The efficacy of orally administered L-carnitine in alleviating ovarian dysfunctions has laid the foundation for targeted in vivo use: a study employing self-control and propensity score matching.

Objective: This study aimed to evaluate the effectiveness of oral L-carnitine administration in patients after treatment failure to lay the groundwork for targeted in vivo use. Methods and materials: A total of 515 In Vitro Fertilization (IVF) patients undergoing subsequent cycles were included after applying exclusion criteria. They were divided into a control group of 362 patients and a study group of 153 patients who received oral L-carnitine until oocyte retrieval.140 patients were matched according to maternal age, infertility duration, body mass index (BMI), day three top-quality embryos rate, by propensity score matching (PSM). The study investigated the relationship between L-carnitine treatment and in vivo oocyte maturation, normal fertilization, and subsequent embryo development. Results: Following PSM, initial differences in BMI and Day3 top-quality embryo rate between groups were nullified, we created two comparable cohorts with highly similar characteristics. In the subsequent cycles, the study group showed significant improvements in in vivo oocyte maturation rate at retrieval (p=0.002), normal in vitro fertilization rate (p=0.003), blastocyst formation rate (p=0.003), and usable blastocyst rate compared to controls. Although there was no significant difference in the top-quality embryo rate on Day 3, the study group showed a 10% increase in the upper quartile (55.35% vs. 66.67%). The cumulative clinical pregnancy and live birth rates showed a significant improvement (59.82% vs. 68.42%,p=0.004, 47.41% vs. 59.80%, p=0.002). Furthermore, self-control analysis revealed substantial enhancements (p<0.001) in all outcome measures following L-carnitine administration, resulting in the birth of 74 healthy neonates without congenital anomalies. Conclusion: We theorized that daily oral intake of L-carnitine before oocyte retrieval could boost oocyte quality and embryonic development, thus improving IVF outcomes. Ongoing investigations hold the potential to offer valuable insights into the applications and mechanisms underlying the therapeutic effectiveness of L-carnitine.

Frozen dough steamed products: Deterioration mechanism, processing technology, and improvement strategies.

Fresh dough products lead to instability in product quality, high production costs, and more production time, which seriously affects the industrial production of the food industry. The frozen dough technology mitigates the problems of short shelf-life and easy deterioration of quality during storage and transportation. It has shown a series of advantages in large-scale industrialization, high-quality standardization, and chain operation. However, the further development of frozen dough is restricted by the deterioration of the main components (gluten, starch, and yeast) caused by freezing. This review summarizes the main production process of frozen steamed bread and buns, and the deterioration reasons for the main component of frozen dough. The improvement mechanisms of raw ingredients, processing technology, processing equipment, and additives on frozen dough quality were analyzed from the perspective of improving gluten network integrity and yeast freeze tolerance. From prefermented frozen raw to steamed products without thawing has become the preferred production process to improve production efficiency. Wheat flour mixed with other flour can maintain the gluten network continuity of frozen dough. The freeze tolerance of yeast was improved by treatment with yeast suspension, yeast cell encapsulation, screening hybridization, and genetic engineering. Process optimization and new technology-assisted fermentation and freezing effectively reduce freezing damage. Various additives improve the freeze resistance of the gluten-starch matrix by promoting protein cross-linking and inhibiting water migration. In addition, ice structural proteins and ice nucleating agents have been proven to change the growth morphology and formation temperature of ice crystals. More new technologies and additive synergies need to be further explored.

Adenanthin exhibits anti-inflammatory effects by covalently targeting the p65 subunit in the NF-κB signaling pathway.

Adenanthin is a structurally unique ent-kaurane diterpenoid isolated from Rabdosia adenantha, a traditional Chinese medicinal plant with potent anti-cancer and anti-inflammatory activities. However, its anti-inflammatory molecular mechanism remains largely elusive to date. Here, we developed an affinity-based label-free protein profiling (ALFPP) to identify potential covalent targets of electrophilic natural products with ketone or aldehyde groups. Using ALFPP, we identified 27 potential covalent targets of adenanthin, among which p65 (RelA) has been associated with its anti-inflammatory activities. Through a series of experiments, including LC-MS/MS, molecular docking, electrophoretic mobility shift assays (EMSA), and genome editing, we demonstrated that adenanthin could covalently modify the Cys38 residue of p65 to affect the binding of DNA to p65, thereby inhibiting the NF-κB signaling pathway. ALFPP will facilitate the target identification of electrophilic carbonylated natural products, especially those containing α, ß-unsaturated keto groups. Furthermore, the elucidation of the molecular mechanism of adenanthin will contribute to new drug development of adenanthin to treat inflammations and cancers, enhancing the possibility for its clinical application.

The [3+2] annulation of in situ formed trifluorodiazoethane with 4-nitroisoxazoles: access to trifluoromethylpyrazolo[3,4-d]isoxazoles.

A general and practical K2CO3-promoted [3+2] annulation between trifluoroacetaldehyde N-triftosylhydrazone (TFHZ-Tfs) and 4-nitroisoxazoles has been developed to access structurally diverse trifluoromethylpyrazolo[3,4-d]isoxazoles. Mechanistically, CF3CHN2 is formed in situ by TFHZ-Tfs decomposition and involves a formal [3+2] dearomative cycloaddition with 4-nitroisoxazoles, followed by aromatization via the elimination of the nitro group. Furthermore, this protocol is metal-free, scalable, mild, and operationally safe, with a broad substrate scope and high functional group compatibility.

Global research landscape of Peutz-Jeghers syndrome and successful endoscopic management of intestinal intussusception in patients with recurrent laparotomies.

BACKGROUND: Peutz-Jeghers syndrome (PJS) has brought significant physical, psychological and economic burdens on the patients and their families due to its early onset, diagnostic and therapeutic challenges and increased recurrence risk. AIM: To explore the current research status and emerging hotspots of PJS. METHODS: Studies on PJS published during 1994-2023 were gathered based on Web of Science Core Collection. Additionally, a case of PJS-induced intestinal intussusception, successfully treated with endoscopic methods despite three laparotomies, was highlighted. Comprehensive bibliometric and visual analysis were conducted with VOSviewer, R and CiteSpace. RESULTS: Altogether 1760 studies were identified, indicating a steady increase in the publication number. The United States had the highest influence, whereas the University of Helsinki emerged as the leading institution, and Aaltonen LA from the University of Helsinki was the most prolific author. Cancer Research, Oncogene and Endoscopy were the top three journals based on H-index. Keyword burst direction analysis revealed that "cancer risk", "management", "surveillance" and "familial pancreatic cancer" were the potential hotspots for investigation. Additionally, "early detection", "capsule endoscopy", "clinical management", "double-balloon endoscopy", "familial pancreatic cancer" and "molecular genetic basis" were identified as the key clusters of co-cited references. Endoscopic polypectomy remained effective on resolving intestinal intussusception in patients who underwent three previous laparotomies. CONCLUSION: In the last three decades, global publications related to PJS show a steadily increasing trend in number. Endoscopic management is currently a research hotspot.

One-Dimensional Red Light-Emissive Organic Manganese(II) Halides as X-Ray Scintillators.

Although metal halide-based X-ray scintillators have obtained significant development with adjustable radioluminescent spectral range, the red light-emitting scintillator has been sparsely reported and remains a great challenge until now. To remedy this research blank, we investigated the scintillating property of red light-emissive one-dimensional (1D) organic manganese halide of (MBIZ)(MnCl3H2O)·H2O (MBIZ = 2-methyl-1H-benzoimidazolium) with a high PLQY of 71% under UV light excitation. Remarkably, this manganese halide single crystal exhibits a compelling X-ray scintillating property in the red light spectral range with a light yield of 19 600 photons MeV-1 and detection limit of 0.204 µGy/s, which is significantly better than the standard dosage for X-ray diagnostics. Furthermore, this manganese halide also exhibits excellent radiation resistance ability toward long-term continuous irradiation of high-dose X-ray with stable radiophotoluminescence intensity. Benefiting from the abovementioned combined merits, (MBIZ)(MnCl3H2O)·H2O demonstrates high-performance X-ray imaging with an outstanding spatial resolution of 11.1 lpmm-1. As far as we know, this is an infrequent red-emissive X-ray scintillator in metal halide materials, which highlights a successful structural design concept to explore new manganese halides as more desirable scintillators and expand the application field in medical diagnosis.

E242-E261 region of MYC regulates liquid-liquid phase separation and tumor growth via providing negative charges.

MYC is one of the most extensively studied oncogenic proteins and is closely associated with the occurrence and progression of many tumors. Previous studies have shown that MYC regulates cell fate through its liquid-liquid phase separation (LLPS) mechanism, which is dependent on two disordered domains within its N-terminal transcriptional activation regions. In this study, we revealed that the negatively charged conserved region (E242-E261) of the MYC protein controls its condensation formation and irreversible aggregation through multivalent electrostatic interactions (MEIs). Furthermore, deletion or mutation of the E242-E261 amino acids in the MYC protein enhances the transcriptional function of MYC by altering its aggregation capacity and subsequently promoting cancer cell proliferation. The discovery of the negatively charged region and its regulatory action on the phase separation of MYC provides a new understanding on the aggregation and function of MYC.

Substrate-directed regioselective alkene functionalizations of (E)-ß,γ-unsaturated carboxylic acids.

A carboxylate-directed regioselective Heck-type alkenylation and alkenylative lactonization of (E)-ß,γ-unsaturated carboxylic acids by simply substrate control is reported. (E)- and (Z)-alkenyl bromides reacted to give energetically more favorable palladacyles, allowing access to fully stereocontrolled conjugated 1,3-dienes and alkenyled γ-lactones. Mechanistic studies suggest that excellent regioselectivity may be strongly influenced by the steric factors of reactants involved in the palladacycle intermediates.

Structurally diversified sesquiterpenoids from Chloranthus henryi and their neuroprotective activities on H2O2 damaged PC12 cells.

Fifteen undescribed sesquiterpenoid monomers, including six pairs of sesquiterpenoid enantiomers (1a/1b-3a/3b and 5a/5b-7a/7b) and three analogues (4, 8, and 9), together with two known sesquiterpenoid dimers (10 and 11) were isolated from the whole plant of Chloranthus henryi Hemsl. Their structures were characterized by spectroscopic data analysis, ECD calculations, and single crystal X-Ray diffractions. Compounds 1a and 1b were highly aromatic cadinane-type sesquiterpenoids. At a concentration of 10 µM, compounds 8, 10, and 11 exhibited potent neuroprotective activity against H2O2-induced PC12 cell damage. Compounds 10 and 11 significantly decreased the level of ROS. In addition, compound 11 increased the levels of p-AMPK, p-SIRT1, and SIRT3 in the H2O2-induced PC12 cell damage via activated the AMPK/SIRT signaling pathway.

Veno-venous extracorporeal membrane oxygenation-assisted treatment of severe airway stenosis due to goiter: Two case reports.

RATIONALE: Extracorporeal membrane oxygenation (ECMO) is a critical care intervention that acts as a temporary substitute for the heart and lungs, facilitating adequate tissue perfusion and gas exchange. The 2 primary configurations, veno-arterial and veno-venous ECMO, are tailored to support either the heart and lungs or the lungs alone, respectively. PATIENT CONCERNS: The case report details patients with tumor-induced airway stenosis who encountered limitations with standard treatments, which were either insufficient or carried the risk of severe complications such as hypoxia and asphyxia. DIAGNOSES: Patients were diagnosed with severe airway stenosis caused by goiter, a condition that required innovative treatment approaches to prevent complications during the management process. INTERVENTIONS: Veno-venous ECMO was implemented as a bridging therapy to provide vital respiratory support during the tumor resection procedure. This intervention was crucial in reducing the risks associated with airway edema or tumor rupture. OUTCOMES: With the use of veno-venous ECMO, the patients successfully underwent tumor resection. They were subsequently weaned off the ECMO support, and after a course of treatment, they were discharged in good condition. LESSONS: The case demonstrates the efficacy of veno-venous ECMO as a bridging therapy for managing severe airway stenosis caused by goiter. Its use facilitated the successful resection of tumors and led to positive patient outcomes, highlighting its potential as a valuable treatment option in similar scenarios.

[Screening and evaluation of core prescriptions for impotence based on network robustness and data mining].

This study aims to explore and analyze ancient proven prescriptions and famous physician cases for treating impotence, so as to obtain the core prescriptions for traditional Chinese medicine(TCM) treatment of impotence. It further selected and evaluated these core prescriptions to provide a demonstration for the development of new drugs for advantageous diseases treated with TCM. Through the retrieval of ancient proven prescriptions and famous physician cases for treating impotence, a database of prescriptions for treating impotence was established, and the TCM inheritance computational platform was used to explore and analyze the medication patterns of these proven prescriptions and famous physician cases. Based on the TCM efficacy prediction platform of network robustness, the interference scores of core prescriptions in the ancient proven prescriptions and famous physician cases were calculated and analyzed. On this basis, the results of ancient proven prescriptions, famous physician cases, and computational analysis were comprehensively evaluated to determine the development priority level of the core prescriptions obtained through clustering. The results revealed that medicines in the ancient proven prescriptions and famous physician cases primarily aimed at tonifying deficiency, promoting blood circulation, eliminating blood stasis, clearing heat, and resolving external symptoms, with a particular focus on warm-natured and sweet-flavored medicines associated with the spleen, liver, kidney, and lung meridians. The core prescriptions obtained from the clustering analysis of ancient proven prescriptions and famous physician cases indicated that ancient proven prescriptions combination 1 had the most perturbing effect on the disease network as determined by network robustness analysis. A comprehensive evaluation indicated that prescription combination 1 had the most optimal development potential. TCM treatment for impotence focused on regulating the functions of the spleen, liver, kidney, and lung, aiming to tonify deficiency, with heat-clearing, blood-activating, stasis-resolving, and exterior-releasing medications supplemented. The obtained ancient proven prescriptions combination 1 exhibited the highest potential development value. The integrated strategy of "ancient proven prescriptions-famous physician cases-computational analysis" can be utilized to screen candidate TCM new drug prescriptions.

Matricellular proteins: From cardiac homeostasis to immune regulation.

Tissue repair after myocardial injury is a complex process involving changes in all aspects of the myocardial tissue, including the extracellular matrix (ECM). The ECM is composed of large structural proteins such as collagen and elastin and smaller proteins with major regulatory properties called matricellular proteins. Matricellular cell proteins exert their functions and elicit cellular responses by binding to structural proteins not limited to interactions with cell surface receptors, cytokines, or proteases. At the same time, matricellular proteins act as the "bridge" of information exchange between cells and ECM, maintaining the integrity of the cardiac structure and regulating the immune environment, which is a key factor in determining cardiac homeostasis. In this review, we present an overview of the identified matricellular proteins and summarize the current knowledge regarding their roles in maintaining cardiac homeostasis and regulating the immune system.

Understanding the impact of tourist behavior change on travel agencies in developing countries: Strategies for enhancing the tourist experience.

The study investigates the impact of tourist behavior change on travel agencies in developing countries, with a focus on strategies for enhancing the tourist experience. The research aims to identify the main factors influencing tourist purchasing behavior and understand their relationship with the customer experience. Data were collected from 368 experienced tourists in Ho Chi Minh City and Hanoi, Vietnam, using a combination of convenience and random sampling. Partial Least Squares Structural Equation modeling (PLS-SEM) is employed to analyze the research model. The findings confirm that product quality, product price, brand image, and marketing strategy significantly influence tourist purchasing behavior. Importantly, the results highlight the indirect effect of these factors on purchasing behavior, mediated through customer experience. It suggests that enhancing the customer experience is a crucial aspect of influencing tourist purchasing decisions. Based on these findings, industry managers and travel agents in developing countries should prioritize enhancing customer experience and building a strong brand through personalized services, digital integration, and active social media engagement. Implementing dynamic pricing strategies and targeted marketing campaigns that address safety concerns and highlight local experiences are crucial for competitiveness and attracting travelers post-crisis. Future research should explore the long-term effects of these strategies on travel agency performance and adapt the model to specific regional contexts. By adopting these multifaceted approaches, travel agencies in developing countries can enhance their competitiveness and better navigate the changing tourist behavior in the post-crisis era.

Prohibitin 2 confers NADPH oxidase 1-mediated cytosolic oxidative signaling to promote gastric cancer progression by ERK activation.

Oxidative signaling plays a dual role in tumor initiation and progression to malignancy; however, the regulatory mechanisms of oxidative stress in gastric cancer remain to be explored. In this study, we discovered that Prohibitin 2 (PHB2) specifically regulates cytosolic reactive oxygen species production in gastric cancer and facilitates its malignant progression. Previously, we found that PHB2 is upregulated in gastric cancer, correlating with increased tumorigenicity of gastric cancer cells and poor patient prognosis. Here, we discovered that PHB2 expression correlates with the activation of the ERK/MAPK cascade, positively regulating the top gene NADPH oxidase 1 (NOX1) within this pathway. Further mechanistic investigation reveals that PHB2 enhances NOX1 transcription by interacting with the transcription factor C/EBP-beta and promoting its translocation into the nucleus, resulting in elevated intracellular oxidative signaling driven by NOX1, which subsequently activates ERK. Therefore, we propose that targeting PHB2-C/EBP-beta-NOX1-mediated cytosolic oxidative stress could offer a promising therapeutic avenue for combating gastric cancer malignant progression.

Effectiveness and safety of tenofovir amibufenamide in chronic hepatitis B patients.

This letter to the editor relates to the study entitled "Tenofovir amibufenamide vs tenofovir alafenamide for treating chronic hepatitis B: A real-world study", which was recently published by Peng et al. Hepatitis B virus infection represents a significant health burden worldwide and can lead to cirrhosis and even liver cancer. The antiviral drugs currently used to treat patients with chronic hepatitis B infection still have many side effects, so it is crucial to identify safe and effective drugs to inhibit viral replication.

Exploring the Molecular Mechanisms of Herbs in the Treatment of Hyperlipidemia Based on Network Pharmacology and Molecular Docking.

Many herbs have been shown to safely and successfully treat hyperlipidemia. However, the molecular mechanisms underlying their treatment remain unclear. In this study, 103 prescriptions for the treatment of hyperlipidemia containing 146 herbs were screened. Cluster analyses identified a core prescription comprising five herbs, namely, Crataegus pinnatifida (Shan Zha), Cassiae semen (Jue Ming Zi), Alisma orientale (Sam.) Juz. (Ze Xie), Salvia miltiorrhiza (Dan Shen), and Radix Polygoni Multiflori (He Shou Wu), in combination for the treatment of hyperlipidemia. Next, 9, 62, 5, 132, and 34 potential targets for each of the core herbs and a total of 512 hyperlipidemia-related protein targets were detected. Finally, 40 targets shared by core herbs and hyperlipidemia were identified. IL6, AKT1, IL1B, PTGS2, VEGFA, PPARG, and NOS3 were the seven proteins that were found to be most important in the treatment of hyperlipidemia. Interestingly, the Kyoto Encyclopedia of Genes and Genomes pathway indicated that these targets were mainly enriched in the lipid and atherosclerosis pathway and the cancer pathway. In addition, core target proteins such as AKT1, PTGS2, and PPARG have been demonstrated to play critical roles in hyperlipidemia and pancreatic cancer. Significant affinity between bioactive chemicals and proteins involved in cancer pathways was found by molecular docking. Molecular docking results showed that AKT1, PTGS2, and PPARG exhibited good binding ability with three bioactive chemicals, including 3-beta-hydroxymethyllenetanshiquinone, danshexinkum d, and physciondiglucoside. The treatment of hyperlipidemia by herbs may be mediated through the modulation of proteins associated with the cancer pathway. This study helps to provide a theoretical basis for future combined therapy for hyperlipidemia and cancer. [Figure: see text].

Circulating Exosomal Transfer RNA-Related Fragments as Diagnostic Biomarkers for Non-small Cell Lung Cancer.

PURPOSE: Exosomal transfer RNA-derived fragments [exo-tRF] possess the capacity to be employed as biomarkers for several types of cancer. We aim to ascertain the diagnostic significance of exosomal 5'tRF-TyrGTA and 5'tRF-ValTAC in non-small cell lung cancer [NSCLC]. METHODS: Ultracentrifugation was deployed to obtain serum exosomes from NSCLC patients and healthy donors. The acquired exosomes were then confirmed by transmission electron microscopy [TEM], qNano, and western blot [WB] techniques. The level of exo- tRF expression was validated by the use of microarrays and RT-qPCR. The diagnostic performance of exo-tRFs for NSCLC was determined through the receiver operating characteristic curve [ROC]. RESULTS: Exosomal 5'tRF-TyrGTA and 5'tRF-ValTAC were significantly downregulated in both early- and late-stage NSCLC patients compared to healthy donors, representing favorable diagnostic efficiency for NSCLC. In addition, the exosomal 5'tRF-TyrGTA level was correlated with tumor stage and lymph node metastasis. CONCLUSION: Exosomal 5'tRF-TyrGTA and 5'tRF-ValTAC can serve as potential biomarkers for NSCLC.

A rare case report of Herlyn-Werner-Wunderlich syndrome: Unraveling unusual urinary anomalies and literature review.

Herlyn-Werner-Wunderlich syndrome (HWWS) is a rare congenital genitourinary abnormality defined by uterine didelphys, obstructed hemivagina, and ipsilateral urological anomalies. Accurate diagnosis and prompt commencement of therapy can be difficult owing to heterogeneous genitourinary malformation among different patients. This is a case report of a patient with rare HWWS with uterine didelphys, obstructed hemivagina, vagina-ureteral remnant fistula (Gartner's duct cyst), and ipsilateral kidney dysgenesis who complained of intermittent abdominal pain during menstruation. The right ureteral remnant of the patient was distinctive, with three portions. The upper section was connected to the right dysplastic kidney, the lower section formed the fistulous tract with the vagina and bladder, while the middle section communicated with Gartner's Duct Cyst, which merged with the vagina and opened to the posterior cavity of hemivagina. The lower section of the right ureter was excised and ligated during laparoscopic surgery, while the upper section was excised. The patient recovered after surgery. We presented this rare case and conducted a literature review to provide a more comprehensive understanding of HWWS. This could help gynecologists effectively reduce misdiagnosis and missed diagnosis, especially when combined with complicated urinary malformation.

A predictive model for therapy failure in chronic myeloid leukemia patients receiving tyrosine kinase inhibitor therapy.

Although tyrosine kinase inhibitor (TKI) therapy has markedly improved the survival of people with chronic-phase chronic myeloid leukemia (CML), 20-30% of people still experienced therapy failure. Data from 1,955 consecutive subjects with chronic-phase CML diagnosed by the European LeukemiaNet (ELN) recommendations from 1 center receiving initial TKI imatinib or a second-generation (2G-) TKI therapy were interrogated to develop a clinical prediction model for TKI therapy failure. This model was subsequently validated in 3,454 subjects from 76 other centers. Using the predictive clinical co-variates associated with TKI therapy failure, we developed a model that stratified subjects into low-, intermediate- and high-risk subgroups with significantly different cumulative incidences of therapy failure (p < 0.001). There was good discrimination and calibration in the external validation dataset, and the performance was consistent with that of the training dataset. Our model had the better prediction discrimination than the Sokal and ELTS scores did, with the greater time-dependent area under the receiver-operator characteristic curve (AUROC) values and a better ability to re-defined the risk of therapy failure. Our model could help physicians estimate the likelihood of initial imatinib or 2G-TKI therapy failure in people with chronic-phase CML.

Association between relative muscle strength and cardiovascular disease among middle-aged and older adults in China.

BACKGROUND: The association between sarcopenia and cardiovascular disease (CVD) is well known. However, the clinical diagnosis of sarcopenia is complex and not suitable for early clinical identification and prevention of CVD. Relative muscle strength (RMS) is a relatively quantitative and straightforward indicator, but its association with CVD remains unclear. Hence, the objective of this research was to investigate the correlation between RMS and CVD incidence. METHODS: This was a cross-sectional study, using data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011. CVD events were assessed through self-reported physician diagnoses. The RMS was determined by dividing the maximum grip strength by the appendicular skeletal muscle mass (ASM). This study used multivariate logistic regression and restricted cubic spline (RCS) curves to explore the correlation between RMS and CVD incidence. Additionally, we conducted subgroup analyses to provide additional evidence supporting the association between the two variables. RESULTS: A total of 8,733 people were included in our study, with 1,152 (13.19%) CVD patients and 7,581 (86.81%) non-CVD patients. When the data were grouped according to quartiles (Q) of RMS, the inverse association between CVD and RMS remained statistically significant even after controlling for all potential confounding factors. Compared with participants in Q1 of RMS, the ORs (95% CIs) of CVD among those in Q2-Q4 were 0.99 (0.83, 1.17), 0.81 (0.67, 0.98), and 0.70 (0.57, 0.85), respectively. Moreover, the RCS results showed a negative linear correlation between the RMS and CVD incidence (P for nonlinearity = 0.555). Subgroup analysis revealed no significant interaction in any of the groups except for the sex group (P for interaction = 0.046). CONCLUSION: Our study indicated a stable negative correlation between RMS and CVD incidence. RMS is helpful for the early identification and prevention of CVD.