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Contextualização: A melatonina é um hormônio endógeno encontrado em quase todos os organismos e participa de vários processos fisiológicos. A suplementação de melatonina tem sido preconizada na mídia para o tratamento e prevenção de várias doenças. Entretanto, há carência de informações científicas disponíveis sobre seu real benefício para a saúde. Objetivos: Sumarizar as evidências de revisões sistemáticas da Cochrane, referentes à efetividade das intervenções com suplementação de melatonina em humanos. Métodos: Trata-se de overview de revisões sistemáticas Cochrane. Procedeu-se à busca na Cochrane Library (2023), sendo utilizado o descritor "MELATONIN". Todas as revisões sistemáticas de ensaios clínicos foram incluídas. O desfecho primário de análise foi a melhora clínica, a redução dos sintomas ou a prevenção da doença. Resultados: Oito estudos foram incluídos, totalizando 53 ensaios clínicos e 4.024 participantes. Houve evidência de efetividade apenas para controle de ansiedade em pacientes em pré-operatório (evidência moderada) em comparação com placebo e para prevenção e tratamento de jet lag de fuso horário (evidência alta de certeza). Discussão: Embora seja muito veiculada na mídia, a suplementação de melatonina carece de estudos de qualidade para análise de sua efetividade. Os estudos clínicos disponíveis até o momento são heterogêneos e apresentam limitações metodológicas. Poucas análises convergem com segurança para um bom nível de evidência que permita sua recomendação. Conclusão: Não há suporte com bom nível de evidência atualmente para a maioria das intervenções com suplementação de melatonina, sendo recomendada a realização de novos estudos prospectivos para melhor robustez dos achados e análises.
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Systematic Review , Melatonin , Primary Prevention , Therapeutics , Clinical TrialABSTRACT
Background Affected by concentration, composition, and population tolerance of air pollutants, the relationship between air pollutants and population health has regional differences. There is still a research gap in Guiyang. Objective To explore the short-term effects of air pollutant concentrations in low-pollution areas on the outpatient volume of respiratory diseases. Methods Spearman correlation analysis was used to evaluate the correlation between air pollutants, meteorological factors, and respiratory outpatient volume from January 1, 2013 to December 31, 2020 in Guiyang City. A single pollutant distribution lag nonlinear model and a multi-pollutant interaction model were established based on Poisson distribution. A three-dimensional diagram was drawn to display the relationship between air pollutants and respiratory outpatient volume. Quantitative analysis was conducted on the attribution risk and lag effect of air pollutant concentration on outpatient volume of respiratory diseases in Guiyang City. Results The results of the single pollutant model showed that fine particulate matter (PM2.5), nitrogen dioxide (NO2), carbon monoxide (CO), and sulfur dioxide (SO2) elevated the outpatient volume of respiratory diseases. The maximum relative risk (RR) and 95%CI values of PM2.5, NO2,CO, and SO2 appeared on Day 2, 0, 5, and 6, respectively, which were 1.019 (1.015, 1.023), 1.146 (1.122, 1.171), 1.129 (1.116, 1.143), and 1.046(1.040, 1.052), respectively. For every quartile concentration increment of PM2.5, NO2, CO, or SO2, the outpatient volume of respiratory diseases increased by 0.943% (0.111%, 1.782%), 4.050% (3.573%, 4.529%), 0.595% (0.317%, 0.874%), or 0.667% (0.235%, 1.100%), respectively. The maximum RR (95%CI) of O3 was 1.015 (1.007, 1.023) and appeared on Day 0. The results of multi-pollutant model showed that PM2.5, NO2, CO, SO2, and O3 all elevated the outpatient volume of respiratory diseases. The maximum RR values of PM2.5, NO2, CO, SO2 and O3 appeared on Day 14, 0, 5, 7 and 0, respectively, which were 1.027 (1.021, 1.034), 1.213 (1.179, 1.248), 1.059 (1.043, 1.074), 1.016 (1.005, 1.026), and 1.024 (1.015, 1.033), respectively. Compared with the single pollutant model, the RR values of PM2.5, NO2, and O3 on the outpatient volume of respiratory diseases in the multi-pollutant model showed an upward trend, while the RR values of CO and SO2 in the multi-pollutant model showed a downward trend. Conclusion The impact of low concentrations of PM2.5, NO2, CO, and SO2 on human health cannot be ignored.
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Ocular accommodation refers to the process by which the ciliary muscle creates a clear image of the object in the retina by changing the refractive power of the lens. When the accommodation ability of the eye is insufficient, the imaging focus falls on the region behind the retina and hyperopic defocus is easily formed, resulting in axial growth and leading to the development of myopia, and it is found that most myopic patients usually have some accommodation dysfunction. Myopia has become a public health problem in China, and the prevalence of adolescents has increased dramatically. How to prevent and stop the occurrence and development of myopia is a major challenge. Previous studies have found that ocular accommodation dysfunction is associated with the occurrence and development of myopia, and the measurement of parameters related to accommodation function has certain guiding significance for the prevention and control of myopia. The purpose of this paper is to review the correlation between myopia and ocular accommodation function, with a view to providing new ideas for the prevention, control and treatment of myopia.
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Resumen El sistema circadiano está sincronizado al ciclo luz-oscuridad que es generado por la rotación de la tierra, asegurando que la vigilia sea durante el día y que el sueño ocurra durante la noche. Sin embargo, el ritmo de sueño-vigilia puede estar desincronizado del ciclo luz-oscuridad o desincronizado de manera endógena, dando como resultado: insomnio, fatiga y bajo rendimiento en las actividades cotidianas. Mientras que los trastornos del sueño están clasificados por la Asociación Americana de Trastornos del Sueño como: disomnias intrínsecas, disomnias extrínsecas, parasomnias o trastornos del sueño médicos/psiquiátricos. Los trastornos circadianos del sueño se han categorizado por separado, en parte para reconocer que en la mayoría de los casos la etiología de los trastornos circadianos es una mezcla de factores internos y ambientales, o por un desajuste temporal entre ambos. Los síntomas generalmente son insomnio o hipersomnia, síntomas comunes en pacientes con trastornos circadianos del sueño, aunque hay otras causas a las que pueden atribuirse y que deben excluirse antes de realizar el diagnóstico de un trastorno circadiano del sueño. En el paciente sin otra patología del sueño, un registro diario de actividades, comidas, ejercicio, siestas y la hora de acostarse es una herramienta esencial para evaluar los trastornos circadianos del sueño. Estos registros deben mantenerse durante 2 semanas o más, ya que una perturbación debida a cambios de trabajo o viajes a través de zonas horarias puede tener efectos sobre el sueño y el estado de alerta durante el día, semanas después del evento.
Abstract The circadian system is synchronized to the light-dark cycle generated by the rotation of the earth, ensuring that wakefulness is during the day and sleep occurs at night. However, the sleep-wake rhythm may be out of sync with the light-dark cycle or endogenously out of sync, resulting in insomnia, fatigue, and poor performance in activities of daily living. Sleep disorders are classified by the American Sleep Disorders Association, as intrinsic dyssomnias, extrinsic dyssomnias, parasomnias, or medical/psychiatric sleep disorders. Circadian sleep disorders have been categorized separately to recognize that in most cases the etiology of circadian disturbances is a mix of internal and environmental factors or a temporary mismatch between the two. Symptoms are usually insomnia or hypersomnia, common symptoms in patients with circadian sleep disorders although other causes can be attributed and must be excluded before a diagnosis of a circadian sleep disorder is made. In the patient without other sleep pathology, a daily record of activities, meals, exercise, naps, and bedtime is an essential tool in assessing circadian sleep disorders. These records should be kept for 2 weeks or more, as a disturbance due to job changes or travel across time zones can have effects on sleep and daytime alertness weeks after the event.
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Objective To analyze the relationship between diurnal temperature range (DTR) and the hospitalization of stroke in Lanzhou,so as to provide a scientific basis for probing into the mechanism of temperature changes in inducing stroke and formulating comprehensive prevention and control measures for stroke by relevant departments.Methods The information of the patients hospitalized due to stroke in Lanzhou during January 2014 to December 2019 and the air pollutants (PM10,SO2,and NO2) and meteorological data in the same period were collected for statistical analysis.Spearman rank correlation analysis was performed to analyze the correlations between air pollutants and meteorological factors.The distributed lag nonlinear model was adopted to fit the relationship between DTR and the number of stroke inpatients,and three-dimensional diagrams and the correlation diagrams of DTR against stroke risk were established.The stratified analysis was performed according to gender and age (< 65 years and ≥65 years).Results From 2014 to 2019,a total of 92 812 stroke patients were hospitalized in Lanzhou,with a male-to-female ratio of 1.35:1.There was a nonlinear relationship between DTR and the number of stroke inpatients in Lanzhou,which presented a lag effect.The low DTR at 4.5 ℃ had the largest RR value of 1.25 (95%CI=1.16-1.35) for stroke inpatients at a cumulative lag of 18 d.The effect of high DTR (18.5 ℃) on the hospitalization of stroke patients peaked at a cumulative lag of 21 d,with an RR value of 1.09 (95%CI=1.01-1.18).The stratified analysis results suggested that low levels of DTR had greater effects on the hospitalization of male stroke patients and stroke patients <65 years.Conclusions Short-term exposure to different levels of DTR had an impact on the number of stroke inpatients,and low levels of DTR had a slightly greater impact on stroke inpatients than high levels of DTR.Importance should be attached to the protection of males and people aged <65 years at low levels of DTR.
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Humans , Male , Female , Temperature , Stroke , Cold Temperature , Hot Temperature , Air Pollutants , China/epidemiologyABSTRACT
Objective:To investigate the correlation between atmospheric particulate matter 2.5 (PM 2.5) concentration and the number of chronic kidney disease (CKD) hospital admissions in the elderly in Taiyuan city. Methods:The atmospheric PM 2.5 concentration in Taiyuan city during 2019—2021 was used as the environmental exposure data, and the number of CKD admission of the elderly patients (> 60 years old) in Taiyuan city at the same time was used as the disease progression index. The distributed lag nonlinear model was used to analyze overall and lag effects of PM 2.5 average daily concentration on the elderly patients admitted to CKD. Results:A total of 6 037 cases elderly patients with CKD admitted to hospital were included, with a male-to-female ratio of 1.36∶1. The average daily concentration of PM 2.5 was 52.80 μg/m 3, which did not exceed China's air quality standard (75 μg/m3); But in autumn and winter, the average daily concentration of PM 2.5 significantly exceeded the normal reference value, with the highest value reaching 302 μg/m 3. The relationship between the average daily concentration of PM 2.5 and the number of elderly patients admitted to CKD was nonlinear and there was a lag effect. The relative risk ( RR) value reached the maximum when PM 2.5 average daily concentration was 87 μg/m 3 with lag time of 11 days [1.074(95% CI 1.018-1.321)]. The subgroup analysis results showed that the risk of admission of elderly female CKD patients was higher than that of male patients with lag time of 10 days, and the RR was 1.073(95% CI 1.001-1.151). Elderly CKD patients with hypertension (PM 2.5 87 μg/m 3) and diabetes (PM 2.5 88 μg/m 3) had a higher risk of admission when exposed to PM 2.5, with maximum RR values of 1.067(95% CI 1.002-1.136) and 1.162(95% CI 1.021-1.320), respectively. Conclusions:High atmospheric PM 2.5 concentration in Taiyuan city can increase the risk of admission in elderly patients with CKD, especially in women and patients with hypertension or diabetes.
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Most literature defines knee extension lag as the failure of the knee joint to achieve the passive extension angle, and some literature defines the inability of the knee to complete the last 15° extension as knee extension lag. Extension lag is one of the common complications after knee surgery, which seriously affects the postoperative knee joint function of patients. Disuse atrophy due to prolonged postoperative bed rest, arthrogenic muscle inhibition due to pain and (or) swelling, direct injury to the knee extensor mechanism during surgery and nerve dysfunction of the quadriceps muscle can all contribute to extension lag. While rehabilitation exercises, physical therapy and medication can significantly improve the patient's symptoms, extension lag due to the knee extension device injury requires surgery if necessary to regain normal knee function. As surgical techniques continue to be refined and rehabilitation interventions advance, the prevention of extension lag and the minimization of angle of knee extension lag need to be given adequate attention by patients, physicians, and researchers. This article reviews clinical studies related to extension lag after knee surgery, focusing on etiology, treatment, prevention and prognosis, with the aim of providing a basis and guidance for the current clinical management.
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Objective:To explore the relationship among physical exercise, self-control, and mobile phone dependence in adolescents.Methods:The entire group of random sampling method was used to extract 882 students from five junior high schools in Nanchang city from September 2020 to March 2021.A longitudinal survey was conducted using the sports activity rating scale, self control scale, and adolescent mobile phone dependence scale on all participants for 2 times with an interval for 6 months.The questionnaire results in the first stage were marked as T1.The questionnaire results in the second stage were marked as T2.SPSS 26.0 statistical software was used to conduct reliability analysis, common method bias test and Pearson correlation analysis on each variable in sequence.AMOS 23.0 was used for cross-lag analysis to explore the relationship among physical exercise, self-control and mobile phone dependence.Results:The score of physical exercise of adolescents was (17.71±5.62), the score of self-control was (51.48±9.71), and the score of mobile phone dependencies was (56.67±12.93). Adolescent physical exercise, self-control, and mobile phone dependence were all related to stability across time.There were positive correlation between T1 physical exercise and T2 physical exercise ( r=0.489), T1 self-control and T2 self-control ( r=0.482), as well as T1 mobile phone dependencies and T2 mobile phone dependencies ( r=0.498)(all P<0.01). Cross-lag analysis showed that: adolescent physical exercise behavior could unidirectionally predict self-control( β=0.197, P<0.01)and mobile phone dependence( β=-0.224, P<0.01) after 6 months, and self-control could predict the mobile phone dependence( β=-0.560, P<0.01) of junior high school students after 6 months.The mediating effect results showed that self-control had a mediating effect between physical exercise and mobile phone dependence of junior high school students, there were gender differences.The mediating effect accounted for 22.22%(-0.018/-0.081). Conclusion:Physical exercise can indirectly reduce the mobile phone dependence of junior high school students by affecting self-control.
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Objective To explore the effect of temperature on the risk of hand-foot-and-mouth disease (HFMD) and population susceptibility. Methods The data of HFMD cases in Chengdu from January 1, 2016 to October 31, 2022 were collected, and local meteorological data during the same period were also collected. Distributional lag nonlinear models were developed. The relative risk (RR) of morbidity at different temperatures and different lags was calculated. Differences in the relative risk levels of different populations were analyzed and compared. Results A total of 263 776 cases of HFDM were reported in Chengdu during the study period. The distribution of HFMD was periodic. For the overall population, the short-term average temperature and RR showed a “U”-shaped relationship. When the lag time was 0-7 days, the cumulative RR was 1.59 (95%CI: 1.18-2.14) at the average temperature of -0.5℃ and 2.16 (95%CI: 1.60-2.91) at the average temperature of 34.5℃. The RR values under high and low temperatures decreased with increasing lag period. When the lag time was extended, the average temperature and RR showed an inverted “U”-shaped relationship, with higher RR at moderate temperatures and increasing as the lag period increased. The results of the subgroups showed that the RR of onset among scattered children was higher at high and low temperatures. Conclusion The risk effect of temperature on the onset of HFMD in different populations is variable and changes with the lag period, and the prevention and control measures should be adjusted in a timely and targeted manner.
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Objective@#To examine the effect of temperature on the risk of varicella in Lu'an City, Anhui Province, so as to provide insights into varicella prevention and control. @*Methods@#Data on incidence of varicella in Lu'an City from 2010 to 2021 were collected from Chinese Disease Prevention and Control System, and meteorological data in Lu'an City were also collected from National Meteorological Science Data Center and China National Urban Air Quality Real-Time Publishing Platform during the same period. The effect of temperature on the risk of varicella was examined using a distributed lag non-linear model (DLNM) and subgroup analyses for gender and age were conducted. The effects of extremely low and high temperatures on the cumulative risk of varicella and trends in the cumulative risk of varicella over time were analyzed using a time-varying DLNM. @*Results@# Totally 25 318 varicella cases were reported in Lu'an City from 2010 to 2021, including 15 013 men (59.30%) and 10 305 women (40.70%). The median number of varicella cases was 4 (interquartile range, 6) cases, and the daily median air temperature was 17.50 (interquartile range, 15.80) ℃, with the lowest temperature recorded as -5.80 ℃ and the highest temperatures as 34.90 ℃. The results from the DLNM showed that the extremely low temperatures reduced the risk of varicella (RR=0.522, 95%CI: 0.375-0.728) in relative to median temperature, while extremely high temperature increased the risk of varicella (RR=1.604, 95%CI: 1.112-2.316). Subgroup analysis revealed the effect curve for men was similar to total populations (extremely low temperature: RR=0.497, 95%CI: 0.331-0.746; extremely high temperature: RR=1.978, 95%CI: 1.260-3.106), and the effect of temperature on varicella risk was mainly concentrated among children at ages of 6 to 12 years (extremely low temperature: RR=0.426, 95%CI: 0.247-0.736; extremely high temperature: RR=2.431, 95%CI: 1.378-4.288). The results from the time-varying DLNM revealed that the cumulative risk of varicella due to both extremely low and high temperatures appeared a tendency towards a rise over years (P<0.05). @*Conclusions@#Low temperature may reduce the risk of varicella, while high temperature increases the risk of varicella in Lu'an City, which is more remarkable among men and children at ages of 6 to 12 years. The cumulative risk of varicella at both extremely low and high temperatures shows a tendency towards a rise over years.
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Objective To investigate the effect of diurnal temperature difference on hospitalization volume of patients with cardiovascular and cerebrovascular diseases in Urumqi City. Methods The daily hospitalization data for cardiovascular and cerebrovascular diseases in Urumqi City from 2019-2021, and meteorological and pollutant data for the same period were collected. The relationship between diurnal temperature range and hospitalizations for cardiovascular and cerebrovascular diseases was analyzed using a distribution lag non-linear model (DLNM), controlling for the long-term trends, the day-of-week effects and other factors. Results The greater the diurnal temperature range, the longer the lag time, and the higher the risk of hospitalization for cardiovascular and cerebrovascular diseases. The lag effect increased significantly when the maximum diurnal temperature range reached 21.0°C. The risk effect appeared on the day of exposure and lasted until day 20, with a maximum RR of 1.266 (95% CI: 1.129-1.421) at a lag of 13 days. At very high diurnal temperature range, the risk of hospitalization for cardiovascular and cerebrovascular diseases was higher in the cold season than that in the warm season. Results after stratified analysis by sex and age showed that men and people aged ≥65 years were more susceptible to diurnal temperature range. Conclusion Extremely high diurnal temperature range is a potential trigger for hospitalization for cardiovascular and cerebrovascular diseases in Urumqi. Men and people aged ≥65 years are more vulnerable to the impact of diurnal temperature range. In the cold season, more attention should be paid to protecting vulnerable people from the impact of the extremely high diurnal temperature difference.
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BACKGROUND@#Congenital heart disease (CHD) is one of the most common congenital malformations in humans. Inconsistent results emerged in the existed studies on associations between air pollution and congenital heart disease. The purpose of this study was to evaluate the association of gestational exposure to air pollutants with congenital heart disease, and to explore the critical exposure windows for congenital heart disease.@*METHODS@#The nested case-control study collected birth records and the following health data in Tianjin Women and Children's Health Center, China. All of the cases of congenital heart disease from 2013 to 2015 were selected matching five healthy controls for each case. Inverse distance weighting was used to estimate individual exposure based on daily air pollution data. Furthermore, the conditional logistic regression with distributed lag non-linear model was performed to identify the association between gestational exposure to air pollution and congenital heart disease.@*RESULTS@#A total of 8,748 mother-infant pairs were entered into the analysis, of which 1,458 infants suffered from congenital heart disease. For each 10 µg/m3 increase of gestational exposure to PM2.5, the ORs (95% confidence interval, 95%CI) ranged from 1.008 (1.001-1.016) to 1.013 (1.001-1.024) during the 1st-2nd gestation weeks. Similar weak but increased risks of congenital heart disease were associated with O3 exposure during the 1st week and SO2 exposure during 6th-7th weeks in the first trimester, while no significant findings for other air pollutants.@*CONCLUSIONS@#This study highlighted that gestational exposure to PM2.5, O3, and SO2 had lag effects on congenital heart disease. Our results support potential benefits for pregnancy women to the mitigation of air pollution exposure in the early stage, especially when a critical exposure time window of air pollutants may precede heart development.
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Infant , Pregnancy , Child , Humans , Female , Air Pollutants/analysis , Case-Control Studies , Prenatal Exposure Delayed Effects/epidemiology , Heart Defects, Congenital/etiology , China/epidemiology , Particulate Matter/adverse effects , Maternal Exposure/adverse effectsABSTRACT
OBJECTIVE@#To analyze the effect of lag screw and support plate through axillary approach for the treatment of Ideberg typeⅡscapular pelvis fracture.@*METHODS@#From January 2016 to June 2021, 26 patients with Ideberg typeⅡglenoid fractures were treated with trans-axillary lag screw combined with supporting plate, including 15 males and 11 females. The age ranged from 21 to 75 years, with an average of (43.12±6.56) years old. The Constant-Murley Shoulder joint Scale and University of California at Los Angeles (UCLA) score were used to evaluate the function and clinical efficacy of shoulder joint.@*RESULTS@#All patients were followed up, and the duration ranged from 19 to 42 months, with an average of (30.6±10.5) months. One year after surgery, the Constant-Murley score increased from preoperative 34.9±2.5(ranged, from 28 to 47) to 87.2±6.8(ranged, from 70 to 95). The UCLA score improved from preoperative 17.9±1.7(9 to 25) to 33.1±2.3(29 to 35). Seventeen patients got an excellent result, with 7 good, and 2 fair. None of the patients had infection, screw, and plate loosening, fracture, and other complications after surgery. Two patients had different degrees of Chronic pain in the shoulder during the follow-up period.@*CONCLUSION@#The treatment of Ideberg typeⅡscapular glenoid fractures through axillary approach with lag screws and supporting steel plates has the advantages of convenient exposure, direct visual restoration of the normal anatomical shape of the scapular glenoid, selection of suitable positions for screw and steel plate placement, achieving better treatment results, and fewer complications. It is an effective and reliable surgical method.
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Female , Male , Humans , Young Adult , Adult , Middle Aged , Aged , Scapula , Bone Plates , Bone Screws , Fractures, Bone , Steel , PelvisABSTRACT
Triple-negative breast cancer (TNBC) accounts for approximately 15%–20% of all breast cancers. Patients with TNBC have a rapidly progressive clinical course, an earlier age of onset, faster distant recurrence, and more common visceral metastases as compared with other subtypes. However, treatment of TNBC is often limited to chemotherapy and has a poor prognosis. Therefore, developing the best treatment strategy for patients is essential to reduce the burden of disease caused by TNBC. Various potential available drug targets have been discovered, as well as precision treatment and classified treatment are changing the clinical practice of TNBC, thereby indicating a new therapeutic area for TNBC in addition to traditional chemotherapy. This article reviews the systemic treatment options for TNBC in recent years, including immunotherapy and targeted therapy.
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Background: SNORE (Sleep deprivation among Night shift health staff On Rotation-Evaluation) study is conceptualized to study the effects of sleep deprivation on healthcare professionals working night shifts on rotation. Materials and Methods: A comparative cross-sectional study is devised including health-care profes-sionals working night shifts on rotation at a tertiary level health-care facility, using a semi-structured questionnaire which can test sleep deprivation, cognitive ability, and quality of life. The process is to ap-proach 309 probable study participants based on stratified random sampling, after exclusion of health-care professionals with other factors which may interfere with sleep deprivation testing. Discussion: The study protocol was set in such a way as to randomly include participants from all cadres of healthcare providers as per population proportion. By measuring the effects on cognitive effect and quality of life necessary steps can be taken to provide better quality of life and to decrease cognitive im-pairment, especially among health care professionals working night shifts.
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Aims: We aimed to determine whether lymphocyte activation gene 3 (LAG-3), also known as CD223, is associated with microvessel density (MVD) in primary hepatocellular carcinoma (HCC), as well as their clinical significance in predicting survival. Materials and methods: One hundred and twenty-seven patients were enrolled in the study. Samples were obtained on resection at the Department of Hepatobiliary Surgery of the Qingdao Municipal Hospital from June 2014 to June 2016. Immunohistochemistry was used to determine vessel density and LAG-3 abundance. Statistical analyses were performed to test for correlation of LAG-3 density and other clinicopathological variables with overall survival (OS). Results: High LAG-3 abundance was significantly correlated with increased MVD in primary HCC (P < 0.05). The ?2 test revealed a significant association of LAG-3 with preoperative AFP level, tumor diameter, N stage, and the presence of HBV infection (P < 0.05). Patients with high LAG-3 expression had shorter OS compared to those with low LAG-3 expression (P < 0.05). The Cox proportional hazards model showed that both higher LAG-3 and MVD density, age, the number of tumors, preoperative AFP level, tissue differentiation, Child–Pugh grade, and lymph node metastasis correlated with survival. Conclusions: High expression of LAG-3 is associated with angiogenesis and poor prognosis in HCC patients. With the deepening of research, LAG-3 is likely to become a novel biomarker for clinical diagnosis and prognosis and can even be a therapeutic target of HCC.
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BACKGROUND@#Although previous studies have shown that meteorological factors such as temperature are related to the incidence of bacillary dysentery (BD), researches about the non-linear and interaction effect among meteorological variables remain limited. The objective of this study was to analyze the effects of temperature and other meteorological variables on BD in Beijing-Tianjin-Hebei region, which is a high-risk area for BD distribution.@*METHODS@#Our study was based on the daily-scale data of BD cases and meteorological variables from 2014 to 2019, using generalized additive model (GAM) to explore the relationship between meteorological variables and BD cases and distributed lag non-linear model (DLNM) to analyze the lag and cumulative effects. The interaction effects and stratified analysis were developed by the GAM.@*RESULTS@#A total of 147,001 cases were reported from 2014 to 2019. The relationship between temperature and BD was approximately liner above 0 °C, but the turning point of total temperature effect was 10 °C. Results of DLNM indicated that the effect of high temperature was significant on lag 5d and lag 6d, and the lag effect showed that each 5 °C rise caused a 3% [Relative risk (RR) = 1.03, 95% Confidence interval (CI): 1.02-1.05] increase in BD cases. The cumulative BD cases delayed by 7 days increased by 31% for each 5 °C rise in temperature above 10 °C (RR = 1.31, 95% CI: 1.30-1.33). The interaction effects and stratified analysis manifested that the incidence of BD was highest in hot and humid climates.@*CONCLUSIONS@#This study suggests that temperature can significantly affect the incidence of BD, and its effect can be enhanced by humidity and precipitation, which means that the hot and humid environment positively increases the incidence of BD.
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Humans , Beijing/epidemiology , China/epidemiology , Dysentery, Bacillary/epidemiology , Humidity , TemperatureABSTRACT
Objective:To explore the lag effect and correlation between daily average temperature and the incidence of other infectious diarrhea in Hebei Province.Methods:The data of meteorological factors (including temperature and average daily temperature) and the daily incidence of other infectious diarrhea in Zhangjiakou City, Chengde City, Tangshan City, Qinhuangdao City, Baoding City, Langfang City, Cangzhou City, Shijiazhuang City, Hengshui City, Xingtai City, and Handan City in Hebei Province from 2017 to 2020 were collected. Eleven prefecture-level cities were divided into four regions, including east, north, middle and south regions. Distributed lag non-linear model was applied to examine the non-linear associations and the lag effect of daily mean temperature on daily incidence of other infectious diarrhea. Meanwhile, the cold and hot effects were used to estinuate the lag-response relationship on the incidence of other infectious diarrhea.Results:A total of 231 008 cases of other infectious diarrhea were reported in Hebei Province. The seasonal distribution was obvious, showing a bimodal distribution of large peaks in summer and small peaks in winter. An inverse S-shaped association between average daily temperature and cumulative risk ratio ( RR) of other infectious diarrhea was observed in Hebei Province. Both high temperature (higher than 27.50 ℃) and low temperature (less than 13.67 ℃) could increase the risk of other infectious diarrhea. When the temperature was lower than 13.00 ℃, the lag time and RR had a U-shaped association (lag four to seven days, 23 to 30 days). Meanwhile, when it was higher than 13.00 ℃, it had an inverted U-shaped association (lag 5 to 21 days). A comparison of four regions of Hebei Province showed that the lag time from south to north was extended from six days to 30 days at low temperature effects with temperature P5=-7.24 ℃. When the temperature getting hot ( P95=28.25 ℃), the risk occurred at lag 0 days, and the lag time gradually got short from north to south. Thus, the high temperature effect reached maximum quickly with a relative short duration. Conclusions:The inverse S-shaped non-linear association between daily average temperature and the incidence of other infectious diarrhea in Hebei Province is observed. Both low temperature and high temperature are associated with increased risk of other infectious diarrhea. But the impact of low temperature is more notable, which has a relative long duration.
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Objective:To investigate the effects of single intermittent theta-burst stimulation on functional connectivity in patients with mild cognitive impairment(MCI).Methods:From July to November 2020, forty MCI patients were selected and randomly divided into iTBS true stimulation group and iTBS sham-stimulation group, with 20 patients in each group.iTBS targeted the left dorsolateral prefrontal cortex (DLPFC). Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), activity of daily living scale(ADL), Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were evaluated at baseline.The resting state electroencephalography (rsEEG) was collected for 5 minutes before and after iTBS in the two groups.The phase lag index(PLI) of EEG functional connectivity was calculated, and the functional connectivity matrix diagram was drawn.SPSS 26.0 software was used for statistical analysis.Data were statistically analyzed by χ2 test, Wilcoxon rank sum test and independent sample t-test. Results:There were no significant differences in scores of MoCA, ADL, HAMD and HAMA between the two groups(all P>0.05). In the iTBS true stimulation group, compared with that before iTBS treatment(0.140(0.133, 0.144)), the PLI of β band increased significantly after iTBS treatment(0.146(0.136, 0.167))( P<0.05). The region of increased PLI was mainly concentrated in the central region(C3/C4-T7/T8). Compared with that before iTBS treatment(0.251(0.232, 0.299)), the PLI of α band increased after iTBS treatment(0.286(0.241, 0.359)), but the difference was not statistically significant( P>0.05). Conclusion:Single iTBS treatment can significantly increase the EEG functional connectivity in patients with MCI, indicating that iTBS targeting the left DLPFC can effectively regulate the EEG functional connectivity in patients with MCI, which may reveal the mechanism of iTBS in improving cognitive function in patients with MCI.
ABSTRACT
Background In the context of global warming, the impact of meteorological factors on human health has gradually become a research hotspot at home and abroad. Objective To describe the distribution of children's bronchopneumonia in Huzhou City, and explore the influence of diurnal temperature range (DTR) on children with bronchopneumonia, so as to provide guidance for identifying vulnerable populations and developing targeted measures. Methods A distributed lag nonlinear model (DLNM) was used to explore the potential nonlinear lag effect of DTR on admission of children with bronchopneumonia in Huzhou City from 2014 to 2019. Then a generalized additive model (GAM) was used to calculate the hospital admission risk of exposure to DTR in total population and sex-, age-, season-stratified populations. Results A total of 17658 hospitalized children with bronchopneumonia were included in the study. When DTR exceeded 7.5 ℃, the relative risk rose abruptly. When DTR reached 17 ℃, the risk of admission to hospital of children with bronchopneumonia was the greatest. In terms of the single-day lag effect, the admission risk of DTR for bronchopneumonia in children began on the same day and persisted until lag day 2; it peaked on the same day, and RR was 1.353 (95%CI: 1.220-1.502). The cumulative lag effect occurred from lag0 to lag0-6, and the highest RR value was at lag0-3, which was 1.938 (95%CI:1.483-2.533). The results of stratified analysis showed that the maximum effect values for boys and girls appeared at lag0-3 (RRboys=2.301, 95%CI: 1.671-3.169) and lag0-2(RRgirls=1.566, 95%CI: 1.152-2.129) respectively, and the effect value and duration of DTR in boys were higher and longer than those in girls. Among different age groups, both children of 0-3 years old and 4-14 years old had the maximum effect value at lag 0-3, the RR values were 1.734 (95%CI: 1.454-2.572) and 1.998 (95%CI: 1.226-2.254) respectively, and the effect value and duration of DTR on the children of 4-14 years old were higher and longer than those of the children of 0-3 years old. As to seasons, no significant increase was found in cumulative effect in summer and autumn (P>0.05); in winter and spring, the maximum effect value appeared at lag0-10, and the RR value was 4.164 (95%CI:1.191-14.561). Conclusion The impact of DTR on bronchopneumonia in children is acute. Boys and children aged 4-14 years old are more sensitive to DTR changes. Therefore, we should be alert to severe DTR changes and take protective measures in advance