Association of blood metals with serum sex hormones in adults: A cross-sectional study.

Heavy metals such as lead, mercury, and cadmium have been identified to have negative impacts on human health. Although the individual effects of these metals have been extensively researched, the present study aims to explore their combined effects and their association with serum sex hormones among adults. Data for this study were obtained from the general adult population of the 2013-2016 National Health and Nutrition Survey (NHANES) and included five metal (mercury, cadmium, manganese, lead, and selenium) exposures and three sex hormones (total testosterone [TT], estradiol [E2], and sex hormone-binding globulin [SHBG]) levels. The free androgen index (FAI) and TT/E2 ratio were also calculated. The relationships between blood metals and serum sex hormones were analysed using linear regression and restricted cubic spline regression. The effect of blood metal mixtures on sex hormone levels was examined using the quantile g-computation (qgcomp) model. There were 3,499 participants in this study, including 1,940 males and 1,559 females. In males, positive relationships between blood cadmium and serum SHBG (ß=0.049 [0.006, 0.093]), lead and SHBG (ß=0.040 [0.002, 0.079]), manganese and FAI (ß=0.080 [0.016, 0.144]), and selenium and FAI (ß=0.278 [0.054, 0.502]) were observed. In contrast, manganese and SHBG (ß=-0.137 [-0.237, -0.037]), selenium and SHBG (ß=-0.281 [-0.533, -0.028]), and manganese and TT/E2 ratio (ß=-0.094 [-0.158, -0.029]) were negative associations. In females, blood cadmium and serum TT (ß=0.082 [0.023, 0.141]), manganese and E2 (ß=0.282 [0.072, 0.493]), cadmium and SHBG (ß=0.146 [0.089, 0.203]), lead and SHBG (ß=0.163 [0.095, 0.231]), and lead and TT/E2 ratio (ß=0.174 [0.056, 0.292]) were positive relationships, while lead and E2 (ß=-0.168 [-0.315, -0.021]) and FAI (ß=-0.157 [-0.228, -0.086]) were negative associations. This correlation was stronger among elderly women (>50 years old). The qgcomp analysis revealed that the positive effect of mixed metals on SHBG was mainly driven by cadmium, while the negative effect of mixed metals on FAI was mainly driven by lead. Our findings indicate that exposure to heavy metals may disrupt hormonal homeostasis in adults, particularly in older women.

Preventive effect of cluster nursing on pressure ulcers in orthopedic patients and predictive value of serum IL-6 and TNF-α for the occurrence of pressure ulcers.

OBJECTIVE: To determine the effect of cluster nursing on pressure ulcer prevention and comfort of orthopedic patients. METHODS: A total of 124 orthopedic inpatients admitted to the Seventh Affiliated Hospital of Sun Yat-sen University from July 2018 to June 2021 were retrospectively analyzed. Among them, 66 cases received cluster nursing who were assigned into the observation group and the other 58 cases received routine nursing and were assigned into the control group. The incidence of pressure ulcers, the degree of pressure the ulcer, quality of life-brief (QOL-BREF), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) scores of the two groups at 7 days after surgery were compared, and the comfort score and nursing satisfaction of the two groups were evaluated and compared. The expression and predictive value of serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in patients with pressure ulcers before operation were analyzed via enzyme-linked immunosorbent assay (ELISA). The levels of IL-6 and TNF-α were compared between the two groups before and after nursing. RESULTS: After nursing, the observation group had significantly lower IL-6, TNF-α, SAS score, and SDS scores than the control group, and showed significantly higher QOL-BREF score, nursing satisfaction and comfort scores than the control group. In addition, the observation group showed a significantly lower incidence of pressure ulcers and a significantly lower severity level than the control group after nursing. Patients with pressure ulcers showed significantly higher serum IL-6 and TNF-α levels before surgery, and receiver operating characteristic curve (ROC) showed that IL-6 and TNF-α had certain value in forecasting the occurrence of pressure ulcers. CONCLUSION: Cluster nursing can substantially lower the incidence of pressure ulcers in hospitalized orthopedic patients and improve their comfort.

The Way of Severe Nursing of Respiratory System Failure.

Respiratory failure is the most common clinical symptom, seriously endangering people's health, which is mainly caused by a series of reasons, leading to serious respiratory dysfunction and severe pulmonary respiratory disorders, damaging the pulmonary airway function, and causing disability to maintain normal human gas exchange activities. At present, the main treatment of respiratory failure is to use the ventilator to help patients exchange gas and keep their breathing unobstructed. The nursing method is also around the artificial airway mechanical ventilation. The nursing of patients with respiratory failure is mainly respiratory nursing and psychological nursing. In this paper, the main research is to explore the way of severe nursing of respiratory failure. Before the nursing of respiratory failure, we should carry out nursing detection of the ventilator and test its performance, tightness, pipeline safety, and airway patency. Then carrying on the respiratory failure mechanical ventilation nursing and clarifying its mechanical ventilation nursing process is the main work of intensive care, at the same time, giving consideration to the psychological nursing of respiratory failure and implementing comprehensive nursing. In this paper, 50 patients were selected and divided into group A and group B; group A was given comprehensive nursing, and group B was given general nursing. The experimental results show that a series of situations in group A are more optimistic than those in group B. There was no doubt that the PH value of the two groups changed significantly 6 months after discharge. The pO2 value of group A was higher than that before discharge, while the pCO2 value of group B was unstable and increased. The pO2 value of group A was 55.52 before discharge and 62.36 six months after discharge. The pCO2 value of group A was 54.31 before discharge and 50.61 six months after discharge. The pCO2 value of group B was 55.23 before discharge and 57.34 six months after discharge.

The Effect of Needle Tract Nursing Methods to Reduce Needle Tract Infection in Patients with Indwelling Percutaneous Bone Puncture.

Percutaneous bone piercing needles are used in orthopedics, which play the role of needle fixation. Needle tract infection is a common complication during the use of percutaneous bone needles. How to prevent needle tract infection is an important topic, so it is necessary to explore better needle tract care methods during percutaneous bone needle indwelling, to provide a basis for clinical work. Based on this, the purpose of this article is to study the effects of needle tract nursing methods for patients with indwelling percutaneous bone puncture needle infections. In this article, through an overview of percutaneous bone needle tract infection, on this basis, a detailed analysis of its occurrence, causes, and main influencing factors are carried out. Experimental studies have shown that the incidence of needle tract infections is 23.64%, mainly mild needle tract infections. Mild needle tract infections account for 84.62% of all needle tract infections, of which grade 1 needle tract infections account for 50.00 of mild needle tract infections. Severe needle tract infections accounted for 15.38% of all needle tract infections. All severe needle tract infections were grade 4 needle tract infections. No patients had bone infections or osteomyelitis.

Relationship between cytotoxic T-lymphocyte antigen 4 -318C/T (rs5742909) gene polymorphism and the risk of acute rejection in renal transplantation.

Results on the relationship between CTLA4 -318C/T (rs5742909) gene polymorphism and risk of acute rejection in renal transplantation are still conflicting. This meta-analysis was performed to update the association between CTLA4 -318C/T and risk of acute rejection in renal transplantation. The association investigations were identified from PubMed and Cochrane Library, and eligible studies were included and synthesized using meta-analysis method. Twelve reports were included in this meta-analysis for the association of CTLA4 -318C/T gene polymorphism with acute rejection risk in renal transplantation, consisting of 728 acute rejection patients and 1628 non-acute rejection controls. The association between CTLA4 -318C/T gene polymorphism and acute rejection risk in renal transplantation for overall populations was not found in this meta-analysis (T allele: OR=0.96, 95% CI: 0.60-1.54, P=.88; TT genotype: OR=0.90, 95% CI: 0.47-1.71, P=.74; CC genotype: OR=1.00, 95% CI: 0.62-1.59, P=.98). Interestingly, T allele was associated with the risk of acute rejection in renal transplantation in African population. In conclusion, CTLA4 -318C/T gene polymorphism is not associated with the risk of acute rejection in renal transplantation in overall populations.

Association of cytotoxic T-lymphocyte antigen 4 +49A/G gene polymorphism with acute rejection risk in renal transplantation.

The conclusions on the association between cytotoxic T-lymphocyte antigen 4 (CTLA4) +49A/G gene polymorphism and acute rejection risk in renal transplantation are still debated. This meta-analysis was performed to update the association between CTLA4 +49A/G and acute rejection risk in renal transplantation. The association investigations were identified from PubMed and Cochrane Library, and eligible studies were included and synthesized using meta-analysis method. Fourteen reports were included into this meta-analysis for the association of CTLA4 A/G gene polymorphism and acute rejection risk in renal transplantation, consisting of 962 acute rejection patients and 2084 non-acute rejection controls. The association between CTLA4 G allele/GG genotype and acute rejection risk in renal transplantation was found in this meta-analysis (G allele: OR=1.21, 95% CI: 1.03-1.44, P=.02; GG genotype: OR=1.37, 95% CI: 1.10-1.69, P=.004). However, the AA genotype was not associated with acute rejection risk in renal transplantation. In conclusion, CTLA4 G allele/GG genotype is associated with the acute rejection risk in renal transplantation.

Vascular endothelial growth factor C promotes cervical cancer metastasis via up-regulation and activation of RhoA/ROCK-2/moesin cascade.

BACKGROUND: The elevated expression of vascular endothelial growth factor C (VEGF-C) is correlated with clinical cervical cancer metastasis and patient survival, which is interpreted by VEGF-C functions to stimulate angiogenesis and lymphatic genesis. However, the direct impact of VEGF-C on cervical cancer cell motility remains largely unknown. METHODS: In this study, we investigated the effects of VEGF-C on actin cytoskeleton remodeling and on cervical cancer cell migration and invasion and how the actin-regulatory protein, moesin regulated these effects through RhoA/ROCK-2 signaling pathway. RESULTS: On cervical carcinoma cell line SiHa cells, exposure of VEGF-C triggered remodeling of the actin cytoskeleton and the formation of membrane ruffles, which was required for cell movement. VEGF-C significantly enhanced SiHa cells horizontal migration and three-dimensional invasion into matrices. These actions were dependent on increased expression and phosphorylation of the actin-regulatory protein moesin and specific moesin siRNA severely impaired VEGF-C stimulated-cell migration. The extracellular small GTPase RhoA/ROCK-2 cascade mediated the increased moesin expression and phosphorylation, which was discovered by the use of Y-27632, a specific inhibitor of Rho kinase and by transfected constitutively active, dominant-negative RhoA as well as ROCK-2 SiRNA. Furthermore, in the surgical cervical specimen from the patients with FIGO stage at cervical intra-epithelial neoplasia and I-II cervical squamous cell carcinoma, the expression levels of moesin were found to be significantly correlated with tumor malignancy and metastasis. CONCLUSIONS: These results implied that VEGF-C promoted cervical cancer metastasis by upregulation and activation of moesin protein through RhoA/ROCK-2 pathway. Our findings offer new insight into the role of VEGF-C on cervical cancer progression and may provide potential targets for cervical cancer therapy.