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Bin Cao,1,2,&ast; Kun Li,1,2,&ast; Jing Ke,1,2 Dong Zhao1,2 1Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, People’s Republic of China; 2Beijing Key Laboratory of Diabetes Research and Care, Beijing, 101149, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jing Ke; Dong Zhao, Email kejing@ccmu.edu.cn; zhaodong@ccmu.edu.cnObjective: This study aimed to investigate the potential association between long-term variations in remnant cholesterol (RC) levels and the development of diabetic foot ulcers (DFU) in participants with type 2 diabetes (T2D).Methods: This was a retrospective cohort study. Variation in RC was assessed by the following metrics: mean, standard deviation (SD), coefficient of variation (CV) and trajectories pattern of RC. To identify RC trajectories, we employed the latent class mixture model. The primary endpoint was the development of DFU, and the time-to-event data were analyzed using Cox regression.Results: A total of 1874 patients with T2D were included, with a median follow-up duration of 4.7 years. Among them, 129 individuals (6.9%) developed DFU. The proportion of DFU was significantly higher in the U-shaped group compared to the median group (P for trend < 0.001). Upon adjustment for confounding variables, the U-shaped trajectory correlated with a higher risk of DFU, demonstrating a hazard ratio (HR) of 2.57 (95% CI, 1.54– 4.27). Subgroup analysis showed the U-shaped trajectory had a higher DFU risk regardless of gender (HR=2.40 and 2.81, respectively), glycemic control (HR=1.89 and 7.41, respectively), smoking (HR=2.36 and 2.93, respectively), or hypertension (HR=2.30 and 2.97, respectively). No association was found between mean, SD and CV of RC and DFU.Conclusion: A U-shape trajectory of RC was independently associated with an elevated risk of DFU among patients with T2D.Keywords: diabetic foot ulcer, remnant cholesterol, trajectories, type 2 diabetes

Meijuan Liu,1 Bingyan Cao,1 Qipeng Luo,2 Yanning Song,1 Yuting Shi,1 Ming Cheng,1 Kai Liu,1 Di Mao,1 Xinmeng Wang,1 Chunxiu Gong1 1Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China; 2Department of Pain Medicine, Peking University Third Hospital, Beijing, 100191, People’s Republic of ChinaCorrespondence: Chunxiu Gong, Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China, Email chunxiugong@sina.comObjective: To explore the gender-, age-, and weight status-specific prevalence of hyperuricemia (HUA) and its associated risk factors among Chinese children and adolescents with obesity.Methods: A total of 1329 children aged 2– 17 years, who were diagnosed with obesity and hospitalized in our center from January 2016 to December 2022 were recruited. They were divided into mild obesity, moderate obesity, and severe obesity groups. HUA was defined as fasting serum uric acid level > 420 μmol/L for boys and > 360 μmol/L for girls. Multivariate logistic regression analyses were performed to identify risk factors for HUA.Results: The highest proportion of hospitalized obese children was aged 10– 13 years comprising 677 (50.9%) followed by those aged 6– 9 years comprising 348 (26.2%) whereas the least proportion was aged 2– 5 years comprising 76 (5.7%). The above differences in age distribution were still present in subgroup analyses according to weight status. Most hospitalized obese children were boys (64.7%), especially in the severe obesity group (75.0%). The overall estimated prevalence of HUA in obese children was 54.8%. It presented a gradual increase trend over the last 7 years, with more rapidly in boys than in girls. Subgroup analysis by weight status showed that the prevalence of HUA was higher in children with moderate obesity (64.3%) and severe obesity (64.2%) when compared with mild obesity (48.2%) (P all< 0.01). Boys reached a relatively high HUA incidence level (≥ 60%) at age 12, which occurred about 2 years later than in girls (age 10). With 12 years as the cut-off point, a high prevalence of HUA (≥ 60%) was observed in both genders. Multivariable logistic regression analyses showed that boy (OR=2.844, 95% CI 2.024– 3.998), age (OR=1.253, 95% CI 1.155– 1.360), BMI-Z score (OR=2.132, 95% CI 1.438– 3.162), fasting blood glucose (OR=0.907, 95% CI 0.860– 0.956), phosphorus (OR=4.123, 95% CI 2.349– 7.239), alkaline phosphatase (OR=1.002, 95% CI 1.001– 1.004), creatinine (OR=1.067, 95% CI 1.037– 1.098), urea nitrogen (OR=1.193, 95% CI 1.032– 1.378), aspartate aminotransferase (OR=1.016, 95% CI 1.002– 1.030), triglycerides (OR=1.339, 95% CI 1.075– 1.667), and high-density lipoprotein cholesterol (OR=0.381, 95% CI 0.160– 0.910) were independently associated with odds of HUA (P all< 0.05).Conclusion: The prevalence of HUA in Chinese obese children and adolescents is unexpectedly high. Childhood HUA was significantly associated with obesity. Gender and age differences were observed in the association between childhood obesity and HUA. Obese children aged ≥ 12 years should be focused on screening the risk of HUA.Keywords: children, hyperuricemia, body mass index, sex, age, obesity

Zemin He,1 Hong Li,1 Boxiong Cao,1 Ziliang Zan,1 Hao Feng,1 Qiang Wei,1 Keting Liu2 1Department of Thoracic Surgery, The First People’s Hospital of Shuangliu District (West China Airport Hospital of Sichuan University), Chendu, Sichuan Province, People’s Republic of China; 2Department of Neurology, Chengdu Seventh People’s Hospital, Chendu, Sichuan Province, People’s Republic of ChinaCorrespondence: Qiang Wei, Department of Thoracic Surgery, The First People’s Hospital of Shuangliu District (West China Airport Hospital of Sichuan University), 120 Chengbei Upper Street, Dongsheng Town, Shuangliu District, Chendu, Sichuan Province, People’s Republic of China, Tel +86 13778533702, Email 993092572@qq.comPurpose: To explore the predictive value of skeletal muscle function measurement combined with stair climbing test for postoperative cardiopulmonary complications in patients with chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC).Patients and Methods: A prospective study was conducted from June 2022 to July 2023 at West China Hospital of Sichuan University, including 335 COPD patients with lung cancer who underwent surgery. The patients were divided into two groups based on the occurrence of postoperative cardiopulmonary complications: the complication group and the non-complication group. The demographic data, including gender, age, smoking history, quadriceps strength, body mass index (BMI), respiratory muscle strength, 6-minute walk test (6MWD), stair climbing test, and preoperative pulmonary function tests, were compared between the two groups. Logistic regression analysis was performed to evaluate the predictive power of each parameter for postoperative cardiopulmonary complications.Results: Among the enrolled patients, 103 (30.7%) developed postoperative cardiopulmonary complications. Significant differences were observed between the two groups in terms of quadriceps strength, respiratory muscle strength, 6MWD, smoking history, stair climbing test, DLCO%, FEV1%, heart rate, oxygen saturation, surgical duration, surgical approach, resection range, and blood loss (P< 0.05). Logistic regression analysis revealed that respiratory muscle strength, quadriceps strength, stair climbing test, FEV1%, DLCO%, ΔHR, ΔSPO2, surgical approach were identified as risk factors for postoperative cardiopulmonary complications in patients with COPD and lung cancer.Conclusion: Skeletal muscle function measurement, stair climbing test, FEV1, surgical approach, and DLCO% can serve as assessment tools for surgical risk in patients with COPD and lung cancer. They can predict the occurrence of postoperative cardiopulmonary complications to a certain extent, providing valuable predictive value for these complications in patients with COPD and NSCLC.Keywords: respiratory muscle function, Cardiopulmonary complications, lung cancer surgery, Climbing test

Wen Wei,1,2,&ast; Chengwen Xie,3,&ast; Ronghua Cao,4,&ast; Yanwen Que,3 Xuejing Zhong,5 Zheyuan Chen,6 Fenyan Lv,6 Qianqian Kang,6 Ruiyu Lin,6 Baozhen Cao,7 Xiaomin Lai,7 Mei Tu1 1Department of Endocrinology, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China; 2Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, People’s Republic of China; 3Department of Ultrasonography, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China; 4Department of Nuclear Medicine, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China; 5Department of Science and Education, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China; 6Department of Endocrinology, Fujian Longyan First Hospital, Fujian Medical University, Fuzhou, 350004, People’s Republic of China; 7Department of Pulmonary and Critical Care Medicine, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Mei Tu, Department of Endocrinology, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China, Tel +86 5972958989, Fax +86 5972292374, Email tm13859596628@163.comObjective: This study aims to examine the clinical significance of ultrasound evaluation of the gastrocnemius muscle (GM) in identifying sarcopenia in patients with type 2 diabetes (T2D).Methods: One hundred and fifty-three patients with T2D were included in this study. We measured the appendicular skeletal muscle mass index (ASMI), handgrip strength, and 6-meter walking speed. The US-derived muscle thickness (MT), cross-sectional area (CSA), and shear wave ultrasound elastography (SWE) of GM were also measured. We assessed the correlations between clinical indicators and US features. The model for screening sarcopenia was established using stepwise logistic regression. Stepwise linear regression was used to identify a set of variables that jointly estimated ASMI. The model’s ability to identify sarcopenia and low muscle mass was assessed by receiver operating characteristic (ROC) curve analysis.Results: The prevalence of sarcopenia in this study was 24.2%. The CSA, MT and SWE values of the patients with sarcopenia were lower than those of patients without sarcopenia (all p < 0.05). ASMI was positively correlated with CSA (r = 0.56, p < 0.001) and MT (r = 0.39, p < 0.001). Handgrip strength was positively correlated with CSA (r = 0.45, p < 0.001), MT (r = 0.25, p < 0.001), and SWE (r = 0.26, p = 0.002). A diagnostic model for sarcopenia was established with a sensitivity of 81.1%, specificity of 75.0%, and an area under the curve (AUC) of 0.800. The estimated ASMI equation was developed and found to have a positive correlation with actual ASMI (r = 0.70, p < 0.001). It was also effective in diagnosing low muscle mass, with an AUC of 0.787 for males and 0.783 for females.Conclusion: Ultrasonographic assessment of the gastrocnemius muscle was found to be a useful and convenient method for detecting sarcopenia in patients with T2D.Keywords: sarcopenia, ultrasound, shear wave elastography, gastrocnemius muscle, T2D

Kun Li,1,2,&ast; Bin Cao,1,2,&ast; Jing Ke,1,2 Longyan Yang,1,2 Dong Zhao1,2 1Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, People’s Republic of China; 2Beijing Key Laboratory of Diabetes Research and Care, Beijing, 101149, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Dong Zhao; Longyan Yang, Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, People’s Republic of China, Tel +86-10-69543901, Email zhaodong@ccmu.edu.cn; lingbeiyangstudent@163.comBackground: Diabetic vascular complications are the leading cause of crippling and death of diabetic patients and seriously affect patients’ quality of life. It is essential to control the risk factors contributing to vascular complications in patients with Type 2 diabetes (T2DM). This study aimed to examine the association between hyper-triglyceridemic waist phenotype (HWP) and the risk of vascular complication index of diabetes in T2DM patients.Methods: The participants with type 2 diabetes mellitus in this study registered at the National Metabolic Management Center (MMC) of Beijing Luhe Hospital from June 2017 to June 2021. Data were collected by trained personnel according to the protocol. The questionnaire containing information on demographic characteristics and lifestyle factors (including alcohol drinking and cigarette smoking et al) was administered by trained interviewers. Logistic regression analysis assessing the associations between the hyper-triglyceridemic waist phenotype and vascular complication index of diabetes. In addition, the subgroup analysis was performed by age, sex, HbA1c, hypertension or not, and education level.Results: After data cleaning, a total of 3221 participants with T2DM were enrolled. The median (IQR) duration of diabetes was 47.00 (3.00, 125.00) months. Compared to the participants in the Normal triglycerides level and Normal waist circumference group (NTNW), those in the Elevated triglycerides level and Enlarged waist circumference group (HTGW) have a higher risk of CKD-related vascular complications; the OR of decreased estimated glomerular filtration rate (GFR) and elevated urinary albumin creatinine ratio (UACR) were 2.21 (95% CI:1.32– 3.82) and 2.18 (95% CI:1.69– 2.81), respectively. Moreover, compared to the participants in the NTNW group, the ORs of the decreased ankle-brachial index (ABI) and elevated Brachial-ankle pulse wave velocity (baPWV) were 2.24 (95% CI:1.38– 3.80) and 1.63 (95% CI:1.28– 2.06) in the HTGW group.Conclusion: In summary, there was an association between hyper-triglyceridemic waist phenotype and diabetic vascular complications in the Chinese population.Keywords: hyper-triglyceridemic waist phenotype, type 2 diabetes mellitus, vascular complication

Tao Sun,1,&ast; Xian-Hong Huang,1,&ast; Shu-E Zhang,2,&ast; Hong-Yan Yin,3 Qing-Lin Li,2 Lei Gao,2 Ye Li,2 Li Li,4 Bing Cao,5 Jin-Hong Yang,6 Bei Liu7 1Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, People’s Republic of China; 2Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China; 3Department of Humanities and Social Sciences, Harbin Medical University (Daqing), Daqing, 163319, People’s Republic of China; 4Department of Administration, School of Law, Zhejiang University City College, Hangzhou, 310015, People’s Republic of China; 5Department of Oncology, Weifang People’s Hospital, Weifang, 261000, People’s Republic of China; 6Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, People’s Republic of China; 7Global Center for Infectious Disease and Policy Research, Peking University, Beijing, 100191, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Bei Liu, Global Center for Infectious Disease and Policy Research, Peking University, Beijing, 100191, People’s Republic of China, Email 18827380717@163.comAim: To clarify the mediating role of burnout and the moderating role of turnover intention in the association between fatigue and job satisfaction among Chinese nurses in intensive care units (ICU) during the COVID-19 pandemic.Methods: A cross-sectional survey of fifteen provinces in China was conducted, using an online questionnaire, from December 2020 to January 2021, during the COVID-19 pandemic. A total of 374 ICU nurses (effective response rate: 71.37%) provided sufficient responses. Sociodemographic factors, job demographic factors, fatigue, burnout, job satisfaction, and turnover intention were assessed using questionnaires. General linear modeling (GLM), hierarchical linear regression (HLR) analysis, and generalized additive modeling (GAM) were performed to examine all the considered research hypotheses.Results: Fatigue was found to be negatively and significantly associated with job satisfaction. Moreover, burnout played a partial mediating role and turnover intention played a moderating role in the relationship between fatigue and job satisfaction.Conclusion: Over time, a state of physical and mental exhaustion and work weariness among Chinese ICU nurses potentially results in job burnout and consequently promotes the level of job dissatisfaction. The results also found that turnover intention played a moderating role in the relationship between burnout and job satisfaction. Specific policies could be considered to eliminate nurses’ fatigue and negative attitudes during times of public health emergencies.Keywords: ICU nurses, fatigue, burnout, job satisfaction, turnover intention, COVID-19 pandemic

Bin Cao,1,2,&ast; Xiaokaiti Mijiti,3,&ast; Le-Le Deng,2,4 Quan Wang,3 Jin-Jie Yu,1,2 Aiketaguli Anwaierjiang,5 Chengyu Qian,2,6 Machao Li,2 Dan-Ang Fang,2,6 Yi Jiang,2 Li-Li Zhao,2 Xiuqin Zhao,2 Kanglin Wan,2 Haican Liu,2 Guilian Li,2 Xiuqin Yuan1 1School of Public Health, University of South China, Hengyang, 421001, People’s Republic of China; 2State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People’s Republic of China; 3The Eighth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, People’s Republic of China; 4National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China; 5College of Xinjiang Uyghur Medicine, Hetian, 848000, People’s Republic of China; 6Wenzhou Key Laboratory of Sanitary Microbiology, Key Laboratory of Laboratory Medicine, Ministry of Education, China, School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiuqin Yuan; Guilian Li, Email wtjysh@126.com; liguilian@icdc.cnBackground: Ethionamide (ETH), a structural analogue of isoniazid (INH), is used for treating multidrug-resistant tuberculosis (MDR-TB). Due to the common target InhA, INH and ETH showed cross-resistance in M. tuberculosis. This study aimed to explore the INH and ETH resistant profiles and genetic mutations conferring independent INH- or ETH-resistance and INH-ETH cross-resistance in M. tuberculosis circulating in south of Xinjiang, China.Methods: From Sep 2017 to Dec 2018, 312 isolates were included using drug susceptibility testing (DST), spoligotyping, and whole genome sequencing (WGS) to analyze the resistance characteristics for INH and/or ETH.Results: Among the 312 isolates, 185 (58.3%) and 127 (40.7%) belonged to the Beijing family and non-Beijing family, respectively; 90 (28.9%) were INH-resistant (INHR) with mutation rates of 74.4% in katG, 13.3% in inhA and its promoter, 11.1% in ahpC and its upstream region, 2.2% in ndh, 0.0% in mshA, whilst 34 (10.9%) were ETH-resistant (ETHR) with mutation rates of 38.2% in ethA, 26.2% in inhA and its promoter, and 5.9% in ndh, 0.0% in ethR or mshA; and 25 (8.0%) were INH-ETH co-resistant (INHRETHR) with mutation rates of 40.0% in inhA and its promoter, and 8% in ndh. katG mutants tended to display high-level resistant to INH; and more inhA and its promoter mutants showed low-level of INH and ETH resistance. The optimal gene combinations by WGS for the prediction of INHR, ETHR, and INHRETHR were, respectively, katG+inhA and its promoter (sensitivity: 81.11%, specificity: 90.54%), ethA+inhA and its promoter+ndh (sensitivity: 61.76%, specificity: 76.62%), and inhA and its promoter+ndh (sensitivity: 48.00%, specificity: 97.65%).Conclusion: This study revealed the high diversity of genetic mutations conferring INH and/or ETH resistance among M. tuberculosis isolates, which would facilitate the study on INHR and/or ETHR mechanisms and provide clues for choosing ETH for MDR treatment and molecular DST methods in south of Xinjiang, China.Keywords: cross-resistance, ethionamide, isoniazid, mutation, Mycobacterium tuberculosis

Jie Wang,&ast; Bin Cao,&ast; Sihao Lin, Yong Wang, Qifa Zhang, Yang Jiang, Wei Li, Yingjian Zhu Department of Urology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201803, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yingjian Zhu; Wei Li, Department of Urology, Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 800 Huangjiahuayuan Road, Shanghai, 201803, People’s Republic of China, Tel +8613764490868 ; +8618117094957, Email zhuyingjian_sjtu@126.com; croma_shh@126.comPurpose: Urologic chronic pelvic pain syndrome has attracted a lot of attention in the new century, and an increasing number of relevant studies have been published. Therefore, we performed a bibliometric analysis of these publications, hoping to show the current research hotspots and future research trends.Methods: The articles on were selected from the Web of Science Core Collection. Countries, authors, references and keywords in the field were visualized and analyzed using CiteSpace and VOSViewer software.Results: A total of 1014 articles on urologic chronic pelvic pain syndrome were identified, with “chronic pelvic pain syndrome” being the most common keyword, with a strong association with “interstitial cystitis” and “chronic prostatitis”. The hotspot of urologic chronic pelvic pain syndrome research has gradually shifted from chronic prostatitis / urologic chronic pelvic pain syndrome to cystitis/bladder pain syndrome over the past few years. Future research tends to focus on urologic chronic pelvic pain syndrome etiology, including oxidative stress and inflammation.Conclusion: Research on urologic chronic pelvic pain syndrome is steadily growing. The United States has made the most prominent contribution in this area, and the share of China’s contribution is expected to grow further. The etiology of urologic chronic pelvic pain syndrome, including inflammation and oxidative stress, have been the focus of current research and developmental trends in the future research.Keywords: bibliometric analysis, chronic pelvic pain syndrome, interstitial cystitis, chronic prostatitis, mechanisms, treatments

Chunjie Yin,1,&ast; Xiaokaiti Mijiti,2,&ast; Haican Liu,3,&ast; Quan Wang,2 Bin Cao,3,4 Aiketaguli Anwaierjiang,5 Machao Li,3 Mengwen Liu,1 Yi Jiang,3 Miao Xu,2 Kanglin Wan,3 Xiuqin Zhao,3 Guilian Li,3 Hui Xiao1 1School of Public Health, Xinjiang Medical University, Urumqi, People’s Republic of China; 2The Eighth Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic of China; 3State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China; 4School of Public Health, University of South China, Hengyang, People’s Republic of China; 5College of Xinjiang Uyghur Medicine, Hetian, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Guilian Li; Hui Xiao, Email liguilian@icdc.cn; xh20108262@sina.comBackground: In the last decades, the molecular epidemiological investigation of Mycobacterium tuberculosis has significantly increased our understanding of tuberculosis epidemiology. However, few such studies have been done in southern Xinjiang, China. We aimed to clarify the molecular epidemic characteristics and their association with drug resistance in the M. tuberculosis isolates circulating in this area.Methods: A total of 347 isolates obtained from southern Xinjiang, China between Sep, 2017 and Sep, 2019 were included to characterize using a 15-locus MIRU-VNTR (VNTR-15China) typing and spoligotyping, and test for drug susceptibility profiles. Then the lineages and clustering of the isolates were analyzed, as well as their association with drug resistance.Results: Spoligotyping results showed that 60 spoligotype international types (SITs) containing 35 predefined SITs and 25 Orphan or New patterns, and 12 definite genotypes were found, and the top three prevalent genotypes were Beijing genotype (207, 59.7%), followed by CAS1-Delhi (46, 13.6%), and Ural-2 (30, 8.6%). The prevalence of Beijing genotype infection in the younger age group (≤ 30) was more frequent than the two older groups (30~59 and ≥ 60 years old, both P values < 0.05). The Beijing genotype showed significantly higher prevalence of resistance to isoniazid, rifampicin, ethambutol, multi-drug or at least one drug than the non-Beijing genotype (All P values ≤ 0.05). The estimated proportion of tuberculosis cases due to transmission was 18.4% according to the cluster rate acquired by VNTR-15China typing, and the Beijing genotype was the risk factor for the clustering (OR 9.15, 95% CI: 4.18– 20.05).Conclusion: Our data demonstrated that the Beijing genotype is the dominant lineage, associated with drug resistance, and was more likely to infect young people and contributed to tuberculosis transmission in southern Xinjiang, China. These findings will contribute to a better understanding of tuberculosis epidemiology in this area.Keywords: MIRU-VNTR, spoligotyping, Beijing genotype, drug resistance, genetic diversity, Mycobacterium tuberculosis

Jing Ke,1,2 Kun Li,1,2 Bin Cao1,2 1Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, People’s Republic of China; 2Beijing Key Laboratory of Diabetes Research and Care, Beijing, 101149, People’s Republic of ChinaCorrespondence: Bin Cao, Tel +86-10-6954-3901, Email dor_caobin666@163.comAim: This study aims to develop a nomogram for predicting vision-threatening diabetic retinopathy (VTDR) in type 2 diabetes mellitus (T2DM) with mild non-proliferative diabetic retinopathy (NPDR) patients.Materials and Methods: In case–control analysis, 440 patients with mild NPDR or VTDR were enrolled to identify predictors and develop a nomogram. In the prospective cohort, 120 T2DM patients with mild NPDR were enrolled for external validation. Sensitivity, specificity, and area under the receiver operating characteristic (AUC) were calculated to evaluate the predictive performance of the nomogram.Results: In case–control analysis, 2-h C-peptide (OR = 0.85, 95% CI: 0.75 to 0.95, p = 0.006), sural nerve conduction impaired (SNCI) (mildly: OR = 2.18, 95% CI: 1.10 to 4.33, p = 0.026; moderately/severely: 3.66, 95% CI: 1.74 to 7.70, p < 0.001) and UACR (microalbuminuria: OR = 2.37, 95% CI: 1.25 to 4.48, p = 0.008; macroalbuminuria: 4.02, 95% CI: 1.61 to 10.06, p = 0.003) were identified as independent predictors. The concordance index of the prediction nomogram was 0.76 in the training set. In the test set, sensitivity, specificity, and AUC were 84.8%, 60.6%, and 0.73, respectively. In the prospective cohort, median follow-up period was 42 months, and 15 patients (12.5%) developed VTDR. Sensitivity, specificity, and AUC of prediction were 66.7%, 89.5%, and 0.75, respectively.Conclusion: Introducing 2-h C-peptide, UACR, and SNCI, the nomogram demonstrated a good discriminatory power for predicting risk of VTDR in mild NPDR individuals.Keywords: nomogram, diabetic retinopathy, type 2 diabetes mellitus, prediction, progression

People's subjective response to any thermal environment is commonly investigated by using rating scales describing the degree of thermal sensation, comfort, and acceptability. Subsequent analyses of results collected in this way rely on the assumption that specific distances between verbal anchors placed on the scale exist and that relationships between verbal anchors from different dimensions that are assessed (e.g. thermal sensation and comfort) do not change. Another inherent assumption is that such scales are independent of the context in which they are used (climate zone, season, etc.). Despite their use worldwide, there is indication that contextual differences influence the way the scales are perceived and therefore question the reliability of the scales’ interpretation. To address this issue, a large international collaborative questionnaire study was conducted in 26 countries, using 21 different languages, which led to a dataset of 8225 questionnaires. Results, analysed by means of robust statistical techniques, revealed that only a subset of the responses are in accordance with the mentioned assumptions. Significant differences appeared between groups of participants in their perception of the scales, both in relation to distances of the anchors and relationships between scales. It was also found that respondents’ interpretations of scales changed with contextual factors, such as climate, season, and language. These findings highlight the need to carefully consider context-dependent factors in interpreting and reporting results from thermal comfort studies or post-occupancy evaluations, as well as to revisit the use of rating scales and the analysis methods used in thermal comfort studies to improve their reliability.

Xiudi Han,1 Liang Chen,2 Hui Li,3 Fei Zhou,3 Xiqian Xing,4 Chunxiao Zhang,5 Lijun Suo,6 Jinxiang Wang,7 Xuedong Liu,1 Bin Cao3 On behalf of the CAP-China network1Department of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital Group, Qingdao City, Shandong Province, 266011, People’s Republic of China; 2Department of Infectious Diseases, Nanjing Lishui People’s Hospital, Nanjing City, Jiangsu Province, 211213, People’s Republic of China; 3National Clinical Research Center of Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital; Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, 100020, People’s Republic of China; 4Department of Respiratory Medicine, Yan’an Hospital Affiliated to Kunming Medical University, Kunming City, Yunnan Province, 652199, People’s Republic of China; 5Department of Respiratory Medicine, Beijing Huimin Hospital, Beijing, 100054, People’s Republic of China; 6Department of Pulmonary and Critical Care Medicine, Zibo Municipal Hospital, Zibo City, Shandong Province, 255000, People’s Republic of China; 7Department of Respiratory Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, People’s Republic of ChinaCorrespondence: Xuedong Liu, Department of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital Group, Jiaozhou Road, Qingdao City, Shandong Province, 266011, People’s Republic of China, Tel +86-18661678256, Fax +86-532-82789055, Email xuedongliu@263.net Bin Cao, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Yinghuayuan East Street, Chao-Yang District, Beijing, 100020, People’s Republic of China, Tel +86-13911318339, Fax +86-10-84206264, Email caobin_ben@163.comBackground: Limited data were available about the burden of cardiovascular events (CVEs) during hospitalization in elderly patients with community-acquired pneumonia (CAP). The aim was to assess the incidence, characteristics, predictive factors and outcomes of CVEs in elderly patients with CAP during hospitalization.Methods: This study was a multicenter, retrospective research on hospitalized elderly patients with CAP from the CAP-China network. Predictive factors for the occurrence of CVEs and 30-day mortality were identified by multivariable logistic regression analysis.Results: Of 2941 hospitalized elderly patients, 402 (13.7%) developed CVEs during hospitalization with the median age of 81 years old. Compared with non-CVEs patients, patients with CVEs were older, more comorbidities, and higher disease severity; use of glucocorticoids, leukocytosis, azotemia, hyponatremia, multilobe infiltration and pleural effusion were more common; the rate of clinical failure (CF), in-hospital mortality and 30-day mortality were higher, which significantly increased with age and the number of CVEs (p < 0.001). Multivariable logistic regression showed previous history of congestive heart failure (odds ratio [OR], 6.16; 95% CI, 4.14– 9.18), CF (OR, 4.69; 95% CI, 3.392– 6.48), previous history of ischemic heart disease (OR, 2.22; 95% CI, 1.61– 3.07), use of glucocorticoids (OR, 2.0; 95% CI, 1.39– 2.89), aspiration (OR, 1.88; 95% CI, 1.26– 2.81), pleural effusion (OR, 1.66; 95% CI, 1.25– 2.20), multilobe infiltration (OR, 1.50; 95% CI, 1.15– 1.96), age (OR, 1.05; 95% CI, 1.04– 1.07), and blood urea nitrogen (OR, 1.03; 95% CI, 1.01– 1.06) were independent predictors for the occurrence of CVEs, while level of blood sodium (OR, 0.98; 95% CI, 0.97– 0.99) was protective factor. Renal failure (OR, 9.46; 95% CI, 4.17– 21.48), respiratory failure (OR, 9.32; 95% CI, 5.91– 14.71), sepsis/septic shock (OR, 7.87; 95% CI, 3.58– 17.31), new cerebrovascular diseases (OR, 5.94; 95% CI, 1.78– 19.87), new heart failure (OR, 4.04; 95% CI, 1.15– 14.14), new arrhythmia (OR, 2.38; 95% CI, 1.11– 5.14), aspiration (OR, 1.95; 95% CI, 1.09– 3.50), CURB-65 (OR, 1.57; 95% CI, 1.21– 2.02), and white blood cell count (OR, 1.05; 95% CI, 1.02– 1.09) were independent predictors for 30-day mortality in elderly patients with CAP, while lymphocyte count (OR, 0.63; 95% CI, 0.46– 0.87) was protective factor.Conclusion: Patients with CVEs had heavier disease burden and worse prognosis. Early recognition of risk factors is meaningful to strengthen the management in elderly patients with CAP.Keywords: community-acquired pneumonia, cardiovascular events, prognostic factors, elderly

Calcite precipitation plays a significant role in processes such as geological carbon sequestration and toxic metal sequestration and, yet, the rates and mechanisms of calcite growth under close to equilibrium conditions are far from well understood. In this study, a quartz crystal microbalance with dissipation (QCM-D) was used for the first time to measure macroscopic calcite growth rates. Calcite seed crystals were first nucleated and grown on sensors, then growth rates of calcite seed crystals were measured in real-time under close to equilibrium conditions (saturation index, SI = log ({Ca2+}/{CO32−}/Ksp) = 0.01–0.7, where {i} represent ion activities and Ksp = 10−8.48 is the calcite thermodynamic solubility constant). At the end of the experiments, total masses of calcite crystals on sensors measured by QCM-D and inductively coupled plasma mass spectrometry (ICP-MS) were consistent, validating the QCM-D measurements. Calcite growth rates measured by QCM-D were compared with reported macroscopic growth rates measured with auto-titration, ICP-MS, and microbalance. Calcite growth rates measured by QCM-D were also compared with microscopic growth rates measured by atomic force microscopy (AFM) and with rates predicted by two process-based crystal growth models. The discrepancies in growth rates among AFM measurements and model predictions appear to mainly arise from differences in step densities, and the step velocities were consistent among the AFM measurements as well as with both model predictions. Using the predicted steady-state step velocity and the measured step densities, both models predict well the growth rates measured using QCM-D and AFM. This study provides valuable insights into the effects of reactive site densities on calcite growth rate, which may help design future growth models to predict transient-state step densities.

Yudong Ning,1 Hong Yang,2 Sheng Qin,2 Bangrong Cao,3 Zuxian Zhong,4 Chuanshi He,5 Guiquan Zhu6 1Department of Head and Neck Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China; 2Department of Pathology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China; 3Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China; 4Department of Head and Neck Radiotherapy, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China; 5Sichuan Key Laboratory of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, People’s Republic of China; 6Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, People’s Republic of ChinaCorrespondence: Guiquan ZhuDepartment of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renmin South Road, Chengdu, Sichuan, 610041, People’s Republic of ChinaEmail zhugq@scu.edu.cnObjective: We aimed to identify new prognostic factors of oral squamous cell carcinoma (OSCC) among platelet-related parameters, establish a survival prediction model to predict the survival status of OSCC patients, and analyze the therapeutic effect of neoadjuvant chemotherapy on OSCC patients on the basis of real-world data.Materials and Methods: The real-world data of patients with OSCC confirmed by pathologic examination at Cancer Hospital from January 2011 to January 2015 and May 2017 to January 2020 were collected. We analyzed clinicopathologic factors using a Cox regression analysis, the Kaplan-Meier method, and propensity score matching (PSM).Results: The multivariate Cox regression analysis of not only validated the traditional prognostic factors such as tumor site, neural invasion, poor differentiation, and tumor-node-metastasis (TNM) stage but also identified a new prognostic factor, preoperative mean platelet volume (MPV) for overall survival (OS, HR, 0.47; 95% CI: 0.25– 0.89, P = 0.020). A nomogram was created to predict the probability of 3-year and 5-year OS. We found that neoadjuvant chemotherapy improved OS in patients with OSCC.Conclusion: Preoperative MPV, being associated with female, neoadjuvant chemotherapy, and advanced stage (Stage III and IV), may be a new prognostic factor for OS of patients with OSCC. The nomograms provided useful prediction for OS in OSCC patients. Neoadjuvant chemotherapy may improve the OS of patients with OSCC.Keywords: oral squamous cell carcinoma, overall survival, nomogram, mean platelet volume, neoadjuvant chemotherapy, induction chemotherapy

Meijuan Liu, Bingyan Cao, Min Liu, Xuejun Liang, Di Wu, Wenjing Li, Chang Su, Jiajia Chen, Chunxiu Gong Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of ChinaCorrespondence: Chunxiu GongDepartment of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of ChinaTel +86-10-59616161Email chunxiugong@sina.comObjective: To investigate the prevalence and associated factors of childhood overweight/obesity in the Shunyi district of Beijing, China.Methods: This study adopted a cross-sectional survey and included 10,855 children aged 6– 18 years in the Shunyi district of Beijing, China. Analyses were stratified by age group (6– 8, 9– 11, 12– 14, and 15– 18 years).Results: The prevalence of overweight and obesity among children aged 6– 18 years was high with 17.62% and 29.05% in boys, 17.57% and 18.04% in girls, respectively. Both boys and girls aged 9– 11 years had the highest rate of obesity in comparison with the other age groups, though the differences in children aged 9– 11 years and 12– 14 years were not statistically significant. Compared with age 6– 8 years, age 9– 11 years (OR=1.59, 95% CI 1.41– 1.79, P< 0.01) and 12– 14 years (OR=1.26, 95% CI 1.48– 1.73, P< 0.01) were independently positively associated with obesity. Importantly, in all subjects, the percentages of being physically active (exercise time ≥ 120 minutes/week) were lower in children aged 9– 11 years in comparison to children in other age groups. This phenomenon remained when this comparison was performed respectively in the normal-weight, overweight, and obesity groups. Even after adjustment for other potential confounders, the probability of being physically active (exercise time ≥ 120 minutes/week) was lower in children aged 9– 11 years (OR=0.86, 95% CI 0.78– 0.94, P< 0.01), but higher in children aged 12– 14 years (OR=1.91, 95% CI 1.69– 2.17, P< 0.01) and aged 15– 18 years (OR=2.22, 95% CI 1.85– 2.66, P< 0.01), when compared with children aged 6– 8 years.Conclusion: Children aged 9– 11 years had a higher prevalence of obesity, but a lower percentage of being physically active. Targeted intervention programs in this key group are needed to address this problem in China.Keywords: overweight, obesity, prevalence, risk factors, exercise time

Wu J, Wang J, Su Q, et al. Onco Targets Ther. 2018;11:2685–2698. The authors have advised the incorrect images were inadvertently selected for Figure 2A, on page 2690, due to the dark background and relatively low resolution of photos captured for the wound healing assay. For Figure 3A on page 2691, all Transwell images were captured and saved in one folder labelled by experimental date. Two overlapping images from different visual fields were captured from one well but labelled incorrectly and inadvertently selected for Figure 3A. The correct Figures 2 and 3 are shown in Download Article. The authors apologize for these errors and advise they do not affect the results of the paper. Read the original article

Xiudi Han,1 Liang Chen,2 Yimin Wang,3 Hui Li,3 Hong Wang,4 Xiqian Xing,5 Chunxiao Zhang,6 Lijun Suo,7 Jinxiang Wang,8 Guohua Yu,9 Guangqiang Wang,10 Xuexin Yao,11 Hongxia Yu,12 Lei Wang,13 Xuedong Liu,1 Bin Cao3 On behalf of the CAP-China Network1Department of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital Group, Qingdao City, Shandong Province, People’s Republic of China; 2Department of Infectious Disease, Beijing Jishuitan Hospital, Beijing, People’s Republic of China; 3National Clinical Research Center of Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 4Department of Nosocomial Infection, Qingdao Municipal Hospital Group, Qingdao City, Shandong Province, People’s Republic of China; 5Department of Pulmonary and Critical Care Medicine, Yan’an Hospital Affiliated to Kunming Medical University, Kunming City, Yunnan Province, People’s Republic of China; 6Department of Pulmonary and Critical Care Medicine, Beijing Huimin Hospital, Beijing, People’s Republic of China; 7Department of Pulmonary and Critical Care Medicine, Zibo Municipal Hospital, Zibo City, Shandong Province, People’s Republic of China; 8Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, People’s Republic of China; 9Department of Pulmonary and Critical Care Medicine, Weifang No. 2 People’s Hospital, Weifang City, Shandong Province, People’s Republic of China; 10Department of Respiratory Medicine, Shandong University Affiliated Qilu Hospital (Qingdao), Qingdao City, Shandong Province, People’s Republic of China; 11Department of Respiratory Medicine, The 2nd Hospital of Beijing Corps, Chinese Armed Police Forces, Beijing, People’s Republic of China; 12Department of Infectious Disease, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai City, Shandong Province, People’s Republic of China; 13Department of Pulmonary and Critical Care Medicine, Rizhao Chinese Medical Hospital Affiliated to Shandong Chinese Medical University, Rizhao City, Shandong Province, People’s Republic of ChinaCorrespondence: Xuedong LiuDepartment of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital Group, Jiaozhou Road, Qingdao City, 266011, Shandong Province, People’s Republic of ChinaTel +86-18661678256Fax +86-532-82789055Email xuedongliu@263.netBin CaoNational Clinical Research Center of Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Yinghuayuan East Street, Chao-yang District, Beijing, 100020, People’s Republic of ChinaTel +86-13911318339Fax +86-10-84206264Email caobin_ben@163.comPurpose: The cost-effectiveness of different guideline-concordant antimicrobial regimens for elderly patients with community-acquired pneumonia (CAP) was rarely discussed. This study attempts to explore the most appropriate cost-effectiveness of guideline-concordant antimicrobial regimen for elderly patients with CAP in general wards.Patients and Methods: This was a multicenter, retrospective, 4:2:1 matched study enrolling 511 elderly patients with CAP hospitalized in general wards. Two hundred ninety-two patients prescribed with β-lactam monotherapy (group A), 146 patients prescribed with fluoroquinolone monotherapy (group B) and 73 patients prescribed with β-lactam/macrolide combination therapy (group C). Clinical outcomes and medical costs were analyzed by χ2 test for categorical variables or Kruskal–Wallis H-test for continuous variables.Results: There were no statistical differences in imaging features, etiology and complications during hospitalization among these three groups. The rates of clinical failure occurrence, in-hospital mortality, 30-day mortality and 60-day mortality also had no significant differences among group A, B and C patients; however, the median length of stay (LOS) in group A patients was 12.0 days, which was significantly higher than that in group B and C patients (both 10.0 days, p< 0.02). The median total, drug, and antibiotic costs for one elderly CAP episode in group B patients were RMB 10368.4, RMB 3874.8, and RMB 1796.3, respectively, which were significantly lower than those in group A and C patients (p< 0.01).Conclusion: Non-inferiority of clinical failure occurrence and short-term mortality was observed in different guideline-concordant antimicrobial regimens for elderly patients with CAP in general wards; however, the median LOS and hospitalization-associated costs for one elderly CAP episode with fluoroquinolone monotherapy were significantly lowest, and this strategy was considered to be the most cost-effective strategy in general wards.Keywords: community-acquired pneumonia, cost-effectiveness, antimicrobial regimen, elderly, general ward

Ruiqi Xu,1,2 Mengnan Zeng,1,2 Yuanyuan Wu,1,2 Shengchao Wang,1,2 Beibei Zhang,1,2 Jingke Zhang,1,2 Yuxuan Kan,1,2 Benke Li,1,2 Bing Cao,1,2 Xiaoke Zheng,1,2 Weisheng Feng1,2 1School of Pharmacy, Henan University of Traditional Chinese Medicine, Zhengzhou, People’s Republic of China; 2The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, People’s Republic of ChinaCorrespondence: Xiaoke Zheng; Weisheng FengSchool of Pharmacy, Henan University of Traditional Chinese Medicine, 156 Jinshui East Road, Zhengzhou, 450046, People’s Republic of ChinaTel +86-371-6019-0296Email zhengxk.2006@163.com; fwsh@hactcm.edu.cnPurpose: This research aims to investigate the intervention and mechanism of 50% acetone extract of C. officinalis leaves (SZYY) on melanoma xenografts.Patients and Methods: Tumor size and cardiac function were measured via ultrasound. The accumulation of 2-deoxy-D-glucose (2-DG) in tumor tissue was examined with near-infrared in vivo imaging. Flow cytometry was performed to assess apoptosis and reactive oxygen species (ROS) levels in tumor and immune cells in spleen. The levels of inflammatory cytokines in serum were detected by cytometric bead array. The expression of proliferation-, apoptosis-, and angiogenesis-related proteins in tumor cells was measured to evaluate the underlying mechanisms. Subsequently, the effects of four compounds separated from SZYY on the proliferation and migration of A375 cells and STAT3 signaling were examined. The peak identification and contents of the four components were performed via high-performance liquid chromatography (HPLC). Finally, we evaluated the inhibitory effects of STAT3 overexpression on the cytotoxic activity of four constituents in A375 cells.Results: SZYY inhibited the growth and glycolysis of melanoma xenograft in mice, improved cardiac function, increased the percentages of macrophages, neutrophils, and lymphocytes in spleen, reduced the levels of IL-6, IL-17A, TNF-α, and IFN-γ in serum, promoted apoptosis and oxidative stress in tumor tissues, and inhibited STAT3 phosphorylation and expression of angiogenic factors. Chemical analysis showed that SZYY is rich in loganin, rutin, triohimas C, and triohimas D, which all could restrain the proliferation and migration of A375 cells and inhibit the phosphorylation and nuclear translocation of STAT3. Moreover, STAT3 overexpression could diminish the cytotoxic activity of four compounds on A375 cells.Conclusion: SZYY could exert anti-melanoma effects via inhibiting STAT3 signaling to induce apoptosis and inhibit tumor angiogenesis. Its active ingredients might be loganin, rutin, triohimas C, and triohimas D.Keywords: Cornus officinalis, melanoma, STAT3, apoptosis, angiogenesis