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Background Subjective cognitive decline (SCD) may be the first symptomatic manifestation of Alzheimer’s disease, but information on its health correlates is still sparse in Chinese older adults. This study aimed to estimate SCD symptoms and its association with socio-demographic characteristics, common chronic diseases among southern Chinese older adults. Methods Participants aged 60 years and older from 7 communities and 2 nursing homes in Guangzhou were recruited and interviewed with standardized assessment tools. Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire–9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure poor sleep quality, depression symptoms and anxiety symptoms. The SCD symptoms were measured by SCD questionnaire 9 (SCD-Q9) which ranged from 0 to 9 points, with a higher score indicating increased severity of the SCD. Participants were divided into low score group (SCD-Q9 score ≤ 3) and higher score group (SCD-Q9 score > 3). Chi-square tests and multivariate logistic regression analysis were used for exploring the influences of different characteristics of socio-demographic and lifestyle factors on SCD symptoms. Univariate and multivariate logistic regression analysis were applied to explore the association between SCD symptoms with common chronic diseases. Results A total of 688 participants were included in our analysis with a mean age of 73.79 ( SD  = 8.28, range: 60–101), while 62.4% of the participants were females. The mean score of the SCD-Q9 was 3.81 ± 2.42 in the whole sample. A total of 286 participants (41.6%) were defined as the low score group (≤3 points), while 402 participants (58.4%) were the high score group (> 3 points). Multivariate logistic regression analysis revealed that female ( OR  = 1.99, 95%CI: 1.35–2.93), primary or lower education level ( OR  = 2.58, 95%CI : 1.38–4.83), nursing home ( OR  = 1.90, 95%CI : 1.18–3.05), napping habits ( OR  = 1.59, 95%CI : 1.06–2.40), urolithiasis ( OR  = 2.72, 95%CI : 1.15–6.40), gout ( OR  = 2.12, 95%CI : 1.14–3.93), poor sleep quality ( OR  = 1.93, 95%CI : 1.38–2.71), depression symptoms ( OR  = 3.01, 95%CI : 1.70–5.34) and anxiety symptoms ( OR  = 3.11, 95%CI : 1.29–7.46) were independent positive related to high SCD-Q9 score. On the other hand, tea-drinking habits ( OR  = 0.64, 95%CI : 0.45–0.92), current smoking ( OR  = 0.46, 95%CI : 0.24–0.90) were independent negative related to high SCD-Q9 score. Conclusions Worse SCD symptoms were closely related to common chronic diseases and socio-demographic characteristics. Disease managers should pay more attention to those factors to early intervention and management for SCD symptoms among southern Chinese older adults.

Background Psychotic-like experiences (PLEs) and game addiction are common among young individuals. The present study aimed to explore the association between game addiction and lifetime PLEs among high school students in Guangzhou, China. Methods Data for this study was derived from the Mental Health and Behavior Disorders among Children and Young People in Guangzhou Survey, which utilized a multistage stratified cluster sampling design. The 15-item positive subscale of the Community Assessment of Psychic Experiences (CAPE-15) was used to assess lifetime PLEs. Univariate and multivariate logistic regression analysis were applied to explore the lifetime PLEs-related factors. Results A total of 5581 high school students aged 13 to 20 years were included in the analysis. The prevalence of lifetime PLEs and game addiction among high school students was 44.9% ( n  = 2507) and 15.0% ( n  = 835), respectively. Multivariate logistic regression analysis showed that age ( OR  = 0.86, 95% CI : 0.80–0.93),single child ( OR  = 1.17, 95%CI: 1.03–1.34), perceived academic stress ( OR  = 1.10, 95% CI : 1.07–1.14), loneliness ( OR  = 1.10, 95% CI : 1.08–1.12), social support ( OR  = 0.93, 95% CI : 1.18–1.23), PHQ-9 score ( OR  = 1.20, 95% CI : 1.18–1.23), game use time for more than 4 h per week (vs. 0 h) ( OR  = 1.53, 95% CI : 1.21–1.93), and game addiction ( OR  = 1.56, 95% CI : 1.29–1.88) were influencing factors of lifetime PLEs ( P  < 0.05). Conclusion The prevalence of lifetime PLEs is high among high school students, and PLEs are related to a variety of psychosocial and behavioral factors. Lifetime PLEs are strongly related to game addiction and long game use time among high school students.

Background This paper investigated how second- and third-trimester gestational weight gain relates to perinatal outcomes among normal weight women with twin pregnancies in Fujian, China. Methods A retrospective study examining the medical records of 931 normal weight twin-pregnant women was conducted in Fujian Maternity and Child Health Hospital from 2014 to 2018.The 2 nd and 3 rd trimester weekly weight gain rates were calculated, and women were categorized as gaining below, within, or above the 2009 Institute of Medicine (IOM) recommended rates. The association between the trimester-specific weight gain rate and perinatal outcome was determined by traditional regression analysis among groups. Results A total of 25.9%, 19.8% and 54.3% of women had rates of weight gain across the 2 nd and 3 rd trimesters less than, greater than or within the recommended rates respectively. Multivariate logistic regression analysis showed that weight gain greater than the recommended rate in the 2 nd trimester was associated with a decreased risk of preeclampsia (aOR:0.489,95%CI:0.289 ~ 0.974). Weight gain less than the recommended rate of weight gain in the 3 rd trimester was associated with increased risks of premature delivery(aOR:2.079, 95%CI:1.467 ~ 2.968), gestational diabetes mellitus (aOR: 2.048, 95%CI:1.411 ~ 2.971), intrahepatic cholestasis syndrome (aOR:3.015,95%CI: 1.058 ~ 8.587), pre-labour rupture of membrane (aOR: 1.708,95%CI: 1.169 ~ 2.493), average twin birth weight < 2500 g(aOR:1.532,95%CI: 1.125 ~ 2.084) and neonatal respiratory distress syndrome (aOR:4.934,95%CI:1.626 ~ 15.083) and was associated with decreased risks of caesarean section (aOR:0.589,95%CI:0.386 ~ 0.898) and preeclampsia (aOR:0.471, 95%CI:0.274 ~ 0.808). In addition, weight gain greater than the recommended rate of weight gain in the 3 rd trimester was associated with increased risks of premature delivery (aOR:1.589,95%CI:1.428 ~ 2.951) and gestational hypertension (aOR:2.137,95% CI:1.034 ~ 4.415) as well as preeclampsia (aOR:2.246, 95%CI:1.462 ~ 3.452). The stratified analysis of weight gain in the 3 rd trimester showed that there was no significant difference in the incidence of adverse pregnancy outcomes compared to the 2 nd trimester weight gain groups. Conclusions While this study showed that a gestational weight gain rate above or below the recommendation in the 3 rd trimester was associated with some adverse maternal and neonatal outcomes, further prospective and multicentre studies are required to explore alternate ranges of gestational weight gain rates in twin pregnancies.

Purpose This study aims to evaluate complications, clinical outcomes, and radiographic results following Coflex implantation. Methods We retrospectively studied 66 patients who had decompressive surgery combined with Coflex implantation to treat lumbar spinal stenosis. All imaging data were collected and examined for imaging changes. Clinical outcomes, included Oswestry Disability Index (ODI), back and leg visual analog scale (VAS) scores, were evaluated before surgery, six months after surgery and at the last follow-up. The number of complications occurring after five years of follow-up was counted. All reoperation cases were meticulously recorded. Results 66 patients were followed up for 5–14 years. The VAS and ODI scores were significantly improved compared with baseline. Heterotopic Ossification (HO) was detectable in 59 (89.4%). 26 (39.4%) patients had osteolysis at the contact site of Coflex with the spinous process. Coflex loosening was detected in 39 (60%) patients. Spinous process anastomosis was found in 34 (51.5%) patients. There was a statistically significant difference in the VAS score of back pain between patients with and without spinous process anastomosis. Nine cases of lumbar spinal restenosis were observed, and prosthesis fracture was observed in one case. Conclusion Our study identified various imaging changes after Coflex implantation, and majority of them did not affect clinical outcomes. The majority of patients had HO, but osteolysis and Coflex loosening were relatively rare. The VAS score for back pain of these patients was higher if they have spinous process anastomosis. After five-year follow-up, we found lumbar spinal restenosis and prosthesis fracture cases.

Background The transversus abdominis plane (TAP) block in conjunction with intrathecal morphine has been demonstrated to provide more superior postcesarean analgesia to intrathecal morphine alone. However, the analgesia efficacy of their conjunction has not been demonstrated in patients with severe pre-eclampsia. The study aimed to compare the postcesarean analgesia of TAP block in conjunction with intrathecal morphine versus intrathecal morphine alone in women with severe pre-eclampsia. Methods Pregnant women with severe pre-eclampsia undergoing planned cesarean section were randomly allocated into 2 groups to receive TAP block with 20 ml of 0.35% Ropivacaine (TAP group) or with the same volume of 0.9% saline (Sham group) after undergoing elective cesarean section under spinal anaesthesia with 15 mg of 0.5% Ropivacaine plus 0.1 mg of morphine. The outcomes for this analysis include the visual analog scale (VAS) pain score at rest and with movement at 4,8,12,24 h after TAP block was performed, times of use of intravenous patient-controlled analgesia (PCA) within 12 h after anesthesia, the occurrence of maternal side effects, maternal satisfaction, and Apgar score at 1 and 5 min of newborns. Results 119 subjects receive TAP block with 0.35% Ropivacaine (n = 59)or 0.9% saline (n = 60). At 4,8, 12 h after TAP block, the TAP group reported lower VAS score at rest [at 4 h: 1(0,1) vs. 1(1,2), P < 0.001 ; at 8 h:1(1,1) vs. 1(1.5,2), P < 0.001 ; at 12 h:1(1,2) vs. 2(1,2), P = 0.001 ] and higher satisfaction [53(89.9%) vs.45(75.0%), P < 0.05 ]. There were no differences between groups in VAS score at 24 h at rest and at all time points above with movement, times of use of PCA within 12 h after anesthesia, maternal side-effect, and Apgar score at 1 and 5 min of newborns. Conclusions In conclusion, The TAP block performed in conjunction with intrathecal morphine may not reduce opioid consumption, but it could reduce VAS scores at rest in the first 12 h after cesarean section in women with severe pre-eclampsia, and improve maternal satisfaction, which is worthy of clinical promotion. Trial registration Registered at Chinese Clinical Trial Registry( http://www.chictr.org.cn ) on 13/12/2021: ChiCTR2100054293.

Background Subjective cognitive decline (SCD) may be the early screening signal to distinguish susceptible population with Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Subjective cognitive complaints (SCCs) have been proved strongly associated with SCD. This study aimed to explore the association between sleep duration and SCCs in the Chinese elderly. Methods We conducted a cross-sectional study involving 688 participants aged 60 years and older in Guangdong Province, China. SCCs were assessed by the Subjective Cognitive Decline questionnaire 9 (SCD-Q9), which contained 9 items with two dimensions, including the overall memory function and time comparison (OMTC) and daily activity ability (DAA). Restricted cubic splines and generalized additive model (GAM) were used to fit the association between sleep duration and SCD-Q9 score. Results There were significant U-shaped associations between sleep duration and overall score of SCD-Q9 ( EDF  = 3.842, P  < 0.001), as well as the OMTC dimension ( EDF  = 4.471, P  < 0.001) in the age- and gender-adjusted GAM. The lowest points on the overall score of SCD-Q9 and OMTC score were observed in those sleeping 8 h per night. After further adjusting for other demographic characteristics, lifestyle behaviors, hypertension and diabetes, the U-shaped associations between sleep duration and the overall score of SCD-Q9 ( EDF  = 3.575, P  = 0.004), sleep duration and the OMTC score ( EDF  = 4.478, P  = 0.010) were still found. The daily activity ability (DAA) score was also non-linear associated with sleep duration both in the age- and gender-adjusted GAM ( EDF  = 2.314, P  < 0.001) and further adjusted GAM ( EDF  = 2.080, P  = 0.010). Conclusions Both longer sleep duration (> 8 h) and shorter duration (< 8 h) were linked to worse SCCs. Future studies should explore the protective effect of managing sleep duration on SCD and its progression to dementia.

Langerhans cell histiocytosis (LCH) is a rare inflammatory myeloid neoplasm in which the inflammatory microenvironment plays a crucial role in the development and progression of disease. The prognostic value of circulating lymphocyte subsets and cytokines remains uncertain. The authors retrospectively analyzed baseline peripheral lymphocyte subsets and serum cytokines in 330 consecutive pediatric patients. Immune profiles were compared across disease extent, clinical events, and biological features. Prognostic associations with progression-free survival (PFS) were tested using univariable and multivariable models. Peripheral immune profiles varied with disease extent. Patients with multisystem risk-organ involvement (MS RO+) had fewer total T and Th1 cells, more CD4⁺ T and B cells, and higher IL-6, IL-10, and IFN-γ. Patients who progressed or relapsed showed a similar pattern, and non-survivors had particularly high IL-10. In the first-line cohort, the proportions of T, B, CD4⁺ T, CD8⁺ T, and Th1 cells, ratios of CD4/CD8 and Th1/Th2, and levels of IL-6, IL-10 predicted progression/relapse, and Youden-derived cut-offs dichotomized with distinct PFS. On multivariable Cox, IL-6, IL-10, Th1/Th2 ratio, RO status, and week-6 responses were independent predictors, and a nomogram model with good predictive capability was formed. IL-10 remained independently prognostic in multisystem LCH; the immune indices were not prognostic in single-system LCH. External validation in 103 patients confirmed risk stratification and model performance with well-calibrated PFS estimates. Baseline peripheral lymphocyte subsets and cytokines carried prognostic information in pediatric LCH. The IL-6, IL-10, and Th1/Th2 profile supported risk stratification and may inform treatment planning.

The purpose of our study is to develop a deep learning (DL) model based on MRI and analyze its consistency with the treatment recommendations for degenerative cervical spine disorders provided by the spine surgeons at our hospital. In this study, MRI of patients who were hospitalized for cervical spine degenerative disorders at our hospital from July 2023 to July 2024 were primarily collected. The dataset was divided into a training set, a validation set, and an external validation set. Four versions of the DL model were constructed. The external validation set was used to assess the consistency between the DL model and spine surgeons' recommendations about indication of cervical spine surgery regarding the dataset. This study collected a total of 756 MR images from 189 patients. The external validation set included 30 patients and a total of 120 MR images, consisting of 43 images for grade 0, 20 images for grade 1, and 57 images for grade 2. The region of interest (ROI) detection model completed the ROI detection task perfectly. For the binary classification (grades 0 and 1, 2), DL version 1 showed the best consistency with the spine surgeons, achieving a Cohen's Kappa value of 0.874. DL version 4 also achieved nearly perfect consistency, with a Cohen's Kappa value of 0.811. For the three-class classification, DL version 1 demonstrated the best consistency with the spine surgeons, achieving a Cohen's Kappa value of 0.743, while DL version 2 and DL version 4 also showed substantial consistency, with Cohen's Kappa values of 0.615 and 0.664, respectively. We initially developed deep learning algorithms that can provide clinical recommendations based on cervical spine MRI. The algorithm shows substantial consistency with experienced spine surgeons.

Uricase (or Urate oxidase), a key enzyme involved in purine metabolism, is commonly used in treating conditions such as gout, hyperuricemia, and tumor lysis syndrome. In this study, a uricase-producing strain (named CSAJ-16) was isolated from the soil sample of Cangshan Mountain, Yunnan Province, China. This strain was identified as sp. CSAJ-16. Based on the gene sequence alignment, the uricase gene (named ) of sp. CSAJ-16 was amplified and heterologously expressed. The recombinant uricase (ArUOX) was about 32 kDa. The optimal pH and temperature of ArUOX were pH 7 and 20°C, respectively. The ArUOX remained above 50% relative activity after incubation at 37°C for 100 min or at pH 6.0–8.6 for 24 h. Moreover, metal ions such as K , Mg , Ca , Ba and Pb can significantly enhance the activity of ArUOX (> 200%). These enzymatic properties indicate that ArUOX has potential applications in pharmaceutical enzymes and uric acid detection kits.