concealed observation method,501 HH opportunities were implemented,the compliance rate was 57.32％,273 HH opportunities were correctly implemented,with an correct rate of 54.49％.The compliance and correct rate of HH among staff in different ICUs varied significantly.Compliance and correct rates of HH among staff with different jobs were statistically different:HH compliance rate of cleaners(31.97％)was lower than that of nurses(63.83％),doctors(58.77％)and other personnel(58.14％);HH correct rate of cleaners(30.77％)was lower than that of nurses(58.17％).The causes for not implementing HH among staff with different jobs and at different HH opportunities were statistically different:the rate of not implementing any HH measures after con-tact with patients(84.75％)was higher than before contact with patients(41.27％),before clean and sterile ma-nipulation(30.00％),as well as after contact with blood and body fluid(45.45％).The rate of not implementing any HH measures after contact with the patient's surrounding environment(66.67％)was higher than before con-tact with patient as well as before clean and sterile manipulation.The rates of incomplete HH steps and insufficient HH time among staff with different jobs were statistically different:The rates of incomplete HH steps of other per-sonnel(82.35％)was higher than that of doctors(52.63％).The rates of insufficient HH time of doctors(82.46％)and nurses(78.18％)were higher than that of cleaners(51.85％).Conclusion The implementation of HH among different occupational groups and at different HH implementation opportunities in ICU is significantly different,which should be intervened based on their characteristics.

Practical study on the integration of life narratives into care services for cancer patients / 中国医学伦理学

This paper took the “see your life story” - volunteer service project of the cancer patient care program of the First Affiliated Hospital of Guangzhou Medical University as an example， and explored the application of life narrative in the care service of cancer patients. The project adopted the multi-dimensional volunteer service model of “doctors and nurses + volunteers + social workers + patient friends”，used the life narrative method， and guided the three groups of cancer patients， patient caregivers， and oncology medical staff to tell their life stories through medical volunteers. Finally， these life stories were delivered in diversified ways， such as physical picture books， interview stories， and sharing meetings. The connection between patients can be promoted in the form of sharing， so that patients and caregivers can get support， and truly achieve to impact life with life. This paper selected the cases in life story books， deeply analyzed the important role of life narrative in promoting the physical and mental recovery of cancer patients， as well as provided reference suggestions for improving patients’medical experience and promoting the cultural development of public hospitals.

A hnRNPA2B1 agonist effectively inhibits HBV and SARS-CoV-2 omicron in vivo

The twenty-first century has already recorded more than ten major epidemics or pandemics of viral disease, including the devastating COVID-19. Novel effective antivirals with broad-spectrum coverage are urgently needed. Herein, we reported a novel broad-spectrum antiviral compound PAC5. Oral administration of PAC5 eliminated HBV cccDNA and reduced the large antigen load in distinct mouse models of HBV infection. Strikingly, oral administration of PAC5 in a hamster model of SARS-CoV-2 omicron (BA.1) infection significantly decreases viral loads and attenuates lung inflammation. Mechanistically, PAC5 binds to a pocket near Asp49 in the RNA recognition motif of hnRNPA2B1. PAC5-bound hnRNPA2B1 is extensively activated and translocated to the cytoplasm where it initiates the TBK1-IRF3 pathway, leading to the production of type I IFNs with antiviral activity. Our results indicate that PAC5 is a novel small-molecule agonist of hnRNPA2B1, which may have a role in dealing with emerging infectious diseases now and in the future.

Microbial monitoring of urban drinking water in Jiangxi Province from 2016 to 2020 / 上海预防医学

ObjectiveTo monitor the microbes in urban drinking water in Jiangxi from 2016 to 2020， to analyze the change in microbial qualification rate， and to provide a scientific basis for government decision-making. MethodsAccording to the Standard Examination Method for Drinking Water （GB/T 5750‒2006） and the Standards for Drinking Water Quality （GB 5749‒2006）， the water samples were collected， tested and evaluated for hygienic safety. The chi-square test was used to compare the qualification rates among different water periods， water source types， water supply modes， water samples， treatment processes， and disinfection methods. ResultsA total of 10 584 water samples were collected and examined from 2016 to 2020，with a qualification rate of 97.72%. The qualified rate of the microbiological index increased gradually over the years. There was no statistically significant difference in the microbiological qualification rate of water samples monitored in different water periods （χ2=0.718，P=0.398）， and the qualification rates were 97.85% and 97.60% in dry and abundant water periods respectively. There was a statistically significant difference in the qualification rates of water samples monitored in different water source types （χ2=79.560，P=0.398）， with groundwater having a higher qualification rate of 98.83% than surface water （97.70%）. The microbiological pass rate of water samples differed among different water supply methods （χ2=201.836，P<0.001）. The microbiological pass rates of municipal centralized water supply， self-built centralized water supply and secondary water supply were 97.51%， 88.94% and 96.56% respectively. The microbiological pass rates of water samples differed among different treatment processes. There were differences in the qualification rates of the water samples between different treatment processes（χ2=855.034，P<0.001）， with 98.22%， 67.19%， 95.60% and 53.13% of the conventionally treated， precipitated filtered， disinfected only and untreated water samples， respectively. The differences in the microbiological qualification rates of the monitored water samples between different disinfection methods were statistically significant （χ2=904.993，P<0.001）. Chlorination disinfection， chlorine dioxide disinfection， other disinfection methods and non-disinfected water samples had the pass rates of 98.35%， 98.19%， 84.38% and 60.16%， respectively. ConclusionThe qualified rate of the microbiological index of drinking water in Jiangxi increases year by year， but there are still some drinking water without appropriate disinfectants and water quality treatment processes. There is still a need to strengthen the purification， disinfection and monitoring of drinking water.

Advances in minimally invasive treatment of upper gastrointestinal bleeding in liver cirrhosis / 临床肝胆病杂志

Liver cirrhosis is a common chronic liver disease in clinical practice, and the main causes of this disease include virus, alcohol, and immunity. Patients may experience a variety of complications in the late stage of liver cirrhosis, including upper gastrointestinal bleeding, hepatic encephalopathy, hepatorenal syndrome, and liver cancer, among which upper gastrointestinal bleeding is the main cause of death, and therefore, the control and prevention of upper gastrointestinal bleeding caused by liver cirrhosis is the key to reducing mortality rate and prolonging survival time. This article summarizes the commonly used minimally invasive methods for the treatment of upper gastrointestinal bleeding in liver cirrhosis and analyzes the indications for different treatment methods and related advances, so as to provide a reference for clinicians to choose the most suitable treatment regimen for the patient, thereby improving the survival rate of patients.

MLL4 Regulates the Progression of Non–Small-Cell Lung Cancer by Regulating the PI3K/AKT/SOX2 Axis / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Mixed-lineage leukemia protein 4 (MLL4/KMT2D) is a histone methyltransferase, and its mutation has been reported to be associated with a poor prognosis in many cancers, including lung cancer. We investigated the function of MLL4 in lung carcinogenesis. @*Materials and Methods@#RNA sequencing (RNA-seq) in A549 cells transfected with control siRNA or MLL4 siRNA was performed. Also, we used EdU incorporation assay, colony formation assays, growth curve analysis, transwell invasion assays, immunohistochemical staining, and in vivo bioluminescence assay to investigate the function of MLL4 in lung carcinogenesis. @*Results@#We found that MLL4 expression was downregulated in non–small cell lung cancer (NSCLC) tissues compared to adjacent normal tissues and tended to decrease with disease stage progression. We analyzed the transcriptomes in control and MLL4- deficient cells using high-throughput RNA deep sequencing (RNA-seq) and identified a cohort of target genes, such as SOX2, ATF1, FOXP4, PIK3IP1, SIRT4, TENT5B, and LFNG, some of which are related to proliferation and metastasis. Our results showed that low expression of MLL4 promotes NSCLC cell proliferation and metastasis and is required for the maintenance of NSCLC stem cell properties. @*Conclusion@#Our findings identify an important role of MLL4 in lung carcinogenesis through transcriptional regulation of PIK3IP1, affecting the PI3K/AKT/SOX2 axis, and suggest that MLL4 could be a potential prognostic indicator and target for NSCLC therapy.

Dissecting Causal Relationships Between Gut Microbiota, Blood Metabolites, and Stroke: A Mendelian Randomization Study / 대한뇌졸중학회지

Background@#and Purpose We investigated the causal relationships between the gut microbiota (GM), stroke, and potential metabolite mediators using Mendelian randomization (MR). @*Methods@#We leveraged the summary statistics of GM (n=18,340 in the MiBioGen consortium), blood metabolites (n=115,078 in the UK Biobank), and stroke (cases n=60,176 and controls n=1,310,725 in the Global Biobank Meta-Analysis Initiative) from the largest genome-wide association studies to date. We performed bidirectional MR analyses to explore the causal relationships between the GM and stroke, and two mediation analyses, two-step MR and multivariable MR, to discover potential mediating metabolites. @*Results@#Ten taxa were causally associated with stroke, and stroke led to changes in 27 taxa. In the two-step MR, Bifidobacteriales order, Bifidobacteriaceae family, Desulfovibrio genus, apolipoprotein A1 (ApoA1), phospholipids in high-density lipoprotein (HDL_PL), and the ratio of apolipoprotein B to ApoA1 (ApoB/ApoA1) were causally associated with stroke (all P<0.044). The causal associations between Bifidobacteriales order, Bifidobacteriaceae family and stroke were validated using the weighted median method in an independent cohort. The three GM taxa were all positively associated with ApoA1 and HDL_PL, whereas Desulfovibrio genus was negatively associated with ApoB/ApoA1 (all P<0.010). Additionally, the causal associations between the three GM taxa and ApoA1 remained significant after correcting for the false discovery rate (all q-values <0.027). Multivariable MR showed that the associations between Bifidobacteriales order, Bifidobacteriaceae family and stroke were mediated by ApoA1 and HDL_PL, each accounting for 6.5% (P=0.028) and 4.6% (P=0.033); the association between Desulfovibrio genus and stroke was mediated by ApoA1, HDL_PL, and ApoB/ApoA1, with mediated proportions of 7.6% (P=0.019), 4.2% (P=0.035), and 9.1% (P=0.013), respectively. @*Conclusion@#The current MR study provides evidence supporting the causal relationships between several specific GM taxa and stroke and potential mediating metabolites.

Influence of Mode of Delivery on Children’s Attention Deficit Hyperactivity Disorder and Childhood Intelligence

Objective@#To investigate whether differences exist in attention deficit hyperactivity disorder (ADHD) and intelligence between children born by cesarean delivery and those born by vaginal delivery. @*Methods@#This retrospective study included singleton children that were born between January 2013 and December 2014. The Chinese version of the Conners’ Parent Rating Scale–Revised (CPRS-48) was required on the probability of psychological and behavioral problems. The China–Wechsler Intelligence Scale for Children (C-WIRS) was used for evaluation of crystallized intelligence and Raven’s Standard Progressive Matrices for evaluation of fluid intelligence. @*Results@#A total of 10,568 valid questionnaires were obtained. CPRS-48 ADHD index and detection rate were higher in cesarean delivery group than those in vaginal delivery group. Cesarean delivery groups had a lower performance intelligence quotient score according to C-WISC. @*Conclusion@#Children born by cesarean delivery were more likely to have a risk of ADHD and a lower performance intelligence quotient compared with those born by vaginal delivery.