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The related factors of diabetic retinopathy (DR) had attracted the attention of many scholars, and a large number of articles had been published, but the research results were not consistent. A meta-analysis was conducted to synthesize recent evidence, aiming at exploring the relationship between DR and multiple risk factors.The China National Knowledge Infrastructure, VIP, Wanfang, PubMed, Embase, Medline, and Cochrane databases were searched. The English and Chinese keywords included diabetes mellitus, DM, diabetic retinopathy, DR, and risk factors. In case-control study, the subjects are DR patients and NDR patients. In the cohort study, the subjects were diabetic patients. Measures in the intervention and control groups were described in detail. The methodological quality of the included literature was assessed using the Newcastle-Ottawa Scale (NOS). Egger's test is used to identify publication bias. With odds ratio (OR) as the effect index, heterogeneity test was conducted, and fixed effect model or random effect model was selected to calculate the combined OR and 95% CI.The meta-analysis included 12 literatures and 13 related risk factors, of which 4 (33.33%) were cohort studies and 8 (66.66%) were case-control studies. NOS shows that there are 7 references with 8 points (58.33%), 4 references with 7 points (33.33%) and 1 reference with 6 points (8.33%). The risk factors associated with the occurrence of DR were: course of diabetes (OR =1.03, 95% CI: 1.02-1.03), systolic blood pressure (OR =1.01, 95% CI: 1.01-1.02), body mass index (OR =0.96, 95% CI: 0.94-0.99), HbA1c (OR =1.08, 95% CI: 1.06-1.10), total cholesterol (OR =1.20, 95% CI: 0.98-1.46), high-density lipoprotein cholesterol (OR =1.74, 95% CI: 1.19-2.56), fasting blood glucose (OR =1.19, 95% CI: 1.13-1.26), and hypertension (OR =1.25, 95% CI: 1.07-1.47), and the overall effect test results were statistically significant. Sensitivity analysis results show that the random effect model is used for meta-analysis of all Meta, and the combined OR is 1.10, and the 95% CI is (1.05, 1.15).The occurrence of DR was related to the course of diabetes, SBP, HbA1c, total cholesterol, high-density lipoprotein cholesterol, fasting blood glucose, and hypertension which provided a more intuitive and comprehensive scientific basis for the prevention and treatment of DR.

This study was undertaken to determine the correlation between instrumental and sensory evaluation on texture-modified carrot puree. Texture-modified foods (TMFs) are prescribed to dysphagia individuals to aid in the oral manipulation and facilitate swallowing of food. There is a lack of correlation between instrumental measurements and sensory attributes on TMF. Understanding this correlation will aid in the formulation of safe foods with desired sensory properties for dysphagia patients. Instrumental measurements of carrot purees were performed by back extrusion method using a texture analyzer and the attributes obtained were firmness, consistency, cohesiveness, and adhesiveness. Quantitative descriptive analysis with eight trained panelists was employed to characterize the texture of the carrot puree based on seven sensory attributes: firmness, viscous, adhesive (mouth), smoothness, adhesive (throat), rate of breakdown, and difficulty to swallow. Five thickeners, namely gellan gum, xanthan gum, Suberakaze, UNI-PURE® Dys-sperse instant thickener, and ULTRA-SPERSE® M Starch, were evaluated against carrot puree without any thickener as control. The correlation results obtained from texture analysis and sensory evaluation were statistically significant (p .05). The firmness attributes from instrumental and sensory results were positively correlated. The consistency parameter was positively correlated to sensory attribute viscous and negatively correlated to smoothness. The sensory attribute rate of breakdown was negatively correlated to instrumental parameter of cohesiveness. Lastly, instrumental adhesiveness was positively correlated to sensory attributes adhesive to mouth and throat, and difficulty to swallow. The correlation results showed a well-designed instrumental technique can be used to understand the impact of thickeners on TMF for dysphagia subjects.

Background We performed a systematic review and meta-analysis to evaluate the risks of ophthalmic adverse events (AEs) associated with immune checkpoint inhibitors (ICIs) in patients with solid tumors.Methods Eligible studies were selected after a comprehensive search of multiple databases including phase II/III randomized controlled trials (RCTs) investigating ICIs in patients with the solid tumor. The data was analyzed by R software.Results After exclusion of ineligible studies, 21 RCTs met our strict inclusion criteria for the meta-analysis, included 11930 patients. Compared with chemotherapy, the odds ratio of all-grade ophthalmic treatment-related adverse events (trAEs) were significantly lower for PD-L1 inhibitors (OR: 0.18; 95% CI: 0.08-0.39; p meta-analysis demonstrated that compared with chemotherapy, PD-L1/PD-1 inhibitors had lower risks of all-grade ophthalmic trAEs and non-specific ophthalmic trAEs (NS-trAEs) but had the same risk of ophthalmic irAEs. Combination therapy of ICIs plus chemotherapy had higher risks of all-grade ophthalmic trAEs and irAEs. Compared with PD-1 or CTLA-4 inhibitors monotherapy, PD-1 plus CTLA-4 inhibitors combination therapy had significantly higher risks of all-grade ophthalmic trAEs and irAEs.

Background This meta-analysis examined the risk of hepatotoxicity in patients with solid tumors who received a PD-1/PD-L1 inhibitor alone, a PD-1/PD-L1 inhibitor plus chemotherapy, or chemotherapy alone. Methods Potentially eligible studies were identified by searches of Embase and PubMed. All included studies were randomized controlled trials (RCTs) that examined patients with solid tumors who received a PD-1/PD-L1 inhibitor and/or chemotherapy. Results We included 20 clinical trials (11,634 patients). Thirteen trials compared PD-1/PD-L1 inhibitor monotherapy with chemotherapy. These two groups had similar risk for elevated markers of hepatotoxicity (based on analysis of all marker grades and high marker grades), although the PD-1/PD-L1 inhibitor group had an elevated relative risk (RR) of elevated aspartate aminotransferase (AST; RR = 2.13, 95% CI = 1.04 to 4.36, P = 0.04) when considering high grades alone; however, this disparity was not significant for comparisons of the pembrolizumab and nivolumab subgroups with the chemotherapy group. Compared with chemotherapy, PD-1/PD-L1 inhibitors increased the risk of all-grade hepatitis (RR = 5.85, 95% CI = 1.85 to 18.46, P < 0.01), and high-grade hepatitis (RR = 5.66, 95% CI = 1.58 to 20.27, P < 0.01). Seven other studies compared PD-1/PD-L1 inhibitor plus chemotherapy with chemotherapy alone. The combined treatment led to a higher risk for all-grade hepatitis (RR = 2.14, 95% CI = 1.29 to 3.55, P < 0.01) and high-grade hepatitis (RR = 5.24, 95%CI = 1.89 to 14.52, P < 0.01), but these groups had similar risk for all-grade and high-grade elevated markers of hepatotoxicity. Conclusions Relative to chemotherapy alone, PD-1/PD-L1 inhibitors with or without chemotherapy increased the risk of all-grade and high-grade hepatitis, but generally did not increase the risk of elevated blood markers of hepatotoxicity.

This study was designed to explore the association between undernutrition in the growth period and cardiovascular risk factors in a middle-aged Chinese population. A total of 1756 subjects, aged 45–60 years, were invited to participate in the Hefei Nutrition and Health Study and divided into three groups according to their self-reported animal food intake in the growth period. Group 1, Group 2 and Group 3 were defined as undernutrition, nutritional improvement and the good nutrition group, respectively. In the three groups, the subjects in Groups 1 and 2 had more oil and salt intake (PP

Here we developed an integrated volumetric bar-chart chip (IV-Chip) technology by integration of our previous V-Chip with a fluid handling design to generate an instrument-free POC device and greatly reduce the detection time and effort. The IV-Chip test requires only 1 μL of serum separated from finger-prick blood. The serum sample and ELISA reagents are directly loaded into the device using a pipette, and a shift of the two layers of the device generates homogeneous liquid segments in the microfluidic channel. Under vacuum pressure generated by a regular syringe, the segments flow into the ELISA wells in sequence and a sandwich ELISA reaction takes place. As a result of the automated washing and reacting strategy, the IV-Chip allows rapid tests for myocardial infarction biomarkers, and turnaround time is greatly reduced to 15 min. The specificity and accuracy of quantitative multiplex detection of MI biomarkers CK-MB, troponin I and myoglobin, are 87.5 % and 95.8 %, respectively.

Although previous studies reported the associations between the intakes of individual foods or nutrients and the risk of non-alcoholic fatty liver disease (NAFLD), the relationship between dietary patterns and NAFLD in the Chinese population has been rarely studied to date. This study aimed to investigate the associations between dietary patterns and the risk of NAFLD in a middle-aged Chinese population. The Study subjects were 999 Chinese adults aged 45–60 years in the Anhui province who participated in the Hefei Nutrition and Health Study. Dietary intake was collected by a semi-quantitative food frequency questionnaire. NAFLD was defined as the presence of moderate-severe hepatic steatosis (by B-ultrasonic examination), the absence of excessive alcohol use (&gt, 20 g day−1 in men and 10 g day−1 in women), no use of steatogenic medications within the past six months, no exposure to hepatotoxins, and no history of bariatric surgery. Log-binomial regression analysis was used to examine the association between dietary patterns and NAFLD with adjustment of potential confounding variables. Out of 999 participants, 345 (34.5%) were classified as having NAFLD. Four major dietary patterns were identified: “Traditional Chinese”, “Animal food”, “Grains-vegetables” and “High-salt” dietary patterns. After adjusting for potential confounders, subjects in the highest quartile of the “Animal food” pattern scores had greater prevalence ratio for NAFLD (prevalence ratio (PR) = 1.354, 95% confidence interval (CI): 1.063–1.724, p &lt, 0.05) than did those in the lowest quartile. After adjustment for body mass index (BMI), compared with the lowest quartile of the “Grains-vegetables” pattern, the highest quartile had a lower prevalence ratio for NAFLD (PR = 0.777, 95% CI: 0.618–0.977, p &lt, 0.05). However, the “traditional Chinese” and “high-salt” dietary patterns showed no association with the risk of NAFLD. Our findings indicated that the “Animal food” dietary pattern was associated with an increased risk of NAFLD.

Background Little is known about the association between weight changes and adverse health outcomes among Chinese adults. Methods A total of 1715 Chinese adults, 45-60 years of age, have been recruited to participate in the Hefei Nutrition and Health Study started in 2012. Multivariate logistic regression analysis was performed to determine the association of weight changes since age 20 (loss ≥5.0 kg; maintain [±4.9 kg]; gain 5.0-9.9 kg; gain ≥10.0 kg) with cardiovascular risk factors. Results Men who gained 10.0 kg or more had increased risks of hypertension (odds ratios (OR) = 3.07; 95% CI: 1.98-4.76), impaired fasting glucose (OR = 1.74; 95% CI: 1.02-2.97), reduced high-density lipoprotein (HDL) cholesterol levels (OR = 2.77; 95% CI: 1.42-5.40) and elevated triglyceride levels (OR = 5.72; 95% CI: 2.94-11.12). Women who gained 10.0 kg or more had increased risks of hypertension, elevated low-density lipoprotein (LDL) cholesterol levels and elevated triglycerides levels of 2.01(95% CI: 1.18-3.42), 3.40 (95% CI: 1.18-9.82) and 5.60 (95% CI: 1.59-19.61), respectively. Conclusion Weight gain during adulthood was associated with increased risks of high triglycerides, hypertension, impaired fasting glucose and risk of reduced HDL cholesterol in men. Furthermore, weight gain was a predictor of high-risk triglycerides, hypertension and elevated LDL cholesterol in women.

Supplementation with folic acid (FA) was proven to prevent neural tube defects (NTDs) and was recommended worldwide before and during early pregnancy. However, much less is known regarding the role of FA after the 12th gestational week (GW). This study aimed to investigate the related effects of continued FA supplementation after the first trimester of pregnancy on fetal growth. The study subjects came from the Ma’anshan-Anhui Birth Cohort Study (MABC) that recruited 3474 pregnant women from the city of Ma’anshan in Anhui Province in China during the period of May 2013 to September 2014. The information on use of vitamin and mineral supplements was recorded in different periods (the first/second/third trimester of pregnancy). Small-for-gestational-age (SGA) births were live-born infants that were

The aim of this nested case-control study was to assess the combined use of urinary kidney injury molecule (KIM)-1 and interleukin (IL)-18 for acute kidney injury (AKI) after cardiopulmonary bypass surgery (CPB). From a cohort of 122 subjects who underwent CPB, serial urinary KIM-1 and IL-18 concentrations were determined in 30 AKI and 92 non-AKI patients. An increased level of urinary KIM-1 was associated with the occurrence of AKI, whereas an increased level of IL-18 was related to progressive AKI. The combination of these two biomarkers facilitates the early diagnosis and assessment of the likely progression of AKI after CPB.

Point-of-care (POC) testing has the potential to enable rapid, low-cost, and large-scale screening. POC detection of a multiplexed biomarker panel can facilitate the early diagnosis of non-small cell lung cancer (NSCLC) and, thus, may allow for more timely surgical intervention for life-saving treatment. Herein, we report the nanoporous glass (NPG) integrated volumetric bar-chart chip (V-Chip) for POC detection of the three NSCLC biomarkers CEA, CYFRA 21-1, and SCCA, by the naked eye. The 3D nanostructures in the NPG membrane efficiently increase the number of binding sites for antibodies and decrease the diffusion distance between antibody and antigen, enabling the low detection limit and rapid analysis time of the NPG-V-Chip. We utilized the NPG-V-Chip to test the NSCLC biomarker panel and found that the limit of detection can reach 50 pg/mL (10-fold improvement over the original V-Chip), and the total assay time can be decreased from 4 to 0.5 h. We then detected CEA in 21 serum samples from patients with common cancers, and the on-chip results showed good correlation with the clinical results. We further assayed 10 lung cancer samples using the device and confirmed the results obtained using conventional ELISA methods. In summary, the NPG-V-Chip platform has the ability of multiplex, low detection limit, low cost, lack of need for accessory equipment, and rapid analysis time, which may render the V-Chip a useful platform for quantitative POC detection in resource-limited settings and personalized diagnostics.

Quantitative assays are of great importance for point-of-care (POC) diagnostics because they can offer accurate information on the analytes. However, current POC devices often require an accessory instrument to give quantitative readouts for protein biomarkers, especially for those at very low concentration levels. Here, we report a microfluidic platform, the digital volumetric bar-chart chip (DV-chip), for quantitative POC diagnostics with ultra-low detection limits that are readable with the naked eye. Requiring no calibration, the DV-chip presents a digital ink bar chart (representing multiple bits composed of 0 and 1) for the target biomarker based on direct competition between O2 generated by the experimental and control samples. The bar chart clearly and accurately defines target concentration, allowing identification of disease status. For the standard PtNP solutions, the detection limit of the platform is approximately 0.1 pM and the dynamic range covers four orders of magnitude from 0.1 to 1000 pM. CEA samples with concentrations of 1 ng mL(-1) and 1.5 ng mL(-1) could be differentiated by the device. We also performed the ELISA assay for B-type natriuretic peptide (BNP) in 20 plasma samples from heart failure patients and the obtained on-chip data were in agreement with the clinical results. In addition, BNP was detectable at concentrations of less than 5 pM, which is three orders of magnitude lower than the detection limit of the previously reported readerless digital methods. By the integration of gas competition, volumetric bar chart, and digital readout, the DV-chip possesses merits of portability, visible readout, and ultra-low detection limit, which should offer a powerful platform for quantitative POC diagnostics in clinical settings and personalized detection.

Point-of-care (POC) testing has become widely used in clinical analysis because of its speed and portability; however, POC tools, such as lateral flow assays, suffer from low specificity, unclear readouts, and susceptibility to environmental and user errors. Herein, we report an ELISA-based competitive volumetric bar-chart chip (CV-chip) that eliminates these limitations. The CV-chip displays the readout in the form of ink bar charts based on direct competition between gases generated by the sample and the internal control. By employing a “competition mode”, this platform decreases the potential influence of background resulting from environmental factors and provides visually clear positive or negative results without the requirement of calibration. In addition, the on-chip comparison enables the device to distinguish imperceptible differences (less than 1.3-fold) in human chorionic gonadotropin (hCG) concentrations that are near the cutoff value for pregnancy (~1.4 ng/mL). We also utilized the ELISA-based CV-chip to successfully detect biomarkers from cancer cells. As a proof-of-concept application in a clinical setting, the CV-chip was employed to evaluate the status of drugs of abuse in 18 patients. For six different drugs, zero false-positive and very few false-negative (

Electrochemiluminescence (ECL) of CdSe quantum dots (QDs) was greatly enhanced by the combination of carbon nanotubes (CNTs) and poly (diallyldimethylammonium chloride) (PDDA) in the CdSe QDs film, and could successfully be used to develop a sensitive ECL immunosensor for the detection of human IgG (Ag). The novel CdSe QDs–CNTs composites exhibited high ECL intensity, good biocompatibility, and high stability, which held great promise for the fabrication of the ECL biosensors with improved sensitivity. After PDDA as a binding linker was conjugated to the CdSe QDs–CNTs composite film on the electrode, the ECL signal was significantly enhanced. Subsequently, gold nanoparticles (GNPs) assembled onto the CdSe QDs–CNTs/PDDA modified electrode could amplify the ECL signal once again. After antibody (Ab) was immobilized onto the electrode through GNPs, the ECL immunosensor was successfully fabricated. It is for the first time that the unique function of PDDA for enhancing QDs ECL was explored and used to develop an ECL biosensor. The principle of ECL detection for target Ag is based on the increment of steric hindrance after immunoreaction, which resulted in the decrease of ECL intensity. The Ag concentration was determined in the linear range of 0.002–500 ng L−1 with a detection limit of 0.6 pg mL−1. The sensor showed good fabrication and detection reproducibility, and the assay results were in acceptable agreement with the clinical sera tests, showing a promising clinical application. This work opened the new avenues for applying QDs ECL in highly sensitive bioassays.

To prospectively study the value of cystatin C in diagnosis of acute kidney injury (AKI) in patients after cardiac surgery.A total of 132 patients undergoing cardiopulmonary bypass were enrolled in this prospectively study. From each patient, blood samples were collected everyday before and after operation to detect the serum creatinine (Scr) and cystatin C levels by enzymatic method and particle-enhanced turbidimetric immunoassay (PETIA), respectively, and the glomerular filtration rate (eGFR) was estimated using MDRD equation. AKI diagnosis was made according to the RIFLE criteria of the Acute Dialysis Quality Initiative (ADQI) (R: Scr increased byor =50%; I: Scr increased byor =100%; F: Scr increased byor =200%; L: Loss of kidney function; E: End-stage renal disease). Another AKI diagnostic criterion was also adopted according to the levels of cystatin C increment, namely an increase byor =50%,or =100%, andor =200%.Twenty-nine patients (21.9%) developed AKI of varied severities, including 10 meeting the R-criteria, 12 the I-criteria, 7 the F-criteria, with the other 103 patients without AKI serving as the control group. Cystatin C of the 29 AKI patients was drastically increased in comparison with that of the control group (P0.001). Significant linear correlation was found between cystatin C and Scr (r=0.732, P0.001) and between [cystatin C]-1 and estimated GFR (R=0.803, P0.001). By the two diagnostic criteria based on cystatin C and Scr levels, respectively, the median diagnostic time of AKI was 2 days (range 1-4 days) and 3 days (range 2-5 days) for R criteria (10 patients, P=0.014), 3.5 days (range 1-6 days) and 5 days (range 2-8 days) for I criteria (12 patients, P=0.008), and 5 days (range 3-7 days) and 6.5 days (range 4-9 days) for F criteria (7 patients, P=0.02), respectively. ROC analysis confirmed excellent accuracy of cystatin C in AKI diagnosis (AUC=0.992). With the cut-off value of cystatin C increment byor =50%, the diagnostic sensitivity and specificity of AKI was 92% and 95%, respectively.Cystatin C can serve as a good indicator for AKI diagnosis to allow earlier detection of AKI than Scr-based diagnosis in patients after cardiac surgery.

A novel label-free highly sensitive electrochemical impedance spectroscopy (EIS) immunosensor was fabricated based on the highly ordered macroporous gold film (HOMGF) in the presence of room-temperature ionic liquid (IL) for the detection of human Apolipoprotein B-100 (ApoB-100). The antibody of ApoB-100 (Ab) was adsorbed directly onto the HOMGF electrode surface and maintained its bioactivity. After the residual active sites at the electrode were passivated by BSA, the mixture of BMIm(+)BF(4)(-) and silica sol was dropped onto the electrode to entrap the adsorbed Ab and BSA molecules firmly. The addition of IL could prevent the inactivation of Ab by releasing alcohol during the sol-gel process, and the conductivity of the IL-gel membrane was increased. Of particular interest is the fact that the fabricated immunosensor could be used at 60 °C. This could be attributed to the interconnected porosity of the IL-gel membrane, which can prevent Ab from unfolding and losing its bioactivities. The immunosensor also exhibited a highly sensitive response to ApoB-100 with the lowest concentration of 5 fg mL(-1). The detection of ApoB-100 levels in five sera samples obtained from hospital showed acceptable accuracy with that using commercial immunonephelometry method.