Department of Minimally Invasive Gynecologic Center Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing, China. Department of Gynecology Shengli Clinical Medical College of Fujian Medical University Fujian Provincial Hospital Fuzhou, Fujian Province, China. Department of Minimally Invasive Gynecologic Center Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing, China. Funding/support: None reported. Financial disclosures/conflicts of interest: None reported.
Abstract Background: Central obesity is strongly associated with obesity-related and metabolic diseases, which is a common health problem in sedentary adults, particularly in women, but the mechanisms remain unclear. This study aimed to investigate the prevalence and factors associated with central obesity in white-collar workers Chinese population, and explore potential sex differences. Methods: A cross-sectional study was conducted between 2017 and 2019 at two large general hospitals in northern and southern China. Totally 6,081 white-collar workers underwent a physical examination and completed an online health self-report questionnaire, which included demographic variables, lifestyle factors and blood lipid test. Multilevel logistic regression analysis was performed to assess the prevalence and factors of central obesity. Results: A total of 4,973 male and 1,108 female white-collar workers were included in this study, and the incidence of central obesity was 67.5% and 30.1%, respectively. In male white-collar workers, increasing age, chronic disease, higher levels of total cholesterol, salt intake and BEE, social engagement, eating spicy food and animal offal were risk factors for central obesity, while a higher HDL-C level, eating fish, and high vegetable intake were protective factors. In female white-collar workers, increasing age, higher total cholesterol level, higher BEE, and overeating were risk factors for central obesity, while a higher HDL-C level, and drinking milk were protective factors. Conclusions: Central obesity was a significant public health concern and the prevalence was high in Chinese adults. Healthy lifestyles and dietary measures to control the rates of central obesity should be undertaken to circumvent the growing disease burden in Chinese people..
Importance Parenteral enoxaparin is a preferred anticoagulant used in the acute phase for patients with acute coronary syndrome (ACS). The safety and efficacy of short-term low-dose rivaroxaban in this clinical setting remain unknown. Objective To compare the safety and efficacy of rivaroxaban vs enoxaparin in the acute phase of ACS. Design, Setting, and Participants This multicenter, prospective, open-label, active-controlled, equivalence and noninferiority trial was conducted from January 2017 through May 2021 with a 6-month follow-up at 21 hospitals in China. Participants included patients with ACS missing the primary reperfusion window or before selective revascularization. Data were analyzed from November 2021 to November 2022. Interventions Participants were randomized 1:1:1 to oral rivaroxaban 2.5 mg or 5 mg or 1 mg/kg subcutaneous enoxaparin twice daily in addition to dual antiplatelet therapy (DAPT; aspirin 100 mg and clopidogrel 75 mg once daily) for a mean of 3.7 days. Main Outcomes and Measures The primary safety end point was bleeding events, as defined by the International Society on Thrombosis and Haemostasis, and the primary efficacy end point was major adverse cardiovascular events (MACEs), including cardiac death, myocardial infarction, rerevascularization, or stroke during the 6-month follow-up. Results Of 2055 enrolled patients, 2046 (99.6%) completed the trial (mean [SD] age 65.8 [8.2] years, 1443 [70.5%] male) and were randomized to enoxaparin (680 patients), rivaroxaban 2.5 mg (683 patients), or rivaroxaban 5 mg (683 patients). Bleeding rates were 46 patients (6.8%) in the enoxaparin group, 32 patients (4.7%) in the rivaroxaban 2.5 mg group, and 36 patients (5.3%)in the rivaroxaban 5 mg group (rivaroxaban 2.5 mg vs enoxaparin: noninferiority hazard ratio [HR], 0.68; 95% CI, 0.43 to 1.07; P = .005; rivaroxaban 5 mg vs enoxaparin: noninferiority HR, 0.88; 95% CI, 0.70 to 1.09; P = .001). The incidence of MACEs was similar among groups, and noninferiority was reached in the rivaroxaban 5 mg group (HR, 0.60; 95% CI, 0.31 to 1.16, P = .02) but not in the rivaroxaban 2.5 mg group (HR, 0.68; 95% CI, 0.36 to 1.30; P = .05) compared with the enoxaparin group. Conclusions and Relevance In this equivalence and noninferiority trial, oral rivaroxaban 5 mg showed noninferiority to subcutaneous enoxaparin (1 mg/kg) for patients with ACS treated with DAPT during the acute phase. Results of this feasibility study provide useful information for designing future randomized clinical trials with sufficient sample sizes. Trial Registration ClinicalTrials.gov Identifier: NCT03363035
Retinoblastoma is the most frequent intraocular malignancy in children. Little is known on the molecular basis underlying the biological and clinical behavior of this cancer. Here, using gene expression profiles, we demonstrate the existence of two major retinoblastoma subtypes that can be divided into six subgroups. Subtype 1 has higher expression of cone related genes and higher percentage of RB1 germline mutation. By contrast, subtype 2 tumors harbor more genes with ganglion/neuronal features. The dedifferentiation in subtype 2 is associated with stemness features including low immune infiltration. Gene Otology analysis demonstrates that immune response regulations and visual related pathways are the key molecular difference between subtypes. Subtype 1b has the highest risk of invasiveness across all subtypes. The recognition of these molecular subtypes shed a light on the important biological and clinical perspectives for retinoblastomas.
To further investigate whether the functional polymorphisms of dopamine D2 receptor (DRD2) and dopamine D3 receptor (DRD3) genes associate with the development of tardive dyskinesia (TD) in schizophrenia, and whether the interactive effects of DRD2, DRD3, 5-hydroxytryptamine 2C receptor (HTR2C) and manganese superoxide dismutase (MnSOD) genes contribute to the severity of TD.The patients with schizophrenia were assessed for TD by the Abnormal Involuntary Movement Scale (AIMS). Eventually, 42 schizophrenics with persistent TD were in the TD group, and 59 schizophrenics without TD were in the non-TD group. The polymorphism of each candidate gene was analyzed using a polymerase chain reaction-based restriction fragment length polymorphism analysis.The genotype distributions of the candidate genes in the groups were all consistent with the Hardy-Weinberg equilibrium. Allele frequencies for -759C/T and -697G/C polymorphisms in HTR2C gene showed a significant excess of -697 variant (P<0.05) in the patients with TD, compared against those in patients without TD. There were no differences in the distributions of the allelic frequencies and genotypes of Taq I. A polymorphism in DRD2 gene, of Ser/Gly polymorphism in DRD3 gene, and of Ala-9Val polymorphism in MnSOD gene between the TD group and non-TD group (P>0.05). Interestingly, as compared with the other joint allelic types, a significant excess of carrying both DRD3 variant allele (Gly) and MnSOD wild allele (Val) was found in the TD group (P<0.05). However, neither the allele and genotypes nor the clinical demographic characteristics contributed to the higher total AIMS scores in the patients of the TD group. There were no significant differences in any of the clinical demographic characteristics between the subgroups of any genotype in TD and non-TD groups.The excess of -697 variant in the promoter regulation region of the HTR2C gene may be a risk factor for the susceptibility to the occurrence of TD in Chinese male patients with schizophrenia. A combination of DRD3 variant allele (Gly) and MnSOD wild allele (Val) may increase the susceptibility to the development of TD.
With the knowledge explosion in molecular biology,genetics and development of new chemotherapies,targeted therapy,the management of cancers becomes more complex. A multidisciplinary Team(MDT) working to cancer care has been widely accepted throughout much of Europe,the United States. Multidisciplinary teams(MDTs) improve coordination,communication and decision making between team members,and produce more positive outcomes for patients. In China,The MDT working is increasingly paid great attention to and has been established in a few medical centers. There are still some barriers in most medical centers.
This paper presents a two-dimensional simplified Hodgkin–Huxley model under exposure to electric fields. The Hopf bifurcations of the simplified Hodgkin–Huxley model are investigated through qualitative analysis and numerical simulations. A necessary and sufficient condition for the existence of Hopf bifurcations is derived, and the conditions for supercritical and subcritical Hopf bifurcations are obtained. Finally, bifurcation diagrams are given for two parameters, and numerical examples are presented to illustrate the effectiveness of the theoretical results.
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