Association between polypharmacy and chronic kidney disease among community-dwelling older people: a longitudinal study in southern China.

BACKGROUND: Polypharmacy would increase the risk of adverse drug events and the burden of renal drug excretion among older people. Nevertheless, the association between the number of medication and the risk of chronic kidney disease (CKD) remains controversial. Therefore, this study aims to investigate the association between the number of medication and the incidence of CKD in older people. METHODS: This study investigates the association between the number of medications and CKD in 2672 elderly people (≥ 65 years older) of the community health service center in southern China between 2019 and 2022. Logistic regression analysis was used to evaluate the relationship between polypharmacy and CKD. RESULTS: At baseline, the average age of the study subjects was 71.86 ± 4.60, 61.2% were females, and 53 (2.0%) suffer from polypharmacy. During an average follow-up of 3 years, new-onset CKD developed in 413 (15.5%) participants. Logistic regression analysis revealed that taking a higher number of medications was associated with increase of CKD. Compared with people who didn't take medication, a higher risk of CKD was observed in the older people who taken more than five medications (OR 3.731, 95% CI 1.988, 7.003), followed by those who take four (OR 1.621, 95% CI 1.041, 2.525), three (OR 1.696, 95% CI 1.178, 2.441), two drugs (OR 1.585, 95% CI 1.167, 2.153), or one drug (OR 1.503, 95% CI 1.097, 2.053). Furthermore, age, systolic blood pressure (SBP), white blood cell (WBC), blood urea nitrogen (BUN) and triglyceride (TG) were also independent risk factors CKD (P < 0.05). CONCLUSION: The number of medications was associated with CKD in older people. As the number of medications taken increased, the risk of CKD was increased.

Cadmium-induced reproductive toxicity combined with a correlation to the oogenesis process and competing endogenous RNA networks based on a Caenorhabditis elegans model.

Accumulation of the heavy metal Cadmium (Cd) in the ovaries and placenta can affect the structure and function of these organs and induce female reproductive toxicity. This toxicity may be due to Cd's similarity to estrogen and its ability to disrupt endocrine systems. However, the exact molecular mechanism by which Cd causes reproductive toxicity at the transcriptome level remains poorly understood. Hence, this study aimed to observe Cd-induced reproductive damage at the gene level, scrutinize the repercussions of Cd exposure on oogenesis, and explicate the putative pathogenesis of Cd-induced oogenesis based on Caenorhabditis elegans (C. elegans) as an in vivo model. The results showed that Cd exposure significantly decreased the number of offspring and prolonged the reproductive span of C. elegans. Cd exposure also reduced the number of cells in mitosis and the pachytene and diakinesis stages of meiosis, thereby disrupting oogenesis. Combined with transcriptional sequencing and bioinformatics analysis, a total of 3167 DEmRNAs were identified. Regarding gene expression, cul-6, mum-2, and vang-1 were found to be related to Cd-induced reproductive toxicity, and their competing endogenous RNA networks were constructed. We observed that mutations of mom-2 and vang-1 in the Wnt pathway could induce susceptibility to Cd-caused meiosis injury. In conclusion, the results indicated that Cd could impair the oogenesis of C. elegans and the Wnt pathway might serve as a protective mechanism against Cd reproductive toxicity. These findings contribute to a better understanding of the damaging effects and molecular biological mechanisms of Cd on the human reproductive system.

Evaluating the efficiency of primary health care institutions in China: an improved three-stage data envelopment analysis approach.

BACKGROUND: Primary health care (PHC) institutions are key to realizing the main functions of the health care system. Since the new health care reform in 2009, the Chinese government has invested heavily in PHC institutions and launched favorable initiatives to improve the efficiency of such institutions. This study is designed to gauge the efficiency of PHC institutions by using 2012-2020 panel data covering 31 provinces in China. METHODS: This study applied an improved three-stage data envelopment analysis (DEA) model to evaluate the efficiency of PHC institutions in China. Unlike the traditional three-stage DEA model, the input-oriented global super-efficiency slack-based measurement (SBM) DEA model is used to calculate the efficiency in the first and third stages of the improved three-stage DEA model, which not only allows the effects of environmental factors and random noise to be taken into account but also deal with the problem of slack, super-efficiency and the comparability of interperiod efficiency values throughout the efficiency measurement. RESULTS: The results show that the efficiency of PHC institutions has been overestimated due to the impact of external environmental factors and random noise. From 2012 to 2020, the efficiency of PHC institutions displayed a downward trend. Moreover, there are significant differences in the efficiency of PHC institutions between regions, with the lowest efficiency being found in the northeast region. The efficiency of PHC institutions is significantly affected by residents' annual average income, per capita GDP, population density, the percentage of the population aged 0-14, the percentage of the population aged 65 and older, the number of people with a college education and above per 100,000 residents, and the proportion of the urban population. CONCLUSIONS: Substantial investment in PHC institutions has not led to the expected efficiency gains. Therefore, more effective measures should be taken to improve the efficiency of PHC institutions in China based on local conditions. This study provides a new analytical approach to calculating the efficiency of PHC institutions, and this approach can be applied to efficiency evaluation either in other fields or in other countries.

Ionic Liquid Directed Spinning of Cellulose Aerogel Fibers with Superb Toughness for Weaved Thermal Insulation and Transient Impact Protection.

Aerogel fibers, combining the nanoporous characteristics of aerogels with the slenderness of fibers, have emerged as a rising star in nanoscale materials science. However, endowing nanoporous aerogel fibers with good strength and high toughness remains elusive due to their high porosity and fragile mechanics. To address this challenge, this paper reports supertough aerogel fibers (SAFs) initially started from ionic-liquid-dissociated cellulose via wet-spinning and supercritical drying in sequence. The supertough nanoporous aerogel fibers assembled with cellulose nanofibers exhibit a high specific surface area (372 m2/g), good mechanical strength (30 MPa), and large elongation (107%). Benefiting from their high strength and elongation, the resultant cellulose nanoporous aerogel fibers show ultrahigh toughness up to 21.85 MJ/m3, much outperforming the known aerogel materials in the literature. Moreover, the toughness of this nanoporous aerogel fiber is 7.4 times higher than that of human knee ligaments, and its specific toughness is comparable to that of commonly used solid polyester fibers. In addition, we also verified the weavability, desirable thermal insulation performance, and supertoughness to resist the transient impact of SAFs. The long-sought strategy to simultaneously resolve the strength and toughness of nanoporous aerogel fibers, in combination with the biodegradable nature of the cellulose, provides multifaceted opportunities for broad potential applications, including lightweight wearable textiles and beyond.

Toxicological effects of micro/nano-plastics on mouse/rat models: a systematic review and meta-analysis.

Micro/nano-plastics (MNPs) are considered a heterogeneous class of environmental contaminants that cause multiple toxic effects on biological species. As the commonly used mammalian models to study the effects of MNPs with regard to their toxic effects, the mouse and rat models are making a great contribution to the disciplines of environmental toxicology and medical health. However, the toxic effects of MNPs have not been systematically summarized. Therefore, a systematic review and a meta-analysis of the toxic effects of MNPs on mouse/rat models were conducted. A total of seven main categories were established in this systematic review, and 24 subcategories were further divided according to the specific physiological significance of the endpoint or the classification of the physiological system, which covered all the selected pieces of literature. A total of 1,762 biological endpoints were found, and 52.78% of them were significantly affected. This fact indicates that there are relative factors, including the size, polymer type, concentration, and exposure time of MNPs and different sexes of mouse/rat models that could significantly affect the biological endpoints. These biological endpoints can be classified into various factors, such as the dose-response relationships between MNP concentration and physiological categories of the nervous system, growth, reproduction, digestive tract histopathology, and inflammatory cytokine level, among others. MNPs negatively affected the blood glucose metabolism, lipid metabolism, and reproductive function in mice. The reproductive function in male mice is more sensitive to the toxic effects of MNPs. These findings also provide insights into and directions for exploring the evidence and mechanisms of the toxic effects of MNPs on human health. It is clear that more research is required on the pathological mechanisms at the molecular level and the long-term effects of tissue accumulation.

Naringin Alleviates Glucose-Induced Aging by Reducing Fat Accumulation and Promoting Autophagy in Caenorhabditis elegans.

Naringin (Nar) is a dihydroflavonoid compound, widely found in citrus fruit and used in Chinese herbal medicine. As a phytochemical, it acts as a dietary supplement that can delay aging and prevent aging-related disease, such as obesity and diabetes. However, its exact mechanism remains unclear. In this study, the high-glucose-induced (HGI) Caenorhabditis elegans model was used to evaluate the anti-aging and anti-obesity effects of Nar. The mean lifespan and fast movement span of HGI worms were extended roughly 24% and 11%, respectively, by Nar treatment. Oil red O staining revealed a significant reduction in fat accumulation and dFP::LGG-labeled worms showed the promotion of autophagy. Additionally, whole transcriptome sequencing and gene set variation analysis suggested that Nar upregulated the lipid biosynthesis and metabolism pathways, as well as the TGF-ß, Wnt and longevity signaling pathways. Protein-protein interaction (PPI) network analysis identified hub genes in these pathways for further analysis. Mutant worms and RNA interference were used to study mechanisms; the suppression of hlh-30, lgg-1, unc-51, pha-4, skn-1 and yap-1 disabled the fat-lowering, lifespan-prolonging, and health-promoting properties of Nar. Collectively, our findings indicate that Nar plays an important role in alleviating HGI-aging and anti-obesity effects by reducing fat accumulation and promoting autophagy.

The Topology of Polymer Brushes Determines Their Nanoscale Hydration.

Time-of-flight neutron reflectometry (ToF-NR) performed under different relative humidity conditions demonstrates that polymer brushes constituted by hydrophilic, cyclic macromolecules exhibit a more compact conformation with lower roughness as compared to linear brush analogues, due to the absence of dangling chain ends extending at the polymer-vapor interface. In addition, cyclic brushes feature a larger swelling ratio and an increased solvent uptake with respect to their linear counterparts as a consequence of the increased interchain steric repulsions. It is proposed that differences in swelling ratios between linear and cyclic brushes come from differences in osmotic pressure experienced by each brush topology. These differences stem from entropic constraints. The findings suggest that to correlate the equilibrium swelling ratios at different relative humidity for different topologies a new form of the Flory-like expression for equilibrium thicknesses of grafted brushes is needed.

Molecular insights on the crystalline cellulose-water interfaces via three-dimensional atomic force microscopy.

Cellulose, a renewable structural biopolymer, is ubiquitous in nature and is the basic reinforcement component of the natural hierarchical structures of living plants, bacteria, and tunicates. However, a detailed picture of the crystalline cellulose surface at the molecular level is still unavailable. Here, using atomic force microscopy (AFM) and molecular dynamics (MD) simulations, we revealed the molecular details of the cellulose chain arrangements on the surfaces of individual cellulose nanocrystals (CNCs) in water. Furthermore, we visualized the three-dimensional (3D) local arrangement of water molecules near the CNC surface using 3D AFM. AFM experiments and MD simulations showed anisotropic water structuring, as determined by the surface topologies and exposed chemical moieties. These findings provide important insights into our understanding of the interfacial interactions between CNCs and water at the molecular level. This may allow the establishment of the structure-property relationship of CNCs extracted from various biomass sources.

The relationship between anthropometric indicators and health-related quality of life in a community-based adult population: A cross-sectional study in Southern China.

Background: This study was designed to analyze the relationship of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), relative fat mass (RFM), lipid accumulation product (LAP) and health-related quality of life (HRQoL) in the community-dwelling population of southern China and to explore the independent contribution of socio-demographic characteristics, number of chronic diseases and anthropometric indicators to HRQoL in that population. Methods: This community-based cross-sectional survey studied 2,663 adults aged 18 years and older. HRQoL was assessed by the 3-level EuroQol 5-dimensional scale (EQ-5D-3L), and HRQoL were calculated using the Chinese EQ-5D-3L value set. The outcome variable was the EQ-5D-3L score (HRQoL). Cluster regression was used to analyse the independent contribution of each obesity indicator to HRQoL. Results: A total of 2,663 people participated in this study, and their mean EQ-5D-3L score was 0.938 ± 0.072. In this study, according to the results of the one-way ANOVA, HRQoL was significantly different between the groups of WHtR, WHR, RFM and LAP, respectively. The independent contributions of socio-demographic factors, number of chronic diseases and anthropometric measures to HRQoL in the whole population accounted for 76.2, 7.9, and 15.9% of the total effect, respectively. Conclusion: RFM and LAP were found to have a previously unreported negative impact on HRQoL in a community-dwelling population. In future studies, RFM and LAP could be used as new indicators of obesity to predict quality of life in humans.

Equity and efficiency of public hospitals' health resource allocation in Guangdong Province, China.

BACKGROUND: To better meet people's growing demand for medical and health services, 21 cities in Guangdong Province were involved in the reform of public hospitals in 2017. This paper evaluates the equity and efficiency of public hospitals' health resource allocation in Guangdong Province and explores ways to change the current situation. METHODS: Data were collected from the Guangdong Health Statistical Yearbook 2016-2020 and Guangdong Statistical Yearbook 2017-2021. The Gini coefficient (G), Theil index (T), and health resource density index (HRDI) were used to measure the equity of health resource allocation. An improved three-stage DEA method was applied in efficiency evaluation. The entropy weight method was employed to calculate the weight of different indicators to obtain a comprehensive indicator representing the overall volume of health resources in each city. A two-dimensional matrix was drawn between the HRDI of the comprehensive indicator and efficiency and the per capita government financial subsidies and efficiency to observe the coordination of equity and efficiency across regions. RESULTS: From 2016 to 2020, the G of public hospital, bed, and health technician allocation by population remained below 0.2, while that by geographical area ranged from 0.4 to 0.6; the G of government financial subsidies by population was above 0.4, while that by geographical area was greater than 0.7. The results for T showed that inequality mainly comes from intraregional differences, and the Pearl River Delta contributes most to the overall differences. Although the HRDI of the Pearl River Delta is far greater than that of other regions, obvious differences exist across cities in the region. Only 38.1% of cities were found to be efficient in 2020. The Pearl River Delta was in the first quadrant, and the other three regions were in the third quadrant, accounting for a large proportion. CONCLUSION: The equity of government financial subsidies allocation was the worst, and there were distinct regional differences in the geographical distribution of health resources. The development of healthcare within the Pearl River Delta was highly unbalanced. The development of healthcare was uneven between the Pearl River Delta, eastern, western, and mountainous regions. In addition, most cities in the eastern, western, and mountainous regions bore the dual pressures of relatively insufficient health resources and inefficiency.

Association between environmental lead/cadmium co-exposure in drinking water and soil and type 2 diabetes mellitus/obesity in Southern China.

Lead (Pb) and cadmium (Cd) in environment can be directly absorbed by drinking water and soil. However, data on human Pb and Cd exposure by drinking water and soil and its long-term consequence for type 2 diabetes mellitus (T2DM) and obesity are lacking. Our study aims to explore the association of typical heavy metals co-exposure in drinking water and soil to the community residents with T2DM and obesity indices in two cities of southern China. A cross-sectional study enrolling total 1,274 participants was performed and the local water and soil samples were collected in two communities in southern China. The average daily dose (ADD) of heavy metals was calculated to assess the exposure. The obesity indices comprise body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC). Binary, multiple logistic and linear regressions were employed for assessing the associations of Pb and Cd exposure with T2DM and obesity. The results showed that there weren't any significant correlations between ADDs of Pb/Cd and T2DM in community residents (all Ps>0.05). Compared with those with 18.5 ≤ BMI <24, with 1 µg/kg bw/d ADD of Pb increase in exposure are associated with 49.2-56.1% lower likelihood of overweight. Besides, with ADDs of Pb exposure was increased by 1 µg/kg bw/d and WHR decreasing by 0.01-0.02, and WC decreasing by 2.22-4.67 cm. We speculate that Pb causes weight loss because it damages the absorption function of the gastrointestinal tract as an initial injury. 1µg/kg bw/d ADD of Cd increase is associated with 100.9% upper likelihood of low weight in Model 1. It suggests that Pb/Cd pollution in the local environment was serious and harmful to residents' health. Government should introduce relevant oversight and accountability systems to improve the prevention and management of lifestyle-related chronic diseases in the future.

Melt Electrowriting of Graded Porous Scaffolds to Mimic the Matrix Structure of the Human Trabecular Meshwork.

The permeability of the human trabecular meshwork (HTM) regulates eye pressure via a porosity gradient across its thickness modulated by stacked layers of matrix fibrils and cells. Changes in HTM porosity are associated with increases in intraocular pressure and the progress of diseases such as glaucoma. Engineered HTMs could help to understand the structure-function relation in natural tissues and lead to new regenerative solutions. Here, melt electrowriting (MEW) is explored as a biofabrication technique to produce fibrillar, porous scaffolds that mimic the multilayer, gradient structure of native HTM. Poly(caprolactone) constructs with a height of 125-500 µm and fiber diameters of 10-12 µm are printed. Scaffolds with a tensile modulus between 5.6 and 13 MPa and a static compression modulus in the range of 6-360 kPa are obtained by varying the scaffold design, that is, the density and orientation of the fibers and number of stacked layers. Primary HTM cells attach to the scaffolds, proliferate, and form a confluent layer within 8-14 days, depending on the scaffold design. High cell viability and cell morphology close to that in the native tissue are observed. The present work demonstrates the utility of MEW for reconstructing complex morphological features of natural tissues.

Probing the Structural Details of Chitin Nanocrystal-Water Interfaces by Three-Dimensional Atomic Force Microscopy.

Chitin is one of the most abundant and renewable natural biopolymers. It exists in the form of crystalline microfibrils and is the basic structural building block of many biological materials. Its surface crystalline structure is yet to be reported at the molecular level. Herein, atomic force microscopy (AFM) in combination with molecular dynamics simulations reveals the molecular-scale structural details of the chitin nanocrystal (chitin NC)-water interface. High-resolution AFM images reveal the molecular details of chitin chain arrangements at the surfaces of individual chitin NCs, showing highly ordered, stable crystalline structures almost free of structural defects or disorder. 3D-AFM measurements with submolecular spatial resolution demonstrate that chitin NC surfaces interact strongly with interfacial water molecules creating stable, well-ordered hydration layers. Inhomogeneous encapsulation of the underlying chitin substrate by these hydration layers reflects the chitin NCs' multifaceted surface character with different chain arrangements and molecular packing. These findings provide important insights into chitin NC structures at the molecular level, which is critical for developing the properties of chitin-based nanomaterials. Furthermore, these results will contribute to a better understanding of the chemical and enzymatic hydrolysis of chitin and other native polysaccharides, which is also essential for the enzymatic conversion of biomass.

Poly(sulfobetaine)-Based Diblock Copolymer Thin Films in Water/Acetone Atmosphere: Modulation of Water Hydration and Co-nonsolvency-Triggered Film Contraction.

The water swelling and subsequent solvent exchange including co-nonsolvency behavior of thin films of a doubly thermo-responsive diblock copolymer (DBC) are studied via spectral reflectance, time-of-flight neutron reflectometry, and Fourier transform infrared spectroscopy. The DBC consists of a thermo-responsive zwitterionic (poly(4-((3-methacrylamidopropyl) dimethylammonio) butane-1-sulfonate)) (PSBP) block, featuring an upper critical solution temperature transition in aqueous media but being insoluble in acetone, and a nonionic poly(N-isopropylmethacrylamide) (PNIPMAM) block, featuring a lower critical solution temperature transition in water, while being soluble in acetone. Homogeneous DBC films of 50-100 nm thickness are first swollen in saturated water vapor (H2O or D2O), before they are subjected to a contraction process by exposure to mixed saturated water/acetone vapor (H2O or D2O/acetone-d6 = 9:1 v/v). The affinity of the DBC film toward H2O is stronger than for D2O, as inferred from the higher film thickness in the swollen state and the higher absorbed water content, thus revealing a pronounced isotope sensitivity. During the co-solvent-induced switching by mixed water/acetone vapor, a two-step film contraction is observed, which is attributed to the delayed expulsion of water molecules and uptake of acetone molecules. The swelling kinetics are compared for both mixed vapors (H2O/acetone-d6 and D2O/acetone-d6) and with those of the related homopolymer films. Moreover, the concomitant variations of the local environment around the hydrophilic groups located in the PSBP and PNIPMAM blocks are followed. The first contraction step turns out to be dominated by the behavior of the PSBP block, whereas the second one is dominated by the PNIPMAM block. The unusual swelling and contraction behavior of the latter block is attributed to its co-nonsolvency behavior. Furthermore, we observe cooperative hydration effects in the DBC films, that is, both polymer blocks influence each other's solvation behavior.

The function and regulation network mechanism of circRNA in liver diseases.

Circular RNA (circRNA), a new type of endogenous non-coding RNA, is abundantly present in eukaryotic cells, and characterized as stable high conservation and tissue specific expression. It has been generated increasing attention because of their close association with the progress of diseases. The liver is the vital organ of humans, while it is prone to acute and chronic diseases due to the influence of multiple pathogenic factors. Moreover, hepatocellular carcinoma (HCC) is the one of most common cancer and the leading cause of cancer death worldwide. Overwhelming evidences indicate that some circRNAs are differentially expressed in liver diseases, such as, HCC, chronic hepatitis B, hepatic steatosis and hepatoblastoma tissues, etc. Additionally, these circRNAs are related to proliferation, invasion, migration, angiogenesis, apoptosis, and metastasis of cell in liver diseases and act as oncogenic agents or suppressors, and linked to clinical manifestations. In this review, we briefly summarize the biogenesis, characterization and biological functions, recent detection and identification technologies of circRNA, and regulation network mechanism of circRNA in liver diseases, and discuss their potential values as biomarkers or therapeutic targets for liver diseases, especially on HCC.

[Clinical Analysis of Bloodstream Infection after Hematopoietic Stem Cell Transplantation].

OBJECTIVE: To analyze the clinical characteristics of bloodstream infection (BSI) in patients treated by hematopoietic stem cell transplantation (HSCT). METHODS: The clinical characteristics, distribution of pathogenic bacteria causing BSI and drug sensitivity of 910 patients treated by HSCT in our department from January 2013 to June 2020 were retrospectively analyzed. RESULTS: Among 910 HSCT patients, 111 patients were diagnosed as BSI within 100 days after transplantation, and 98 patients showed BSI during the period of agranulocytosis. Multivariate analysis showed that the usage of anti-thymocyte globulin (ATG), long duration of agranulocytosis and low infusion volume of mononuclear cell (MNC) were the independent risk factors affecting BSI after HSCT. Among 121 pathogenic bacteria isolated, 76 Gram-negative (G-) bacteria (62.8%), 40 Gram-positive (G+) bacteria (33.0%), and 5 fungi (4.1%) were detected out. The top three pathogens were Escherichia coli, Staphylococcus epidermidis and Pseudomonas aeruginosa. The drug-resistance rates of Escherichia coli and Klebsiella pneumoniae to carbapenems was 14.3% and 7.7%, respectively, and Pseudomonas aeruginosa was 66.7%. The susceptibility of G+ bacteria to vancomycin, linezolid and teicoplanin was 97.5%, 100% and 100%, respectively. The crude mortality rate of the patients with BSI at 100 days after HSCT was significantly higher than that of patients without BSI (P<0.001). CONCLUSION: The usage of ATG, long duration of agranulocytosis and low infusion volume of MNC are independent risk factors for BSI after HSCT. The pathogens after HSCT are mainly G- bacteria. Pseudomonas aeruginosa is highly resistant to carbapenems. Key words　　;

Comparison of several blood lipid-related indexes in the screening of non-alcoholic fatty liver disease in women: a cross-sectional study in the Pearl River Delta region of southern China.

BACKGROUND: Lipid metabolism disorders play a critical role in the progression of non-alcoholic fatty liver disease (NAFLD). However, the number of studies on the relationships among blood lipid-related indexes and NAFLD is limited, and few studies have emphasized the comparison of blood lipid-related indexes in the same population to identify the optimal index for NAFLD screening. This study aimed to investigate the relationships among several blood lipid-related indexes and NAFLD, and to find the index with the best screening value for NAFLD. METHODS: Based on a general health examination at community health service agencies in the Pearl River Delta region of China in 2015, 3239 women were recruited in this cross-sectional study. The relationships among blood lipid-related indexes and NAFLD were assessed separately by constructing multivariate logistic regression models. Receiver operating characteristic analysis was used to evaluate and compare the screening abilities of the indexes for NAFLD. All data analyses were conducted in SPSS and MedCalc software. RESULTS: Whether in the crude model or each model adjusted for possible confounding factors, the risk of NAFLD significantly rose with increasing cardiometabolic index (CMI), triglyceride glucose index (TyG), triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C), total cholesterol (TC) to HDL-C ratio (TC/HDL-C) and low-density lipoprotein (LDL-C) to HDL-C ratio (LDL-C/HDL-C). Moreover, the area under the curve (AUC) of CMI was 0.744, which was better than that of TyG (0.725), TG/HDL-C (0.715), TC/HDL-C (0.650), and LDL-C/HDL-C (0.644) (P < 0.001). In addition, the optimal cut-off points were 0.62 for CMI, 8.55 for TyG, 1.15 for TG/HDL-C, 4.17 for TC/HDL-C, and 2.22 for LDL-C/HDL-C. CONCLUSIONS: CMI is easy to obtain, is a recommended index in the screening of NAFLD in women and may be useful for detecting populations that are at high risk of NAFLD.

The Construction and Analysis of ceRNA Network and Immune Infiltration in Kidney Renal Clear Cell Carcinoma.

Background: Kidney renal clear cell carcinoma (KIRC) has the highest invasion, mortality and metastasis of the renal cell carcinomas and seriously affects patient's quality of life. However, the composition of the immune microenvironment and regulatory mechanisms at transcriptomic level such as ceRNA of KIRC are still unclear. Methods: We constructed a ceRNA network associated with KIRC by analyzing the long non-coding RNA (lncRNA), miRNA and mRNA expression data of 506 tumor tissue samples and 71 normal adjacent tissue samples downloaded from The Cancer Genome Atlas (TCGA) database. In addition, we estimated the proportion of 22 immune cell types in these samples through "The Cell Type Identification by Estimating Relative Subsets of RNA Transcripts." Based on the ceRNA network and immune cells screened by univariate Cox analysis and Lasso regression, two nomograms were constructed to predict the prognosis of patients with KIRC. Receiver operating characteristic curves (ROC) and calibration curves were employed to assess the discrimination and accuracy of the nomograms. Consequently, co-expression analysis was carried out to explore the relationship between each prognostic gene in a Cox proportional hazards regression model of ceRNA and each survival-related immune cell in a Cox proportional hazards regression model of immune cell types to reveal the potential regulatory mechanism. Results: We established a ceRNA network consisting of 12 lncRNAs, 25 miRNAs and 136 mRNAs. Two nomograms containing seven prognostic genes and two immune cells, respectively, were successfully constructed. Both ROC [area under curves (AUCs) of 1, 3, and 5-year survival in the nomogram based on ceRNA network: 0.779, 0.747, and 0.772; AUCs of 1, 3, and 5-year survivals in nomogram based on immune cells: 0.603, 0.642, and 0.607] and calibration curves indicated good accuracy and clinical application value of both models. Through co-correlation analysis between ceRNA and immune cells, we found both LINC00894 and KIAA1324 were positively correlated with follicular helper T (Tfh) cells and negatively correlated with resting mast cells. Conclusion: Based on the ceRNA network and tumor-infiltrating immune cells, we constructed two nomograms to predict the survival of KIRC patients and demonstrated their value in improving the personalized management of KIRC.

Association between sleep quality and central obesity among southern Chinese reproductive-aged women.

BACKGROUND: The connections between sleep quality and central obesity among reproductive-aged women are not clear. The study aimed to explore the association between sleep quality and central obesity among Chinese reproductive-aged women and identify the independent contributions of sociodemographic characteristics, health-related factors, and sleep quality to central obesity. METHODS: In this cross-sectional survey, the minimal sample sizes were 2404 subjects; 2449 Chinese women aged 18-49 participated in this study. Sleep quality was assessed by the Chinese version of the Pittsburgh Sleep Quality Index (PSQI). Central obesity as the outcome of interest was a binary variable; women were categorized as with versus without central obesity measured by waist circumference (WC). The independent contribution of sociodemographic characteristics (Cluster 1), health-related variables (Cluster 2), and sleep quality (Cluster 3) to central obesity was derived from the corresponding R2 change (individual R2 change/total R2 × 100%), using clustered multiple logistic regression analyses. RESULTS: The risk of central obesity increased significantly with poor sleep quality (assessed by global PSQI score) [adjusted odds ratio (OR) = 2.20 per SD increase; 95% confidence interval (CI) = 1.28-3.78; P = 0.004], increased sleep disturbance score (adjusted OR = 1.11 per SD increase; 95% CI = 1.01-1.22; P = 0.042) and decreased subjective sleep quality score (adjusted OR = 0.81 per SD increase; 95% CI = 0.73-0.90; P < 0.001). The independent contribution of sleep quality was 9.9%, less than those of sociodemographic (73.3%) and health-related (16.8%) variables. Among complaints related to sleep disturbance, the inability to breathe comfortably, and having bad dreams showed significant associations with central obesity. CONCLUSIONS: There exists some degree of correlation between sleep quality and central obesity among Chinese reproductive-aged women. These findings underscore the need for future public health guidelines to formulate some detailed strategies to improve sleep quality, such as preventing and intervening risk factors that influence sleep quality and suggesting optimal sleep duration, which might effectively reduce the incidence of central obesity in this population group.

The Review of Anti-aging Mechanism of Polyphenols on Caenorhabditis elegans.

Micronutrients extracted from natural plants or made by biological synthesis are widely used in anti-aging research and applications. Among more than 30 effective anti-aging substances, employing polyphenol organic compounds for modification or delaying of the aging process attracts great interest because of their distinct contribution in the prevention of degenerative diseases, such as cardiovascular disease and cancer. There is a profound potential for polyphenol extracts in the research of aging and the related diseases of the elderly. Previous studies have mainly focused on the properties of polyphenols implicated in free radical scavenging; however, the anti-oxidant effect cannot fully elaborate its biological functions, such as neuroprotection, Aß protein production, ion channel coupling, and signal transduction pathways. Caenorhabditis elegans (C. elegans) has been considered as an ideal model organism for exploring the mechanism of anti-aging research and is broadly utilized in screening for natural bioactive substances. In this review, we have described the molecular mechanisms and pathways responsible for the slowdown of aging processes exerted by polyphenols. We also have discussed the possible mechanisms for their anti-oxidant and anti-aging properties in C. elegans from the perspective of different classifications of the specific polyphenols, such as flavonols, anthocyanins, flavan-3-ols, hydroxybenzoic acid, hydroxycinnamic acid, and stilbenes.