Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective fact...Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective factors on frailty transition by constructing a Protection Index(PI)to guide targeted interventions.Methods Data were extracted from the 4th Sample Survey of the Aged Population in Urban and Rural China,including baseline(2017)and follow-up(2019)surveys.Frailty was assessed using the Frailty Index(FI),whereas the PI measured protective factors.Frailty transitions over 2 years were analyzed prospectively.Pearson’s correlation examined the relationship between FI and PI,and logistic regression assessed the effects of PI on frailty transitions.Results This study included 9,093 older adults.FI values increased with age and were higher in women,whereas PI values decreased with age and were higher in men.Over 2 years,56.2%of the participants showed a stable frailty status,14.2%improved,and 29.6%worsened.Negative transitions were more common than positive transitions,with transitions occurring most frequently between adjacent states.The PI was moderately negatively correlated with the FI(r=−0.349,P<0.001).A higher PI was associated with a lower risk of negative transitions among robust and prefrail individuals(OR=0.989,0.981,both P<0.05),but showed no significant effect among those with existing frailty.Conclusion Negative frailty transitions were more common with advancing age.Enhancing PI may help prevent negative frailty transitions among robust and pre-frail older adults,underscoring the value of early interventions.展开更多
Objective The study aims to prospectively examine the association between the minimum dietary diversity for women(MDD-W)score and risk of gestational diabetes mellitus(GDM).Methods All participants were pregnant women...Objective The study aims to prospectively examine the association between the minimum dietary diversity for women(MDD-W)score and risk of gestational diabetes mellitus(GDM).Methods All participants were pregnant women enrolled in the Tongji Maternal and Child Health Cohort.Dietary intake was assessed using a food frequency questionnaire(FFQ)or 24-h dietary recall.The MDD-W score was constructed by categorizing all food items into 10 food groups,following the Food and Agriculture Organization guidelines.Oral glucose tolerance tests(OGTT)were conducted during 24−28 weeks of gestation to screen for GDM.Poisson regression models were used to assess the association between MDD-W scores and GDM risk.Results In total,357(11.8%)of the 3,026 women were diagnosed with GDM.Compared with participants whose MDD-W score was≥8,those with a score of 5−7 had an increased risk of GDM(relative risk(RR):1.32;95%confidence interval(CI):1.03,1.69),and those with a score≤4 had a significantly higher GDM risk(RR:1.58;95%CI:1.12,2.26).Furthermore,these findings indicate that pregnant women with MDD-W scores<8,in conjunction with being overweight or obese before pregnancy and excessive gestational weight gain,have the highest risk of developing GDM.Conclusions These data suggest that a higher MDD-W score during pregnancy is independently associated with a lower GDM risk.Therefore,promoting dietary diversity and weight management is recommended to protect pregnant women from developing gestational diabetes.展开更多
Objective:The incidence and mortality of colorectal carcinoma(CRC)continue to rise globally,highlighting the need to identify modifiable risk factors for early detection and prevention.Previous studies have demonstrat...Objective:The incidence and mortality of colorectal carcinoma(CRC)continue to rise globally,highlighting the need to identify modifiable risk factors for early detection and prevention.Previous studies have demonstrated significant associations between CRC risk and various serum metabolites as well as inflammatory cytokines;however,due to limitations in study design and potential confounding factors,the causal relationships remain unclear.This study aims to investigate the causal relationships between inflammatory cytokines,serum metabolites,and CRC risk,providing a theoretical basis for the development of novel early diagnostic biomarkers and therapeutic targets.Methods:A two-sample Mendelian randomization(MR)design was applied using summary statistics from genome-wide association studies(GWAS).Instrumental variables(IVs)were derived from:1)metabolomics GWAS data of 1400 serum metabolites(n=8299);2)cytokine GWAS data of 91 inflammatory factors(n=14824);and 3)CRC risk data from the FinnGen consortium(6847 cases and 314193 controls).The primary analysis was conducted using the inverse-variance weighted(IVW)method,with sensitivity analyses performed using MR Egger regression and the weighted median method.Effect estimates including odds ratios(OR),95%confidence intervals(CI),and false discovery rates(FDR)were calculated.Results:MR analysis indicated that higher levels of axin-1(AXIN1)(OR=0.84195%CI 0.714 to 0.991)and Fms-related tyrosine kinase 3 ligand(Flt3L)(OR=0.916,95%CI 0.844 to 0.994)were associated with a reduced risk of CRC.In contrast,higher levels of Delta/Notchlike epidermal growth factor-related receptor(DNER)(OR=1.119,95%CI 1.009 to 1.241)and vascular endothelial growth factor A(VEGF-A)(OR=1.078,95%CI 1.011 to 1.150)were associated with an increased risk of CRC(all P<0.05).Metabolomics association analysis further identified 144 serum metabolites significantly correlated with these four key inflammatory cytokines(FDR<0.05),suggesting that they may regulate CRC risk through inflammatory pathways.Conclusion:Specific inflammatory cytokines and serum metabolites have causal relationships with the risk of CRC.These findings provide insights for further exploration of potential risk factors and the development of effective prevention strategies for CRC.展开更多
Background:Antipsychotic-induced movement disorders(AIMDs)are prevalent side effects of antipsychotics,particularly during the acute phase of treatment.This study aimed to elucidate the genetic mechanisms underlying A...Background:Antipsychotic-induced movement disorders(AIMDs)are prevalent side effects of antipsychotics,particularly during the acute phase of treatment.This study aimed to elucidate the genetic mechanisms underlying AIMDs using a genome-wide association study(GWAS).Methods:GWASs on AIMDs were conducted in three independent cohorts:a discovery cohort of 3067 patients(2016 subjects were reserved after quality control),a validation cohort of 277 patients,and a multi-ancestry validation cohort of 766 patients.Subsequent post-GWAS analyses included gene-based analyses,transcriptome-wide association studies(TWASs),and polygenic risk score(PRS)profiling.Results:Our study identified two loci located in RAB44 gene(rs116249243,P=5.98×10-9;rs117097482,P=1.17×10-8)associated with extrapyramidal symptoms(EPSs),1 locus(rs6826172,P=5.56×10-9)related to akathisia,and 76 loci linked to involuntary movements(11 genes were mapped).Risk loci located in CNTNAP2,LUZP2,TMEM167A,and RAB44 genes were successfully replicated in the validation cohort,whereas the locus located in RAB44 was also replicated in the multi-ancestry cohort.Gene-based analyses indicated that XRCC4 and PAIP2B reached significance at the genome-wide level in involuntary movements.Tissue expression analysis revealed that involuntary movement-related genes are predominantly expressed in the substantia nigra.Additionally,the TWAS suggested a causal relationship between XRCC4 and involuntary movement.The PRSs derived from the discovery cohort significantly predicted AIMDs in the validation cohort,with area under the receiver operating characteristic curve(AUC)values from 0.60 to 0.80.Conclusions:Our findings highlight the role of substantia nigra related gene polymorphisms in AIMDs.This study provides novel insights into the pathogenesis of AIMDs and supports the potential for personalized treatment approaches for schizophrenia.展开更多
Mental disorders(MDs)significantly impair cognition,mood,and social behavior,ranking among the top 10 leading causes of the global disease burden.Rising ambient temperatures are a critical factor triggering mental hea...Mental disorders(MDs)significantly impair cognition,mood,and social behavior,ranking among the top 10 leading causes of the global disease burden.Rising ambient temperatures are a critical factor triggering mental health-related conditions[1],especially under extreme temperature conditions[2].Humidity further exacerbates these effects by inhibiting sweating and intensifying heat stress,making it a significant contributor to heat-related mental health impacts[3].Existing evidence highlights an elevated risk of MDs associated with the combined effects of temperature and humidity[3,4].However,current research lacks a comprehensive analysis of these combined effects on mental health.展开更多
Objective:To describe the clinical features and effectiveness of Xuanbai Shengmai Decoction(XB,a compound Chinese herbal medicine)on disease progression,clinical effect and viral RNA shedding in COVID-19 cases.Methods...Objective:To describe the clinical features and effectiveness of Xuanbai Shengmai Decoction(XB,a compound Chinese herbal medicine)on disease progression,clinical effect and viral RNA shedding in COVID-19 cases.Methods:We collected demographic and clinical information of 212 COVID-19 cases from December2022 to January 2023,and divided these cases into two groups based on whether XB was used or not.Survival curves in the two groups were estimated by the Kaplan-Meier method.A smoothing approximation of time-to-event distributions was created based on a log-rank test and a restricted mean survival time model,and the Gaussian density estimation method.In addition,the effect of XB treatment on survival time was assessed using a series of Cox proportional hazards models.Results:Of all 212 COVID-19 cases,there were respectively 63 and 149 cases reported in XB group and non-XB group.Of those,128(60.4%)were male,with median age of 75.00 years,and 72.6%had one or more underlying medical conditions.The most common symptoms on admission were cough(64.6%),fever(39.6%),wheezing(27.8%)and sputum(13.2%).In addition,the gender,age group distribution,smoking,and drinking between two groups were of no significant difference(P>0.05).However,the clinical characteristics and CT findings in XB group were more serious than those in non-XB group.Nevertheless,the hazard of death in XB group was lower than that in non-XB group,especially on severe cases.Treatment with XB significantly protected against adverse outcomes,shorten the time of viral RNA shedding.Moreover,interventional therapy of XB within 1–2 days after hospital admission is confirmed with particularly effectiveness.Conclusion:Treatment of XB is effective for COVID-19 cases,particularly in reducing the mortality rate of severe cases,suggesting that XB may be used as an alternative treatment of SARS-COV-2 infection.展开更多
The development of wheat cultivars with improved nitrogen(N),phosphorus(P),and potassium(K)use efficiency is essential for sustainable agriculture.Genetic dissection and identification of causative genes underlying nu...The development of wheat cultivars with improved nitrogen(N),phosphorus(P),and potassium(K)use efficiency is essential for sustainable agriculture.Genetic dissection and identification of causative genes underlying nutrient use efficiency represent a key strategy toward this goal.We conducted an extensive genome-wide association study(GWAS)using a panel of 431 wheat cultivars,identifying 1,659 significant single-nucleotide polymorphisms(SNPs)(LOD>5)through genotyping-by-sequencing.This analysis revealed 534 quantitative trait loci(QTLs)associated with 12 nutrient use efficiency traits across five distinct environments,among which 14 QTLs were consistently detected in at least three environments.Notably,meta-QTL analysis,showed that QTL80(72.12–74.24 Mb,chr2A),QTL387(32.88–33.56 Mb,chr6A),and QTL500(535.53–540.80 Mb,chr7B)exhibit clear co-localization with MQTL-2A-2,MQTL-6A-1,and MQTL-7B-2,respectively.This overlap highlights their robustness across diverse environmental conditions.Within these regions,critical candidate genes-including members of the bZIP transcription factor family and a potassium transporter gene-were identified in relation to nutrient use efficiency.Furthermore,a novel locus,QTL234,was discovered,harboring key candidate genes such as dof zinc finger protein,Ankyrin repeat family protein,and cytochrome P450.To validate the SNP within QTL234 associated with nitrogen harvest index(NHI),we developed a dCAPS marker for AX-109095537.These findings demonstrate the effectiveness of high-resolution SNP-based GWAS in rapidly pinpointing promising candidate genes.They also establish a foundation for large-scale QTL fine mapping,candidate gene validation,and the development of functional markers essential for enhancing nutrient use efficiency in wheat breeding programs.展开更多
Liver cancer ranks sixth in cancer incidence and third in cancer-related deaths worldwide.Hepatocellular carcinoma(HCC)is the primary histological subtype,and hepatitis B virus(HBV)carriers have a higher risk of HCC.A...Liver cancer ranks sixth in cancer incidence and third in cancer-related deaths worldwide.Hepatocellular carcinoma(HCC)is the primary histological subtype,and hepatitis B virus(HBV)carriers have a higher risk of HCC.Although several susceptibility loci for HCC have been identified in East Asian populations through genome-wide association studies(GWAS),the underlying biological mechanisms of this malignancy remain incompletely understood.Here,we conduct a two-stage GWAS including 2413 cases and 2794 HBV-positive controls from a high-incidence region in Southern China.The function of the susceptibility locus is investigated by bioinformatic and experimental approaches,supported by a xenograft model.We identify a 4p14 locus significantly associated with the risk of HCC(rs55718051,OR[95%CI]=0.73[0.67-0.80],Pmeta=9.14×10-11),and 18q23 locus with borderline significance(rs12964643:OR[95%CI]=0.75[0.67-0.83],Pmeta=1.11×10-7).Functional experiments indicate the role of rs55718051 in FAM114A1 expression regulation,possibly through the interaction with FOXA1.Knockdown of FAM114A1 significantly promote the oncogenic phenotypes in liver cancer cells,suggesting its potential tumor suppressor role.Our findings expand the understanding of HCC susceptibility and suggest FAM114A1 as a potential suppressor in HBV-related HCC carcinogenesis.展开更多
OBJECTIVE:To observe the characteristics of acupoint sensitization in patients with essential hypertension,analyze the mechanical pain threshold and tenderness threshold of each acupoint,and summarize the clinical cha...OBJECTIVE:To observe the characteristics of acupoint sensitization in patients with essential hypertension,analyze the mechanical pain threshold and tenderness threshold of each acupoint,and summarize the clinical characteristics of high-sensitivity acupoints.METHODS:This study employed a cross-sectional matched case-control design and enrolled a total of 448 volunteer participants,including 224 patients with hypertension and 224 healthy controls.The main outcome measures included measuring the mechanical pain threshold and tenderness threshold of 16 highly sensitive acupoints in both hypertensive subjects and healthy controls.The receiver operating characteristic curve method was used to evaluate the sensitivity of each acupoint.Additionally,the rules of mechanical pain threshold,tenderness threshold sensitization rate,and degree of sensitization of each acupoint in hypertension patients were summarized to identify the optimal highly sensitive acupoints related to hypertension.RESUITS:The mechanical pain threshold and tenderness threshold of hypertensive patients were significantly lower than those of healthy subjects,the difference was statistically significant(P<0.001),indicating that the mechanical pain threshold and tenderness threshold of hypertensive patients at various points had a downward trend.Acupoints with high incidence of sensitization in hypertensive patients include Quchi(LI11),Taichong(LR3),Fenglong(ST40),Xingjian(LR2),Taixi(KI3)and Renying(ST9).CONCLUSION:This study successfully achieved the objective of exploring acupoint sensitization in patients with primary hypertension.Hypertensive patients exhibited significantly lower mechanical pain thresholds and pressure pain thresholds compared to healthy subjects.These findings provide clinical evidence for acupoint selection in acupuncture treatment for primary hypertension.展开更多
Increasing the sucrose content of sugarcane,a major sugar crop,is a key breeding objective.However,the complex genetic background of sugarcane affects development of sugarcane hybrids.In this study,we sequenced 292 su...Increasing the sucrose content of sugarcane,a major sugar crop,is a key breeding objective.However,the complex genetic background of sugarcane affects development of sugarcane hybrids.In this study,we sequenced 292 sugarcane germplasm accessions and identified 2,542,965 single nucleotide polymorphisms(SNPs) and insertions/deletions(InDels).We performed a genome-wide association study(GWAS) for two important sugarcane traits:sucrose content and stem diameter.Both traits followed a normal distribution and showed typical characteristics of quantitative traits.Population structure analysis revealed four subpopulations with an average genetic distance of 0.236.GWAS of the sucrose content detected 27 SNPs.After annotating genes at or near significant loci,17 candidate genes were screened.For stem diameter,GWAS revealed 19 SNPs,from which 9 candidate genes were identified.These results improve our understanding of genetic mechanisms affecting sucrose content in sugarcane,and identify important genetic resources to accelerate breeding of new sugarcane varieties with high sucrose content.展开更多
Genetic variations are risk factors for neonatal hyperbilirubinemia(NHB),a common cause of infant hospitalization in the first postnatal week,but their contribution and long-term impacts remain unclear.This population...Genetic variations are risk factors for neonatal hyperbilirubinemia(NHB),a common cause of infant hospitalization in the first postnatal week,but their contribution and long-term impacts remain unclear.This population-based multicenter study enrolls 1780 hospitalized NHB newborns and 38,158 genetically screened newborns across 20 hospitals(2019-2022).Excluding cases with clear clinical causes,977 NHB cases are categorized into genetic variation-positive and-negative groups.Results show significantly higher NHB-related gene variants(81.63%vs.65.62%)and positive variation rates(36.29%vs.9.4%)in NHB cases than in the general newborn population(all P<0.001).Among the 977 NHB cases,325(33.3%)have positive variants,with higher rates of severe hyperbilirubinemia(16.9%vs.9.7%,P=0.001),prolonged jaundice(36.3%vs.27.6%,P=0.005),and cholestasis/hypercholanaemia(23.7%vs.14.7%,P<0.001)in the positive group.Cumulative genetic variants in bilirubin metabolism pathways exhibit dosedependent associations with increased risks of complications.Long-term follow-up reveals that UGT1A1 variants prolong jaundice up to one month,while severe SLC10A1 variants cause persistent cholestasis/hypercholanaemia beyond nine months.This large-scale evidence highlights genetic factors as key NHB determinants,with implications for neonatal care protocols to integrate genetic testing and establish longterm surveillance for variant carriers.展开更多
Huff-n-puff(HnP)is currently an important means to enhance the oil recovery of tight oil reservoirs.In this study,taking tight sedimentary tuff oil reservoirs in Santanghu Basin,China as an example,the oil production ...Huff-n-puff(HnP)is currently an important means to enhance the oil recovery of tight oil reservoirs.In this study,taking tight sedimentary tuff oil reservoirs in Santanghu Basin,China as an example,the oil production law,pore utilization characteristics,and influencing factors of water,N2,CO2,N2 water alternating,and CO2 water alternating HnP(WHP,NHP,CHP,NWAHP,CWAHP)are comprehensively studied.The results show that middle pores(MPs)are the main pore utilization interval for various HnP mediums.The recovery rates(RRs)of five rounds of WHP,NHP,and CHP are 39.32%,44.45%,and 61.24%,with contribution rates(CRs)of MPs being 68.60%,47.87%,and 56.00%.The RRs and CRs of various pores are closely related to their pore distribution and the oil recovery mechanism of the medium.Under the experimental conditions of this study,the RR of CHP does not have an obvious rock sample size effect,with sweep depth exceeding 1.25 cm in each round.The RR of CHP is positively correlated with injection pressure and shut-in time,and the injection exceeding the rock fracture fracturing and 300 min shut-in time are recommended.The RRs of six rounds of NWAHP and CWAHP are 51.98% and 62.75%,with CRs of MPs being 60.39%and 58.32%.The oil recovery effect(ORE)of NWAHP is better than that of their individual,while the ORE of CWAHP is better than that of WHP but close to that of CHP.The alternating sequence affects the stage RR of NWAHP and CWAHP.The NWAHP and CWAHP have great advantages in improving RR,reducing injection cost,and stabilizing production,and are expected to achieve rapid development.展开更多
Traditional villages represent a concentrated expression of the preservation and transmission of traditional culture within the context of rural revitalization,conveying important social,historical,and cultural values...Traditional villages represent a concentrated expression of the preservation and transmission of traditional culture within the context of rural revitalization,conveying important social,historical,and cultural values.Based on the perspective of spatial genes,this study selected 67 typical traditional villages in the Wuling Mountain Area in Southwest China as the case study.Between 2021 and 2024,by identifying and extracting spatial genes through the semi-structured interviews,Laddering Technique,and Landscape Pattern Index,and applying the geo-detector,the study explored the morphological characteristics and influencing mechanisms of traditional Tujia villages from the perspective of spatial genes of ecological-production-living.The findings are as follows:1)the spatial genes of traditional Tujia villages in the Wuling Mountain Area exhibit distinct patterns.Ecological genes,categorized by natural environment and layout,demonstrate a transition from clustered to dispersed patterns from the southern to northern regions.Production genes,categorized by location and cultivation patterns,show concentrated agricultural lands in the south and fragmented in the north.Living genes,divided into house plans,facades,and public buildings,reveal a higher prevalence of courtyards,stilted houses,and public buildings in northern areas.2)The spatial genes have evolved through the combined influence of four key factors:natural environment,socioeconomic development,policy systems,and ethnic culture.3)The integration of multi-source data and the application of both qualitative and quantitative approaches provide a comprehensive framework for analyzing traditional village form and their influencing mechanisms.This methodology offers valuable insights for developing sustainable strategies for the conservation of traditional Tujia traditional villages in this region.展开更多
Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenn...Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenness with AMD,modification and mediation effect of air pollution,we conducted this prospective study.We con-structed weighted quantile sum(WQS)index as co-exposure to nitrogen oxides(NOx),particulate matter<2.5μm(PM2.5),particulate matter<10μm(PM10).Stratified Cox regression models were applied to test the effect of exposure.Effect modification of air pollution was assessed.Stratified Cox models through the indirect method and Aalen additive risk models were used in mediation analysis.Over median follow-up of 11.67 years,4596 AMD events were ascertained.Hazard ratios(HRs)and 95%confidence intervals(95%CIs)of incident AMD for pollution per interquartile range(IQR)increment were 1.10(1.04–1.16)for nitrogen dioxide(NO2),1.09(1.03–1.15)for NOx,1.14(1.05–1.24)for PM2.5,1.13(1.05–1.21)for PM10.The HR(95%CI)of AMD associated with greenness 1000 m buffer per IQR increment was 0.91(0.86–0.97),300 m buffer was 0.94(0.89–0.99).The as-sociation between greenness 1000 m and AMD was 28.59%,44.77%,35.59%,32.31%and 27.08%mediated by the decreased WQS index,NO2,NOx,PM2.5 and PM10,respectively.Increased greenness was associated with lower AMD incidence,and air pollution partly mediate it,which implies that interventions aimed at improving air quality and increasing greenness could have a dual benefit in mitigating AMD risk.展开更多
BACKGROUND The overlap between non-erosive reflux disease(NERD)and epigastric pain syndrome(EPS)is common in China,but its clinical profile and healthcare burden are poorly defined.AIM To characterize patients with NE...BACKGROUND The overlap between non-erosive reflux disease(NERD)and epigastric pain syndrome(EPS)is common in China,but its clinical profile and healthcare burden are poorly defined.AIM To characterize patients with NERD-EPS overlap and identify factors linked to frequent gastroenterology clinic visits.METHODS In a multicenter,cross-sectional study,800 consecutive patients with NERD-EPS overlap were enrolled from four tertiary hospitals in China.Data were collected via questionnaires on socio-demographics,clinical manifestations,medication use,visit frequency,and psychological distress(4-item Patient Health Questionnaire).Multivariable ordinal logistic regression identified factors independently associated with higher visit frequency.RESULTS Among the 800 patients(mean age 44.50±14.43 years;66.70%female),42.40%had≥3 clinic visits.Independent risk factors for more frequent visits included older age[adjusted odds ratio(aOR)=1.02],longer NERD duration(aOR=1.004),higher psychological distress(aOR=1.08 per 1-point 4-item Patient Health Questionnaire increase),mixed labor(aOR=3.37)or physical labor(aOR=1.91),married status(aOR=2.05),proton pump inhibitor use(aOR=1.39),and Chinese herbal preparation use(aOR=6.64).A significant synergistic interaction on visit frequency was found between proton pump inhibitor and herbal use(interaction aOR=29.06,P<0.001).CONCLUSION Frequent outpatient visits in NERD-EPS overlap is driven by a combination of demographic factors,chronicity,psychological comorbidity,and complex medication patterns,rather than symptoms alone.These findings highlight the strong association between psychological distress and frequent visits,suggesting that integrating psychological screening into routine care may help identify at-risk patients.Prospective studies are needed to determine whether psychosomatic interventions can effectively reduce healthcare utilization in this population.展开更多
BACKGROUND:This study aims to evaluate the immediate and 12-month effects of communitybased first-aid training on public knowledge and attitude,assess satisfaction,and identify factors associated with score changes.ME...BACKGROUND:This study aims to evaluate the immediate and 12-month effects of communitybased first-aid training on public knowledge and attitude,assess satisfaction,and identify factors associated with score changes.METHODS:This was a prospective study.In 2022-2023,a total of 2,010 community residents in Hainan Province received first-aid training and completed structured questionnaires at baseline,immediately after training,and at 3,6,and 12 months after training.First-aid knowledge was assessed through 33 items,with a maximum total score of 33.First-aid attitude was evaluated using seven items,totaling a maximum score of 21.Satisfaction was measured on a 5-point Likert scale.Paired-sample t-tests were used to compare baseline and post-training scores,repeated-measures analysis of variance(ANOVA)was used to examine time effects,and multiple linear regression was used to analyze factors associated with score changes.RESULTS:The satisfaction score with the training was high(mean score>4.3 for all items).The first-aid knowledge and attitude scores increased significantly after training(first-aid knowledge at baseline,14.90±7.63;immediately after training,20.70±5.72,P<0.001;and attitude at baseline,17.52±2.29;immediately after training,17.89±1.54,P<0.001).At 12 months after training,knowledge scores declined slightly compared with those immediately after training but remained above baseline(time effect P<0.001),whereas attitude scores remained stable(time effect P<0.001).Knowledge improvement was greater among middle-income participants and less among participants with lower levels of education,those in professional occupations,widowed individuals,or those who had previously received first-aid training.Attitude improvements were more pronounced among male participants,younger participants,and those in the agriculture or sales/service sectors.CONCLUSION:Community-based first-aid training improved public first-aid knowledge and attitude and was well received by participants.While knowledge levels declined somewhat over time,attitude remained relatively stable,highlighting the importance of continuous reinforcement training.Personalized reinforcement strategies may be particularly beneficial for individuals with lower levels of education,specific professional backgrounds,widowhood,or prior training experience to further enhance training effectiveness.展开更多
BACKGROUND Solid fuel use for cooking and heating is a major environmental risk factor,yet its association with new-onset heart disease(HD)remains unclear.The aim of this study was to investigate the relationship betw...BACKGROUND Solid fuel use for cooking and heating is a major environmental risk factor,yet its association with new-onset heart disease(HD)remains unclear.The aim of this study was to investigate the relationship between solid fuel exposure and new-onset HD in a large cohort.METHODS Multivariable logistic regression models assessed associations between cooking/heating fuel types(coal,crop residue/wood,liquefied petroleum gas,natural gas,and others)and new-onset HD.Subgroup analyses explored effect modification by age,sex,education,smoking,alcohol use,and region.RESULTS A prospective cohort study included 5915 participants,with 781 participants(13.2%)developing new-onset HD.Coal use for cooking showed an initial association with new-onset HD risk(OR=1.41,95%CI:1.06–1.86,P=0.02),which attenuated after full adjustment(OR=1.28,95%CI:0.96–1.72,P=0.10).Coal use for heating demonstrated robust associations across all models(OR=1.86,95%CI:1.42–2.43,P<0.001).Crop residue/wood burning for heating was also significant(Model 2:OR=1.40,95%CI:1.06–1.86,P=0.02).Subgroup analyses revealed stronger associations among females,non-smokers,non-drinkers,and less-educated participants.Geographic stratification showed significant associations in southern but not northern regions.CONCLUSIONS Solid fuel use,particularly coal for heating,is associated with increased new-onset HD risk.Reducing solid fuel exposure is crucial for HD prevention in low-resource settings.展开更多
Few repeated-measures studies with multiple time points have evaluated the sex-specific association between mitochondrial DNA copy number(mtDNAcn)and long-term exposure to metal mixtures.We conducted a repeatedmeasure...Few repeated-measures studies with multiple time points have evaluated the sex-specific association between mitochondrial DNA copy number(mtDNAcn)and long-term exposure to metal mixtures.We conducted a repeatedmeasures study with three time points and 2550 observations in the manganese-exposed workers healthy cohort.Specifically,the blood concentrations of 15 metals and mtDNAcn were measured in 2012,2017,and 2021.We employed a machine learning approach(GLMMLASSO)to select the metals most associated with mtDNAcn and used Bayesian kernel machine regression to examine their joint effects.In cross-sectional analyses(2550 visits),statistical methods consistently showed Calcium(Ca)was positively associated with mtDNAcn among overall visits(β=0.292 in the linear mixed-effects model(LMM))and dominated the positive overall effects of magnesium,Ca,titanium,iron,nickel,rubidium on mtDNAcn.An inverted“U”-shaped exposure–response curve between Ca and mtDNAcn appeared in males but not in females.Interaction analysis showed the association between Ca and mtDNAcn was significantly modified by gender.In repeated-measures analyses(807 visits),we explored the tendency for metals and mtDNAcn to change over three time points;the results confirmed the cross-sectional analyses.In overall visits,the positive association between Ca and mtDNAcn remained significant(β=0.207 in LMM).For metal selection,Ca was identified as the predictor for mtDNAcn,and an inverted“U”-shaped exposure–response curve was found with mtDNAcn in males.Our findings reveal a consistent positive association between Ca and mtDNAcn with sex-dependent heterogeneity and suggest Ca may mitigate mitochondrial dysfunction induced by other metals.展开更多
Dear Editor,Acute aortic dissection(AAD)refers to the tearing of the aortic intima,with high-pressure blood flowing into the media.It can be classified into Stanford type A and type B according to whether the ascendin...Dear Editor,Acute aortic dissection(AAD)refers to the tearing of the aortic intima,with high-pressure blood flowing into the media.It can be classified into Stanford type A and type B according to whether the ascending aorta is involved.Acute type A aortic dissection(ATAAD)is a life-threatening cardiovascular disease with high mortality rates(approximately 50%and 1%–2% per hour)within the first 48 h[1].展开更多
Owing to the continuous increase in industrialization,the extent of soil salinization is escalating globally.Brassica napus is among the most advantageous field crops for the development and utilization of saline-alka...Owing to the continuous increase in industrialization,the extent of soil salinization is escalating globally.Brassica napus is among the most advantageous field crops for the development and utilization of saline-alkali land.Nevertheless,the molecular regulation of salt tolerance during the seedling stage in this species remains unclear.To explore this mechanism,an association population consisting of 202 accessions was subjected to a 257 mmol/L NaCl solution at the seedling(four-leaf)stage.After 14 days of salt treatment,the above-ground and under-ground fresh and dry weights of each accession line were measured,and the correlations between these traits were evaluated.By integrating phenotypic data with resequencing data,a genome-wide association study identified 2043 single nucleotide polymorphisms(SNPs)that were significantly associated with these traits.Ninety SNPs were detected repeatedly,with a single SNP accounting for 1.3%–5.29%of the phenotypic variation.Subsequently,two candidate genes were identified,and six germplasm resources with strong salt tolerance at the seedling stage were selected.These results will guide strategies for breeding salt-tolerant B.napus and will offer a theoretical foundation for the restoration and management of salinized land.展开更多
基金supported by grants from the National Key R&D Program of China[Grant Nos.2020YFC2003000 and 2020YFC2003001]the National High Level Hospital Clinical Research Funding(BJ-2023-074 and BJ-2023-018)+1 种基金Beijing Municipal Science&Technology Commission“AI+Health Collaborative Innovation Cultivation”Project(Z221100003522015)the Non-Profit Central Research Institute Fund of the Chinese Academy of Medical Sciences(2021-JKCS-024).
摘要Objective Frailty is becoming increasingly common among aging adults.Frailty transitionis shaped by biological,social,psychological,and environmental factors.This study investigated combined effects of protective factors on frailty transition by constructing a Protection Index(PI)to guide targeted interventions.Methods Data were extracted from the 4th Sample Survey of the Aged Population in Urban and Rural China,including baseline(2017)and follow-up(2019)surveys.Frailty was assessed using the Frailty Index(FI),whereas the PI measured protective factors.Frailty transitions over 2 years were analyzed prospectively.Pearson’s correlation examined the relationship between FI and PI,and logistic regression assessed the effects of PI on frailty transitions.Results This study included 9,093 older adults.FI values increased with age and were higher in women,whereas PI values decreased with age and were higher in men.Over 2 years,56.2%of the participants showed a stable frailty status,14.2%improved,and 29.6%worsened.Negative transitions were more common than positive transitions,with transitions occurring most frequently between adjacent states.The PI was moderately negatively correlated with the FI(r=−0.349,P<0.001).A higher PI was associated with a lower risk of negative transitions among robust and prefrail individuals(OR=0.989,0.981,both P<0.05),but showed no significant effect among those with existing frailty.Conclusion Negative frailty transitions were more common with advancing age.Enhancing PI may help prevent negative frailty transitions among robust and pre-frail older adults,underscoring the value of early interventions.
基金supported by the National Program of the Basic Research Project of China(grant numbers 2019FY101003 and 2013FY114200).
摘要Objective The study aims to prospectively examine the association between the minimum dietary diversity for women(MDD-W)score and risk of gestational diabetes mellitus(GDM).Methods All participants were pregnant women enrolled in the Tongji Maternal and Child Health Cohort.Dietary intake was assessed using a food frequency questionnaire(FFQ)or 24-h dietary recall.The MDD-W score was constructed by categorizing all food items into 10 food groups,following the Food and Agriculture Organization guidelines.Oral glucose tolerance tests(OGTT)were conducted during 24−28 weeks of gestation to screen for GDM.Poisson regression models were used to assess the association between MDD-W scores and GDM risk.Results In total,357(11.8%)of the 3,026 women were diagnosed with GDM.Compared with participants whose MDD-W score was≥8,those with a score of 5−7 had an increased risk of GDM(relative risk(RR):1.32;95%confidence interval(CI):1.03,1.69),and those with a score≤4 had a significantly higher GDM risk(RR:1.58;95%CI:1.12,2.26).Furthermore,these findings indicate that pregnant women with MDD-W scores<8,in conjunction with being overweight or obese before pregnancy and excessive gestational weight gain,have the highest risk of developing GDM.Conclusions These data suggest that a higher MDD-W score during pregnancy is independently associated with a lower GDM risk.Therefore,promoting dietary diversity and weight management is recommended to protect pregnant women from developing gestational diabetes.
基金supported by the Natural Science Foundation of Hunan Province (2022JJ30987)the Key Research and Development Project of Hunan Province (2024JK2107),China。
摘要Objective:The incidence and mortality of colorectal carcinoma(CRC)continue to rise globally,highlighting the need to identify modifiable risk factors for early detection and prevention.Previous studies have demonstrated significant associations between CRC risk and various serum metabolites as well as inflammatory cytokines;however,due to limitations in study design and potential confounding factors,the causal relationships remain unclear.This study aims to investigate the causal relationships between inflammatory cytokines,serum metabolites,and CRC risk,providing a theoretical basis for the development of novel early diagnostic biomarkers and therapeutic targets.Methods:A two-sample Mendelian randomization(MR)design was applied using summary statistics from genome-wide association studies(GWAS).Instrumental variables(IVs)were derived from:1)metabolomics GWAS data of 1400 serum metabolites(n=8299);2)cytokine GWAS data of 91 inflammatory factors(n=14824);and 3)CRC risk data from the FinnGen consortium(6847 cases and 314193 controls).The primary analysis was conducted using the inverse-variance weighted(IVW)method,with sensitivity analyses performed using MR Egger regression and the weighted median method.Effect estimates including odds ratios(OR),95%confidence intervals(CI),and false discovery rates(FDR)were calculated.Results:MR analysis indicated that higher levels of axin-1(AXIN1)(OR=0.84195%CI 0.714 to 0.991)and Fms-related tyrosine kinase 3 ligand(Flt3L)(OR=0.916,95%CI 0.844 to 0.994)were associated with a reduced risk of CRC.In contrast,higher levels of Delta/Notchlike epidermal growth factor-related receptor(DNER)(OR=1.119,95%CI 1.009 to 1.241)and vascular endothelial growth factor A(VEGF-A)(OR=1.078,95%CI 1.011 to 1.150)were associated with an increased risk of CRC(all P<0.05).Metabolomics association analysis further identified 144 serum metabolites significantly correlated with these four key inflammatory cytokines(FDR<0.05),suggesting that they may regulate CRC risk through inflammatory pathways.Conclusion:Specific inflammatory cytokines and serum metabolites have causal relationships with the risk of CRC.These findings provide insights for further exploration of potential risk factors and the development of effective prevention strategies for CRC.
基金supported by the National Natural Science Foundation of China(82330042,82441005 and 82301687)the National Key R&D Program of China(2023YFE0119400)+9 种基金the Capital’s Funds for Health Improvement and Research(2024-1-4111)the STI2030-Major Projects-2021ZD0200702Fundamental Research Funds for the Central Universities(Peking University Medicine Fund for world’s leading discipline or discipline cluster development,BMU2022DJXK007)the Beijing Municipal Health Commission Research Ward Programme(3rd batch)Beijing Nova Program(20230484425)the Beijing Municipal Science&Technology Commission,Administrative Commission of Zhongguancun Science Park(Z221100003522010)the China Postdoctoral Science Foundation(2024M760141 and 2022M720302)the National Postdoctoral Program for Innovative Talents(BX20240029)the Beijing Natural Science Foundation(7254462)the Peking University Medicine Sailing Program for Young Scholars’Scientific&Technological Innovation,the Fundamental Research Funds for the Central Universities(BMU2025YFJHPY044 and BMU2025YFJHPY046).
摘要Background:Antipsychotic-induced movement disorders(AIMDs)are prevalent side effects of antipsychotics,particularly during the acute phase of treatment.This study aimed to elucidate the genetic mechanisms underlying AIMDs using a genome-wide association study(GWAS).Methods:GWASs on AIMDs were conducted in three independent cohorts:a discovery cohort of 3067 patients(2016 subjects were reserved after quality control),a validation cohort of 277 patients,and a multi-ancestry validation cohort of 766 patients.Subsequent post-GWAS analyses included gene-based analyses,transcriptome-wide association studies(TWASs),and polygenic risk score(PRS)profiling.Results:Our study identified two loci located in RAB44 gene(rs116249243,P=5.98×10-9;rs117097482,P=1.17×10-8)associated with extrapyramidal symptoms(EPSs),1 locus(rs6826172,P=5.56×10-9)related to akathisia,and 76 loci linked to involuntary movements(11 genes were mapped).Risk loci located in CNTNAP2,LUZP2,TMEM167A,and RAB44 genes were successfully replicated in the validation cohort,whereas the locus located in RAB44 was also replicated in the multi-ancestry cohort.Gene-based analyses indicated that XRCC4 and PAIP2B reached significance at the genome-wide level in involuntary movements.Tissue expression analysis revealed that involuntary movement-related genes are predominantly expressed in the substantia nigra.Additionally,the TWAS suggested a causal relationship between XRCC4 and involuntary movement.The PRSs derived from the discovery cohort significantly predicted AIMDs in the validation cohort,with area under the receiver operating characteristic curve(AUC)values from 0.60 to 0.80.Conclusions:Our findings highlight the role of substantia nigra related gene polymorphisms in AIMDs.This study provides novel insights into the pathogenesis of AIMDs and supports the potential for personalized treatment approaches for schizophrenia.
基金supported by grants fromNational Natural Science Foundation of China(No.72404117).
摘要Mental disorders(MDs)significantly impair cognition,mood,and social behavior,ranking among the top 10 leading causes of the global disease burden.Rising ambient temperatures are a critical factor triggering mental health-related conditions[1],especially under extreme temperature conditions[2].Humidity further exacerbates these effects by inhibiting sweating and intensifying heat stress,making it a significant contributor to heat-related mental health impacts[3].Existing evidence highlights an elevated risk of MDs associated with the combined effects of temperature and humidity[3,4].However,current research lacks a comprehensive analysis of these combined effects on mental health.
基金supported by the National Natural Science Foundation of China(Nos.82141202 and 82474428)Capital’s Funds for Health Improvement(No.2024-1-1161)Research and National Multidisciplinary Innovation Team Project of Traditional Chinese Medicine(No.ZYYCXTD-D-202201)。
摘要Objective:To describe the clinical features and effectiveness of Xuanbai Shengmai Decoction(XB,a compound Chinese herbal medicine)on disease progression,clinical effect and viral RNA shedding in COVID-19 cases.Methods:We collected demographic and clinical information of 212 COVID-19 cases from December2022 to January 2023,and divided these cases into two groups based on whether XB was used or not.Survival curves in the two groups were estimated by the Kaplan-Meier method.A smoothing approximation of time-to-event distributions was created based on a log-rank test and a restricted mean survival time model,and the Gaussian density estimation method.In addition,the effect of XB treatment on survival time was assessed using a series of Cox proportional hazards models.Results:Of all 212 COVID-19 cases,there were respectively 63 and 149 cases reported in XB group and non-XB group.Of those,128(60.4%)were male,with median age of 75.00 years,and 72.6%had one or more underlying medical conditions.The most common symptoms on admission were cough(64.6%),fever(39.6%),wheezing(27.8%)and sputum(13.2%).In addition,the gender,age group distribution,smoking,and drinking between two groups were of no significant difference(P>0.05).However,the clinical characteristics and CT findings in XB group were more serious than those in non-XB group.Nevertheless,the hazard of death in XB group was lower than that in non-XB group,especially on severe cases.Treatment with XB significantly protected against adverse outcomes,shorten the time of viral RNA shedding.Moreover,interventional therapy of XB within 1–2 days after hospital admission is confirmed with particularly effectiveness.Conclusion:Treatment of XB is effective for COVID-19 cases,particularly in reducing the mortality rate of severe cases,suggesting that XB may be used as an alternative treatment of SARS-COV-2 infection.
基金funded by the National Key R&D Program of China(2021YFD1900700)。
摘要The development of wheat cultivars with improved nitrogen(N),phosphorus(P),and potassium(K)use efficiency is essential for sustainable agriculture.Genetic dissection and identification of causative genes underlying nutrient use efficiency represent a key strategy toward this goal.We conducted an extensive genome-wide association study(GWAS)using a panel of 431 wheat cultivars,identifying 1,659 significant single-nucleotide polymorphisms(SNPs)(LOD>5)through genotyping-by-sequencing.This analysis revealed 534 quantitative trait loci(QTLs)associated with 12 nutrient use efficiency traits across five distinct environments,among which 14 QTLs were consistently detected in at least three environments.Notably,meta-QTL analysis,showed that QTL80(72.12–74.24 Mb,chr2A),QTL387(32.88–33.56 Mb,chr6A),and QTL500(535.53–540.80 Mb,chr7B)exhibit clear co-localization with MQTL-2A-2,MQTL-6A-1,and MQTL-7B-2,respectively.This overlap highlights their robustness across diverse environmental conditions.Within these regions,critical candidate genes-including members of the bZIP transcription factor family and a potassium transporter gene-were identified in relation to nutrient use efficiency.Furthermore,a novel locus,QTL234,was discovered,harboring key candidate genes such as dof zinc finger protein,Ankyrin repeat family protein,and cytochrome P450.To validate the SNP within QTL234 associated with nitrogen harvest index(NHI),we developed a dCAPS marker for AX-109095537.These findings demonstrate the effectiveness of high-resolution SNP-based GWAS in rapidly pinpointing promising candidate genes.They also establish a foundation for large-scale QTL fine mapping,candidate gene validation,and the development of functional markers essential for enhancing nutrient use efficiency in wheat breeding programs.
基金funded by the National Science Foundation of China (82460668)the Joint Project on Regional High-Incidence Diseases Research of Guangxi Natural Science Foundation (2024GXNSFDA010040)+3 种基金the Key Research and Development Project of Guangxi, China (AA18221001)the Key Project of Guangxi Natural Science Foundation, China (2018GXNSFDA050012)the 111 Projects (D17011)Shanghai Key Disciplines of Public Health (2023-2025) for the New Three-year Action Plan (GWVI-11.1-23)。
摘要Liver cancer ranks sixth in cancer incidence and third in cancer-related deaths worldwide.Hepatocellular carcinoma(HCC)is the primary histological subtype,and hepatitis B virus(HBV)carriers have a higher risk of HCC.Although several susceptibility loci for HCC have been identified in East Asian populations through genome-wide association studies(GWAS),the underlying biological mechanisms of this malignancy remain incompletely understood.Here,we conduct a two-stage GWAS including 2413 cases and 2794 HBV-positive controls from a high-incidence region in Southern China.The function of the susceptibility locus is investigated by bioinformatic and experimental approaches,supported by a xenograft model.We identify a 4p14 locus significantly associated with the risk of HCC(rs55718051,OR[95%CI]=0.73[0.67-0.80],Pmeta=9.14×10-11),and 18q23 locus with borderline significance(rs12964643:OR[95%CI]=0.75[0.67-0.83],Pmeta=1.11×10-7).Functional experiments indicate the role of rs55718051 in FAM114A1 expression regulation,possibly through the interaction with FOXA1.Knockdown of FAM114A1 significantly promote the oncogenic phenotypes in liver cancer cells,suggesting its potential tumor suppressor role.Our findings expand the understanding of HCC susceptibility and suggest FAM114A1 as a potential suppressor in HBV-related HCC carcinogenesis.
基金the Open Project of National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion:a Study on The Evidence-Based Evaluation of the Acupuncture Therapy of Promoting Blood Circulation and Dispelling Wind in the Treatment of Primary Hypertension(No.NCRCOP2023004)the Young Faculty and HighLevel Project Incubation Program of Beijing Union University:a Study on the Mechanism of Pingchong Jiangni Acupuncture in Regulating the Adenosine 5‘-monophosphate-activated Protein Kinase/Perilipin 2 Lipophagy Signaling Pathway in the Paraventricular Nucleus of Spontaneously Hypertensive Rats(No.ZK30202508)。
摘要OBJECTIVE:To observe the characteristics of acupoint sensitization in patients with essential hypertension,analyze the mechanical pain threshold and tenderness threshold of each acupoint,and summarize the clinical characteristics of high-sensitivity acupoints.METHODS:This study employed a cross-sectional matched case-control design and enrolled a total of 448 volunteer participants,including 224 patients with hypertension and 224 healthy controls.The main outcome measures included measuring the mechanical pain threshold and tenderness threshold of 16 highly sensitive acupoints in both hypertensive subjects and healthy controls.The receiver operating characteristic curve method was used to evaluate the sensitivity of each acupoint.Additionally,the rules of mechanical pain threshold,tenderness threshold sensitization rate,and degree of sensitization of each acupoint in hypertension patients were summarized to identify the optimal highly sensitive acupoints related to hypertension.RESUITS:The mechanical pain threshold and tenderness threshold of hypertensive patients were significantly lower than those of healthy subjects,the difference was statistically significant(P<0.001),indicating that the mechanical pain threshold and tenderness threshold of hypertensive patients at various points had a downward trend.Acupoints with high incidence of sensitization in hypertensive patients include Quchi(LI11),Taichong(LR3),Fenglong(ST40),Xingjian(LR2),Taixi(KI3)and Renying(ST9).CONCLUSION:This study successfully achieved the objective of exploring acupoint sensitization in patients with primary hypertension.Hypertensive patients exhibited significantly lower mechanical pain thresholds and pressure pain thresholds compared to healthy subjects.These findings provide clinical evidence for acupoint selection in acupuncture treatment for primary hypertension.
基金supported by the National Natural Science Foundation of China (32060505, 31660418)the Project of National Key Laboratory for Tropical Crop Breeding, China (NKLTCB202318)+3 种基金the Yunnan Seed Laboratory, China (202205AR070001-13)the Technology Innovation Talents in Yunnan Province, China (202305AD160041)the National Sugar Industry Technology System, China (CARS-170101)the High-performance Computing Platform of YaZhou Bay Science and Technology City Advanced Computation Center, China。
摘要Increasing the sucrose content of sugarcane,a major sugar crop,is a key breeding objective.However,the complex genetic background of sugarcane affects development of sugarcane hybrids.In this study,we sequenced 292 sugarcane germplasm accessions and identified 2,542,965 single nucleotide polymorphisms(SNPs) and insertions/deletions(InDels).We performed a genome-wide association study(GWAS) for two important sugarcane traits:sucrose content and stem diameter.Both traits followed a normal distribution and showed typical characteristics of quantitative traits.Population structure analysis revealed four subpopulations with an average genetic distance of 0.236.GWAS of the sucrose content detected 27 SNPs.After annotating genes at or near significant loci,17 candidate genes were screened.For stem diameter,GWAS revealed 19 SNPs,from which 9 candidate genes were identified.These results improve our understanding of genetic mechanisms affecting sucrose content in sugarcane,and identify important genetic resources to accelerate breeding of new sugarcane varieties with high sucrose content.
基金supported by the Guangzhou Science and Technology Plan Project(2024B03J0191)to Hu Haothe Research Projects of the Sixth Affiliated Hospital,Sun Yat-sen University(No.2023-053 and No.2023-063)to Hu Hao.
摘要Genetic variations are risk factors for neonatal hyperbilirubinemia(NHB),a common cause of infant hospitalization in the first postnatal week,but their contribution and long-term impacts remain unclear.This population-based multicenter study enrolls 1780 hospitalized NHB newborns and 38,158 genetically screened newborns across 20 hospitals(2019-2022).Excluding cases with clear clinical causes,977 NHB cases are categorized into genetic variation-positive and-negative groups.Results show significantly higher NHB-related gene variants(81.63%vs.65.62%)and positive variation rates(36.29%vs.9.4%)in NHB cases than in the general newborn population(all P<0.001).Among the 977 NHB cases,325(33.3%)have positive variants,with higher rates of severe hyperbilirubinemia(16.9%vs.9.7%,P=0.001),prolonged jaundice(36.3%vs.27.6%,P=0.005),and cholestasis/hypercholanaemia(23.7%vs.14.7%,P<0.001)in the positive group.Cumulative genetic variants in bilirubin metabolism pathways exhibit dosedependent associations with increased risks of complications.Long-term follow-up reveals that UGT1A1 variants prolong jaundice up to one month,while severe SLC10A1 variants cause persistent cholestasis/hypercholanaemia beyond nine months.This large-scale evidence highlights genetic factors as key NHB determinants,with implications for neonatal care protocols to integrate genetic testing and establish longterm surveillance for variant carriers.
基金supported by the China Postdoctoral Science Foundation(2024MD753988)Postdoctoral Fellowship Program of CPSF(GZB20240614)+1 种基金Natural Science Basic Research Program of Shaanxi(2025JC-YBQN-716)Scientific Research Program Funded by Shaanxi Provincial Education Department(24JR131).
摘要Huff-n-puff(HnP)is currently an important means to enhance the oil recovery of tight oil reservoirs.In this study,taking tight sedimentary tuff oil reservoirs in Santanghu Basin,China as an example,the oil production law,pore utilization characteristics,and influencing factors of water,N2,CO2,N2 water alternating,and CO2 water alternating HnP(WHP,NHP,CHP,NWAHP,CWAHP)are comprehensively studied.The results show that middle pores(MPs)are the main pore utilization interval for various HnP mediums.The recovery rates(RRs)of five rounds of WHP,NHP,and CHP are 39.32%,44.45%,and 61.24%,with contribution rates(CRs)of MPs being 68.60%,47.87%,and 56.00%.The RRs and CRs of various pores are closely related to their pore distribution and the oil recovery mechanism of the medium.Under the experimental conditions of this study,the RR of CHP does not have an obvious rock sample size effect,with sweep depth exceeding 1.25 cm in each round.The RR of CHP is positively correlated with injection pressure and shut-in time,and the injection exceeding the rock fracture fracturing and 300 min shut-in time are recommended.The RRs of six rounds of NWAHP and CWAHP are 51.98% and 62.75%,with CRs of MPs being 60.39%and 58.32%.The oil recovery effect(ORE)of NWAHP is better than that of their individual,while the ORE of CWAHP is better than that of WHP but close to that of CHP.The alternating sequence affects the stage RR of NWAHP and CWAHP.The NWAHP and CWAHP have great advantages in improving RR,reducing injection cost,and stabilizing production,and are expected to achieve rapid development.
基金Under the auspices of Natural Science Foundation General Project of Hainan Province(No.722MS066)Chongqing Municipal Education Science Planning Project(No.K25ZZ2070096)。
摘要Traditional villages represent a concentrated expression of the preservation and transmission of traditional culture within the context of rural revitalization,conveying important social,historical,and cultural values.Based on the perspective of spatial genes,this study selected 67 typical traditional villages in the Wuling Mountain Area in Southwest China as the case study.Between 2021 and 2024,by identifying and extracting spatial genes through the semi-structured interviews,Laddering Technique,and Landscape Pattern Index,and applying the geo-detector,the study explored the morphological characteristics and influencing mechanisms of traditional Tujia villages from the perspective of spatial genes of ecological-production-living.The findings are as follows:1)the spatial genes of traditional Tujia villages in the Wuling Mountain Area exhibit distinct patterns.Ecological genes,categorized by natural environment and layout,demonstrate a transition from clustered to dispersed patterns from the southern to northern regions.Production genes,categorized by location and cultivation patterns,show concentrated agricultural lands in the south and fragmented in the north.Living genes,divided into house plans,facades,and public buildings,reveal a higher prevalence of courtyards,stilted houses,and public buildings in northern areas.2)The spatial genes have evolved through the combined influence of four key factors:natural environment,socioeconomic development,policy systems,and ethnic culture.3)The integration of multi-source data and the application of both qualitative and quantitative approaches provide a comprehensive framework for analyzing traditional village form and their influencing mechanisms.This methodology offers valuable insights for developing sustainable strategies for the conservation of traditional Tujia traditional villages in this region.
基金supported by the High-level Talents Introduction Plan from Central South University(No.502045003)the National Natural Science Foundation of China(No.42277438)Hunan Provincial Natural Science Foundation for Distinguished Young Scholars(No.2024JJ2082)to Fang Xiao,and the Postgraduate Independent Exploration and Innovation Project of Central South University,China(Nos.2024ZZTS0557 and 2023ZZTS0993)。
摘要Existing evidence suggests residential greenness is beneficial to human,while no research to date explored the associations of greenness with age-related macular degeneration(AMD).To evaluate the association of greenness with AMD,modification and mediation effect of air pollution,we conducted this prospective study.We con-structed weighted quantile sum(WQS)index as co-exposure to nitrogen oxides(NOx),particulate matter<2.5μm(PM2.5),particulate matter<10μm(PM10).Stratified Cox regression models were applied to test the effect of exposure.Effect modification of air pollution was assessed.Stratified Cox models through the indirect method and Aalen additive risk models were used in mediation analysis.Over median follow-up of 11.67 years,4596 AMD events were ascertained.Hazard ratios(HRs)and 95%confidence intervals(95%CIs)of incident AMD for pollution per interquartile range(IQR)increment were 1.10(1.04–1.16)for nitrogen dioxide(NO2),1.09(1.03–1.15)for NOx,1.14(1.05–1.24)for PM2.5,1.13(1.05–1.21)for PM10.The HR(95%CI)of AMD associated with greenness 1000 m buffer per IQR increment was 0.91(0.86–0.97),300 m buffer was 0.94(0.89–0.99).The as-sociation between greenness 1000 m and AMD was 28.59%,44.77%,35.59%,32.31%and 27.08%mediated by the decreased WQS index,NO2,NOx,PM2.5 and PM10,respectively.Increased greenness was associated with lower AMD incidence,and air pollution partly mediate it,which implies that interventions aimed at improving air quality and increasing greenness could have a dual benefit in mitigating AMD risk.
基金Supported by the National Natural Science Foundation of China,No.82374434 and No.82174363the Youth Science Foundation Project of the National Natural Science Foundation of China,No.82205104the Excellent Young Scientific and Technological Talent Training Program of the Fundamental Scientific Research Business Expenses of China Academy of Chinese Medical Sciences,No.ZZ16-YQ-002.
摘要BACKGROUND The overlap between non-erosive reflux disease(NERD)and epigastric pain syndrome(EPS)is common in China,but its clinical profile and healthcare burden are poorly defined.AIM To characterize patients with NERD-EPS overlap and identify factors linked to frequent gastroenterology clinic visits.METHODS In a multicenter,cross-sectional study,800 consecutive patients with NERD-EPS overlap were enrolled from four tertiary hospitals in China.Data were collected via questionnaires on socio-demographics,clinical manifestations,medication use,visit frequency,and psychological distress(4-item Patient Health Questionnaire).Multivariable ordinal logistic regression identified factors independently associated with higher visit frequency.RESULTS Among the 800 patients(mean age 44.50±14.43 years;66.70%female),42.40%had≥3 clinic visits.Independent risk factors for more frequent visits included older age[adjusted odds ratio(aOR)=1.02],longer NERD duration(aOR=1.004),higher psychological distress(aOR=1.08 per 1-point 4-item Patient Health Questionnaire increase),mixed labor(aOR=3.37)or physical labor(aOR=1.91),married status(aOR=2.05),proton pump inhibitor use(aOR=1.39),and Chinese herbal preparation use(aOR=6.64).A significant synergistic interaction on visit frequency was found between proton pump inhibitor and herbal use(interaction aOR=29.06,P<0.001).CONCLUSION Frequent outpatient visits in NERD-EPS overlap is driven by a combination of demographic factors,chronicity,psychological comorbidity,and complex medication patterns,rather than symptoms alone.These findings highlight the strong association between psychological distress and frequent visits,suggesting that integrating psychological screening into routine care may help identify at-risk patients.Prospective studies are needed to determine whether psychosomatic interventions can effectively reduce healthcare utilization in this population.
基金supported by grants from the National Science Foundation of China(82160647)Sanming Project of Medicine in Shenzhen(SZSM202402020)+1 种基金Hainan Clinical Medical Research Center Project(LCYX202310)Chongqing Natural Science Foundation General Program(CSTB2024NSCQMSX0948).
摘要BACKGROUND:This study aims to evaluate the immediate and 12-month effects of communitybased first-aid training on public knowledge and attitude,assess satisfaction,and identify factors associated with score changes.METHODS:This was a prospective study.In 2022-2023,a total of 2,010 community residents in Hainan Province received first-aid training and completed structured questionnaires at baseline,immediately after training,and at 3,6,and 12 months after training.First-aid knowledge was assessed through 33 items,with a maximum total score of 33.First-aid attitude was evaluated using seven items,totaling a maximum score of 21.Satisfaction was measured on a 5-point Likert scale.Paired-sample t-tests were used to compare baseline and post-training scores,repeated-measures analysis of variance(ANOVA)was used to examine time effects,and multiple linear regression was used to analyze factors associated with score changes.RESULTS:The satisfaction score with the training was high(mean score>4.3 for all items).The first-aid knowledge and attitude scores increased significantly after training(first-aid knowledge at baseline,14.90±7.63;immediately after training,20.70±5.72,P<0.001;and attitude at baseline,17.52±2.29;immediately after training,17.89±1.54,P<0.001).At 12 months after training,knowledge scores declined slightly compared with those immediately after training but remained above baseline(time effect P<0.001),whereas attitude scores remained stable(time effect P<0.001).Knowledge improvement was greater among middle-income participants and less among participants with lower levels of education,those in professional occupations,widowed individuals,or those who had previously received first-aid training.Attitude improvements were more pronounced among male participants,younger participants,and those in the agriculture or sales/service sectors.CONCLUSION:Community-based first-aid training improved public first-aid knowledge and attitude and was well received by participants.While knowledge levels declined somewhat over time,attitude remained relatively stable,highlighting the importance of continuous reinforcement training.Personalized reinforcement strategies may be particularly beneficial for individuals with lower levels of education,specific professional backgrounds,widowhood,or prior training experience to further enhance training effectiveness.
基金supported by the Sichuan Provincial Cadre Health Research Project(ZH2024-101)the Key Natural Science Foundation of Sichuan Province(No.2025 ZNSFSC0053)。
摘要BACKGROUND Solid fuel use for cooking and heating is a major environmental risk factor,yet its association with new-onset heart disease(HD)remains unclear.The aim of this study was to investigate the relationship between solid fuel exposure and new-onset HD in a large cohort.METHODS Multivariable logistic regression models assessed associations between cooking/heating fuel types(coal,crop residue/wood,liquefied petroleum gas,natural gas,and others)and new-onset HD.Subgroup analyses explored effect modification by age,sex,education,smoking,alcohol use,and region.RESULTS A prospective cohort study included 5915 participants,with 781 participants(13.2%)developing new-onset HD.Coal use for cooking showed an initial association with new-onset HD risk(OR=1.41,95%CI:1.06–1.86,P=0.02),which attenuated after full adjustment(OR=1.28,95%CI:0.96–1.72,P=0.10).Coal use for heating demonstrated robust associations across all models(OR=1.86,95%CI:1.42–2.43,P<0.001).Crop residue/wood burning for heating was also significant(Model 2:OR=1.40,95%CI:1.06–1.86,P=0.02).Subgroup analyses revealed stronger associations among females,non-smokers,non-drinkers,and less-educated participants.Geographic stratification showed significant associations in southern but not northern regions.CONCLUSIONS Solid fuel use,particularly coal for heating,is associated with increased new-onset HD risk.Reducing solid fuel exposure is crucial for HD prevention in low-resource settings.
基金supported by the National Natural Science Foundation of China(No.82304105)the Natural Science Foundation of Guangxi Zhuang Autonomous Region(No.2024GXNSFBA010177)China Postdoctoral Science Foundation(No.2023MD744189)。
摘要Few repeated-measures studies with multiple time points have evaluated the sex-specific association between mitochondrial DNA copy number(mtDNAcn)and long-term exposure to metal mixtures.We conducted a repeatedmeasures study with three time points and 2550 observations in the manganese-exposed workers healthy cohort.Specifically,the blood concentrations of 15 metals and mtDNAcn were measured in 2012,2017,and 2021.We employed a machine learning approach(GLMMLASSO)to select the metals most associated with mtDNAcn and used Bayesian kernel machine regression to examine their joint effects.In cross-sectional analyses(2550 visits),statistical methods consistently showed Calcium(Ca)was positively associated with mtDNAcn among overall visits(β=0.292 in the linear mixed-effects model(LMM))and dominated the positive overall effects of magnesium,Ca,titanium,iron,nickel,rubidium on mtDNAcn.An inverted“U”-shaped exposure–response curve between Ca and mtDNAcn appeared in males but not in females.Interaction analysis showed the association between Ca and mtDNAcn was significantly modified by gender.In repeated-measures analyses(807 visits),we explored the tendency for metals and mtDNAcn to change over three time points;the results confirmed the cross-sectional analyses.In overall visits,the positive association between Ca and mtDNAcn remained significant(β=0.207 in LMM).For metal selection,Ca was identified as the predictor for mtDNAcn,and an inverted“U”-shaped exposure–response curve was found with mtDNAcn in males.Our findings reveal a consistent positive association between Ca and mtDNAcn with sex-dependent heterogeneity and suggest Ca may mitigate mitochondrial dysfunction induced by other metals.
基金supported by the National Natural Science Foundation of China(82241205,82422007,82370471,82170487,82470495,82300538 and 82400548)the Beijing Natural Science Foundation(JQ24038,7232037,24G10071 and L232030)+2 种基金Beijing Nova Program(20220484151)the Beijing Municipal Science&Technology Commission(Z221100007422015 and Z241100007724008)the Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(ZLRL202317)。
摘要Dear Editor,Acute aortic dissection(AAD)refers to the tearing of the aortic intima,with high-pressure blood flowing into the media.It can be classified into Stanford type A and type B according to whether the ascending aorta is involved.Acute type A aortic dissection(ATAAD)is a life-threatening cardiovascular disease with high mortality rates(approximately 50%and 1%–2% per hour)within the first 48 h[1].
基金supported by Biological Breeding-National Science and Technology Major Project(2022ZD04010)Jiangsu Provincial Frontier Technology R&D Program(Modern Agriculture)(BF2025305)+1 种基金Jiangsu Agricultural Science and Technology Innovation Fund(CX(24)1003)China Agriculture Research System of MOF and MARA(CARS-12)。
摘要Owing to the continuous increase in industrialization,the extent of soil salinization is escalating globally.Brassica napus is among the most advantageous field crops for the development and utilization of saline-alkali land.Nevertheless,the molecular regulation of salt tolerance during the seedling stage in this species remains unclear.To explore this mechanism,an association population consisting of 202 accessions was subjected to a 257 mmol/L NaCl solution at the seedling(four-leaf)stage.After 14 days of salt treatment,the above-ground and under-ground fresh and dry weights of each accession line were measured,and the correlations between these traits were evaluated.By integrating phenotypic data with resequencing data,a genome-wide association study identified 2043 single nucleotide polymorphisms(SNPs)that were significantly associated with these traits.Ninety SNPs were detected repeatedly,with a single SNP accounting for 1.3%–5.29%of the phenotypic variation.Subsequently,two candidate genes were identified,and six germplasm resources with strong salt tolerance at the seedling stage were selected.These results will guide strategies for breeding salt-tolerant B.napus and will offer a theoretical foundation for the restoration and management of salinized land.