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Objective To explore the relationship between the dynamics of plant-based diets and mortality in Chinese older adults. Methods Based on the data from the Chinese Longitudinal Healthy Longevity and Happy Family Study (CLHLS), older adults who participated in the three surveys from 2011-2018 were selected. The HPDI and UPDI scores of the study participants were calculated in 2011 and 2014, respectively, and they were categorized into four groups based on the median of their two scores: low-low, low-high, high-low and high-high groups. Cox proportional risk regression models were used to analyze the relationship between the dynamics of plant-based diets and mortality in the elderly. Results A total of 4 382 subjects were enrolled in this study, and 1 689 (38.5%) of them died during the 7-year follow-up period. The results of Cox proportional hazards regression model showed that after adjusting for confounding factors such as gender, age, and education, the risk of death in the high-high HPDI group was reduced by 17% (HR=0.83, 95%CI: 0.72-0.97), while the risk of death in the high-high UPDI group was increased by 29% (HR=1.29, 95%CI: 1.11-1.49). Conclusion Older adults who maintain a healthy plant-based diet have a lower risk of death. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between metabolic syndrome (MS)and its components with the risk of stroke incidence. Methods: A prospective cohort study was conducted to compare the differences in demographic information, behavioral lifestyle, dietary habits, medical history, and MS - related indicators between people with and without stroke. The Cox proportional hazards regression analysis model was used to analyze the association between MS components, their interactions, and the incidence of stroke. Results: Stroke patients had higher age, waist circumference (WC), body mass index (BMI), blood pressure (BP), total cholesterol (TC), triglycerides (TG), and fasting plasma glucose (FPG)compared to non - stroke patients. After adjusting for confounding factors, MS, WC, TG, BP, and FPG were all associated with an increased risk of stroke, with abnormal BP showing the strongest association with stroke incidence. There were no multiplicative interaction or additive interactions between WC, TG, BP, and FPG. Conclusion: MS is associated with an increased risk of stroke incidence. WC, TG, BP, and FPG independently contribute to stroke risk, with abnormal BP exerting the greatest impact on stroke incidence. [ABSTRACT FROM AUTHOR]

Liver cancer is a significant global disease burden with a major impact on population health, and it is one of the important concerns in terms of public health worldwide. Cancer risk prediction models can estimate an individual’s absolute risk of developing cancer. Individual risk assessment allows targeted screening of high-risk populations, which is essential for primary and secondary cancer prevention. In this review, we examine existing epidemiological studies to explore key issues in the design, predictive variables, and performance of risk prediction models for liver cancer in the general population. The aim is to provide an important reference for the future development of highly comprehensive liver cancer risk prediction models. [ABSTRACT FROM AUTHOR]

BACKGROUND: The number of hip fracture patients with dementia is increasing with an aging population, posing challenges for surgical treatment. OBJECTIVE: To determine the effect of dementia on postoperative complications in older patients with hip fractures. METHODS: Patients aged over 60 years old with hip fractures from 2000 to 2019 at Chinese PLA General Hospital were included. Dementia patients with a preexisting diagnosis of dementia at admission were identified. Each dementia patient was matched, for age ± 5 years, gender, and fracture type with 10 non-dementia patients. The differences in postoperative complications were compared between the two groups, including pneumonia, respiratory failure, gastrointestinal bleeding, urinary tract infection, surgical site infection, deep venous thrombosis, pulmonary embolism, angina pectoris, arrhythmia, heart failure, myocardial infarction, stroke, and death. The impact of dementia on major complications was evaluated using multivariate conditional logistic regression. RESULTS AND CONCLUSION: A total of 2887 patients were included, of whom 125 (4.3%) were dementia patients and matched with 1 243 non-dementia patients. The average age of dementia patients was (80.6±7.4) years; 64.8% were female; 53.6% were intertrochanteric fractures, and 46.4% were femoral neck fractures. Major complications occurred in 25 (20.0%) patients with dementia and 123 (9.9%) patients without dementia (P < 0.01). The risk of major complications was 200.0 per 1 000 persons (95%CI, 139.3-278.6) in dementia patients and 99.0 per 1 000 persons (95%CI, 83.6-116.9) in non-dementia patients. Multivariate conditional logistic regression showed that a 2-fold risk of major postoperative complications after hip fracture surgery was found in dementia patients than in those without dementia (adjusted OR, 2.11; 95%CI, 1.08-4.10). The results show that dementia is an independent risk factor for postoperative complications in elderly patients with hip fractures. Appropriate preoperative risk assessment and corresponding preventive and therapeutic measures should be given to this vulnerable population to mitigate postoperative complications. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between muscle strength and the risk of depression in the middle-aged and elderly, and to provide reference for the prevention and treatment of depression in the middle-aged and elderly in China. Methods Based on the data of China Health and Retirement Longitudinal Study (CHARLS), the middle-aged and elderly people who participated in the survey in 2015 and 2018 were selected. Firstly, restricted cubic splines (RCS) were used to analyze whether there was a dose-response relationship between upper limb strength (standardized grip strength) and lower limb strength (time to stand up from a chair) and the risk of depression in the middle-aged and elderly. Secondly, the upper and lower limb strength were divided into three groups, and Logistic regression model was used to evaluate the correlation between upper and lower limb strength, overall muscle strength and depression risk in the middle-aged and elderly. Results A total of 6 245 subjects were enrolled in this study. During the 3-year follow-up periods a total of 2 095 (33.5%) subjects had depressive symptoms. There was a dose-response relationship between upper and lower limb strength and the risk of depression in the middle -aged and elderly. Logistic regression model showed that after adjusting the confounding factors such as sex, age and marital status, stronger upper and lower limb strength could reduce the risk of depression by 24% and 28%, respectively. Compared with the weakest overall muscle strength group, the strongest muscle strength group had a 48% lower risk of depression (OR=0.52, 95%CJ: 0.41-0.67). Conclusion Strong muscle strength can reduce the risk of depression in the middle-aged and elderly. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between hearing loss and the risk of muscular dystrophy in the middle-aged and elderly, so as to provide scientific basis for the prevention and intervention of myogenic in this population. Methods In this study, people aged 45 and above in the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015 were selected as research subjects. Self-reported hearing loss was used to evaluate hearing loss. Based on the consensus of Asian muscular dystrophy working group in 2019, muscular dystrophy was determined. Cox proportional hazard model was used to investigate the relationship between hearing loss and the risk of myasthenia. Results Among 11 528 middle-aged and elderly people, the incidence of baseline hearing loss was 12.8%. During the 4-year follow-up, there were 558 new cases of muscular dystrophy, with an incidence of 6.4%. The results of the Cox proportional hazard model showed that subjects with hearing loss had an increased risk of muscular dystrophy by 31.1% (R=1.311, 95%CI: 1.059-1.625) compared with those without hearing loss. The results of stratified analysis showed that the relationship between hearing loss and muscular dystrophy was more obvious in women, the elderly, rural household registration, married people, those with education level of junior high school or above, and those with high annual family income. Conclusion Hearing loss is related to the increased risk of muscular dystrophy in middle-aged and elderly people in China. Early screening and intervention for hearing loss may help reduce the incidence of future muscular dystrophy. [ABSTRACT FROM AUTHOR]

Objective　To investigate the influence of triglyceride （TG）/high-density lipoprotein cholesterol （HDL-C） ratio on the onset of primary liver cancer. Methods　A prospective cohort study was conducted. Physical examination data were collected from 99 750 cases of on-the-job and retired employees of Kailuan Group who participated health examination from July 2006 to December 2007， and they were followed up till December 31， 2021 to observe the onset of primary liver cancer. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups； the chi-square test was used for comparison of categorical data between groups. According to the tertiles of TG/HDL-C ratio， the subjects were divided into Q1， Q2， and Q3 groups， and the incidence density of primary liver cancer was calculated for each group. The Kaplan-Meier method was used to calculate the cumulative incidence rate of primary liver cancer in each group， and the log-rank test was used to compare the difference in cumulative incidence rate between groups. The Cox proportional hazards model was used to analyze the influence of TG/HDL-C ratio on the onset of primary liver cancer. Results　There were significant differences between the three groups in age， proportion of male subjects， waist circumference， body mass index， fasting blood glucose， systolic pressure， diastolic pressure， triglyceride， total cholesterol， HDL-C， low-density lipoprotein cholesterol， alanine aminotransferase， high-sensitivity C-reactive protein， chronic liver diseases， hypertension， diabetes， the family history of malignant tumor， drinking， smoking， physical exercise， and educational level （P<0.05）. During the mean follow-up time of 14.06±2.71 years， there were 484 cases of new-onset liver cancer， among whom there were 446 male subjects and 38 female subjects. The incidence density of primary liver cancer was 0.39/1 000 person-years in the Q1 group， 0.35/1 000 person-years in the Q2 group， and 0.30/1 000 person-years in the Q3 group， and the cumulative incidence rates of primary liver cancer in the three groups were 6.03‰， 5.28‰， and 4.49‰， respectively， with a significant difference between the three groups based on the long-rank test （χ²=6.06， P=0.048）. After adjustment for the confounding factors considered， the Cox proportional hazards model showed that compared with the Q3 group， the Q1 group had a hazard ratio of 2.04（ 95% confidence interval［ CI］： 1.61 — 2.58， Pfor trend<0.05）， and the Q2 group had a hazard ratio of 1.53（ 95%CI： 1.21 — 1.92， Pfor trend<0.05）. Conclusion　The reduction in TG/HDL-C ratio is associated with an increase in the rask of primary liver cancer， especially in people with chronic liver diseases. [ABSTRACT FROM AUTHOR]

工作相关肌肉骨骼疾患（work-related musculoskeletal disorders，WMSDs）是一种常见的工作相关疾病，为世界各 国的劳动者带来了沉重的疾病和经济负担，已成为21 世纪重大的公共卫生问题之一。对近5 年国内外关于不同作 业人群WMSDs 的队列研究进行回顾，探讨损伤发生率、影响因素和预防策略，并对未来研究方向进行展望，旨在为 有效预防和控制WMSDs 的发生，保障劳动者职业健康提供科学依据. [ABSTRACT FROM AUTHOR]

Objective To explore the effect of s(rimi lipid l(v(ds on the risk of(l(v(doping cognitiw (lcclinc in middle -- aged and adults. Methods Data wcm obtained from the China Retirement and Follow - up Survey Cohort (CHARLS) cohort from 2011 -2018, and middle - aged and older adults ag(xl A45 years 冇etc selected fbt cognitive assessment of middles - aged and(Ade,r adults who 刊cm followed up in 2018 by using the Chinese version of the Brief Mental Seale (MMSE), and multifactorial logistic regmssion was utilized to analyze middle -- ag(xl and adult populations for scrum total cholesterol (TC), triglyccricl(於(TG), high -- density lipoprotein cholcst(江ol(HDL), low -- density lipoprotein cholesterol(LDL) and lipid composite inch:龙(LCI) in ndation to cognitivc fimetion. Results A total of 6 556 participants with a mean age of 57. 03 ± 8. 03 years were in(dud(xL After adjusting for multiple(onfbim(l(rs? (*ompar(xl with the lowest quartile group (QI), highest quartiles group(Q4) of TG(OR 二 1.229, 95%CZ： 1.036 - 1.456), LDL(05 = 1.221,95%CZ： 1,034 - 1.443), and LCI(OR = 1.282, 95% CI： 1.081 -- 1. 522) wem positively asso(*iat(xl with the cognitive decline. The risk of d(v(doping cognitivc decline was positively asso(*iat(xl with the risk of cognitive decline, HDL(OR = 0. 765, 95%C/：0. 646 -0. 906) was n(gativ(dy associated with the risk of cognitive decline, and TC(0R =1.010, 95%C7：0. 855 - 1. 193) was not associated with the risk of cognitiw dysfunction, and the (liffcmncc was not statistically significant. Conclllsion TG, LDL and LCI an risk factors for the risk of cognitiw: decline in middle -- ag(xl and (ddcrly people, and HDL arc protective factors for the risk of cognitive decline in middle 一 ag(xl and(d.d(rly people. [ABSTRACT FROM AUTHOR]

Abstract Background Depression may be associated with the risk of developing type 2 diabetes. The goal of this study was to explore the association of severe of depression with the risk of type 2 diabetes in adults in Guizhou, China. Methods A 10‐year prospective cohort study of 7158 nondiabetes adults aged 18 years or older was conducted in Guizhou, southwest China from 2010 to 2020. The Patient Health Questionnaire‐9 (PHQ‐9) was used to measure the prevalence of depression. Cox proportional hazard models were used to estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) of depression and incident type 2 diabetes. A quantile regression (QR) analytical approach were applied to evaluate the associations of PHQ‐9 score with plasma glucose values. Results A total of 739 type 2 diabetes cases were identified during a median follow‐up of 6.59 years. The HR (95% CI) per 1‐SD increase for baseline PHQ‐9 score was 1.051 (1.021, 1.082) after multivariable adjustment. Compared with participants without depression, those with mild or more advanced depression had a higher risk of incident type 2 diabetes (HR:1.440 [95% CI, 1.095, 1.894]). Associations between depression with type 2 diabetes were suggested to be even stronger among women or participants aged ≥45 years (p

Objective To investigate the combined effects of sleep duration and muscle strength on depressive symptoms in Chinese middle-aged and elderly adults, and to provide reference for mental health promotion. Methods A total of 4 225 participants from the China Health and Retirement Longitudinal Survey (CHARLS) who participated in both 2011 and 2018 waves. Sleep duration and depressive symptoms were assessed using a questionnaire, and muscle strength (grip strength and chair-rising time) was measured. Multivariable adjusted cox regression models were used to explore the combined effects of sleep duration and muscle strength on depressive symptoms. Results In total 1 465 (34.67%) participants reported depressive symptoms in 2018. After adjusting for confounding factors, participants with non-recommended sleep duration (> 9 h/d or < 7 h/d), lower grip strength, and longer chair-rising time had significantly increased risk of depressive symptoms. Compared with those with recommended sleep duration (7 to 9 h/d) and high muscle strength (high grip strength and short chair-rising time) group, individuals with non-recommended sleep duration and low muscle strength showed significantly increased risk of depressive symptoms (HR=1.99, 95% CI: 1.38-2.87). Conclusion Non-recommended sleep duration and low muscle strength are significant risk factors for depressive symptoms. Thus, increasing muscle strength and improving sleep duration should be recommended for mental health promotion in middle-aged and elderly people. [ABSTRACT FROM AUTHOR]

Objective To explore the relationship between C-reactive protein (CRP) and blood glucose in prediabetic population through a cohort study, and to explore whether grip strength can regulate the correlation. Methods Based on the China health and retirement longitudinal study (CHARLS), the middle-aged and elderly people who participated in the baseline survey (2011) and the follow-up survey (2015) were selected. Multiple Logistic regression model was used to analyze the relationship between CRP and pre-diabetic people who developed into diabetes or returned to normal blood glucose as well as the regulatory effect of grip strength. Results A total of 2 811 subjects were included in this study. During the follow-up period, 441 (15.7%) developed diabetes, 1 762 (62.7%) maintained the status of prediabetes, and 608 (21.6%) returned to normal blood glucose. After adjusting the covariates, the results of multiple Logistic regression showed that compared with CRP first quartile (Quartile 1), both CRP third quartile (Quartile 3) and fourth quartile (Quartile 4) increased the risk of diabetes, their OR values and 95%CI being 1.63 (1.18-2.24) and 1.67 (1.14-2.17), respectively, and the probability of returning to normal blood glucose was reduced by 32% in Quartile 4 group. In the low grip strength group, the risk of developing diabetes in the Quartile 3 and Quartile 4 groups was 1.80 (95%CI:1.13-2.87) and 2.04 (95%CI:1.29-3.23) times higher than that in the Quartile1 group, while the Quartile 4 group reduced the chance of returning to normal blood sugar by 41%, but the association was not observed in the high grip strength group. Conclusion CRP is closely related to the change of blood glucose in pre-diabetic population, but high grip strength can regulate this correlation. [ABSTRACT FROM AUTHOR]

Objective To investigate the influence of socio-economic status (SES) on the incidence of overweight and obesity. Methods By using the method of multi-stage cluster random sampling, a baseline survey was conducted on 9 280 people in Guizhou Province in 2010. All participants in the cohort were followed up from 2016 to 2020. In total 2 681 people were included in the analysis after excluding those who lost follow-up and did not meet the requirements. Univariate analysis and COX proportional regression model were used to analyze the effects of SES comprehensive score and SES single index on the incidence of overweight and obesity. Results The median follow-up was 6.42 years, and the population incidence density was 41.72/1 000 person-years. The results of multivariate COX regression showed that compared with the people with per capita annual income less than 2 667 yuan, the risks of disease for those with income of 5 000 to < 10000 yuan and ≥ 10 000 yuan were HR=0.756 (95%CI: 0.611-0.934) and HR=0.626 (95%CI: 0.498-0.787), respectively (Ptrend < 0.001). Compared with illiterate and semi-illiterate, the disease risk was lower for people with education of primary school (HR=0.740, 95%CI: 0.599-0.914), junior high school (HR=0.666, 95%CI: 0.541-0.820), and senior high school/technical secondary school and above HR=0.634 (95%CI: 0.468-0.859), respectively (Ptrend <0.001). There was no correlation between occupation and disease risk. Compared with the population with SES comprehensive score < 6, the risks of disease in the population with 8 points and ≥ 9 points were HR=0.735 (95%CI: 0.566-0.955) and HR=0.540 (95%CI: 0.417-0.700), respectively (P<0.001). The results of urban and rural subgroup analysis showed that the effect of comprehensive score of SESS on the risk of disease was more significant in rural population. In terms of single index, the incidence of urban population was only related to individual education level (Ptrend =0.008), and the incidence of rural population was only related to family per capita annual income (Ptrend =0.002). Conclusion The risk of overweight and obesity is closely related to SES, and SES inequality causes health differences. Attention should be paid to urban low-education and rural low-income population. [ABSTRACT FROM AUTHOR]

Background: Depression may be associated with the risk of developing type 2 diabetes. The goal of this study was to explore the association of severe of depression with the risk of type 2 diabetes in adults in Guizhou, China. Methods: A 10‐year prospective cohort study of 7158 nondiabetes adults aged 18 years or older was conducted in Guizhou, southwest China from 2010 to 2020. The Patient Health Questionnaire‐9 (PHQ‐9) was used to measure the prevalence of depression. Cox proportional hazard models were used to estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) of depression and incident type 2 diabetes. A quantile regression (QR) analytical approach were applied to evaluate the associations of PHQ‐9 score with plasma glucose values. Results: A total of 739 type 2 diabetes cases were identified during a median follow‐up of 6.59 years. The HR (95% CI) per 1‐SD increase for baseline PHQ‐9 score was 1.051 (1.021, 1.082) after multivariable adjustment. Compared with participants without depression, those with mild or more advanced depression had a higher risk of incident type 2 diabetes (HR:1.440 [95% CI, 1.095, 1.894]). Associations between depression with type 2 diabetes were suggested to be even stronger among women or participants aged ≥45 years (p <.05). There are significant positive associations of PHQ‐9 score with 2‐h oral glucose tolerance test blood glucose levels. Conclusion: Depression significantly increased the risk of incident type 2 diabetes, especially in women, participants aged ≥45 years, Han ethnicity, and urban residents. These findings highlighted the importance and urgency of depression health care. [ABSTRACT FROM AUTHOR]

Objective To analyze the effects of low -density lipoprotein cholesterol (LDL -C), high -density lipoprotein cholesterol (HDL-C), and the ratio (LDL-C/HDL-C) on the risk of hypertension, and to provide reference for the prevention and treatment of hypertension. Methods The data of this study came from the natural population cohort in Guizhou Province, which was established in 2010 and followed up from 2016 to 2020. The data were analyzed by/-test and Chi-square test with the use of SPSS20.0. The effects of LDL-C, HDL-C, and LDL-C/HDL-C on hypertension were analyzed by Cox proportional hazard regression model. The corrected risk ratio (adjusted hazard ratio, aHR) and its 95% confidence interval (95% CT) were calculated, and the dose -response relationship was described by restricted cubic spline method. Subgroup analyses by genders and ages were performed • Results A total of 5 388 participants were included and were followed up for 37 47537 person-years. During the follow-up period, there were 1 160 new cases of hypertension, and the incidence density was 30.96/1 000 person-years. The results of Cox proportional hazard regression model analysis showed that after adjusting the related factors, for every unit increase of LDL-C and LDL-C/HDL-C in the whole population, the risk of hypertension increased by 17% (aHR=lA7, 95%CI: 1.09-126) and 6% (aHR=1.06, 95%CI: L02_l.il), LDL-C and LDL-C/HDL-C were grouped according to quartile method and included in the model as classified variables. Compared with QI, the aHR of Q4 hypertension was 1.59 (95%CZ: 1.28-1.98) and 1.44 (95%CZ:1.20-1.71), respectively. Subgroup analysis showed that the risk of hypertension in Q4 was 146 (95%CZ: 1.08-1.99), L81 (95%CZ: 132-247), 1.53 (95%C?:1.21 -1.94)，and 240 (95C7:1.23-4.66) in men, women, < 65 years old, and 3 65 years old respectively compared with QI of LDL-C. Compared with QI of LDL-C/HDL-C, the risk of hypertension in Q4 was 1.41 (95%CZ: 1.10-1.82), 1.51 (95%CZ: 1.18--1.94), 1.41 (95%Cf: 1.16-1.70), and 2.09 (95%CI: 1.27-3.44)，respectively. The results of restricted cubic spline showed that the levels of LDL-C and LDL-C/HDL-C were positively correlated with the risk of hypertension. Conclusion The increase of LDL-C and LDL-C/HDL-C are the risk factors of hypertension, especially in women and people over 65 years old. [ABSTRACT FROM AUTHOR]

Abstract Background Existing evidence concerning the relationship between daytime napping and type 2 diabetes (T2D) is inconsistent, and whether the effects of napping differ by body fat percentage (BFP) and C‐reactive protein (CRP) is unclear. We aimed to investigate the association between daytime napping frequency and T2D risk and whether such an association was modified by BFP and CRP. Methods We included 435 342 participants free of diabetes from the UK Biobank. Participants were categorized as nonnappers, occasional nappers, and frequent nappers based on napping frequency, and BFP/CRP was divided into quartiles. Cox proportional hazards models were used. Results During a median follow‐up of 9.2 years, 17 592 T2D cases occurred. Higher frequency of daytime napping was significantly associated with an increased risk of T2D. Compared with nonnappers, the adjusted hazard ratios (HRs) for occasional nappers and habitual nappers were 1.28 (95% confidence interval [CI]: 1.24–1.32) and 1.49 (95% CI: 1.41–1.57), respectively. There was a significant additive and multiplicative interaction (relative excess risk due to interaction [RERI] = 0.490, 95% CI 0.307–0.673; p for multiplicative interaction

Background and purpose: The implementation of intensity-modulated radiotherapy (IMRT) has significantly enhanced the survival outcomes for patients with nasopharyngeal carcinoma (NPC). However, this therapeutic approach still falls short in meeting the prognostic requirements of individuals with locally advanced NPC (LANPC). Therefore, it is imperative to identify effective prognostic markers to enhance the efficacy of radiotherapy and achieve personalized treatment. Given the potential predictive value demonstrated in previous studies regarding radiotherapy-related body dose parameters and immune blood cells, this study aimed to investigate the correlation between body dose parameters and reduced immune cells and patient prognosis during radiotherapy in LANPC patients. Methods: Clinical data of 423 patients with LANPC (stage Ⅲ-Ⅳa) treated in Fudan University Shanghai Cancer Center from Jan.1, 2012 to Dec. 31, 2016 were retrospectively analyzed. Percentage changes of different immune blood cells during radiotherapy were also collected. Cox proportional hazard model was used to determine prognostic factors for overall survival (OS), locoregional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS). Body dose-based parameters were extracted from dose-volume histograms (DVHs). Logistic regression was applied to determine parameters that could predict white blood cells reduction. Results: High ΔLYM% (ΔLYM%≥7 7.0%) and high ΔMONO% (ΔMONO%≥2 8.5%) were identified as two adverse prognostic factors in LANPC patients. In multivariable analysis, high ΔLYM% was found to be a significant predictor of worse OS (HR=1.672, P=0.012), LRFS (HR=1.712, P=0.006), and DMFS (HR=1.971, P=0.001). High ΔMONO% was associated with worse OS (HR=1.355, P=0.015) and DMFS (HR=1.704, P=0.003). The change of ΔLYM% was influenced by the integral body dose (IBD) (OR=1.004, P=0.037) and body V60 (OR=1.046, P=0.036). ΔMONO% was significantly affected by body V55 (OR=1.144, P=0.009) and V70 (OR=0.734, P=0.022). Conclusion: Integral body dose, V60, and V55, V70 can serve as dose-volume constraints to retain sufficient immune cell populations to improve prognosis. [ABSTRACT FROM AUTHOR]

Objective To evaluate the association between pre-and post-diagnosis body mass index (BMI) and risk of colorectal cancer (CRC) death. Methods The cohort consisted of 3, 057 CRC patients from Shanghai who were diagnosed from Jan. 1, 2009 to Dec. 31, 2011 and aged from 20 to 74 years. The pre- and post-diagnosis BMI and clinical and lifestyle factors were collected at baseline. Death information was collected using record linkage with the Shanghai Cancer Registry and telephone confirmation during follow-up by the end of 2019. The Cox proportional regression model was used to estimate HR with 95% CI. Results Analysis by multivariable Cox model showed no association between pre-diagnosis BMI and death risk in both male and female patients. Male patients with a post-diagnosis underweight BMI had an elevated risk of death compared to those in normal weight (HR=1.69, 95% CI: 1.21-2.37), especially in early stage cases. Overweight patients (HR=0.74, 95% CI: 0.61-0.89) and patients with obesity class Ⅰ (HR=0.63, 95% CI: 0.45-0.89)had better survival with decreased risks of death, especially in advanced stage cases. The decreased death risk in patients with obesity class Ⅱ was not significant (HR=0.57, 95% CI: 0.24-1.39). The Ptrend value for decreased risk of death with increased BMI in female patients was statistically significant (P<0.001), and the overweight and obesity class Ⅰ categories had better survival in advanced stage(HRover weight=0.62, 95% CI: 0.42-0.93; HRobesity class Ⅰ=0.39, 95% CI: 0.16-0.98). Both male and female patients with post-diagnosis BMI loss >2.0 kg/m² had an increased death risk when compared with those with stable BMI (change≤1.0 kg/m²) between pre- and post-diagnosis. BMI gain after diagnosis did not change death risk. Conclusions Post-diagnosis BMI in the overweight or obesity class Ⅰ groups might be conducive to prolonging male CRC patients′ survival, while underweight might result in poor prognosis. Keeping weight and avoiding excessive weight loss should be suggested for all CRC patients after diagnosis. [ABSTRACT FROM AUTHOR]

Objective The study aimed to investigate the association between the body height and the risk of novel cerebral infarction in the elderly with hypertension. Methods 9 574 elderly hypertension patients were monitored in this cohort research based on the Kailuan research group for cerebral infarction. Patients were categorized into quartile groups. The life table method was used to calculate the cumulative incidences of outcomes in different groups. Cox proportional hazards model was used to analyze hazard ratios (HR) with the corresponding 95% confidence interval (CI) of outcomes in different groups. Results Compared to the body height ≤ 161.5 cm (Q1) group, the multivariate Cox proportional hazard regression model showed that the hazard ratio [HR (95%CI) ] for cerebral infarction in model 2 were 0.95 (0.78 ~ 1.16), 1.00 (0.81 ~ 1.23) and 0.71 (0.56 ~ 0.90) respectively in 161.5 ~ 166.0 cm (Q2), 166.0 ~ 170.0 cm (Q3) and ≥ 170.0 cm (Q4) ; in model 3, cerebral infarction [HR (95%CI) ] in each group were 1.01 (0.81 ~ 1.24), 1.10 (0.89 ~ 1.36) and 0.76 (0.60 ~ 0.96) respectively; in model 4 were 0.98 (0.79 ~ 1.21), 1.06 (0.85 ~ 1.33) and 0.72 (0.56 ~ 0.93), respectively. Conclusion In the elderly with hypertension, a taller body height is connected with a decreased incidence of cerebral infarction. [ABSTRACT FROM AUTHOR]

Background: Existing evidence concerning the relationship between daytime napping and type 2 diabetes (T2D) is inconsistent, and whether the effects of napping differ by body fat percentage (BFP) and C‐reactive protein (CRP) is unclear. We aimed to investigate the association between daytime napping frequency and T2D risk and whether such an association was modified by BFP and CRP. Methods: We included 435 342 participants free of diabetes from the UK Biobank. Participants were categorized as nonnappers, occasional nappers, and frequent nappers based on napping frequency, and BFP/CRP was divided into quartiles. Cox proportional hazards models were used. Results: During a median follow‐up of 9.2 years, 17 592 T2D cases occurred. Higher frequency of daytime napping was significantly associated with an increased risk of T2D. Compared with nonnappers, the adjusted hazard ratios (HRs) for occasional nappers and habitual nappers were 1.28 (95% confidence interval [CI]: 1.24–1.32) and 1.49 (95% CI: 1.41–1.57), respectively. There was a significant additive and multiplicative interaction (relative excess risk due to interaction [RERI] = 0.490, 95% CI 0.307–0.673; p for multiplicative interaction <.001) between napping and BFP, whereby a higher hazard of T2D associated with more frequent napping was greatest among participants in the highest BFP quartile (HR = 4.45, 95% CI: 3.92–5.06). The results for CRP were similar (RERI = 0.266, 95% CI: 0.094–0.439; p for multiplicative interaction <.001). Conclusions: Higher daytime napping frequency is associated with an increased T2D risk, and such relationships are modified by BFP and CRP. These findings underscore the importance of adiposity and inflammation control to mitigate diabetes risk. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether a previous caesarean section affects the clinical outcomes of patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) for the first oocyte retrieval cycle. Methods: This was a retrospective cohort study among women with one previous delivery history and undergoing IVF/ICSI-ET for the first-time treatment during January 2015 to December 2020 at the reproductive medicine center of Tianjin Central Hospital of Gynecology Obstetrics. All subjects were followed to the first delivery after ET, use -up of all embryos, drop -out or the end of the study period. We retrospectively analyzed the association between previous caesarean section and the cumulative live birth rate (CLBR). Results: A total of 1 216 women were included, including 605 with a history of caesarean section and 611 with a history of vaginal delivery. Women with a previous caesarean section went through 1 053 ET cycles, and women with a previous virginal delivery went through 947 ET cycles. No significant differences were observed in the baseline characteristics (except for prolactin and infertility time), clinical features of the treatment, number of oocytes retrieved and laboratory outcomes between the two groups (all P＞0.05). Women with previous caesarean section history had higher proportions of single-embryo ET cycles and FET cycles (P＜0.05). The CLBR among women with a previous caesarean section was 59.00% (95%CI: 55.08%-62.92%), and the CLBR among women with a previous vaginal delivery was 62.68% (95%CI: 58.84%-66.51%), the difference between the two groups was significant (χ²=13.665, P＜0.001). For the women with a previous caesarean section compared to women with a previous vaginal delivery, the OR of CLBR after adjusting for age, number of oocytes retrieved, quality of embryos and the endometrium thickness was 0.825 (95%CI: 0.712-0.956, χ² =6.531, P=0.011). Conclusions: Compared to women with a previous vaginal delivery, women with a previous caesarean section had lower CLBR following IVF/ICSI-ET. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective We aimed to verify the efficacy of integrated Chinese and Western medicine in the treatment of patients with metastatic colorectal cancer ( mCRC). Methods 733 mCRC patients who visited Xiyuan Hospital of Chinese Academy of Chinese Medical Sciences, Beijing Cancer Hospital and Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine between August 1, 2013 and December 31, 2015 were enrolled. A cohort study design was adopted, and “ receiving continuous traditional Chinese medicine (TCM) for ≥3 months” was taken as the exposure factor. Patients who met this criterion were classified into the integrated Chinese and Western medicine cohort, and patients who did not meet this criterion were classified into the Western medicine cohort. Overall survival (OS) and the 1 -, 3 - and 5 - year survival rates were compared between the two cohorts. A multivariate risk proportional regression model was used to explore the factors affecting the prognosis of mCRC patients. Results A total of 335 patients with mCRC were included in this study, including 129 patients in Chinese and Western medicine cohort and 206 patients in Western medicine cohort. The median overall survival (mOS) in the Chinese and Western medicine cohort was 28. 0 months and that of the Western medicine cohort was 20. 3 months. The difference was statistically significant (HR = 0. 748, 95% CI = 0. 587-0. 950, P<0. 05). The 1-, 3- and 5-year survival rates of the Chinese and Western medicine cohort were 96. 0% (120 / 125), 36. 8% (46 / 125) and 10. 4% (13 / 125), respectively. The 1-, 3-, and 5-year survival rates of the Western medicine cohort were 79. 9% (159 / 199), 23. 1% (46 / 199) and 6. 0% ( 12 / 199), respectively. The 1 -, 3-year survival rates of Chinese and Western medicine cohort was higher than Western medicine cohort(P<0. 01). Subgroup analysis showed that there was a significant difference in mOS between the two cohorts in the female, right-side colon, RAS mutation, no targeted therapy, and non-chemotherapy subgroups (P<0. 05, P<0. 01). Multivariate analysis showed that right-side colon, non-chemotherapy, RAS mutation, and low differentiation were independent prognostic factors for poor prognosis of mCRC and integrated of Chinese and Western medicine was a protective factor (HR = 0. 529, 95%CI = 0. 386-0. 714, P<0. 01), which reduced the risk of death by 47. 1%. Conclusion Integrated of Chinese and Western medicine can prolong the OS of mCRC patients, and the benefits are more obvious in women and in patients with right-side colon cancer and RAS mutation. Integrated of Chinese and Western medicine can significantly reduce the risk of death in mCRC patients. At the beginning of Western medicine treatment, the early integrated of traditional Chinese medicine will bring greater survival benefits to mCRC patients. [ABSTRACT FROM AUTHOR]

目的探讨老年人婚姻状况与轻度认知障碍（MCI）及痴呆患病率的相关性，为老年认知障碍防控提供社会学数据。方法采用整群随机抽样方法选取湖北省城乡65岁及以上老年人，在社区卫生服务中心采用面对面访谈形式完成一般情况调查和神经心理学评估，以及临床体检和实验室检查；由两名神经病学家和两名具有痴呆专业知识的神经心理学家组成诊断专家组，根据Petersen的MCI诊断标准和《中国痴呆与认知障碍诊断指南》对参与者进行MCI和痴呆诊断；采用多因素Logistic回归分析不同年龄段老年人婚姻状况与MCI及痴呆患病的相关性。结果在2018~2020年，共8 221人完成全套神经认知评估和临床体检，平均年龄71.96±5.90岁，有1 953人无配偶，占总人数的23.75%。MCI患病率为25.98%， 95%CI （24.99%，26.98%），痴呆患病率为7.24%， 95%CI （6.68%，7.80%），使用湖北省2010年人口普查数据进行年龄和性别标准化后，MCI和痴呆的患病率分别为26.28%和6.98%，无配偶者MCI及痴呆患病率［28.07%，95%CI （26.08%，30.06%）；12.45%，95%CI （10.99%，13.91%）］明显高于有配偶者［22.85%，95%CI （21.81%，23.89%）；5.62%，95%CI （5.05%，6.19%）］。多因素Logistic回归模型发现有配偶的65~69岁男性老人［P=0.028，OR=0.639，95%CI（0.429，0.952）］和80岁及以上男性老人［P=0.004，OR=0.460，95%CI（0.269，0.785）］的MCI和痴呆患病率显著低于无配偶者，然而女性老年人有无配偶与MCI和痴呆患病的关联性无差异统计性（P>0.05）。结论MCI和痴呆患病率在无配偶老年群体中增高，特别是针对65~69岁和80岁及以上的男性老人，有配偶对保护认知功能至关重要。

目的 探讨心率减速力（DC）变化对老年稳定性冠心病（SCAD）患者长期预后的影响。方法 选择SCAD 患者，随访（5. 59±1. 84）年，共发生全因死亡23例（死亡组), 存活93例（存活组）。收集患者临床资料；患者均行24 h 动态心电图监测，计算 DC 值，根据 DC 值将患者分为 DC<2. 6 ms组 17例、DC 2. 6~4. 5 ms组 34例、DC>4. 5 ms 组 65 例。采用多因素 Cox 比例风险回归模型分析DC对SCAD患者长期预后的影响。结果 死亡组年龄、糖尿病患者比 例、抗血小板药物和硝酸酯类药物使用比例、DC 与存活组比较差异均有统计学意义（P均<0. 05）。将DC（以连续性 变量的形式）作为自变量，全因死亡为因变量，年龄、高血压、高脂血症、硝酸酯类药物、抗血小板药物、他汀类药物和 LDL-C为协变量，Cox 比例风险回归分析显示，DC、年龄是 SCAD 患者全因死亡的影响因素. 在校正了年龄、高血压、 高脂血症、LDL-C、他汀类药物应用后，DC作为连续变量，每增加1个单位，SCAD 患者全因死亡风险降低25%（HR= 0. 75，95% CI：0. 58~0. 96). 与 DC>4. 5 ms组相比, DC 2. 6~4. 5 ms 组及 DC<2. 6 ms组全因死亡风险分别增加 2. 03, 2. 3倍 (HR=3. 03，95% CI:1. 1~8. 36；HR=3. 3，95% CI：1. 11~9. 79). 分层分析显示，年龄、2 型糖尿病和 β受体阻滞 剂与 DC 在 SCAD 患者全因死亡风险的分析中均不存在交互作用。结论 DC下降为SCAD患者长期预后不良的独 立危险因素. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between recent stress events and aggressive behaviors（AGB） in patients with schizophrenia in Shanghai community. Methods A total of 9 520 schizophrenic patients in Shanghai community（Xuhui District，Hongkou District and Jiading District）were included in this study.The demographic characteristics，medication adherence，insight，psychiatric symptoms involving violence，social functioning，family care and recent stress events were collected by questionnaires in Apr 2018. AGB were followed up in Jul and Oct 2018. Multivariate Logistic regression model was applied to analyze the association between the occurrence of recent stress events（none/mild/severe）and AGB. Subgroup analysis was conducted according to age，gender and other characteristics. Results A total of 7 955 subjects were included in the analysis，and the occurrence number of AGB was 203（2.55%） during the 6-month follow-up. After adjusting the related factors，the risk of AGB in patients with mild stress events was 7.18（95%CI：4.17-12.37） times，and the risk of AGB in patients with severe stress events was 9.33（95%CI：2.33-37.41）times，with a reference of patients without current stress events. In the stratification of senior high school，compared to the patients without stress events，the risk of AGB was 21.65（95%CI：8.95-52.40）times higher in patients with stress events in the last 3 months. While in the stratification of junior high school or primary school and below education，the corresponding ratio was 7.37 （95%CI：3.27-16.61） and 2.32（95%CI：0.19-27.88，respectively，Pfor interaction=0.010）. Similarly，in the stratification of regular medication，compared to the patients without stress events，the risk of AGB was 12.61（95%CI：6.95-22.88）times higher in patients with stress events in the last 3 months. While in the irregular medication group，the corresponding ratio was 2.86 （95%CI：0.82-9.97，Pfor interaction=0.015）. Conclusion Recent stress events had a detrimental effect on AGB in the in community schizophrenics in Shanghai，and this effect intensified in patients with secondary education or regular medication. [ABSTRACT FROM AUTHOR]

Copyright of China Tropical Medicine is the property of China Tropical Medicine Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To evaluate the incidence and risk factors of sarcopenia in the elderly in community using meta-analysis method. Methods We collected data from database including PubMed, Web of Science, the Cochrane Library, China Hownet, and Wanfang from their establishment to January 2021. Cohort studies about incidence of sarcopenia and its influencing factors were included. The statistic data are calculated using Review Manager 5.4 and STATA 15.0 software. Results Thirteen articles and 13,750 subjects were included. The results showed that the incidence of sarcopenia was 11%. The incidences of sarcopenia were 6% and 12% at 1-2-year and 3-4-year follow-up, respectively. The incidences in Asian region and in the non-Asian region were 9% and 13%, respectively. They were 16% in women and 11% in men, respectively. In terms of risk factors, advanced age (OR = 1.11, 95%CI: 1.09 - 1.12, P<0.00001), history of stroke (OR = 2.92, 95%CI: 1.60- 5 .31, P=0.0005), low BMI (OR = 1.51, 95%CI: 1.42 - 1.60, P<0.00001), and lack of exercise (OR = 1.44, 95%CI: 1.18 - 1.76, P=0.0003) were important risk factors for community sarcopenia. Conclusion The incidence of sarcopenia in the elderly in community is high. Senior age, low BMI, history of stroke, and lack of exercise are the important risk factors for sarcopenia. [ABSTRACT FROM AUTHOR]

Copyright of China Journal of Oral & Maxillofacial Surgery is the property of Shanghai Jiao Tong University, College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the association of ideal cardiovascular health metrics with the incidence rate of nonalcoholic fatty liver disease (NAFLD), and to provide a basis for the prevention and control of NAFLD. Methods A prospective cohort study was conducted for the data of 50 511 employees of Kailuan Group who participated in physical examination from July 2006 to June 2007, and the onset of NAFLD was observed during follow-up once every two years. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the Kruskal-Wallis H test used for comparison of continuous data with skewed distribution between multiple groups; the chi-square test was used for comparison of categorical data between groups. The subjects were divided into four groups according to the quartile of cardiovascular health score (CHS), and person-year incidence rate was used to calculate the incidence rate of NAFLD in each group. Restricted cubic spline (RCS) curve was used to calculate the dose-response relation between continuous variables and outcome events; the Cox proportional hazards model was used to analyze hazard ratio (HR) and 95% confidence interval (CI) in each group and investigate the effect of ideal cardiovascular health metrics on the incidence rate of NAFLD. Results During the mean follow-up time of 5.58 years, a total of 15 265 cases of NAFLD were observed, and the incidence rate of NAFLD was 77.88/1000 person-year in the Q1 group, 61.33/1000 person-year in the Q2 group, 46.37/1000 person-year in the Q3 group, and 33.69/1000 person-year in the Q4 group. RCS results showed a non-linear relationship between CHS continuous variable and the risk of NAFLD (P < 0.05). The multivariate Cox proportional risk model analysis showed that compared with the Q1 group in terms of the risk of NAFLD, the Q2, Q3, and Q4 groups had an HR of 0.78 (95%CI 0.74~0.81), 0.57 (95%CI 0.54~0.59), and 0.38 (95%CI 0.36~0.41), respectively, and similar results were observed in subjects stratified by sex and age. The analysis of each component showed that ideal body mass index (HR=0.37, 95%CI: 0.36~0.39), ideal blood glucose (HR=0.80, 95%CI: 0.77~0.84), ideal blood pressure (HR=0.72, 95%CI: 0.69~0.75), ideal cholesterol (HR=0.86, 95%CI: 0.83~0.89), and ideal diet (HR=0.94, 95%CI: 0.90~0.99) were protective factors against NAFLD. Conclusion Ideal cardiovascular health metrics are protective factors against NAFLD, and maintaining a healthy lifestyle may help to prevent the onset of NAFLD. [ABSTRACT FROM AUTHOR]

Background: Social cognitive impairments, specifically in facial emotion processing and mental state attribution, are common in post-traumatic stress disorder. However few studies so far have examined whether social cognitive ability impacts on PTSD recovery. Objective: To examine whether baseline social cognitive abilities are associated with treatment outcomes following trauma-focused therapy for PTSD. Method: This is a cohort study that will relate treatment outcomes post-discharge to baseline measures of social cognition (five tasks: Emotion Odd-One-Out Task (Oddity), Reading the Mind in the Eyes Task (RMET), Social Shapes Test (SST), Spontaneous Theory of Mind Protocol (STOMP), and Reflective Functioning Questionnaire (RFQ-8)) in people starting a course of psychological therapy for PTSD (target N = 60). The primary outcome will be pre- to post-treatment change in PTSD symptom severity (assessed using the PTSD Checklist for DSM-5). Secondary outcomes include functional impairment (assessed using the Work and Social Adjustment Scale), drop-out rate, and analyses differentiating participants with DSM-5 PTSD and ICD-11 PTSD and CPTSD. Regression models will be used to examine associations between baseline social cognitive performance and outcome measures while adjusting for potential confounders. Two pilot studies informed the development of our study protocol. The first involved qualitative analysis of interviews with nine participants with lived experience of mental health problems to inform our research questions and study protocol. The second involved trialling social cognitive tasks on 20 non-clinical participants to refine our test battery. Discussion: This study will address a gap in the literature about whether abilities in social cognition in people living with PTSD are associated with treatment-related recovery. Impairments in social cognition are recognised in people with PTSD. Few studies have examined whether social cognitive ability is associated with recovery from PTSD. We present a study protocol, developed after pilot testing, to address this question. [ABSTRACT FROM AUTHOR]

Copyright of China Journal of Oral & Maxillofacial Surgery is the property of Shanghai Jiao Tong University, College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)