Conectar
Smoking cessation is a pressing public health concern. Behavioral therapy has been widely promoted as a means to aid smoking cessation. Acceptance and commitment therapy (ACT), based on the principles of cognitive behavioral therapy, can help participants accept, rather than suppress, the physical and emotional experiences and thoughts associated with not smoking, identify experiential avoidance behaviors, strengthen the determination to quit, and ultimately commit to adaptive behavioral changes guided by smoking-cessation-related values, thereby achieving the goal of quitting smoking.
To assess the effects of ACT compared with other smoking cessation interventions by examining three key outcomes: cessation rates, smoking behaviors, and psychological outcomes.
We searched 8 databases and 2 registration platforms, covering the period from inception to March 26, 2025. We included only randomized controlled trials that recruited adult smokers and implemented ACT for smoking cessation, with the comparison group receiving either active treatment, no treatment, or any other intervention.
A total of 23 studies involving 8951 participants were included. The findings indicated that, compared with all types of control interventions, ACT significantly increased smoking cessation rates both immediately postintervention (RR = 1.48, 95% CI [1.03, 2.14], p = 0.04, I 2 = 81%) and at short-term follow-up (RR = 1.63, 95% CI = 1.31 to 2.01, p < 0.01, I 2 = 0%). Subgroup analyses showed that ACT significantly improved short-term cessation rates compared with behavioral support (RR = 1.60, 95% CI [1.27, 2.02], p < 0.01, I 2 = 0%), while, compared with the blank control, ACT significantly increased smoking cessation rates across three different time points (postintervention: RR = 3.11, 95% CI [2.13, 4.54], p < 0.01, I 2 = 0%; medium-term follow-up: RR = 2.55, 95% CI [1.32, 4.93], p < 0.01; long-term follow-up: RR = 3.33, 95% CI [1.66, 6.68], p < 0.01). Narrative synthesis suggested that compared with behavioral therapy, ACT may confer benefits in improving psychological outcomes, while compared with the blank control, it may also reduce daily cigarette consumption and nicotine dependence, and enhance psychological outcomes.
Acceptance and commitment therapy may be a beneficial approach for improving cessation rates, enhancing smoking cessation behaviors, and promoting psychological well-being among adult smokers. However, the quality of the included evidence was limited, thereby weakening the strength of these findings. Future rigorously designed trials with larger sample sizes, particularly those comparing ACT against other smoking cessation interventions, are warranted to further confirm its effects.
by Bing-Nan Zhao, Zi-Yang Xie, Jia-Ning Liu, Xiao-Ran Chen, Xin-Xin Wang, Jia-Yi Li, Rui Zhang, Chao Si
Fermented spent coffee grounds (FSCG) serve as a valuable soil amendment to improve soil structure and fertility, while earthworms play a well-established role in enhancing soil processes and plant growth. However, their combined effects on bioactive compound accumulation in medicinal plants remain unclear. This study investigated the individual and interactive effects of FSCG (0%, 10%, and 20%, v/v) and earthworms (with and without Pheretima guillelmi) on the growth and phytochemical content of Glechoma longituba, a common medicinal herb, under greenhouse conditions. Results showed that 10% FSCG generally promoted plant growth, whereas 20% FSCG generally enhanced the accumulation of total flavonoids, chlorogenic acid, and soluble protein. Earthworms enhanced aboveground biomass and node number but significantly reduced chlorogenic acid content. These findings highlight the potential of FSCG as a sustainable soil amendment in medicinal plant cultivation and underscore the need to consider earthworm activity when optimizing both plant biomass and phytochemical quality.by Yinli Shi, Shuang Guan, Sicun Wang, Muzhi Li, Yanan Yu, Jun Liu, Weibin Yang, Zhong Wang
BackgroundAlthough filgotinib, a selective Janus kinase 1 inhibitor, has been increasingly applied in the treatment of inflammatory diseases, its comprehensive safety profile remains insufficiently characterized. Using data from the FAERS database covering Q1 2014 to Q2 2024, this study attempts to analyze adverse event signals linked to filgotinib and provide guidance for the safe and sensible clinical usage of filgotinib.
MethodsFrom Q1 2014 to Q2 2024, information on adverse drug events (ADEs) associated with filgotinib was gathered. The reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma Poisson shrinker (MGPS) were among the signal detection methods that were employed for analysis following data normalization.
ResultsFilgotinib was shown to be the main suspected medication in ADE reports, exposing 103 preferred terms (PTs) in 17 system organ classes (SOCs). Infections, gastrointestinal disorders, and musculoskeletal and connective tissue disorders were the most commonly reported adverse effects. Additionally, atrial fibrillation, alopecia, elevated serum creatinine, blood creatinine increased, pulmonary embolism, epididymitis, respiratory failure, and osteopenia were identified as potential disproportionate reporting signals for filgotinib, although these were not listed in the official drug label. Notable significant signals included large intestine erosion (ROR 2186.05, 95%CI(ROR): 1015.94–4703.86, PRR 2176.18, 95%CI(PRR): 1014.64–4667.42), mesenteric arterial occlusion (ROR 1832.17, 95%CI(ROR): 897.68–3739.48, PRR 1822.71, 95%CI(PRR): 896.17–3707.20), repetitive strain injury (ROR 1149.27, 95%CI(ROR): 363.16–3637.01, PRR 1147.05, 95%CI(PRR): 363.24–3622.15), oligoarthritis (ROR 755.02, 95%CI(ROR): 310.74–1834.54, PRR 752.59, 95%CI(PRR): 310.60–1823.51), and periostitis (ROR 676.03, 95%CI(ROR): 319.36–1431.06, PRR 672.98, 95%CI(PRR): 318.97–1419.87). The subgroup analysis identified obvious sex and age-specific trends in filgotinib-related adverse reactions, emphasizing a higher risk of renal disorders in females, a preponderance of gastrointestinal events in males, and age-dependent trends involving mesenteric occlusion, increased serum creatinine, and immunoglobulin reduction.
ConclusionWhile filgotinib demonstrates therapeutic efficacy, it is associated with a range of potential adverse events, underscoring the need for vigilant clinical monitoring. Particular attention should be given to gastrointestinal, cardiovascular, respiratory, and metabolic complications.
by Xianxiang Lu, Yangrui Duan
Resilience is a crucial ability of an economy to withstand sudden events and uncertain shocks. Using the entropy method, this study measures the economic resilience of 281 Chinese cities (prefecture-level and above) from 2017 to 2022, and empirically examines the impact of COVID-19 on this resilience, as well as its transmission channels. The results show that COVID-19 adversely affected overall urban economic resilience, with contrasting effects across its sub-dimensions: an insignificant negative impact on shock resistance, a significant negative impact on adaptive recovery, and an insignificant positive impact on innovative transformation. Transmission channels analysis reveals COVID-19 impaired urban economic resilience through the channels of employment structure, consumption, investment, and unrelated diversification, with consumption identified as the predominant one. Heterogeneity analysis reveals that the economic resilience of cities in both the high and low manufacturing specialization groups was more adversely affected by COVID-19 than that of cities in the medium group. Regarding services specialization, the economic resilience of cities with a medium degree of services specialization were more negatively affected by COVID-19 than that of cities with low services specialization. Furthermore, the economic resilience of cities with a higher degree of related diversification was less negatively affected by COVID-19. This study provides a replicable analytical framework and empirical evidence for enhancing urban economic resilience in China and other countries in post-pandemic era.by Min Zhang, Jining Yang
Increasingly frequent disruptions from diseases, disasters, and human activities pose a significant challenge to the resilience of the agri-food supply chain (AFSCRE). This study systematically explores the factors influencing AFSCRE and their mechanisms of action by integrating fuzzy Decision-Making Trial and Evaluation Laboratory (DEMATEL) and Interpretative Structural Modeling (ISM). Based on bibliometrics and expert interviews, a three-dimensional indicator system (12 key factors) contains flexibility, agility, and visibility. Triangular fuzzy numbers were used to process expert rating data, and combined with the Converting Fuzzy Numbers into Crisp Scores (CFCS) defuzzification method to establish a total influence matrix. The strength of the influence relationships between factors was determined through the setting of appropriate thresholds, which ultimately results in a five-layer hierarchical structure. The research results show that: level of application of digital technologies, information system maturity, information sharing and synergies, data sharing and analysis capacity and risk management capacity constitute the deep driving factors; degree of simplification of the supply chain structure and level of inventory management are the direct surface factors, presenting isolated characteristics. The study proposes resilience enhancement strategies such as supplier diversification, blockchain traceability technology embedding, and multi-body collaborative decision-making mechanisms, which provide decision support for coping with climate change and public health emergencies.by Yizhe Yang, Ruifeng Liang, Yan Luo, Doudou Zhu, Yi Liu, Yuyan Guo, Jiafen Zhang, Qiao Niu
ObjectiveInvestigate the Knowledge-Attitude-Practice (KAP) of students from Medical College towards emerging infectious diseases, and assess their impact, can provide a scientific basis and practical guidance for enhancing medico’s prevention and control capabilities.
MethodsA total of 2,395 participants from various grades and majors at Medical University were randomly selected using a stratified cluster sampling method. This cross-sectional study was conducted between April 25 and May 31, 2020, using a self-administered questionnaire developed on the Wenjuanxing platform to assess COVID-19-related knowledge, attitudes, and practices (KAP) among medical students.
ResultsA total of 2,245 participants (aged 16–28 years) were included in the study, coming from five medical disciplines: Clinical Medicine, Preventive Medicine, Nursing, Clinical Pharmacy, Health Inspection and Quarantine. The average scores for the COVID-19 epidemiological knowledge and the control measures for the epidemic were 4.92 ± 1.03 and 4.50 ± 0.78, respectively. Among them, the scores of epidemiological knowledge exhibited significant differences in sex, nation, type of dwelling place, major, grade, annual per capita household income, and age. The scores of preventive knowledge significantly differed by sex, major, grade, physical condition, and age. Further, behavioral data indicated that 96.0% of the students thought the pandemic had severely affected their daily life, while >90% maintained consistent mask usage and >80% insisted on health-protective practices. Practice scores finally varied significantly by sex, family structure, and ethnicity.
ConclusionsAltogether, medical students possess certain basic knowledge in controlling emerging infectious diseases, but some still generally suffer from insufficient cognitive depth and anxiety. Colleges can systematically enhance students’ rational cognitive level which include offering specialized courses as well as promoting cutting-edge research achievements, and through standardized operations stabilize their psychological states.
by Qijun Wo, Jiafeng Shou, Jun Shi, Lei Shi, YunKai Yang, Yifan Wang, Liping Xie
Prostate cancer (PCa) remains a leading cause of cancer-related mortality in men, with challenges in diagnosis and treatment due to tumor heterogeneity. This study identifies palmitoylation-related signature genes as potential diagnostic and therapeutic targets. Integrating GEO datasets, six differentially expressed genes (DEGs) linked to palmitoylation were identified. Machine learning algorithms (LASSO, RF, SVM) selected three core genes: TRPM4, LAMB3, and APOE. A diagnostic model based on these genes achieved an AUC of 0.929, demonstrating robust accuracy in distinguishing PCa from normal tissues. Functional analysis revealed roles in lipid metabolism and immune modulation, with ssGSEA highlighting correlations between key genes and immune cell infiltration. Experimental validation showed that LAMB3 overexpression suppressed PCa cell proliferation, migration, and invasion, while knockdown enhanced these processes. Molecular docking identified diethylstilbestrol as a potential therapeutic agent targeting LAMB3 and APOE. These findings emphasize the clinical relevance of palmitoylation-related genes in PCa diagnosis and therapy, offering novel biomarkers and insights for personalized treatment strategies.Colorectal cancer (CRC) incidence is increasing, and treating low rectal cancer poses challenges in balancing oncological control with functional preservation. While preoperative chemoradiotherapy (CRT) improves sphincter preservation, anastomotic leakage (AL) remains a major complication. This trial aims to compare the efficacy of modified pull-through procedure versus coloanal anastomosis (CAA) with temporary stoma in low rectal cancer patients following preoperative CRT.
This is a multicentre, assessor-blinded, randomised controlled trial. A total of 216 patients with low rectal cancer (≤7 cm from the anal verge) after preoperative CRT will be enrolled and randomly assigned (1:1) to undergo either the modified pull-through procedure or CAA with temporary stoma. The primary outcome is the incidence of AL within 1 month. Secondary outcomes include complications (Clavien-Dindo classification), length of hospital stay, anorectal function (LARS score (Low Anterior Resection Syndrome Score)), and quality of life (EQ-5D questionnaire (EuroQol five dimensions questionnaire)). Patients will be followed for 36 months.
The study has obtained ethics approval from the Biomedical Ethics Committee of West China Hospital, Sichuan University (ethics approval ID: 2025-Review-(144)). All centres have obtained local institutional review board approval. Results will be disseminated via academic conferences and peer-reviewed journals to optimise clinical practice for low rectal cancer surgery.
ChiCTR2500100246.
Gastric cancer (GC) remains a leading cause of cancer-related mortality worldwide, with most Chinese patients diagnosed at a locally advanced stage. Neoadjuvant chemotherapy (NAC) is increasingly used to improve resectability and survival. Laparoscopy-assisted distal gastrectomy (LADG) provides short-term recovery benefits compared with open distal gastrectomy (ODG), but its safety and oncologic efficacy following NAC remain uncertain. This trial aims to determine whether LADG is non-inferior to ODG in terms of long-term survival outcomes in patients with locally advanced distal gastric cancer (LAGC) after NAC.
This is a multicentre, randomised, controlled, non-inferiority trial conducted at high-volume GC centres in China. Eligible patients (aged 18–75 years; cT3–4a, N0/+, M0) with histologically confirmed distal gastric adenocarcinoma who have completed standard NAC will be randomised 1:1 to LADG or ODG with D2 lymphadenectomy. Surgical quality will be standardised through operative manuals, intraoperative video recording and central auditing. The primary endpoint is 3-year disease-free survival. Secondary endpoints are 3- and 5-year overall survival. A total of 998 patients (499 per arm) will be enrolled, providing 80% power to test non-inferiority with an absolute 8% margin, accounting for 15% attrition. Analyses will follow the intention-to-treat principle, with Cox models used for survival comparisons and subgroup analyses according to nodal status, tumour size and pathological response.
This trial has been reviewed and approved by the Biomedical Ethics Committee of West China Hospital, Sichuan University (Approval No. 2025 (865), 16 July 2025). Written informed consent will be obtained from all participants. The results will be disseminated through peer-reviewed journals and international conferences, providing high-level evidence to guide the surgical management of LAGC after NAC.
Chinese Clinical Trial Registry, ChiCTR2500109677; registered on 23 September 2025. Protocol V.2.1, dated 29 June 2025.
To evaluate the cost-effectiveness of implementing a penicillin allergy assessment pathway (PAAP) versus usual care within the NHS.
A decision tree analysis over a 5-year time-period, informed by a randomised controlled trial (RCT) of PAAP and systematic review. Value of information analysis was also conducted to estimate the value of conducting a new trial.
Model inputs were informed by the ALABAMA RCT participants included in the primary analysis, 811 adults with penicillin allergy labels and recent antibiotic prescriptions, and data from published literature.
Participants in the ALABAMA trial included in the primary analysis: PAAP (n=401) and usual care (n=410).
Costs are presented in GBP (£) at 2022–2023 prices, quality-adjusted life years (QALYs), incremental cost-effectiveness ratio, incremental net monetary benefit (INMB), the probability of cost-effectiveness at the £20,000 and £30,000 per QALY threshold, and the cost effectiveness of a new follow-on trial.
PAAP had incremental costs of £–83 (probability of cost saving 47.5%) and incremental QALYs of 0.036 (probability of positive benefits 47.5%). The INMBs (probability of cost-effectiveness) were £806 (48%) and £1167 (48%) under the decision thresholds of £20,000 and £30,000 per QALY, respectively. PAAP was more cost-effective among females, people aged >65 years, and more frequent antibiotic users. A new follow-on trial involving 1267 participants was estimated to cost £2.4 million and, by reducing uncertainty in the evidence, would avoid £19.6 million in costs of incorrect management decisions for eligible patients over the next 10 years.
The PAAP was considered cost-effective, but significant uncertainty remained. Future trials with adequate power and longer follow-up are needed to determine the most cost-effective models for penicillin allergy testing.
Advance Care Planning (ACP) has the potential to enhance end-of-life care and improve the allocation of healthcare resources for patients with cancer. However, its successful implementation requires considerable effort to overcome challenges and deliver health benefits. Healthcare providers and patients are key players in ACP, and their perceptions of the process must be understood to address implementation challenges effectively.
To identify barriers and facilitators to ACP implementation in Chinese oncology settings, providing a foundation for culturally appropriate healthcare strategies.
A qualitative study guided by the Consolidated Framework for Implementation Research (CFIR). Semi-structured interviews (n = 30) were conducted between April and August 2022 to synthesise the perspectives of nurses, physicians, patients with cancer and their families who had participated in ACP. Data were analysed using a directed qualitative content analysis approach, and reporting followed the SRQR guidelines.
Twenty implementation determinants were identified across four CFIR domains, including 13 barriers and 7 facilitators. Key barriers included limited adaptability of ACP to local cultural and family norms, high complexity of ACP processes, insufficient knowledge and skills among clinicians, unclear team responsibilities, low organisational readiness, limited resources and poor public awareness. Facilitators included strong team culture, clinician motivation, supportive leadership and alignment with national policies. Two determinants showed mixed influences: the relative advantage of ACP compared to existing practices, and the extent of collaboration with external organisations.
Our study highlights the challenges of implementing ACP in China, as well as the unique and specific barriers to implementation. These findings contribute to a deeper understanding of context-specific determinants and offer actionable insights to inform the development of culturally tailored ACP implementation strategies in resource-limited healthcare settings.
To inform the development of implementation strategies to promote ACP in healthcare systems dominated by traditional medicine.
Flexible ureteroscopy has advanced modern stone management; however, lower pole renal stones remain a challenge due to suboptimal ureteroscope deflection and navigation using conventional flexible and navigable suction ureteral access sheaths (FANS). The SCULPT trial is designed to assess whether the novel steerable FANS—which enables active controlled deflection—can improve the success rate of lower pole access during flexible ureteroscopy.
This multicentre, prospective, single-blinded, randomised controlled superiority trial will recruit 400 adult patients (aged 18–75 years) with solitary lower pole renal stones ≤2 cm diagnosed by CT from 20 high-volume urological centres in China. Participants will be randomised 1:1 to undergo flexible ureteroscopy with either steerable or conventional FANS. The primary outcome is the success rate of navigating into the lower pole calyx (defined as successful direct stone visualisation, laser lithotripsy and aspiration without adjunct use). Secondary outcomes include immediate and 1 month stone-free rates, operative time, complication profiles (graded by Clavien–Dindo), instrument damage rates, quality-of-life assessments and cost analysis. Statistical analysis will be performed using appropriate tests for continuous and categorical data, with their significance set by prespecified superiority margins.
The study protocol has been designed in accordance with the Declaration of Helsinki and ICH-GCP guidelines. Ethical approval was centrally granted by the Institutional Review Board of The First Affiliated Hospital of Guangzhou Medical University and adopted by all participating centres following local feasibility review. The trial results will be disseminated via peer-reviewed publication and presentation at international conferences.
by Lijun Guo, Qiong Li, Jingyi Li, Feng Yang
Parkinson’s disease (PD) is a neurodegenerative disorder characterized by dopaminergic neuron loss and neuroinflammation, with emerging roles of peripheral immune dysregulation in disease progression. This study aimed to investigate the regulatory network of CD4 + T cells in PD through multi-omics integrative analysis. Transcriptomic and miRNA datasets from peripheral blood mononuclear cells (PBMCs) of 20 PD patients and 17 healthy controls were analyzed (GSE22491, GSE100054, GSE16658). Differential expression analysis identified 287 mRNAs and 73 miRNAs (|log₂(fold change)| ≥ 0.5, false discovery rate CD4 and SEMA6A. A competing endogenous RNA (ceRNA) network was constructed, comprising 38 lncRNAs, three miRNAs (miR-155-5p, miR-27a-3p, miR-27b-3p), and their target mRNAs CD4 and SEMA6A. Four lncRNAs (including XIST, NORAD, and INE1) were identified to functionally regulate CD4. Immune cell infiltration analysis revealed increased proportions of naïve CD4 + T cells and activated dendritic cells in PD patients. CD4 expression positively correlated with γδ T cells (r = 0.48, p = 0.032) and activated NK cells (r = 0.45, p = 0.048). Gene set enrichment analysis associated CD4 with neurodegenerative pathways (e.g., Parkinson’s disease: normalized enrichment score = 1.57, p = 0.002) and oxidative phosphorylation (normalized enrichment score = 1.89, p = 7.4 × 10 ⁻ ⁶). These findings highlight a peripheral CD4 + T cell-centric ceRNA network that modulates immune-metabolic crosstalk and neuroinflammation in PD. This study provides novel insights into immune-driven neurodegeneration and suggests potential therapeutic targets for PD through metabolic-immune reprogramming.This study aimed to develop and preliminarily validate the KAP scale for pain management in older adults with dementia among nursing assistants.
A cross-sectional study.
An initial item pool was constructed through literature reviews, semi-structured interviews and team discussions. Items were screened and optimised through two rounds of Delphi expert consultations, a pilot survey and item analysis, yielding a draft version of the scale. Psychometric evaluation was conducted to refine the scale into its final form.
The final KAP scale developed in this study comprised 31 items. The scale exhibited good content validity, with item-level content validity index (I-CVI) values ranging from 0.83 to 1.00. Exploratory factor analysis revealed that the scale extracted five factors, which accounted for 65.732% of the cumulative variance, and all items demonstrated rotated factor loadings > 0.5, indicating good construct validity. The Cronbach's α coefficients for the knowledge, attitudes and practices dimensions were 0.877, 0.915 and 0.935, respectively, and the split-half reliability coefficients were 0.909, 0.886 and 0.864.
The KAP scale for pain care in older adults with dementia developed in this study possesses good reliability and validity and can be used to assess the knowledge, attitudes and behavioural levels of nursing assistants in pain care.
This study developed and psychometrically validated a KAP scale specifically designed to assess pain care for older adults with dementia among nursing assistants. Clinical managers can utilise this tool to systematically identify deficiencies in staff members' knowledge, attitudes or practices, thereby providing scientific evidence for the development of targeted pain care training programs and pain management strategies. This contributes to enhancing nursing assistants' pain care competence, ultimately alleviating the pain burden of older adults with dementia and improving their quality of life.
The STROBE checklist was used as a guideline.
No patient or public involvement.
by Xin Xu, Ghada Homsi, Sherry T. Liu, Jennifer M. Gaber, Naa A. Inyang, Brian L. Rostron, Caryn F. Nagler, James Nonnemaker
BackgroundIn 2022, 3.7% of U.S. adults currently smoked cigars. This study assesses cigar-smoking-attributable fractions in U.S. healthcare expenditures and associated annual healthcare expenditures overall and by payer, including publicly funded healthcare programs.
MethodsData were obtained from the 2000, 2005, 2010, and 2015–2017 National Health Interview Survey linked with corresponding panels from the Medical Expenditure Panel Survey data through 2018. The final sample (n = 53,733) was restricted to adults aged 25 + . Estimates from four-part models and data from the Personal Health Care component of the 2001–2018 National Health Expenditures Accounts were combined to estimate fractions of and annual healthcare expenditures attributable to cigar smoking. All models controlled for sociodemographic characteristics and health-related behaviors.
ResultsDuring 2001–2018, an estimated 1.8% (95% CI = 0.9%–3.4%) or $29.7 billion annually of U.S. healthcare expenditures could be attributed to cigar smoking. Most of this was funded by other third-party health insurance programs, a mix of private and public payers (e.g., Department of Veterans Affairs).
ConclusionsCigar smoking creates a preventable financial burden on the U.S. healthcare system. Health consequences associated with cigar smoking may remain after successful quitting. The findings underscore the importance of preventing initiation of cigar smoking and providing evidence-based cessation methods to reduce the health and economic burden of cigar smoking.
by Yi-Hua Wu, Chia-Ing Li, Chiu-Shong Liu, Chih-Hsueh Lin, Shing-Yu Yang, Cheng-Chieh Lin, Tsai-Chung Li
Glycemic variability (GV) is an emerging biomarker of glycemic control and may be a predictor for lung function impairment in persons with type 2 diabetes mellitus (T2DM). However, the associations between GV and lung function variables and lung function impairment have not been fully evaluated. The objective of this study was to assess the associations of glycemic variability (GV) with lung function impairment in persons with T2DM. A follow-up study was conducted on the data of 3,108 subjects collected from 2001 to 2020 using the diabetes care management program database in Taiwan. GV in fasting plasma glucose (FPG) was calculated using standard deviation (SD), average real variability (ARV), coefficient of variation (CV), variability independent of the mean (VIM), and slope of 1-year repeated measurements. A ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) less than 0.70 was used to define lung function impairment. Multivariable linear and logistic regression models were applied to explore the relationships of GV with lung function variables and lung function impairment. A total of 359 (11.6%) subjects were defined as having lung function impairment. After multivariable adjustment, FPG‐SD, FPG-CV, FPG-AVR, FPG-VIM and were found to be negatively linked with FEV1, % predicted FEV1, and FVC but not FEV1/FVC. Relative to those for the first tertile, the odds ratios (ORs) of lung function impairment for the second and third tertiles were 1.37 (95% confidence interval [CI]: 1.01, 1.87) and 1.51 (1.10, 2.08) for FPG-CV, respectively; 1.59 (1.16, 2.17) and 1.73 (1.24, 2.40) for FPG‐SD, respectively; and 1.57 (1.15, 2.13) and 1.69 (1.22, 2.33) for FPG-AVR, respectively. GV, measured by CV, SD, VIM, and VIM, is linked with lung function impairment and all lung function variables, except for FEV1/FVC ratio. GV may serve as a useful biomarker for assessing lung function impairment in persons with T2DM.Self-regulatory fatigue (SRF) is a common psychological issue among patients with coronary heart disease (CHD). However, research on the heterogeneity of SRF in this patient population is currently very limited, which hinders the implementation of precision-oriented nursing interventions. This study aimed to explore potential subgroups of SRF in patients with CHD and identify associated factors.
Cross-sectional survey.
Two tertiary Grade A hospitals in Daqing City, Heilongjiang Province, China.
A convenience sample of 339 patients with CHD.
Latent profile analysis identified four distinct SRF subgroups: Low SRF group (28.4%), Moderate SRF—poor behavioural regulation group (23.6%), Moderate SRF—poor emotional regulation group (27.4%) and High SRF group (20.6%). Multivariate logistic regression showed that age, duration of CHD and illness perception were commonly associated factors for SRF across all groups; frequency of use of medications and experiential avoidance were associated factors for the Moderate SRF—poor behavioural regulation group; female gender was an associated factor for the Moderate SRF—poor emotional regulation group; hope and experiential avoidance were associated factors for the High SRF group.
Patients with CHD exhibit four distinct SRF subgroups. Healthcare providers can use these findings to identify patients with varying SRF profiles early and implement targeted, subgroup-specific interventions to alleviate SRF.
Myoglobin (Mb) exerts both direct and indirect nephrotoxic effects, contributing to the progression of kidney injury. For patients with rhabdomyolysis (RM) and acute kidney injury (AKI) requiring renal replacement therapy (RRT), Mb clearance is a critical therapeutic goal. Recent studies have indicated that haemoadsorption (HA) combined with continuous renal replacement therapy (CRRT) is an effective strategy for removing circulating Mb. However, clinical data regarding the efficiency of Mb clearance and long-term patient outcomes with this approach remain limited. This study aims to evaluate the efficacy and safety of HA combined with CRRT in treating severe RM and AKI.
This single-center, open-label, randomised controlled trial will be conducted at West China Hospital of Sichuan University. A total of 60 patients with severe RM and AKI will be enrolled and randomly assigned in a 1:1 ratio to either the CRRT group or the CRRT+HA group. Randomisation will be conducted by drawing lots, performed by the patient’s legal representative (with ‘0’ indicating the CRRT group and ‘1’ indicating the CRRT+HA group).
The primary outcome of the study is the plasma clearance of Mb. Secondary outcomes include the plasma clearance of creatine kinase, haemodynamic changes, changes in acute physiology and chronic health II (APACHE) II score and sequential organ failure assessment (SOFA) score, renal function recovery, length of hospital stay, all-cause mortality, and pre- and post-treatment changes in albumin, platelet and haemoglobin counts. Data will be analysed using both intention-to-treat and per-protocol analysis methods.
The study will comply with the Declaration of Helsinki and the Chinese Clinical Trials Act. The study protocol has been approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (2024.1914). Written informed consent will be obtained from all participants. The study results will be presented at academic meetings and in peer-reviewed academic journals.
ChiCTR2400092176.
by Jing Liu, Junshuang Wang, Shuang Lv, Hengjiao Wang, Defu Yang, Ying Zhang, Ying Li, Huiling Qu, Ying Xu, Ying Yan
ObjectiveRadiation-induced brain injury (RIBI) is a significant complication following radiotherapy for brain tumors, leading to neurocognitive deficits and other neurological impairments. This study aims to identify potential biomarkers and therapeutic targets for RIBI by utilizing advanced proteomic techniques to explore the molecular mechanisms underlying RIBI.
MethodsA rat model of RIBI was established and subjected to whole-brain irradiation (30 Gy). Tandem mass tagging (TMT)-based quantitative proteomics, combined with high-resolution mass spectrometry, was used to identify differentially expressed proteins (DEPs) in the brain tissues of irradiated rats. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were conducted to identify the biological processes and pathways involved. Protein-protein interaction (PPI) networks were constructed to identify key hub proteins.
ResultsA total of 35 DEPs were identified, including PHLDA3, APOE and CPE. GO enrichment analysis revealed that the DEPs were mainly involved in lipid transport, cell adhesion, and metabolic processes. KEGG analysis highlighted the enrichment of pathways related to metabolism, tight junctions, and PPAR signaling. APOE was identified as a key hub protein through PPI network analysis, indicating its potential role in RIBI pathophysiology. Immunohistochemistry further validated the increased expression of PHLDA3, APOE, and CPE in the brain tissue of irradiated rats.
ConclusionThis study provides valuable insights into the molecular mechanisms of RIBI by identifying key proteins and their associated pathways. The findings suggest that these proteins, particularly APOE and PHLDA3, could serve as potential biomarkers and therapeutic targets for clinical intervention in RIBI. These results not only enhance our understanding of RIBI’s molecular pathology but also open new avenues for the development of targeted therapies to mitigate radiation-induced neurotoxicity.
FreshRSS 