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Objective: Paragangliomas of the urinary bladder (UBPGLs) are rare neuroendocrine tumours and pose a diagnostic and surgical challenge. It remains unclear what factors contribute to a timely presurgical diagnosis. The purpose of this study is to identify factors contributing to missing the diagnosis of UBPGLs before surgery. Design, Patients and Measurements: A total of 73 patients from 11 centres in China, and 51 patients from 6 centres in Europe and 1 center in the United States were included. Clinical, surgical and genetic data were collected and compared in patients diagnosed before versus after surgery. Logistic regression analysis was used to identify clinical factors associated with initiation of presurgical biochemical testing. Results: Among all patients, only 47.6% were diagnosed before surgery. These patients were younger (34.0 vs. 54.0 years, p <.001), had larger tumours (2.9 vs. 1.8 cm, p <.001), and more had a SDHB pathogenic variant (54.7% vs. 11.9%, p <.001) than those diagnosed after surgery. Patients with presurgical diagnosis presented with more micturition spells (39.7% vs. 15.9%, p =.003), hypertension (50.0% vs. 31.7%, p =.041) and catecholamine‐related symptoms (37.9% vs. 17.5%, p =.012). Multivariable logistic analysis revealed that presence of younger age (<35 years, odds ratio [OR] = 6.47, p =.013), micturition spells (OR = 6.79, p =.007), hypertension (OR = 3.98, p =.011), and sweating (OR = 41.72, p =.013) increased the probability of initiating presurgical biochemical testing. Conclusions: Most patients with UBPGL are diagnosed after surgery. Young age, hypertension, micturition spells and sweating are clues in assisting to initiate early biochemical testing and thus may establish a timely presurgical diagnosis. [ABSTRACT FROM AUTHOR]

Background: Anhui Province is currently facing an increase in imported malaria cases as a result of globalization and international travel. In response, Anhui Province has implemented a comprehensive adaptive framework to effectively address this threat. Methods: This study collected surveillance data from 2012 to 2022 in Anhui Province. Descriptive statistics were used to analyze the epidemiological characteristics of imported malaria cases. Additionally, multivariate logistic regression was employed to identify factors associated with severe malaria. Documents were reviewed to document the evolution of the adaptive framework designed to combat imported malaria. The effectiveness of the adaptive framework was evaluated based on the rates of timely medical visits, timely diagnosis, and species identification. Results: During the study period, a total of 1008 imported malaria cases were reported across 77 out of 105 counties in Anhui Province, representing a coverage of 73.33%. It was found that 10.52% of imported cases went undiagnosed for more than seven days after onset. The multivariate analysis revealed several potential risk factors for severe malaria, including increasing age (OR = 1.049, 95%CI:1.015–1.083), occupation (waitperson vs. worker, OR = 2.698, 95%CI:1.054–6.906), a longer time interval between onset and the initial medical visit (OR = 1.061, 95%CI:1.011–1.114), and misdiagnosis during the first medical visit (OR = 5.167, 95%CI:2.535–10.533). Following the implementation of the adaptive framework, the rates of timely medical visits, timely diagnosis, and species identification reached 100.00%, 78.57%, and 100.00%, respectively. Conclusions: Anhui Province has successfully developed and implemented an adaptive framework for addressing imported malaria, focusing on robust surveillance, prompt diagnosis, and standardized treatment. The experiences gained from this initiative can serve as a valuable reference for other non-endemic areas. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the predictive factors for post-conization of residual disease in subsequent hysterectomy for cervical intraepithelial neoplasia grade 2 or 3. Methods: This retrospective study included 267 patients with histologically confirmed cervical intraepithelial neoplasia grade 2 or 3 who underwent hysterectomy within 7 months after conization. Clinical data (e.g., age, menopausal status, gravidity, parity, type of transformation zone, conization method) as well as pathological data pertaining to conization and hysterectomy were collected from medical records. A logistic regression model was used to analyze the relationship between the variables and risk of residual lesions in hysterectomy samples. Results: Overall, 70 (26.2%) patients had residual lesions in their hysterectomy specimens. Univariate analyses revealed that age ≥ 50 years (p=0.019), endocervical gland involvement(p=0.013), positive margin(p < 0.001), and involvement of 3–4 quadrants(p < 0.001) were risk factors for residual lesions. Conversely, postmenopausal status, gravidity ≥ 3, parity ≥ 2, loop electrosurgical excision procedure, and type III transformation zone were not risk factors for residual lesions. A positive margin(p < 0.001) and multiple-quadrant involvement(p < 0.001) were identified as independent risk factors for residual lesions on multivariate analysis. Conclusions: Multiple-quadrant involvement and a positive cone margin were reliable predictive factors for residual disease. Total hysterectomy or repeated cervical conization should be considered for patients with these two risk factors. The identification of high-risk patients with extensive lesions by colposcopic examination before conization is indispensable, as it will enable surgeons to perform conization with consideration of risk factors and possibly improve the approach used for the excisional procedure. For high-risk patients, colposcope-guided cold-knife conization is preferred when resources permit. [ABSTRACT FROM AUTHOR]

Bronchopulmonary dysplasia (BPD) is the most common complication of extremely preterm birth. This study was aimed at detecting cytokine and fractional exhaled nitric oxide (FeNO) levels to evaluate their mechanisms and predicted significance for BPD. Preterm infants born at g e s t a t i o n a l a g e ≤ 32 w e e k s were recruited, and clinical data were collected. We detected ten cytokines, including IFN-γ, IL-10, IL-12p70, IL-13, IL-1β, IL-2, IL-4, IL-6, IL-8, and TNF-α on Days 1–3, Days 7–14, and Days 21–28 after birth by using the Meso Scale Discovery (MSD) technology. The FeNO levels of infants were measured when they met the discharge criteria. A total of 46 preterm infants were enrolled, consisting of 14 infants in BPD group and 32 infants in the control group. The gestational age (27.5 ± 1.3 vs. 29.9 ± 1.3 weeks) and birth weight (1021 ± 261 g vs. 1489 ± 357 g) were lower in the BPD group. The following were high-risk factors for BPD, as determined by multivariate logistic regression analysis: g e s t a t i o n a l a g e < 30 w e e k s , b i r t h w e i g h t < 1000 g , PDA, longer mechanical ventilation, and higher FeNO. The cytokines of IL-6 and IL-8 on Days 7–14 and IL-4, IL-6, IL-8, and TNF-α on Days 21–28 were also high-risk factors for BPD. IL-6 contributed to BPD disease severity. Conclusion. The preterm infants with PDA and prolonged mechanical ventilation tended to develop BPD. The IL-6 and IL-8 were significantly increased on Days 7–14 and were high-risk factors for BPD. Moreover, the IL-6 level was associated with BPD disease severity. We speculated that NO was related to BPD via Th2 cell-mediated inflammatory responses such as IL-4 and IL-6. Cytokines might predict the occurrence of BPD. [ABSTRACT FROM AUTHOR]

Objective: To assess the independent and combined effects of night sleep duration and sleep quality on depressive symptoms.Methods: A total of 28,202 participants (11,236 males and 16,966 females) aged 18-79 years from the Henan Rural Cohort were included in this study. Night sleep duration and sleep quality were defined by the Pittsburgh Sleep Quality Index (PSQI). Logistic regression and restricted cubic splines were applied to evaluate the association of night sleep duration and sleep quality with depressive symptoms.Results: A U-shaped dose-response relationship between night sleep duration and depressive symptoms along with a J-shaped relationship between sleep quality and depressive symptoms were observed. Compared with reference group (7-<8 h), shorter sleep duration (<6 h) and longer sleep duration (≥10 h) were associated with increased risk of depressive symptoms in males (short sleep: Odds Ratio (OR) = 1.84, 95% confidence interval (CI), 1.34-2.52; long sleep: OR = 1.56, 95% CI, 1.01-2.42) and females (short sleep: OR = 2.19, 95% CI, 1.77-2.70; long sleep: OR = 1.51, 95% CI, 1.10-2.10). Compared with good sleepers, poor sleepers had 4.23-fold (95% CI:3.54-5.06) and 3.87-fold (95% CI: 3.41-4.40) increased odds of depressive symptoms in males and females. Furthermore, participants with longer night sleep duration (≥10 h) and poorer sleep quality had the strongest effect on depressive symptoms (males: OR = 6.64, 95% CI, 3.21-13.74; females: OR = 7.76, 95% CI, 5.00-12.02).Conclusions: Extreme night sleep duration and poor sleep quality were independently and combinedly related to elevated depressive symptoms, suggesting that keeping optimal night sleep duration and good sleep quality maybe benefit for maintaining mental health.Trial Registration: Chinese Clinical Trial Register. Registration number: ChiCTR-OOC-15006699. [ABSTRACT FROM AUTHOR]

Background The study was conducted to evaluate the independent dose-response of the night sleep duration and sleep initiation time on hypertension, and to explore their combined effect with hypertension. Methods Participants from the Henan Rural Cohort were enrolled in this study. Information on sleep was collected using the Pittsburgh Sleep Quality Index. Hypertension was defined as systolic blood pressure/diastolic blood pressure ≥140/90 mmHg or self-reported hypertension and current use of anti-hypertensive medicines. Logistic regression and restricted cubic spline were conducted to evaluate the association of night sleep duration and sleep initiation time with hypertension. Results Of the 37 317 included participants, 12 333 suffered from hypertension. 14 474 (38.79%) were men and 22 843 (61.21%) were women, the mean age were 57.18 ± 12.10 and 55.24 ± 11.98 in men and women. Compared to reference (7–h), fully adjusted odd ratios (ORs) and 95% confidence interval (CI) of hypertension were 0.91 (0.66–1.25) in <5 h group and 1.74 (1.41–2.16) in ≥10 h among men, respectively. Fully adjusted ORs (95% CIs) for hypertension compared with reference (21:00–22:00) were 1.05 (95% CI 0.78–1.41) in the <20:00 group, 1.52 (1.25–1.85) in ≥24:00 in men. The combined effect of sleep duration and sleep initiation time on hypertension were statistically significant in the category of (≥8 h)/night and ≥24:00 (OR 1.87, 95% CI 1.07–3.25) compared to reference in fully adjusted model among men. Conclusions Long night sleep duration and late sleep initiation time were associated with the higher odds of hypertension, and the sleep duration and sleep initiation time might cumulatively increase the prevalence of hypertension in men. Clinical trial registration The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx? proj=11375. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the association between poor sleep quality and hypertension, and evaluated how the Pittsburgh Sleep Quality Index (PSQI) score correlates with blood pressure and prevalent hypertension.Methods: A total of 27, 912 participants aged 18-79 years from the Henan Rural Cohort Study were included into the current study. PSQI score was classified as <3, 3-, 6-, ≥9. Multivariate logistic regression models and restricted cubic spline with hypertension as a dependent variable were conducted. A meta-analysis was conducted to validate the result of the cross-sectional study.Results: Altogether, 6,085 (21.80%) were poor sleepers and 9,056 (32.44%) suffered from hypertension. The odds ratios (ORs) (95% confidence intervals (CIs)) of participants with sleep quality of 3-, 6-, ≥9 were 1.16(1.07-1.26), 1.35(1.21-1.50) and 1.62 (1.39-1.88) compared to the participants with a score of less than 3 among participants excluding undiagnosed hypertension. ORs and 95% CIs per 3 increment score were higher for hypertension (1.16, 1.11-1.21) among total population, (1.18, 1.10-1.27) among men and (1.13, 1.08-1.19) among women. Compared to reference, poor sleep quality was associated with a higher odd of hypertension (OR 1.09, 95% CI 1.01-1.17) for total population, (1.14, 1.00-1.30) for men and (1.04, 0.95-1.13) for women. Moreover, the odds of hypertension were increased with increment of PSQI score after fitting restricted cubic splines (Ptrend <0.01). The meta-analysis showed that pooled OR of hypertension was significantly higher for poor sleepers (1.62, 1.03-2.56, I2 = 97.3%, P < 0.001).Conclusions: Higher PSQI score was associated with increased odds of prevalent hypertension in both genders. In addition, poorer sleepers might suffer from hypertension. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore the independent and combined dose-response association of napping and night sleep duration with type 2 diabetes mellitus (T2DM) among different genders in the rural Chinese population.Methods: For this research, a total of 19,257 participants were enrolled in the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study. Napping and night sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). Restricted cubic splines and logistic regression were used to estimate the relationship between napping and night sleep duration with T2DM.Results: A linear dose-response relationship between napping duration and T2DM as well as a U-shaped relationship between night sleep duration and T2DM were found. Compared with those who reported no napping, participants who had a napping duration of ≥91 min were associated with a 19% increase in prevalence of T2DM. Adjusted odds ratios (ORs) (95% confidence intervals (CIs)) for T2DM were 1.48 (1.03, 2.14) and 1.50 (1.22, 1.85) for shorter (≤5 h) and longer (>9 h) night sleep duration compared with the referential group. Additionally, the combination of longer napping duration (≥91 min) and night sleep duration (>9 h) increased 104% (95% CI: 45%, 128%) prevalence for T2DM. These associations were not found in males but were evident in females.Conclusions: Longer napping duration and extreme night sleep duration increased the prevalence of T2DM. Meanwhile, longer napping and night sleep duration might be jointly associated with a higher prevalence of T2DM. [ABSTRACT FROM AUTHOR]