Introduction: Early-life educational attainment contributes to cognitive reserve (CR). We investigated the associations of lifelong CR with dementia and mild cognitive impairment (MCI) among older people with limited formal education. Methods: This population-based cohort study included 2127 dementia-free participants (≥60 years; 59.4% women; 81.5% with no or elementary school) who were examined at baseline (August-December 2014) and follow-up (March-September 2018). Lifelong CR score at baseline was generated from six lifespan intellectual factors. Dementia, MCI, and their subtypes were defined according to the international criteria. Data were analyzed using Cox proportional-hazards models. Results: During the total of 8330.6 person-years of follow-up, 101 persons were diagnosed with dementia, including 74 with AD and 26 with VaD. The high (versus low) tertile of lifelong CR score was associated with multivariable-adjusted hazards ratio (95% confidence interval) of 0.28 (0.14–0.55) for dementia and 0.18 (0.07–0.48) for AD. The association between higher CR and reduced AD risk was significant in people aged 60-74 but not in those aged≥75 years (P-for-interaction=0.011). Similarly, among MCI-free people at baseline (n=1635), the high (versus low) tertile of lifelong CR score was associated with multivariable-adjusted hazard ratio of 0.51 (0.38–0.69) for MCI and 0.46 (0.33–0.64) for amnestic MCI. Lifelong CR was not related to VaD or non-amnestic MCI. Discussion: High lifelong CR is associated with reduced risks of dementia and MCI, especially AD and amnestic MCI. It highlights the importance of lifelong CR in in maintaining late-life cognitive health even among people with no or limited education.
This article summarizes the ultrasonographic features of female urethral diverticula on biplane transrectal ultrasound (B-TRUS).A retrospective study was performed with 25 consecutive women who were diagnosed and treated as having urethral diverticulum (UD) between January 2012 and March 2016. All the patients were preoperatively evaluated using B-TRUS. The number, location, configuration, size, and type of the UD on B-TRUS were assessed.Twenty-eight diverticula were found on B-TRUS. Twenty-two patients had single diverticulum, whereas the other 3 had double diverticula. The locations included proximal (14%), mid (46%), and distal (40%) urethra. In transverse section, the configuration presented as round or oval (46%), and horseshoe-like or circumferential (54%). The maximal diameter of the 28 diverticula ranged from 3 to 48 mm. The types contained simple UD (36%) and complex UD (64%). Color blood flow signal could be detected in the septa, cystic wall, and solid mass, whereas negative in other areas inside the UD.Various sonographic characters of female UD could be observed during the evaluation, including single or multiple diverticula, different sites, diverse shapes, and septa, calculi, or neoplasm inside diverticulum, all of which could be clearly displayed on B-TRUS.
To evaluate the effects of different delivery modes on pelvic floor function in parturients 6-8 weeks after delivery using transperineal four-dimensional ultrasound.Pelvic floor function 6-8 weeks after delivery in 40 vaginal delivery parturients between November 2018 and December 2020 was assessed by four-dimensional ultrasound, with 40 selective cesarean section delivery parturients as a control group. The imaging results of the two groups were compared.The levels of clinical indexes such as UVJ-M, Ar , Av , θ, Dr , Dv , and ARJ-VDv in the selective cesarean section group were significantly lower than those in the vaginal delivery group 6-8 weeks after delivery (P < 0.05). However, no significant difference in CV-VD was observed under Valsalva action and at rest between the two groups (P > 0.05). No significant difference in ARJ-VD was found at rest between the two groups (P > 0.05). The incidence of pelvic organ prolapse in the selective cesarean section group (40.0%) was significantly lower than that in the vaginal delivery group (62.5%) (P < 0.05). No significant difference in the parameters of pelvic diaphragm hiatus at rest was observed between the two groups (P > 0.05). The parameters of pelvic diaphragm hiatus under maximum Valsalva action in the vaginal delivery group were significantly higher than those in the selective cesarean section group (P < 0.05). Whether the patient was complicated with diabetes had no significant effect on the functional injury of pelvic floor muscle (P > 0.05).The pelvic floor function 6-8 weeks after delivery was significantly more affected in vaginal delivery than in selective cesarean section. Selective cesarean section had certain but limited protective effect on maternal pelvic floor tissue.
Knee pain is a prominent symptom of osteoarthritis (OA). Joint synovial effusion could contribute to pain, but the relationship between them remains controversial. In addition, the effects of joint effusions at different knee compartments on knee pain are unclear.
Objectives
Aim of this study was to determine the cross-sectional and longitudinal associations between knee joint effusions at different compartments and knee pain in older adults.
Methods
Population-based cohort study of older adults randomly selected from local community (N=976, mean age 62.3 years, range from 50 to 80; 50.1% females). Knee joint effusions were measured at baseline using T2 weighted magnetic resonance imaging (MRI) at 4 compartments (suprapatellar pouch, central portion, posterior femoral recess, and subpopliteal recess). Other structural changes including cartilage defects, bone marrow lesions and meniscal lesions were assessed by MRI. OARSI atlas was used to assess knee osteophytes, joint space narrowing (JSN) and radiographic OA. Knee pain was assessed by self-administered Western Ontario and McMasters osteoarthritis index (WOMAC) questionnaire at baseline and 2.6 years later. The 5 WOMAC pain subscales were clinically constructed into weight-bearing pain and non-weight-bearing pain. Univariable and multivariable logistic regression analysis and generalized linear models with Poisson regression analysis were used to estimate prevalence ratios (PR) or relative risks (RR) for the association between knee effusion (0-3) and baseline or increases in knee pain.
Results
Prevalence of knee joint effusion (≥2) was 42.9% at suprapatellar pouch, 48.8% at central portion, 10.3% at posterior femoral recess and 14.4% at subpopliteal recess. Cross-sectionally, knee effusion at suprapatellar pouch was significantly associated with total (PR: 1.26, 95% CI 1.08 to 1.48) and non-weight bearing knee pain (PR: 1.24, 95% CI 1.06 to 1.46), but not with weight-bearing pain, after adjustment for age, gender, BMI, rheumatoid arthritis, radiographic OA and other knee structures. Joint effusions at other compartments were not significantly associated with knee pain. Longitudinally, effusion at suprapatellar pouch was associated with increases in total (RR: 1.20, 95% CI 1.00 to 1.44), non-weight-bearing (RR: 1.38, 95% CI 1.09 to 1.75) and weight-bearing knee pain (RR: 1.26, 95% CI 1.04 to 1.53) after adjustment for above covariates. Effusions at posterior femoral recess and central portion were associated with increases in non-weight-bearing knee pain (RR: 1.55, 95% CI 1.25 to 1.91 and RR: 1.29, 95% CI 1.01 to 1.65; respectively) but not with weight-bearing knee pain. Effusion at subpopliteal recess was significantly associated with an increase in total knee pain (RR: 1.16, 95% CI 1.01 to 1.32) after adjustment for age, sex and BMI, but became non-significant after further adjustments.
Conclusions
Knee joint effusions have independent compartment-specific associations with knee pain in older adults. Suprapatellar pouch effusion is associated with both non-weight-bearing and weight-bearing knee pain, while posterior femoral recess and central portion effusions are only associated with non-weight-bearing knee pain.
Acknowledgements
We especially thank the participants who made this study possible, and we gratefully acknowledge the role of the Tasmania Older Adult Cohort staff and volunteers in collecting the data.
Berberine, a natural isoquinoline alkaloid derived from Berberis species, has been reported to have anticancer effects. However, the mechanisms of action in human colorectal cancer (CRC) are not well established to date. In the present study, the cell cytotoxicity effect of berberine on human CRC cells, as well as the possible mechanisms involved, was investigated. The results of the cell viability and apoptosis assay revealed that treatment of CRC cells with berberine resulted in inhibition of cell viability and activation of cell apoptosis in a concentration‑dependent manner. To reveal the underlying mechanism of berberine‑induced anti‑tumor activity and cell apoptosis, RNA‑sequencing followed by reverse‑transcription quantitative PCR were performed. In addition, RNA immunoprecipitation, chromatin immunoprecipitation and western blot analysis were used to identify the functional regulation of CASC2/EZH2/BCL2 axis in berberine‑induced CRC cell apoptosis. The data revealed that lncRNA CASC2 was upregulated by berberine treatment. Gain‑ or loss‑of‑function assays suggested that lncRNA CASC2 was required for the berberine‑induced inhibition of cell viability and activation of cell apoptosis. Subsequently, the downstream antiapoptotic gene BCL2 was identified as a functional target of the berberine/CASC2 mechanism, as BCL2 reversed the berberine/CASC2‑induced cell cytotoxicity. lncRNA CASC2 silenced BCL2 expression by binding to the promoter region of BCL2 in an EZH2‑dependent manner. In summary, berberine may be a novel therapeutic agent for CRC and lncRNA CASC2 may serve as an important therapeutic target to improve the anticancer effect of berberine.
BACKGROUND:Albumin level does not precisely reflect nutritional status. We aimed to investigate the impact of a nutrition intervention on hemodialysis patients by use of fluorescence-based plasma albumin (FPA) detection. MATERIAL AND METHODS:Eighty patients underwent maintenance hemodialysis for more than half a year and had a mean albumin <3.5 g/dL for over 3 months. The subjects were randomly divided into either a Control Group (CG) or an Intervention Group (IG). The IG received nutritional supplementation, and the CG group received routine nutritional support for 12 months. FPA and plasma albumin (PA) concentrations were measured. The fluorescence probe 1,3-Dichloro-7-hydroxy-9,9-dimethyl-2(9H)-acridone methyl biphenyl benzoate was used in FPA detection. Quality of life was estimated using WHOQOL-BREF (Quality of Life Scale developed through the World Health Organization), the 36-Item Short-Form Survey (SF-36), and the 6-minute walking test (6MWT). RESULTS:After a 6-month and a 12-month intervention, PA and FPA concentrations increased, and the increase in FPA concentration was higher than that of PA in the IG group (P<0.05). Comparatively, the parameters of quality of life and 6MWT were improved in the IG group (P<0.05) but there were only minor changes in the CG group (P>0.05). There is an obvious association between the changes in FPA concentration and the parameters of quality of life and 6MWT but not PA. CONCLUSIONS:Use of the fluorescence probe improves the detection sensitivity of plasma albumin and provides a potential method to assess clinical outcomes in hemodialysis patients.
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