To further investigate the one-dimensional(1D)rheological consolidation mechanism of double-layered soil,the fractional derivative Merchant model(FDMM)and the non-Darcian flow model with the non-Newtonian index are re...To further investigate the one-dimensional(1D)rheological consolidation mechanism of double-layered soil,the fractional derivative Merchant model(FDMM)and the non-Darcian flow model with the non-Newtonian index are respectively introduced to describe the deformation of viscoelastic soil and the flow of pore water in the process of consolidation.Accordingly,an 1D rheological consolidation equation of double-layered soil is obtained,and its numerical analysis is performed by the implicit finite difference method.In order to verify its validity,the numerical solutions by the present method for some simplified cases are compared with the results in the related literature.Then,the influence of the revelent parameters on the rheological consolidation of double-layered soil are investigated.Numerical results indicate that the parameters of non-Darcian flow and FDMM of the first soil layer greatly influence the consolidation rate of double-layered soil.As the decrease of relative compressibility or the increase of relative permeability between the lower soil and the upper soil,the dissipation rate of excess pore water pressure and the settlement rate of the ground will be accelerated.Increasing the relative thickness of soil layer with high permeability or low compressibility will also accelerate the consolidation rate of double-layered soil.展开更多
BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neut...BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia...BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.展开更多
Extreme weather events,such as floods and droughts,are expected to rise significantly worldwide as a result of climate change.Investigating future drought patterns is therefore a key approach for elaborating anticipat...Extreme weather events,such as floods and droughts,are expected to rise significantly worldwide as a result of climate change.Investigating future drought patterns is therefore a key approach for elaborating anticipatory water resources management responses to climate change.In this paper,future meteorological drought conditions are investigated based on the SPEI(Standardised Precipitation Evapotranspiration Index).This study makes use of observed and projected data.The simulated data were retrieved from the CMIP6(Coupled Model Intercomparison Project Phase 6)over the period 2025-2050,and the Delta change method was adopted to remove the bias in the dataset.Then SPEI at various scales has been estimated under four future scenarios(SSP1-2.6,SSP2-4.5,SSP3-7.0 and SSP5-8.5).The trend analysis of the projected SPEI was performed at p<0.05 using the MMK(Modified Mann-Kendall)test in order to detect the statistically significant trend of the drought against the null hypothesis of no trend.Results show large variability in the magnitude of drought in the past and future.Based on SPEI at 24 months accumulation,the result shows that under SSP1-2.6,the basin will experience a wet period during the first decade(SPEI=0.60),the second decade will be dry(SPEI24=-0.43).The remaining years will be also dry(SPEI=-0.34).Under SSP2-4.5,SSP3-7.0 and SSP5-8.5 scenarios,the district will experience a wet period during the first two decades with SPEI ranging from 0.38 to 0.59.This wet period will be followed by a dry period under these scenarios ranging from-0.14 to-0.06.Overall,under SSPs scenarios,two main periods characterized by a rainfall recovery spanning from followed by a moderately prolonged drought are identified within the study area.The findings of this study may provide valuable information for developing proactive measures to reduce water insecurity in Fada N’Gourma through effective drought mitigation.展开更多
In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in...In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in Hainan Province,it has been found that the quality of vocational education generally depends on the talent training program and professional construction at the macro level.At the meso level,the teacher level and teaching environment are critical,while at the micro level,the evaluation of talent training quality cannot be underestimated.Strategies for quality improvement in vocational education are proposed from the perspectives of talent training programs,major construction,teacher development,teaching environment,and talent training quality,all under the lens of digital transformation.展开更多
BACKGROUND:This study aims to explore the causal relationship of body weight,body mass index(BMI),and waist circumference (WC) with the risk of cardiac arrest (CA) using two-sample Mendelian randomization (MR).METHODS...BACKGROUND:This study aims to explore the causal relationship of body weight,body mass index(BMI),and waist circumference (WC) with the risk of cardiac arrest (CA) using two-sample Mendelian randomization (MR).METHODS:Data were summarized using genome-wide association studies (GWAS).Twosample MR analyses were performed using the inverse variance weighting (IVW) method,the weighted median method,and the MR-Egger analysis.Heterogeneity test and sensitivity analysis were performed using Cochran’s Q test and the leave-one-out method,respectively.The Steiger test was used to detect reverse causality.Bayesian model-averaged MR was used to identify the most influential risk factors.RESULTS:A total of 13 GWAS data were collected for BMI,body weight and WC.IVW analyses showed a positive correlation of body weight,BMI,and WC with CA (all OR>1 and P<0.05),with MR-Egger and weighted median methods confirming the IVW findings.No horizontal pleiotropy or heterogeneity was observed.Sensitivity analysis indicated that no single nucleotide polymorphism(SNP) caused significant changes in overall causality.Bayesian model-averaged MR was also used to rank causality based on marginal inclusion probability (MIP),and the corresponding modelaveraged causal estimate (MACE) were confirmed,which indicated that WC (GWAS ID:ukb-b-9405)was the highest-ranked risk factor (MIP=0.119,MACE=0.011);its posterior probability was 0.057.A total of 14 sex-specific GWAS data on weight,BMI,and WC were analyzed in relationship with CA,and the MR results showed no significant effects of sex-specific factors.CONCLUSION:Body weight,BMI,and WC are causally associated with an increased risk of CA,with WC identified as the most important risk factor.展开更多
纽结理论是拓扑学的一个重要分支,虚拟纽结理论是经典纽结理论的推广,对它的研究是通过一种图解理论来展开的。虚拟纽结多项式是一类以多项式表达的虚拟纽结不变量,例如Arrow多项式和Wriggle多项式。Affine index多项式是以虚拟纽结图...纽结理论是拓扑学的一个重要分支,虚拟纽结理论是经典纽结理论的推广,对它的研究是通过一种图解理论来展开的。虚拟纽结多项式是一类以多项式表达的虚拟纽结不变量,例如Arrow多项式和Wriggle多项式。Affine index多项式是以虚拟纽结图的整数标记定义的单变量多项式。本文主要计算一类特殊虚拟纽结的Affine index多项式。按照Cheng着色的规则,对虚拟纽结图的每一段弧进行整数标记,计算每个经典交叉点的指标值,进而得到这类特殊虚拟纽结的Affine index多项式的表达式。Knot theory is an important branch of topology. Virtual knot theory is a generalization of classical knot theory, and its research is carried out through a graphic theory. The virtual knot polynomial refers to a class of virtual knot invariant expressed by polynomials, such as the Arrow polynomial and the Wriggle polynomial. The affine index polynomial is a univariate polynomial defined by the integer label of a virtual knot graph. In this paper, we mainly calculate affine index polynomials for a special class of virtual knots. According to the rules of Cheng coloring, we will integer label each arc of the virtual knot graph and calculate the index value of each classical crossings, and then get the expression of the affine index polynomial of this special virtual knot.展开更多
Atrial fibrillation(Afib)is a common arrhythmia with significant public health implications,affecting millions of individuals worldwide.Catheter ablation(CA)is an established treatment for drug-resistant Afib,yet recu...Atrial fibrillation(Afib)is a common arrhythmia with significant public health implications,affecting millions of individuals worldwide.Catheter ablation(CA)is an established treatment for drug-resistant Afib,yet recurrence remains a major concern,impacting quality of life in a significant portion of patients.Inflammation plays a critical role in the recurrence of Afib after ablation,with systemic inflammatory markers such as C-reactive protein being linked to higher recurrence rates.In this editorial,we discuss the study by Wang et al,published in the latest issue,which investigates the predictive role of the systemic immune inflammation index(SII)in Afib recurrence following radiofrequency CA.Elevated pre-ablation SII levels are identified as an independent predictor of recurrence,significantly enhancing the predictive power of the APPLE score.Integration of SII improved the APPLE score’s predictive performance,as shown by enhanced area under the curve,net reclassification improvement,and integrated discrimination improvement.This combined model highlights the importance of both structural and inflammatory factors in Afib recurrence,offering a more personalized approach to patient management.Additionally,the affordability and accessibility of SII enhance its practicality in clinical workflows.The study by Wang et al underscores the potential of integrating SII with existing scoring systems to refine risk stratification and optimize treatment strategies.Future research should validate these findings across diverse populations,explore limitations such as the potential influence of comorbidities on SII reliability,and investigate additional biomarkers to enhance predictive accuracy.展开更多
BACKGROUND Noninvasive tests are crucial for the management and follow-up of patients with autoimmune hepatitis,but their validation is limited because of insufficient data.AIM To investigate the diagnostic performanc...BACKGROUND Noninvasive tests are crucial for the management and follow-up of patients with autoimmune hepatitis,but their validation is limited because of insufficient data.AIM To investigate the diagnostic performance of three fibrosis noninvasive tests[FibroTest,vibration-controlled transient elastography(VCTE),and the fibrosis-4 index(FIB-4)and two activity biomarkers(alanine aminotransferase(ALT)and ActiTest].METHODS This study enrolled 103 patients for whom liver biopsy,hepatic elastography results,and laboratory markers were available.Diagnostic performance was assessed with receiver operating characteristic(ROC)curves,the Obuchowski measure(OM),and the Bayesian latent class model.RESULTS FibroTest and VCTE outperformed FIB-4 in cases of significant fibrosis(≥F2),with areas under the ROC curve of 0.83[95%confidence interval(CI):0.73-0.90],0.86(95%CI:0.77-0.92),and 0.71(95%CI:0.60-0.80),respectively.The mean(standard error)OM values were 0.92(0.01),0.93(0.01),and 0.88(0.02)for FibroTest,VCTE,and FIB-4,respectively;FibroTest and VCTE performed comparably,and both were superior to FIB-4(P=0.03 and P=0.005).The areas under the ROC curve values for activity biomarkers were 0.86(95%CI:0.76-0.92)for ActiTest and 0.84(95%CI:0.73-0.90)for ALT(P=0.06).The OM values for ActiTest and ALT were 0.92(0.02)and 0.90(0.02),respectively(P=0.005).CONCLUSION FibroTest and VCTE outperformed FIB-4 according to the OM.FibroTest-ActiTest facilitated the evaluation of both fibrosis and activity.展开更多
Atrial fibrillation(AF)is the most common arrhythmia in humans,affecting more than 40 million people worldwide.Radiofrequency catheter ablation(RFCA)was first introduced as a treatment for AF by Haïssaguerre M in...Atrial fibrillation(AF)is the most common arrhythmia in humans,affecting more than 40 million people worldwide.Radiofrequency catheter ablation(RFCA)was first introduced as a treatment for AF by Haïssaguerre M in the late 1990s.This procedure quickly became the treatment of choice,especially for symptomatic patients with AF refractory to medication.However,up to 45%of patients may experience AF recurrence within 12 months after RFCA.In this setting,AF recurrence is likely multifactorial,including atrial remodeling,local fibrosis or incomplete ablation due to failure in locating the trigger.Additionally,patients with obesity,sleep apnea,hypertension,or diabetes are at an increased risk of AF recurrence after RFCA.Inflammation is increasingly recognized as a potential key factor in AF recurrence and may arise both from the healing response of heart tissue post-ablation or from chronic low-grade inflammation,as observed in many risk factors.Here,we present an original study by Wang et al,which investigated the combination of the systemic immune-inflammation index-a marker developed to assess overall inflammatory status-and the APPLE score,designed to predict AF recurrence following RFCA.The study found that using both indicators together improved the accuracy of AF recurrence prediction.These findings underscore the significant role of inflammation in cardiovascular disease and demonstrated its impact on AF recurrence after RFCA.Further research is warranted to validate the combined use of these two scores in clinical settings for predicting AF recurrence following catheter ablation.展开更多
BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic...BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.展开更多
The Wiener index of a graph is defined to be the sum of the distances of all pairs of vertices in the graph.The kth power G^(k) of a graph G is the graph on V(G)and two vertices are adjacent if and only if their dista...The Wiener index of a graph is defined to be the sum of the distances of all pairs of vertices in the graph.The kth power G^(k) of a graph G is the graph on V(G)and two vertices are adjacent if and only if their distance in G is less or equal to k.In this paper,we computed the Wiener index of the kth power of paths and cycles for any k≥2.展开更多
BACKGROUND The association between body mass index(BMI)and bone mineral density(BMD)has shown inconsistent results,varying by sex and skeletal site.Despite normal or elevated bone mass,individuals with type 2 diabetes...BACKGROUND The association between body mass index(BMI)and bone mineral density(BMD)has shown inconsistent results,varying by sex and skeletal site.Despite normal or elevated bone mass,individuals with type 2 diabetes have an increased risk of hip and vertebral fractures.AIM To assess lumbar spine trabecular volumetric BMD(vBMD)across different BMI categories in individuals with and without diabetes.METHODS This cross-sectional study included 966 men over 50 years old and 1001 postmenopausal women from the Pinggu Metabolic Disease Study.The vBMD of lumbar vertebrae 2 through 4 was measured using quantitative computed tomography.Total adipose tissue,subcutaneous adipose tissue(SAT),visceral adipose tissue(VAT),and lumbar skeletal muscle area were also quantified.RESULTS In men with obesity(P=0.038)and overweight(P=0.032),vBMD was significantly higher in the diabetes group compared to non-diabetic men.After adjusting for age and sex,no significant saturation effect between BMI and BMD was found in participants with diabetes or in women without diabetes.However,a BMI threshold of 22.33 kg/m²indicated a saturation point for vBMD in nondiabetic men.Independent predictors of vBMD in men included age(r=-0.387,P<0.001),BMI(r=0.130,P=0.004),and VAT(r=-0.145,P=0.001).For women,significant predictors were age(r=-0.594,P<0.001),BMI(r=0.157,P=0.004),VAT(r=-0.112,P=0.001),and SAT(r=-0.068,P=0.035).CONCLUSION The relationship between BMI and trabecular vBMD differs in individuals with and without diabetes.Overweight and obese men with diabetes exhibit higher vBMD.展开更多
BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of...BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.展开更多
AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National ...AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National Health and Nutrition Examination Survey(NHANES,2005-2008)for a cross-sectional study.DII was calculated from 24-hour dietary recall questionnaire conducted by experienced researchers and data analyzed in R according to the NHANES user guide,“Stratified Multi-stage Probability Sampling”.The relationship between DII and glaucoma was evaluated by multi-factor logistic regression analysis and the existence of a non-linear association examined by restricted cubic spline(RCS)analysis.RESULTS:A total of 5359 subjects were included and the cross-sectional analysis weighted to represent the US population of 109 million.DII was elevated in glaucoma patients(P<0.001)and smoking and alcohol use contributed to significant differences(P<0.001).DII correlated negatively with Healthy Eating Index(HEI)-2015(Spearman rank correlation coefficient,r=-0.49).RCS analysis showed a linear relationship between DII and glaucoma risk(P of non-linear relationship=0.575).CONCLUSION:An increased DII is strongly associated with high risk of glaucoma and diet-induced inflammation should be controlled to delay glaucoma progression.展开更多
BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic shock.METHODS:This prospective cohort study,conducted at the emergency intensive care unit of Peking Univers...BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic shock.METHODS:This prospective cohort study,conducted at the emergency intensive care unit of Peking University People's Hospital,recruited 200 patients with septic shock between January 2023 and August 2023.These patients were divided into survival(n=84)and death(n=116)groups based on 28-day outcomes.Clinical evaluations included laboratory tests and clinical scores,with lactate and PPI values assessed upon admission to the emergency room and at 6 h and 12 h after admission.Risk factors associated with mortality were analyzed using univariate and multivariate Cox regression analyses.Receiver operator characteristic(ROC)curve was used to assess predictive performance.Mortality rates were compared,and Kaplan-Meier survival plots were created.RESULTS:Compared to the survival group,patients in the death group were older and had more severe liver damage and coagulation dysfunction,necessitating higher norepinephrine doses and increased fl uid replacement.Higher lactate levels and lower PPI levels at 0 h,6 h,and 12 h were observed in the death group.Multivariate Cox regression identifi ed prolonged prothrombin time(PT),decreased 6-h PPI and 12-h PPI as independent risk factors for death.The area under the curves for 6-h PPI and 12-h PPI were 0.802(95%CI 0.742-0.863,P<0.001)and 0.945(95%CI 0.915-0.974,P<0.001),respectively,which were superior to Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA)scores(0.864 and 0.928).Cumulative mortality in the low PPI groups at 6 h and 12 h was signifi cantly higher than in the high PPI groups(6-h PPI:77.52%vs.22.54%;12-h PPI:92.04%vs.13.79%,P<0.001).CONCLUSION:PPI may have value in predicting 28-day mortality in patients with septic shock.展开更多
Due to a prolonged operation time and low mass transfer efficiency, the primary challenge in the aeration process of non-Newtonian fluids is the high energy consumption, which is closely related to the form and rate o...Due to a prolonged operation time and low mass transfer efficiency, the primary challenge in the aeration process of non-Newtonian fluids is the high energy consumption, which is closely related to the form and rate of impeller, ventilation, rheological properties and bubble morphology in the reactor. In this perspective, through optimal computational fluid dynamics models and experiments, the relationship between power consumption, volumetric mass transfer rate(kLa) and initial bubble size(d0) was constructed to establish an efficient operation mode for the aeration process of non-Newtonian fluids. It was found that reducing the d0could significantly increase the oxygen mass transfer rate, resulting in an obvious decrease in the ventilation volume and impeller speed. When d0was regulated within 2-5 mm,an optimal kLa could be achieved, and 21% of power consumption could be saved, compared to the case of bubbles with a diameter of 10 mm.展开更多
BACKGROUND Triglyceride-glucose(TyG)index values are a new surrogate marker for insulin resistance.This study aimed to explore the relationship between cumulative TyG index values and atrial fibrillation(AF)recurrence...BACKGROUND Triglyceride-glucose(TyG)index values are a new surrogate marker for insulin resistance.This study aimed to explore the relationship between cumulative TyG index values and atrial fibrillation(AF)recurrence after radiofrequency catheter ablation(RFCA).METHODS A total of 576 patients with AF who underwent RFCA at the Second Affiliated Hospital of Xi'an Jiaotong University were included in this study.The participants were grouped based on cumulative TyG index values tertiles within 3 months after ablation.Cox regression and restricted cubic spline analyses were used to determine the relationship between cumulative TyG index values and AF recurrence.The predictive value of all risk factors was assessed by receiver operating curve analysis.RESULTS There were 375 patients completed the study(age:63.23±10.73 years,64.27%male).The risk of AF recurrence increased with increasing cumulative TyG index values tertiles.After adjusting for potential confounders,patients in the medium cumulative TyG index group[hazard ratio(HR)=4.949,95%CI:1.778–13.778,P=0.002]and the high cumulative TyG index group(HR=8.716,95%CI:3.371–22.536,P<0.001)had a higher risk of AF recurrence than those in the low cumulative TyG index group.The restricted cubic spline regression model also showed an increased risk of AF recurrence with increasing cumulative TyG index values.When considering cumulative TyG index values,left atrial diameter,and lactate dehydrogenase levels as a comprehensive factor,the model could effectively predict AF recurrence after RFCA[area under the curve(AUC)=0.847,95%CI:0.797–0.897,P<0.001].CONCLUSIONS Cumulative TyG index values were a risk factor for AF recurrence after RFCA.Monitoring longitudinal TyG index values may assist with optimized for risk stratification and outcome prediction for AF recurrence.展开更多
This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the ...This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal Surgery.It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features valuable.There are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical surgery.Neutrophils release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell invasion.Neutrophils promote the adhesion of tumor cells to endothelial cells,through physical anchoring.That results in the migration of tumor cells.Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs.Platelets can form a protective film on the surface of tumor cells.This allows avoiding blood flow damage as well as immune system attack.It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness.High SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall survival.HCC patients are a very special population that requires increased attention.SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings.The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features.Those features provide tumor nutrition,growth,and distribution throughout the body,such as vascular invasion.On the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings.The article is of considerable interest.It would be helpful to continue the study follow-up to 2 years and longer.External validation of the data is needed.展开更多
In traditional Chinese medicine(TCM),based on various pathogenic symptoms and the‘golden chamber’medical text,Huangdi Neijing,diabetes mellitus falls under the category‘collateral disease’.TCM,with its wealth of e...In traditional Chinese medicine(TCM),based on various pathogenic symptoms and the‘golden chamber’medical text,Huangdi Neijing,diabetes mellitus falls under the category‘collateral disease’.TCM,with its wealth of experience,has been treating diabetes for over two millennia.Different antidiabetic Chinese herbal medicines re-duce blood sugar,with their effective ingredients exerting unique advantages.As well as a glucose lowering effect,TCM also regulates bodily functions to prevent diabetes associated complications,with reduced side effects compared to western synthetic drugs.Chinese herbal medicine is usually composed of polysaccharides,saponins,al-kaloids,flavonoids,and terpenoids.These active ingredients reduce blood sugar via various mechanism of actions that include boosting endogenous insulin secretion,enhancing insulin sensitivity and adjusting key enzyme activity and scavenging free radicals.These actions regulate glycolipid metabolism in the body,eventually achiev-ing the goal of normalizing blood glucose.Using different animal models,a number of molecular markers are available for the detection of diabetes induction and the molecular pathology of the disease is becoming clearer.Nonetheless,there is a dearth of scientific data about the pharmacology,dose-effect relationship,and structure-activity relationship of TCM and its constituents.Further research into the efficacy,toxicity and mode of action of TCM,using different metabolic and molecular markers,is key to developing novel TCM antidiabetic formulations.展开更多
基金Project(51578511)supported by the National Natural Science Foundation of China。
文摘To further investigate the one-dimensional(1D)rheological consolidation mechanism of double-layered soil,the fractional derivative Merchant model(FDMM)and the non-Darcian flow model with the non-Newtonian index are respectively introduced to describe the deformation of viscoelastic soil and the flow of pore water in the process of consolidation.Accordingly,an 1D rheological consolidation equation of double-layered soil is obtained,and its numerical analysis is performed by the implicit finite difference method.In order to verify its validity,the numerical solutions by the present method for some simplified cases are compared with the results in the related literature.Then,the influence of the revelent parameters on the rheological consolidation of double-layered soil are investigated.Numerical results indicate that the parameters of non-Darcian flow and FDMM of the first soil layer greatly influence the consolidation rate of double-layered soil.As the decrease of relative compressibility or the increase of relative permeability between the lower soil and the upper soil,the dissipation rate of excess pore water pressure and the settlement rate of the ground will be accelerated.Increasing the relative thickness of soil layer with high permeability or low compressibility will also accelerate the consolidation rate of double-layered soil.
文摘BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.
基金Supported by the Scientific Research Project of Hospital Pharmacy of Guangxi Pharmaceutical Association in 2022,No.GXYXH1-202202.
文摘BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.
文摘Extreme weather events,such as floods and droughts,are expected to rise significantly worldwide as a result of climate change.Investigating future drought patterns is therefore a key approach for elaborating anticipatory water resources management responses to climate change.In this paper,future meteorological drought conditions are investigated based on the SPEI(Standardised Precipitation Evapotranspiration Index).This study makes use of observed and projected data.The simulated data were retrieved from the CMIP6(Coupled Model Intercomparison Project Phase 6)over the period 2025-2050,and the Delta change method was adopted to remove the bias in the dataset.Then SPEI at various scales has been estimated under four future scenarios(SSP1-2.6,SSP2-4.5,SSP3-7.0 and SSP5-8.5).The trend analysis of the projected SPEI was performed at p<0.05 using the MMK(Modified Mann-Kendall)test in order to detect the statistically significant trend of the drought against the null hypothesis of no trend.Results show large variability in the magnitude of drought in the past and future.Based on SPEI at 24 months accumulation,the result shows that under SSP1-2.6,the basin will experience a wet period during the first decade(SPEI=0.60),the second decade will be dry(SPEI24=-0.43).The remaining years will be also dry(SPEI=-0.34).Under SSP2-4.5,SSP3-7.0 and SSP5-8.5 scenarios,the district will experience a wet period during the first two decades with SPEI ranging from 0.38 to 0.59.This wet period will be followed by a dry period under these scenarios ranging from-0.14 to-0.06.Overall,under SSPs scenarios,two main periods characterized by a rainfall recovery spanning from followed by a moderately prolonged drought are identified within the study area.The findings of this study may provide valuable information for developing proactive measures to reduce water insecurity in Fada N’Gourma through effective drought mitigation.
文摘In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in Hainan Province,it has been found that the quality of vocational education generally depends on the talent training program and professional construction at the macro level.At the meso level,the teacher level and teaching environment are critical,while at the micro level,the evaluation of talent training quality cannot be underestimated.Strategies for quality improvement in vocational education are proposed from the perspectives of talent training programs,major construction,teacher development,teaching environment,and talent training quality,all under the lens of digital transformation.
基金This study is supported by the National Natural Science Foundation of China (No. 82072127)。
文摘BACKGROUND:This study aims to explore the causal relationship of body weight,body mass index(BMI),and waist circumference (WC) with the risk of cardiac arrest (CA) using two-sample Mendelian randomization (MR).METHODS:Data were summarized using genome-wide association studies (GWAS).Twosample MR analyses were performed using the inverse variance weighting (IVW) method,the weighted median method,and the MR-Egger analysis.Heterogeneity test and sensitivity analysis were performed using Cochran’s Q test and the leave-one-out method,respectively.The Steiger test was used to detect reverse causality.Bayesian model-averaged MR was used to identify the most influential risk factors.RESULTS:A total of 13 GWAS data were collected for BMI,body weight and WC.IVW analyses showed a positive correlation of body weight,BMI,and WC with CA (all OR>1 and P<0.05),with MR-Egger and weighted median methods confirming the IVW findings.No horizontal pleiotropy or heterogeneity was observed.Sensitivity analysis indicated that no single nucleotide polymorphism(SNP) caused significant changes in overall causality.Bayesian model-averaged MR was also used to rank causality based on marginal inclusion probability (MIP),and the corresponding modelaveraged causal estimate (MACE) were confirmed,which indicated that WC (GWAS ID:ukb-b-9405)was the highest-ranked risk factor (MIP=0.119,MACE=0.011);its posterior probability was 0.057.A total of 14 sex-specific GWAS data on weight,BMI,and WC were analyzed in relationship with CA,and the MR results showed no significant effects of sex-specific factors.CONCLUSION:Body weight,BMI,and WC are causally associated with an increased risk of CA,with WC identified as the most important risk factor.
文摘纽结理论是拓扑学的一个重要分支,虚拟纽结理论是经典纽结理论的推广,对它的研究是通过一种图解理论来展开的。虚拟纽结多项式是一类以多项式表达的虚拟纽结不变量,例如Arrow多项式和Wriggle多项式。Affine index多项式是以虚拟纽结图的整数标记定义的单变量多项式。本文主要计算一类特殊虚拟纽结的Affine index多项式。按照Cheng着色的规则,对虚拟纽结图的每一段弧进行整数标记,计算每个经典交叉点的指标值,进而得到这类特殊虚拟纽结的Affine index多项式的表达式。Knot theory is an important branch of topology. Virtual knot theory is a generalization of classical knot theory, and its research is carried out through a graphic theory. The virtual knot polynomial refers to a class of virtual knot invariant expressed by polynomials, such as the Arrow polynomial and the Wriggle polynomial. The affine index polynomial is a univariate polynomial defined by the integer label of a virtual knot graph. In this paper, we mainly calculate affine index polynomials for a special class of virtual knots. According to the rules of Cheng coloring, we will integer label each arc of the virtual knot graph and calculate the index value of each classical crossings, and then get the expression of the affine index polynomial of this special virtual knot.
文摘Atrial fibrillation(Afib)is a common arrhythmia with significant public health implications,affecting millions of individuals worldwide.Catheter ablation(CA)is an established treatment for drug-resistant Afib,yet recurrence remains a major concern,impacting quality of life in a significant portion of patients.Inflammation plays a critical role in the recurrence of Afib after ablation,with systemic inflammatory markers such as C-reactive protein being linked to higher recurrence rates.In this editorial,we discuss the study by Wang et al,published in the latest issue,which investigates the predictive role of the systemic immune inflammation index(SII)in Afib recurrence following radiofrequency CA.Elevated pre-ablation SII levels are identified as an independent predictor of recurrence,significantly enhancing the predictive power of the APPLE score.Integration of SII improved the APPLE score’s predictive performance,as shown by enhanced area under the curve,net reclassification improvement,and integrated discrimination improvement.This combined model highlights the importance of both structural and inflammatory factors in Afib recurrence,offering a more personalized approach to patient management.Additionally,the affordability and accessibility of SII enhance its practicality in clinical workflows.The study by Wang et al underscores the potential of integrating SII with existing scoring systems to refine risk stratification and optimize treatment strategies.Future research should validate these findings across diverse populations,explore limitations such as the potential influence of comorbidities on SII reliability,and investigate additional biomarkers to enhance predictive accuracy.
文摘BACKGROUND Noninvasive tests are crucial for the management and follow-up of patients with autoimmune hepatitis,but their validation is limited because of insufficient data.AIM To investigate the diagnostic performance of three fibrosis noninvasive tests[FibroTest,vibration-controlled transient elastography(VCTE),and the fibrosis-4 index(FIB-4)and two activity biomarkers(alanine aminotransferase(ALT)and ActiTest].METHODS This study enrolled 103 patients for whom liver biopsy,hepatic elastography results,and laboratory markers were available.Diagnostic performance was assessed with receiver operating characteristic(ROC)curves,the Obuchowski measure(OM),and the Bayesian latent class model.RESULTS FibroTest and VCTE outperformed FIB-4 in cases of significant fibrosis(≥F2),with areas under the ROC curve of 0.83[95%confidence interval(CI):0.73-0.90],0.86(95%CI:0.77-0.92),and 0.71(95%CI:0.60-0.80),respectively.The mean(standard error)OM values were 0.92(0.01),0.93(0.01),and 0.88(0.02)for FibroTest,VCTE,and FIB-4,respectively;FibroTest and VCTE performed comparably,and both were superior to FIB-4(P=0.03 and P=0.005).The areas under the ROC curve values for activity biomarkers were 0.86(95%CI:0.76-0.92)for ActiTest and 0.84(95%CI:0.73-0.90)for ALT(P=0.06).The OM values for ActiTest and ALT were 0.92(0.02)and 0.90(0.02),respectively(P=0.005).CONCLUSION FibroTest and VCTE outperformed FIB-4 according to the OM.FibroTest-ActiTest facilitated the evaluation of both fibrosis and activity.
文摘Atrial fibrillation(AF)is the most common arrhythmia in humans,affecting more than 40 million people worldwide.Radiofrequency catheter ablation(RFCA)was first introduced as a treatment for AF by Haïssaguerre M in the late 1990s.This procedure quickly became the treatment of choice,especially for symptomatic patients with AF refractory to medication.However,up to 45%of patients may experience AF recurrence within 12 months after RFCA.In this setting,AF recurrence is likely multifactorial,including atrial remodeling,local fibrosis or incomplete ablation due to failure in locating the trigger.Additionally,patients with obesity,sleep apnea,hypertension,or diabetes are at an increased risk of AF recurrence after RFCA.Inflammation is increasingly recognized as a potential key factor in AF recurrence and may arise both from the healing response of heart tissue post-ablation or from chronic low-grade inflammation,as observed in many risk factors.Here,we present an original study by Wang et al,which investigated the combination of the systemic immune-inflammation index-a marker developed to assess overall inflammatory status-and the APPLE score,designed to predict AF recurrence following RFCA.The study found that using both indicators together improved the accuracy of AF recurrence prediction.These findings underscore the significant role of inflammation in cardiovascular disease and demonstrated its impact on AF recurrence after RFCA.Further research is warranted to validate the combined use of these two scores in clinical settings for predicting AF recurrence following catheter ablation.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.
文摘BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.
基金Supported by National Natural Science Foundation of China(Grant No.12201471)the Special Foundation in Key Fields for Universities of Guangdong Province(Grant No.2022ZDZX1034).
文摘The Wiener index of a graph is defined to be the sum of the distances of all pairs of vertices in the graph.The kth power G^(k) of a graph G is the graph on V(G)and two vertices are adjacent if and only if their distance in G is less or equal to k.In this paper,we computed the Wiener index of the kth power of paths and cycles for any k≥2.
基金National Natural Science Foundation of China,No.81970698 and No.81900805Peking University People's Hospital Research and Development Funds,No.Project RS2022-03。
文摘BACKGROUND The association between body mass index(BMI)and bone mineral density(BMD)has shown inconsistent results,varying by sex and skeletal site.Despite normal or elevated bone mass,individuals with type 2 diabetes have an increased risk of hip and vertebral fractures.AIM To assess lumbar spine trabecular volumetric BMD(vBMD)across different BMI categories in individuals with and without diabetes.METHODS This cross-sectional study included 966 men over 50 years old and 1001 postmenopausal women from the Pinggu Metabolic Disease Study.The vBMD of lumbar vertebrae 2 through 4 was measured using quantitative computed tomography.Total adipose tissue,subcutaneous adipose tissue(SAT),visceral adipose tissue(VAT),and lumbar skeletal muscle area were also quantified.RESULTS In men with obesity(P=0.038)and overweight(P=0.032),vBMD was significantly higher in the diabetes group compared to non-diabetic men.After adjusting for age and sex,no significant saturation effect between BMI and BMD was found in participants with diabetes or in women without diabetes.However,a BMI threshold of 22.33 kg/m²indicated a saturation point for vBMD in nondiabetic men.Independent predictors of vBMD in men included age(r=-0.387,P<0.001),BMI(r=0.130,P=0.004),and VAT(r=-0.145,P=0.001).For women,significant predictors were age(r=-0.594,P<0.001),BMI(r=0.157,P=0.004),VAT(r=-0.112,P=0.001),and SAT(r=-0.068,P=0.035).CONCLUSION The relationship between BMI and trabecular vBMD differs in individuals with and without diabetes.Overweight and obese men with diabetes exhibit higher vBMD.
基金Supported by Sanming Project of Medicine in Shenzhen,No.SZZYSM202202010。
文摘BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.
基金Supported by the National Natural Science Foundation of China(No.82074500)CACMS Innovation Fund(No.CI2021A02605)+1 种基金Administration of Traditional Chinese Medicine of Zhejiang Province(No.2024ZR029)Science and Technology Program of Wenzhou City(No.Y2023210).
文摘AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National Health and Nutrition Examination Survey(NHANES,2005-2008)for a cross-sectional study.DII was calculated from 24-hour dietary recall questionnaire conducted by experienced researchers and data analyzed in R according to the NHANES user guide,“Stratified Multi-stage Probability Sampling”.The relationship between DII and glaucoma was evaluated by multi-factor logistic regression analysis and the existence of a non-linear association examined by restricted cubic spline(RCS)analysis.RESULTS:A total of 5359 subjects were included and the cross-sectional analysis weighted to represent the US population of 109 million.DII was elevated in glaucoma patients(P<0.001)and smoking and alcohol use contributed to significant differences(P<0.001).DII correlated negatively with Healthy Eating Index(HEI)-2015(Spearman rank correlation coefficient,r=-0.49).RCS analysis showed a linear relationship between DII and glaucoma risk(P of non-linear relationship=0.575).CONCLUSION:An increased DII is strongly associated with high risk of glaucoma and diet-induced inflammation should be controlled to delay glaucoma progression.
基金supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region(2020D01C236)
文摘BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic shock.METHODS:This prospective cohort study,conducted at the emergency intensive care unit of Peking University People's Hospital,recruited 200 patients with septic shock between January 2023 and August 2023.These patients were divided into survival(n=84)and death(n=116)groups based on 28-day outcomes.Clinical evaluations included laboratory tests and clinical scores,with lactate and PPI values assessed upon admission to the emergency room and at 6 h and 12 h after admission.Risk factors associated with mortality were analyzed using univariate and multivariate Cox regression analyses.Receiver operator characteristic(ROC)curve was used to assess predictive performance.Mortality rates were compared,and Kaplan-Meier survival plots were created.RESULTS:Compared to the survival group,patients in the death group were older and had more severe liver damage and coagulation dysfunction,necessitating higher norepinephrine doses and increased fl uid replacement.Higher lactate levels and lower PPI levels at 0 h,6 h,and 12 h were observed in the death group.Multivariate Cox regression identifi ed prolonged prothrombin time(PT),decreased 6-h PPI and 12-h PPI as independent risk factors for death.The area under the curves for 6-h PPI and 12-h PPI were 0.802(95%CI 0.742-0.863,P<0.001)and 0.945(95%CI 0.915-0.974,P<0.001),respectively,which were superior to Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA)scores(0.864 and 0.928).Cumulative mortality in the low PPI groups at 6 h and 12 h was signifi cantly higher than in the high PPI groups(6-h PPI:77.52%vs.22.54%;12-h PPI:92.04%vs.13.79%,P<0.001).CONCLUSION:PPI may have value in predicting 28-day mortality in patients with septic shock.
基金financial support of the National Natural Science Foundation of China(21776122).
文摘Due to a prolonged operation time and low mass transfer efficiency, the primary challenge in the aeration process of non-Newtonian fluids is the high energy consumption, which is closely related to the form and rate of impeller, ventilation, rheological properties and bubble morphology in the reactor. In this perspective, through optimal computational fluid dynamics models and experiments, the relationship between power consumption, volumetric mass transfer rate(kLa) and initial bubble size(d0) was constructed to establish an efficient operation mode for the aeration process of non-Newtonian fluids. It was found that reducing the d0could significantly increase the oxygen mass transfer rate, resulting in an obvious decrease in the ventilation volume and impeller speed. When d0was regulated within 2-5 mm,an optimal kLa could be achieved, and 21% of power consumption could be saved, compared to the case of bubbles with a diameter of 10 mm.
基金supported by the National Natural Science Foundation of China(No.82360608)the Free Exploration Project of the Second Affiliated Hospital of Xi’an Jiaotong University(2020YJ153)。
文摘BACKGROUND Triglyceride-glucose(TyG)index values are a new surrogate marker for insulin resistance.This study aimed to explore the relationship between cumulative TyG index values and atrial fibrillation(AF)recurrence after radiofrequency catheter ablation(RFCA).METHODS A total of 576 patients with AF who underwent RFCA at the Second Affiliated Hospital of Xi'an Jiaotong University were included in this study.The participants were grouped based on cumulative TyG index values tertiles within 3 months after ablation.Cox regression and restricted cubic spline analyses were used to determine the relationship between cumulative TyG index values and AF recurrence.The predictive value of all risk factors was assessed by receiver operating curve analysis.RESULTS There were 375 patients completed the study(age:63.23±10.73 years,64.27%male).The risk of AF recurrence increased with increasing cumulative TyG index values tertiles.After adjusting for potential confounders,patients in the medium cumulative TyG index group[hazard ratio(HR)=4.949,95%CI:1.778–13.778,P=0.002]and the high cumulative TyG index group(HR=8.716,95%CI:3.371–22.536,P<0.001)had a higher risk of AF recurrence than those in the low cumulative TyG index group.The restricted cubic spline regression model also showed an increased risk of AF recurrence with increasing cumulative TyG index values.When considering cumulative TyG index values,left atrial diameter,and lactate dehydrogenase levels as a comprehensive factor,the model could effectively predict AF recurrence after RFCA[area under the curve(AUC)=0.847,95%CI:0.797–0.897,P<0.001].CONCLUSIONS Cumulative TyG index values were a risk factor for AF recurrence after RFCA.Monitoring longitudinal TyG index values may assist with optimized for risk stratification and outcome prediction for AF recurrence.
文摘This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal Surgery.It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features valuable.There are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical surgery.Neutrophils release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell invasion.Neutrophils promote the adhesion of tumor cells to endothelial cells,through physical anchoring.That results in the migration of tumor cells.Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs.Platelets can form a protective film on the surface of tumor cells.This allows avoiding blood flow damage as well as immune system attack.It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness.High SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall survival.HCC patients are a very special population that requires increased attention.SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings.The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features.Those features provide tumor nutrition,growth,and distribution throughout the body,such as vascular invasion.On the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings.The article is of considerable interest.It would be helpful to continue the study follow-up to 2 years and longer.External validation of the data is needed.
基金the National Key Research and Development Program of China,Grant/Award Number:2021YFD1600100 and 2022YFD1600303。
文摘In traditional Chinese medicine(TCM),based on various pathogenic symptoms and the‘golden chamber’medical text,Huangdi Neijing,diabetes mellitus falls under the category‘collateral disease’.TCM,with its wealth of experience,has been treating diabetes for over two millennia.Different antidiabetic Chinese herbal medicines re-duce blood sugar,with their effective ingredients exerting unique advantages.As well as a glucose lowering effect,TCM also regulates bodily functions to prevent diabetes associated complications,with reduced side effects compared to western synthetic drugs.Chinese herbal medicine is usually composed of polysaccharides,saponins,al-kaloids,flavonoids,and terpenoids.These active ingredients reduce blood sugar via various mechanism of actions that include boosting endogenous insulin secretion,enhancing insulin sensitivity and adjusting key enzyme activity and scavenging free radicals.These actions regulate glycolipid metabolism in the body,eventually achiev-ing the goal of normalizing blood glucose.Using different animal models,a number of molecular markers are available for the detection of diabetes induction and the molecular pathology of the disease is becoming clearer.Nonetheless,there is a dearth of scientific data about the pharmacology,dose-effect relationship,and structure-activity relationship of TCM and its constituents.Further research into the efficacy,toxicity and mode of action of TCM,using different metabolic and molecular markers,is key to developing novel TCM antidiabetic formulations.