Current evidence remains limited regarding associations between serum indirect bilirubin (IBIL) levels and chronic kidney disease (CKD) risk, particularly in gender-stratified analyses. This study investigated the gender-specific relationship between serum IBIL and CKD incidence. Using data from a prospective cohort in northwestern China, we followed 25,684 CKD-free participants. Cox proportional hazards models and restricted cubic spline regression were employed to assess IBIL-CKD associations. The discriminatory performance of IBIL was evaluated through ROC curve analysis. Robustness of results was examined via subgroup and sensitivity analyses. Over 122,401.17 person-years of follow-up, 1,219 incident CKD cases were identified. Adjusted hazard ratios (95

Objective: To conduct an ecological vulnerability assessment in the ecologically fragile Hexi region of western China, providing a reference basis for promoting the health of residents in ecologically vulnerable areas. Methods: In Wuwei City, located within China's Hexi Corridor and characterized by its proximity to desert regions, an ecological vulnerability evaluation system has been developed employing the Sensitivity-Resilience-Pressure (SRP) model. The Analytic Hierarchy Process-Principal Component Analysis Entropy Weight Combination Model (AHP-PCA) was then applied to analyze the Ecological Vulnerability Comprehensive Index (EVSI) of Wuwei City from 2014 to 2023, followed by classification using the natural breakpoint method. Based on the ecological vulnerability classification, the distributed lag nonlinear model (DLNM) was employed to examine the impact of drought-related indicators (Standardized Precipitation Index (SPI) and temperature-humidity index (THI) ) at each level on population mortality, calculating the cumulative relative risk (CRR). Finally, the synergy index was used to evaluate potential interactions between SPI and THI in impacting mortality rates. Results: (1) An ecological vulnerability assessment index system for Wuwei City was constructed using 13 natural and socio-environmental variables, categorizing ecological vulnerability into highly vulnerable (EVSI > 3.814), moderately vulnerable (2.927 < EVSI ≤ 3.814), and low vulnerability (EVSI ≤ 2.927). (2)The differences in mortality rates among high, medium and low ecologically fragile areas in Wuwei City were statistically significant. (3) Across all ecological vulnerability levels, SPI in moderately vulnerable areas showed the highest cumulative effect on mortality at lag 0 days and cumulative lag 14 days, with CRRs of 1.10 (95% CI: 1.07–1.14) and 1.10 (95% CI: 1.06–1.14), respectively. In low-vulnerability areas, the cumulative effect on mortality was highest when the THI reached 23 on the same day (CRR=1.16, 95% CI: 1.13–1.18), and also when the cumulative THI reached 60 after 21 days (CRR=1.16, 95% CI: 1.11–1.21). Conclusion: The mortality rate of the population varies in different areas with fragile ecological environments, and there is a correlation between ecological environment vulnerability and the risk of population death.In highly ecologically fragile environments, the risk of mortality increases due to extreme drought, with effects persisting longer. When ecological conditions are favorable at low fragility levels, the impact of THI on mortality becomes more pronounced.

To describe the spatial-temporal epidemiological characteristics of influenza outpatient visits in Gansu province, and to explore their correlation with temperature and humidity using the 24 solar terms (24-STs) as the time dimension. Using influenza visit data from Gansu (2019–2024), spatiotemporal analysis employed gravity center shift, standard deviational ellipses, and seasonal decomposition. A distributed lag non-linear model (DLNM) assessed the effects of daily mean temperature (DMT, °C) and daily mean relative humidity (DMRH,

There is less evidence on the association between long-term PM2.5, O3, greenness exposure and cardiometabolic multimorbidity (CMM), and the aim of this study was to investigate the combined effects of PM2.5, O3 and greenness exposure on the risk of developing CMM.Our findings demonstrated that a 10 µg/m³ rise in PM2.5 concentration led to a 23.8

BACKGROUND:Kidney stones are a prevalent urological issue globally, with risk factors like obesity, hypertension and metabolic disorders driving an increase in incidence rates. Metabolic syndrome (MetS), characterised by hypertension, obesity, hyperglycaemia and dyslipidaemia, has been increasingly linked to nephrolithiasis. This study investigates the association between metabolic syndrome and nephrolithiasis risk in a large Chinese cohort. METHODS:A cohort of 36,811 adults who underwent health screenings from 2018 to 2023 was analysed. Cox proportional hazards models assessed the influence of MetS and its components on nephrolithiasis risk. Stratified analyses examined variations by gender, age and renal function (glomerular filtration rate). Incidence density was calculated per 1000 person-years across follow-up. RESULTS:During 93,966 person-years of follow-up, 573 participants developed kidney stones, with a higher incidence in males. Individuals with MetS had a 60.5% increased nephrolithiasis risk (hazard ratio = 1.61). Obesity and hypertension were identified as significant risk factors, whereas hyperglycaemia and dyslipidaemia showed no clear association. Higher glomerular filtration rate, older age and male gender were correlated with increased risk amongst those with MetS. CONCLUSIONS:MetS, obesity and hypertension are independent predictors of nephrolithiasis, particularly in males. The findings underscore the importance of targeted interventions to reduce kidney stone incidence in populations with high MetS prevalence, highlighting public health benefits in addressing modifiable metabolic risks.

This study evaluated the Air Pollution Prevention and Control Action Plan (APPCAP) in China using 2000–2023 data. The average annual PM2.5 concentration dropped from 46.11 ± 16.18 µg/m3 to 31.75 ± 14.22 µg/m3 (P < 0.05) after APPCAP, with components showing a similar decline. Temporal analysis via Mann–Kendall test indicated a decreasing trend (Z < 0, P < 0.05), seasonally peaking in winter and lowest in summer. Spatially, APPCAP reduced concentration distribution, with key regions improving but areas like Shandong and Henan still facing severe pollution. The main PM2.5 driver shifted from human (e.g., population density) to meteorological (e.g., temperature) factors post-APPCAP, and anthropogenic influence varied across regions. In summary, APPCAP has curbed PM2.5 pollution, yet SO42−, NO3−, and NH4+ remain relatively high, and the increasing human impact in central and southeastern China demands attention in future policies.

Background Current evidence remains limited regarding associations between serum indirect bilirubin (IBIL) levels and chronic kidney disease (CKD) risk, particularly in gender-stratified analyses. This study investigated the gender-specific relationship between serum IBIL and CKD incidence. Methods Using data from a prospective cohort in northwestern China, we followed 25,684 CKD-free participants. Cox proportional hazards models and restricted cubic spline regression were employed to assess IBIL-CKD associations. The predictive capacity of IBIL was evaluated through ROC curve analysis. Robustness of results was examined via subgroup and sensitivity analyses. Results Over 122,401.17 person-years of follow-up, 1,219 incident CKD cases emerged. Adjusted hazard ratios (95% CIs) for CKD were 0.794 (0.676–0.932) overall and 0.713 (0.589–0.862) among males. Area under the curve (AUC) values were 0.710 (0.704–0.715; p < 0.001) overall, 0.710 (0.703–0.718; p < 0.001) for males, and 0.679 (0.670–0.688; p < 0.001) for females. A linear dose-response pattern was observed exclusively in males. Results remained consistent across subgroup and sensitivity analyses. Conclusions Our findings demonstrate an inverse association between serum IBIL levels and CKD risk, with particular clinical relevance in male populations. These results suggest serum IBIL could function as a valuable biomarker for early CKD detection in males.

Prostate cancer (PC) is a significant global health concern, particularly among older men (OM), and smoking is a well-established modifiable risk factor contributing to its incidence and mortality. However, a comprehensive assessment of the global burden of PC attributable to smoking among OM, with specific analyses by age and Socio-demographic Index (SDI) regions, is still lacking. This study utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to systematically analyze the global burden of PC attributable to smoking among OM (aged 55 years and older) from 1990 to 2021. The analysis included trends in deaths and Disability-Adjusted Life Years (DALYs) across different age groups and SDI regions. The estimated annual percentage change (EAPC) and Joinpoint regression analysis were employed to assess temporal trends. From 1990 to 2021, the global burden of PC attributable to smoking among OM exhibited a significant decline, with the age-standardized death rate decreasing from 3.08 per 100,000 in 1990 to 1.80 per 100,000 in 2021 (EAPC: -2.02, 95% CI: -2.14 to -1.90). Similarly, the age-standardized DALY rate decreased from 65.28 per 100,000 in 1990 to 37.75 per 100,000 in 2021 (EAPC: -2.05, 95% CI: -2.16 to -1.94). However, disparities across SDI regions were evident. The high SDI region experienced the most substantial decline in burden. In contrast, the low-middle SDI region showed an increasing trend, highlighting enduring socioeconomic disparities. Notably, Despite the overall reduction in the global burden, the burden among the older age group, specifically 90-95 years old, remained the most severe in 2021. This study reveals a complex landscape of the global burden of PC attributable to smoking among OM, with an overall decline masking enduring socioeconomic disparities and a severe burden among the older age group. These findings underscore the need for targeted interventions and public health strategies to address these disparities. Future efforts should focus on implementing smoking cessation programs and improving healthcare access in vulnerable populations.

Exposure to fine particulate matter (PM2.5) and its constituents (SO42−, NO3−, NH4+, OM, BC) is strongly linked to the incidence of diabetes. This study aimed to assess the health benefits of improved air quality on the incidence risk of type 2 diabetes mellitus (T2DM). Data from 19,884 participants in the Jinchang Cohort were analyzed. The concentration levels of PM2.5 and its constituents were obtained from the China Air Pollution Tracking (TAP) dataset. The effects of reduced pollutant concentrations on the risk of T2DM and glucose and lipid indicators were assessed via Cox proportional hazards models and generalized linear models (GLMs). Exposure‒response relationships were plotted, with subgroup analyses by sex and age. The combined effects of multiple pollutants were also evaluated. A decrease in the concentration of mixed pollutants was significantly associated with a reduced risk of T2DM (HR = 0.57, 95

Objective: To analyze the association between serum bilirubin levels (total, direct, and indirect) and Chronic Kidney Disease (CKD) in the Jinchang cohort. The study aimed to further investigate the impact of serum bilirubin levels on the incidence rate of CKD, and to provide new perspectives for the early identification of high-risk populations and the prevention and treatment of CKD. Methods: A cross-sectional analysis was conducted on a cohort of 43,161 individuals from Jinchang who completed their baseline survey between June 2011 and December 2013. Participants were categorized into quartiles based on their serum bilirubin levels. The prevalence increases with age and rises significantly, especially among people over 70 years of age. An unconditional logistic regression model was employed to evaluate the impact of serum bilirubin levels on CKD. Additionally, a Regression Discontinuity Design (RDD) was utilized to examine potential threshold effects between serum bilirubin levels and CKD. Results: Among 43,161 participants, 1,907 (4.42%) were diagnosed with CKD. The prevalence was higher in males than in females (4.86% vs. 3.74%). CKD prevalence increased with age across all gender groups. CKD prevalence increased with age across all gender groups, with a significant increase in those over 60 years of age. After adjusting for confounders, compared with Q1 concentration group, the risk of CKD in serum total bilirubin Q2-Q4 concentration group was reduced by 13.7% (OR: 0.863, 95%CI: 0.756-0.986) and 14.9% (OR: 0.851, 95%CI: 0.744-0.972) and 18.9% (OR: 0.811, 95%CI: 0.709-0.928); The risk of CKD in serum indirect bilirubin Q2-Q4 concentration group was reduced by 14.8% (OR: 0.852, 95%CI: 0.750-0.968), 27.6% (OR: 0.724, 95%CI: 0.634-0.827) and 27.8% (OR: 0.722, 95%CI: 0.632-0.825); the risk of CKD in serum direct bilirubin Q4 concentration group was increased by 28.0% (OR: 1.280, 95%CI: 1.123-1.459) in those with serum direct bilirubin Q4 concentrations. RDD analysis between serum bilirubin levels and CKD found that the risk of CKD in the general population "jumps" up by 0.7% (P=0.003) only when serum direct bilirubin =4.0μmol/L. Conclusions: The Jinchang cohort displayed a relatively low prevalence of CKD. High levels of total and indirect bilirubin were associated with a reduced risk of CKD, suggesting a protective effect. In contrast, elevated direct bilirubin levels were identified as a risk factor for CKD. A notable threshold effect was observed at a serum direct bilirubin level of 4.0 μmol/L, beyond which the risk of CKD increased.

Objective: To assess the association between airborne particulate matter (PM) exposure and the development of asthma in children, a systematic review and meta-analysis that included nearly 10 years of related literature was conducted. Study Design: The study investigators conducted a systematic review of relevant research articles published between March 2013 and March 2023, which were accessible through several medical literature data bases of. Random-effects meta-analyses were used to analyze the effects of PM on childhood asthma. Subgroup analyses, including exposure period, type of PM, regional factors, and study type, were also used. Odds ratio (OR) and 95% confidence intervals (CI) were used to represent the estimated effect of the population. Publication bias was assessed by using the Egger test and funnel plot. Data analyses were performed using statistical analysis software and a systematic review management tool. Results: A total of 15,365 articles were identified, of which 19 studies were included in this meta-analysis. The results showed that PM exposure was positively correlated with asthma in children, with the overall random-effects risk estimates of OR 1.10 (95% CI, 1.07-1.13). In stratified analyses, PM exposure was found to be a risk factor for the development of childhood asthma. Both prenatal and postnatal PM exposure were associated with an increased risk of asthma in children, but prenatal exposure was associated with a greater increase in risk than postnatal exposure, with an effect estimate OR of 1.21 (95% CI, 1.02-1.43). In the analysis of different PM types, the OR of PM2.5 (PM < 2.5 μm in diameter) exposure was OR 1.10 (95% CI, 1.05-1.15), and no association was found between PM10 (PM < 10 μm in diameter), coarse PM (PM with an aerodynamic diameter between 2.5 and 10 μm), and black carbon BC (diameter of 0.01-0.05 μm) exposure. In different regional analyses, the effects of PM exposure on childhood asthma risk were OR 1.15 (95% CI, 1.13-1.17) in South America and OR 1.02 (95% CI, 1.01-1.03) in Asia, but no association was found in Europe and North America. In addition, the results of different study types only found that the literature that used the time-series research method had a significant association with OR 1.03 (95% CI, 1.02-1.04), whereas the literature that used the cohort study method had no statistical difference. Conclusion: Exposure to airborne PM increased the risk of asthma in children. Both prenatal and postnatal PM exposure was associated with an increased risk of childhood asthma, but prenatal PM exposure was associated with a greater increase than postnatal PM exposure.

Exposure to air pollutants is linked to an increased risk of obesity, and socioeconomic status (SES) could modulate this risk. We employed the “Jinchang Cohort” as a platform to investigate the influence of SES (education level, monthly income per household, and marital status) on the obesity risk associated with PM2.5 and its constituents. Study has demonstrated that air pollutant exposure enhances the likelihood of overweight/obesity, with a risk ratio (HR) of 1.229 for each quartile increase in PM2.5 concentration (95% CI: 1.137–1.328, P < 0.05). The risk of overweight/obesity rises with pollutant levels across various SES strata, with the effect being most marked among those with higher SES. For instance, the HRs and 95% CIs for overweight/obesity with each quartile increase in SO42− concentration were 1.338 (1.207–1.484), 1.311 (1.121–1.533), and 2.224 (1.823, 2.714) at low, medium, and high SES levels, respectively (all P < 0.05). An interaction between air pollutants and SES was observed in the context of obesity risk, with RERIs of 0.723 (0.473–0.973) and 0.562 (0.268–0.856) for medium-high SES levels and high NO3− exposure, respectively (both P < 0.05). These findings have practical implications. Public health campaigns could be launched to raise awareness among higher SES individuals about the obesity risk associated with air pollutants and encourage them to adopt preventive measures such as using air purifiers and increasing physical activity.

Background As persistent organic pollutants (POPs), perfluoroalkyl substances (PFAS) may potentially impact human health. Our study aimed to investigate the prospective association between PFAS exposure and the incidence risk of breast cancer in females. Methods By fully following the Jinchang Cohort after a decade, we conducted this nested case-control study with 135 incidence cases of breast cancer (BC) and 540 bias-paired controls. The PFAS levels were tested by baseline serum samples. Conditional logistic regression and a restricted cubic spline model were employed to investigate the BC incidence risks and the dose-response associated with single PFAS component exposure. Furthermore, the Quantile g-computation model (Qgc), random forest model (RFM), and bayesian kernel machine regression models (BKMR) were integrated to estimate the mixed effects of PFAS exposure on the incidence risk of BC. Results Exposures to specific PFAS components were positively associated with an increased incidence risk of breast cancer. By grouping the study population into different baseline menopausal statuses, PFHxS, PFNA, PFBA, PFUdA, PFOS, and PFDA demonstrated a similarly positive correlation with BC incidence risks. However, the increased incidence risks of BC associated with PFOA, PFOS, PFUdA, and 9CL-PF3ONS exposure were exclusively found in the premenopausal population. Both BKMR and Qgc revealed that exposure to mixed PFAS was associated with an increased risk of breast cancer, with Qgc specifically indicating an odds ratio (OR) of 2.21 (95% CI: 1.53, 3.19). Random forests showed that PFBA, PFOS, PFHxS, and PFDA emerged as predominant factors potentially influencing breast cancer incidence. Conclusion Our findings suggest a strong association between PFAS exposure and the incidence of breast cancer. Premenopausal women should exercise more caution regarding PFAS exposure.

Studies have demonstrated that fine particulate matter (PM2.5) is an underlying risk factor for type 2 diabetes mellitus (T2DM), but evidence exploring the relationship between PM2.5 chemical components and T2DM was extremely limited, to investigate the effects of long-term exposure to PM2.5 and its five constituents (sulfate [SO42−], nitrate [NO3−], ammonium [NH4+]), organic matter [OM] and black carbon [BC]) on incidence of T2DM. Based on the “Jinchang Cohort” platform, a total of 19,884 participants were selected for analysis. Daily average concentrations of pollutants were gained from Tracking Air Pollution in China (TAP). Cox proportional hazards regression models were utilized to estimate the hazard ratios (HR) and 95

Background The COVID-19 pandemic and the resulting non-pharmaceutical interventions (NPIs) have led to changes in the epidemiology of other respiratory pathogens. This study was conducted to explore the epidemiological characteristics of 13 respiratory pathogens, including 11 respiratory viruses and 2 non-classical microorganisms, in hospitalised patients with acute respiratory tract infections (ARTIs) and to compare the prevalence of respiratory pathogens during and after the COVID-19 pandemic.Methods We conducted a single-centre retrospective study involving 8979 patients with ARTIs in Shijiazhuang City from December 2019 to December 2023. The GeXP analysis platform and multiple reverse transcription-PCR (mRT-PCR) technology were used to simultaneously detect 13 respiratory pathogens. The ARIMA model was constructed to predict the pathogen detection rate in each quarter of Shijiazhuang City in the next 2 y.Results Among the 8979 patients, 4169 (46.43%) tested positive for respiratory pathogens. The total pathogen detection rate rebounded in the year after the COVID-19 pandemic. After the COVID-19 pandemic, the positive rates in men were slightly higher than those in women and the positive rates in spring and winter were significantly higher than those in summer. The dominant pathogens during the COVID-19 pandemic were Influenza A viru (InfA; 24.08%) and Human Rhinovirus (HRV; 21.77%), and after the COVID-19 pandemic were InfA (27.92%) and H3 (21.17%). During the COVID-19 pandemic, InfA and HRV frequently occurred in all age groups. After the COVID-19 pandemic, InfA and Seasonal Influenza virus H3N2 (H3) frequently occurred in all age groups.Conclusions A series of NPIs introduced by the Chinese government during the COVID-19 pandemic had a significant impact on acute upper respiratory pathogenic infections. After the withdrawal of the NPIs, the spectrum of respiratory pathogens changed.

Objective To understand the incidence of carotid atherosclerosis(CAS)and the association of CAS with stroke incidence in an occupational population of the Jinchang Cohort,and to provide an evidence for the prevention and treatment of CAS and stroke.Methods The analysis included 6 262 employees of a nonferrous metal company who participated in the Jinchang Cohort Study and had complete information from the baseline examination,including carotid color Doppler ultrasound,from June 2011 to December 2013 and two rounds of follow-up in 2015 and 2017.The cumulative incidence rates of CAS,carotid intima-media thickening,carotid atherosclerotic plaque,and stroke were calculated among the employees during the follow-up period.A multivariate unconditional logistic regression model was used to analyze the factors associated with CAS,carotid intima-media thickening,and carotid atherosclerotic plaque.A multivariate Cox proportional hazards regression model was used to analyze the risk of stroke incidence and its influencing factors in individuals with CAS,carotid intima-media thickening,and carotid atherosclerotic plaque.Results During the initial follow-up of a mean of 1.71±0.55 years(ranging from 0.08 to 3.75 years),a total of 1 147 cases of CAS,287 cases of carotid intima-media thickening,and 860 cases of carotid atherosclerotic plaque were observed,with cumulative incidence rates of 18.32％,4.58％,and 13.73％,respectively.The results of multivariate unconditional logistic regression analysis showed that age≥45 years,smoking,hypertension,diabetes,abnormal total cholesterol(TC),working as a cadre or technical personnel,and internal staff were risk factors for CAS in the occupational population;whereas education level of college or above was a protective factor;age≥45 years,working as a cadre or technical personnel,smoking,having high-sugar diet,and hypertension were risk factors for carotid intima-media thickening,whereas female gender was a protective factor;females,age≥45 years,working as internal staff,hypertension,diabetes,and abnormal TC were risk factors for carotid atherosclerotic plaque,whereas college education or higher was a protective factor.At the second follow-up of a mean of 2.67±0.55 years(ranging from 0.06 to 4.37 years),a total of 240 stroke cases were identified,with a cumulative incidence of 3.83％.The numbers of stroke cases in subjects with CAS,carotid intima-media thickening,and carotid atherosclerotic plaque were 104,19,and 85,with cumulative stroke incidences of 9.07％,6.62％,and 9.88％,respectively.The results of the multivariate Cox proportional hazards regression model analysis showed that after adjusting for gender,age,education level,occupation,smoking,alcohol consumption,physical activity,high-salt diet,high-fat diet,high-sugar diet,hypertension,diabetes,hyperuricemia,body mass index(BMI),abnormal TC,abnormal triglycerides(TG),abnormal high-density lipoprotein cholesterol(HDL-C),abnormal low-density lipoprotein cholesterol(LDL-C),and reduced glomerular filtration rate,the risk of stroke was significantly increased in the individuals with CAS(hazard ratio[HR]=1.421,95％confiidence interval[95％CI]:1.030-1.961)compared with those without CAS.The results also showed that,age≥45 years,high-salt diet,and overweight were risk factors for stroke incidence in the individuals with CAS;females and hyperuricemia were risk factors for stroke incidence in individuals with carotid intima-media thickening;and high school or technical secondary school education,high-salt diet,and overweight were risk factors for stroke incidence in individuals with carotid atherosclerotic plaque.Conclusion The cumulative incidence of both CAS and stroke was high during follow-up in the occupational population of the Jinchang Cohort Study and in the occupational population,the individuals with CAS had a higher risk of stroke,and older age,high-salt diet,and overweight were the main risk factors for stroke in the individuals with CAS.

Extensive research has established the link between PM2.5 exposure and blood pressure (BP) levels among normal individuals. However, the association between PM2.5 components and BP levels in hypertensive patients has not been fully explored. In this study, 12 971 hypertensive cases from Jinchang cohort (in Jinchang City, China) with nearly 9 years of follow-up were enrolled. Based on the linear mixed-effect model, the effects of fine particulate matter (PM2.5) and five major components [sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), black carbon (BC) and organic matter (OM)]on BP [systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP)]were evaluated by single-component model, component-joint model and component-residual model, respectively. A positive correlation was found between PM2.5 as well as its components (SO42-, NO3-, NH4+, BC and OM) exposure and BP levels. The effects of SO42-, BC and OM on BP were observed to be the most robust among the three models. Based on the results of interaction effects and stratified analysis, the effect of BC exposure on SBP, and the effect of PM2.5 and its five components on PP were greater in female than in males. Compared with elderly hypertensive patients, OM had more significant effects on SBP, DBP and MAP in young and (or) middle-aged hypertensive patients. During the heating season, the effect of PM2.5 and its components on BP was grater compared to the non-heating season. Meanwhile, PM2.5 and its components have a greater influence on BP in patients with hypertension combined with diabetes. Therefore, the findings suggested that both PM2.5 exposure and its components had a significant effect on BP in patients with hypertension. Women and young and middle-aged hypertensive patient were the sensitive population. The implementation of source control and reduction of PM2.5 emission (mainly for SO42-, BC and OM) may be of great significance to control BP level and could reduce the risk of cardiovascular disease in patients with hypertension.

BACKGROUNDS:This investigation seeks to explore the correlation between nonalcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVDs), and to to provide evidence for the prevention and treatment of CVDs. METHODS:This study utilized data from the Jinchang cohort platform, including 19,399 participants without pre-existing major CVDs. Based on the general population and gender stratification, Cox models were used to analyze the risk of NAFLD for CVDs. The combined effect of NAFLD and different obesity indicators on CVDs was analyzed by additive and multiplicative interaction models and subgroups. RESULTS:There were 3129 NAFLD patients out of 19399 subjects, and 723 (23.11%) of them had the CVD. After adjusting for multiple confounding factors, the Cox model revealed a 1.17-fold increase in the risk of CVDs among patients with NAFLD compared to those without NAFLD. Moreover, there was no notable disparity in CVDs risk among most NAFLD patients at the same level of obesity. The results indicated no additive interaction between NAFLD and obesity concerning CVDs risk, but rather a positive multiplicative interaction. Using the normal population as a reference, it was found that people with both obesity and NAFLD significantly increased the risk of developing CVDs, with HRs and 95% CIs of 1.790 (1.508, 2.126), 1.356 (1.213, 1.517), and 1.807 (1.503, 2.174), respectively, for BMI, WC, and the combination of BMI and WC. CONCLUSIONS:NAFLD and obesity are independent risk factors for CVDs. The synergy of obesity and NAFLD implies that NAFLD patients should control weight gain. Larger BMI and WC values may increase the CVDs risk for NAFLD patients, especially women.

OBJECTIVE:To evaluate the efficacy of electroacupuncture (EA) intervention on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). METHODS:Eight databases, including PubMed, Embase, the Cochrane Library, Web of Science, Chinese BioMedical Literature Database, China National Knowledge Infrastructure Database, Wanfang Data, China Science and Technology Journal Database, and two clinical trial registries, were searched. All randomized controlled trials (RCTs) related to EA intervention in cardiac surgery with CPB were collected. Based on the inclusion and exclusion criteria, two researchers independently screened articles and extracted data. After the quality evaluation, RevMan 5.3 software was used for analysis. RESULTS:Fourteen RCTs involving 836 patients were included. Compared with the control treatment, EA significantly increased the incidence of cardiac automatic rebeat after aortic unclamping [relative risk (RR) = 1.15, 95% confidence interval (CI) (1.01, 1.31), P < 0.05; moderate]. Twenty-four hours after aortic unclamping, EA significantly increased the superoxide dismutase [standardized mean difference (SMD) = 0.96, 95% CI(0.32, 1.61), P < 0.05; low], and interleukin (IL)-2 [SMD = 1.33, 95% CI(0.19, 2.47), P < 0.05; very low] expression levels and decreased the malondialdehyde [SMD =－1.62, 95% CI(－2.15, －1.09), P < 0.05; moderate], tumour necrosis factor-α [SMD = －1.28, 95% CI(－2.37, －0.19), P < 0.05; moderate], and cardiac troponin I [SMD = －1.09, 95% CI(－1.85, －0.32), P < 0.05; low] expression levels as well as the inotrope scores [SMD = －0.77, 95% CI(－1.22, －0.31), P < 0.05; high]. There was no difference in IL-6 and IL-10 expression levels. The amount of intraoperative sedative [SMD = -0.31, 95% CI(－0.54, －0.09), P < 0.05; moderate] and opioid analgesic [SMD = -0.96, 95% CI(－1.53, －0.38), P < 0.05; low] medication was significantly lower in the EA group than in the control group. Moreover, the postoperative tracheal intubation time [SMD = －0.92, 95% CI(－1.40, －0.45), P < 0.05; low] and intensive care unit stay [SMD = －1.71, 95% CI(－3.06, －0.36), P < 0.05; low] were significantly shorter in the EA group than in the control group. There were no differences in the time to get out of bed for the first time, total days of antibiotic use after surgery, or postoperative hospital stay. No adverse reactions related to EA were reported in any of the included studies. CONCLUSIONS:In cardiac surgery with CPB, EA may be a safe and effective strategy to reduce myocardial ischaemia-reperfusion injury and speed up the recovery of patients after surgery. These findings must be interpreted with caution, as most of the evidence was of low or moderate quality. More RCTs with larger sample sizes and higher quality are needed to provide more convincing evidence.

To investigate the effect of urinary PAHs on MAFLD. The study included 3,136 adults from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2016. Among them, 1,056 participants were diagnosed with MAFLD and were designated as the case group. The analysis of the relationship between monohydroxy metabolites of seven PAHs in urine and MAFLD was carried out using logistic regression and Bayesian kernel regression (BKMR) models. In single-pollutant models, the concentration of 2-hydroxynaphthalene (2-OHNAP) was positively correlated with MAFLD (OR = 1.47, 95