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Purpose: This study analyzes the relationship between human papillomavirus (HPV) infection, vaginal microecology, and cervical lesions to provide a basis for the prevention and treatment of cervical cancer (CC) in the Xinjiang region. Methods: Real‐time quantitative PCR was used for HPV genotyping and viral load. The Gram staining and dry biochemical enzyme kit were utilized to diagnose vaginal secretions. The χ2 test and Logistic regression analysis were used for statistical analysis. Results: The HPV infection rate among women in the Xinjiang region was 30.29%, of which the single HPV infection accounts for 77%. HPV16 and HPV52 were the main infection types. There was significant differences in the HPV infection rate and infection types among the Han, Uighur, Hui, and Kazakh ethnic groups. The viral load of HPV16 and HPV52 increases with the upgrade of cervical lesions. There were significant differences in vaginal microecology evaluation indicators H2O2, SNA, LE, GUS, trichomonas, clue cells, and lactobacilli among different ethnic groups. HPV negative patients with varying grades of cervical lesions exhibit a notable variance in H2O2 and LE, which is statistically significant. Single HPV infection and high viral load HPV significantly increase the risk of CC. Conclusions: This study indicates that HPV infection and vaginal microecology differ among ethnic groups, which have a strong correlation with the progression of CC, offering guidance on CC screening and interventions in the Xinjiang area. [ABSTRACT FROM AUTHOR]

Background: Depression is a major health condition among the aging population. Previous studies indicated that edentulism was a risk factor for depression. The link between edentulism and depression has not been fully clarified. Objectives: This study aimed to estimate whether chewing difficulties play a mediating role in the association between edentulism and depression among middle‐aged and older populations with national cross‐sectional data. Methods: Data were obtained from the latest fourth wave of the China Health and Retirement Longitudinal Study (CHARLS). The outcome variable was set as depression, which was measured by the Center for Epidemiologic Studies Depression Scale (CES‐D‐10). Independent and mediated variables were separately set as self‐assessed edentulism and chewing difficulties. The nearest neighbour propensity score matching (PSM) method was used to construct a matching group to balance the basic characteristics of individuals with and without edentulism with minimised bias in the estimation. Causal mediation analysis was performed to estimate the degree of contribution of chewing difficulties to the association between edentulism and depression. Several sensitivity analyses were performed to evaluate the robustness of the primary result. Results: A total of 15 853 individuals remained for analysis. After PSM, 809 individuals with edentulism and 2628 without edentulism remained for analysis. Among the matched individuals, the mean age was 66.3 ± 9.2 years, 58.5% were female, 78.8% lived in rural areas, 23.5% had edentulism, 51.1% had depressive symptoms, and 50.1% had chewing difficulties. Logistic regression results showed that a higher incidence of edentulism was associated with a higher rate of depression (OR: 1.39, 95% CI: 1.19–1.63) in the matching group. Causal mediation analysis results indicated that the average mediation effect of chewing difficulties on the association between edentulism and depression was 0.010 (95% CI: 0.005–0.015), and the average direct effect was 0.072 (95% CI: 0.036–0.11). The mediation proportion of chewing difficulties was 11.7% (95% CI: 0.079–0.21). Conclusion: A higher prevalence of edentulism was associated with a higher rate of depression among middle‐aged and elderly populations. Chewing difficulties moderately mediated the association between edentulism and depression. Fundamental oral function should not be neglected to improve mental health among the aging population. [ABSTRACT FROM AUTHOR]

Background: Delirium is one of the most common complications in critically ill children. Once delirium occurs, it will cause physical and psychological distress in children and increase the length of their ICU stay and hospitalization costs. Understanding the risk factors for delirium in critically ill children can help develop targeted nursing interventions to reduce the incidence of delirium. Aims: To investigate the incidence and the risk factors of delirium in the paediatric intensive care unit (PICU). Study design: We performed a prospective observational study in critically ill patients in the PICU between February and July 2020. Delirium was diagnosed by the Cornell Assessment of Paediatric Delirium (CAPD) and the Richmond Agitation Sedation Scale and analysed via univariate analysis and multivariate logistic regression to determine the independent risk factors of delirium in critically ill children. Results: The study enrolled 315 patients ranging in age from 1–202 (65.3–54.3) months, with 56.2% (n = 177) being male. The incidence of delirium was 29.2% (n = 92) according to CAPD criteria. Among them, 33 cases (35.9%) were of hyperactive delirium, 16 cases (17.4%) were of hypoactive delirium, and 43 cases (46.7%) were of mixed delirium. By using stepwise logistic regression, the independent risk factors of delirium included mechanical ventilation (odds ratio [OR], 11.470; 95% confidence interval [CI], 4.283–30.721), nervous system disease (OR, 5.596; 95%CI, 2.445 to 12.809), developmental delay (OR, 5.157; 95% CI, 1.990–13.363), benzodiazepine (OR, 3.359; 95% CI 1.278–8.832), number of catheters (OR, 1.918; 95% CI, 1.425 to 2.582), and age (OR, 0.985; 95% confidence interval CI, 0.976–0.993). Conclusions: Delirium is a common complication in the PICU. The independent risk factors include mechanical ventilation, nervous system disease, developmental delay, benzodiazepines, higher number of catheters, and younger age. This study may help develop intervention strategies to reduce the incidence of delirium in critically ill children by targeting modifiable risk factors. Relevance to Clinical Practice: Recommendations for practice include paying attention to high‐risk children in the ICU who are prone to delirium, removing influencing factors as soon as possible, and providing targeted nursing interventions. [ABSTRACT FROM AUTHOR]

Severe fever with thrombocytopenia syndrome (SFTS) is a life‐threatening infectious disease caused by the SFTS virus (SFTSV). This study aimed to evaluate the predictive power of C‐reactive protein to lymphocyte ratio (CLR) and establish an early‐warning model for SFTS mortality. We retrospectively analyzed hospitalized SFTS patients in six clinical centers from May 2011 to 2022. The efficacy of CLR prediction was evaluated by the receiver operating characteristic (ROC) analysis. A nomogram was established and validated. Eight hundred and eighty‐two SFTS patients (median age 64 years, 48.5% male) were enrolled in this study, with a mortality rate of 17.8%. The area under the ROC curve (AUC) of CLR was 0.878 (95% confidence interval [CI]: 0.850−0.903, p < 0.001), which demonstrates high predictive strength. The least absolute shrinkage and selection operator regression selected seven potential predictors. Multivariate logistic regression analysis determined three independent risk factors, including CLR, to construct the nomogram. The performance of the nomogram displayed excellent discrimination and calibration, with significant net benefits in clinical uses. CLR is a brand‐new predictor for SFTS mortality. The nomogram based on CLR can serve as a convenient tool for physicians to identify critical SFTS cases in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: Our objective is to validate the effectiveness of the Global Leadership Initiative on Malnutrition (GLIM) criteria in malnutrition diagnosis compared with Patient-Generated Subjective Global Assessment (PG-SGA) and assess the impact of malnutrition diagnosed using GLIM criteria on the clinical outcomes of patients with GC.Methods: We retrospectively analyzed the data of 895 patients who underwent radical gastrectomy at the First Affiliated Hospital of Wenzhou Medical University. Nutrition assessment was performed on all patients according to the GLIM criteria and PG-SGA. The κ statistic was used to evaluate the agreement between two methods. Multivariate logistic regression and Cox regression based on single-factor analysis were used to predict postoperative complications and overall survival rates.Results: Based on the GLIM criteria, 38.3% of the patients were diagnosed as malnourished, including 21.7% Stage I (moderate malnutrition) and 16.6% Stage II (severe malnutrition). GLIM criteria had a moderate agreement with PG-SGA (κ = 0.548). Patients in the Stage II malnutrition group had a higher incidence of complications, a longer postoperative length of stay, and higher hospitalization costs. Logistic regression showed that Stage II malnutrition was an independent risk predictor of postoperative complications (odds ratio, 3.28; 95% confidence interval [CI], 2.18-4.94). Furthermore, Cox regression analysis showed that both Stage I (hazard ratio [HR], 1.52; 95% CI, 1.11-2.07; P = .009) and Stage II (HR, 1.85; 95% CI, 1.34-2.53; P < .001) malnutrition were independent risk predictors of overall survival.Conclusion: Diagnosis of malnutrition according to the GLIM criteria is useful in predicting the adverse postoperative clinical outcomes of patients with gastric cancer. [ABSTRACT FROM AUTHOR]

Aim: To examine whether various aspects of adverse childhood experiences (ACEs) are associated with comorbid cardiovascular diseases (CVDs) and diabetes among middle‐aged and old adults in China. Methods: Using the 2018 China Health and Retirement Longitudinal Study survey and the 2014 Life History survey, in total, 17 115 respondents aged ≥45 years were included. Logistic regressions were applied to estimate the relationship between aspects of ACEs and diagnosis of both CVDs and diabetes while adjusting for adulthood demographics, health and health behaviors. Results: Childhood hunger (OR = 1.75, P < 0.01), childhood socioeconomic status (OR = 1.45, P < 0.05) and abuse from father (OR = 1.50, P < 0.05) were significantly associated with greater odds of comorbid CVDs and diabetes above and beyond adulthood characteristics. In addition, the effects of these ACEs on comorbidity were stronger than their effects on the single chronic condition. Conclusions: Our findings suggest that, for middle‐aged and old Chinese adults, ACEs could have long‐lasting impacts on multiple chronic conditions in later life. Public health interventions should focus on the early life stage as the protective childhood conditions might help in warning of later clustering chronic diseases. Geriatr Gerontol Int 2022; 22: 12–18. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the trends and geographic variations of incident diabetes as well as the corresponding sex differences in China. Methods: The open cohort study derived data of 16,610 individuals from the China Health and Nutrition Survey 1997–2015. Direct standardisation was employed to calculate the age‐standardised diabetes incidence. Mixed effects logistic regression models with interaction terms were performed to examine variations in incident diabetes. Socio‐demographic (age, sex, marital status, racial compositions and educational attainment) and lifestyle attributes (smoking history, BMI and waist circumference) were sequentially included as covariates. Results: Overall age‐standardised diabetes incidence increased from 2.94 per 1000 person‐years (95% CI, 2.44–3.44) in 1997–2004 to 5.54 (95% CI, 4.94–6.14) in 2009–2015. Models with interaction terms suggest that the increase among men was higher than that among women (wave 2006–2009 × Female: OR = 0.45, 95% CI 0.28–0.72). Age‐standardised incidence of diabetes varied across regions, ranging from 5.67 (95% CI, 4.95–6.40) in Eastern China to 2.69 (95% CI 2.19–3.19) in Western China. Subsequent modelling analyses suggest that the geographic variations could be mostly explained by the variations in the BMI and waist circumference across regions. Conclusions: Results suggest that the incidence of self‐reported diabetes approximately doubled during the study period. The increase among men was steeper than that among women. Public interventions reducing the population's obesity level hold promise to alleviate geographic variations and flatten the growth curve. [ABSTRACT FROM AUTHOR]

Accumulating evidence indicates that persistent infection with high‐risk oncogenic human papillomavirus (HPV) genotypes is the most important risk factor for cervical cancer, and that the distribution of HPV genotypes varies regionally. This study explored the prevalence and genotype distribution of HPV infection among Han, Yi, and Bai women in various regions of Dali Bai Autonomous Prefecture, Yunnan Province, China. This cross‐sectional study included 2779 women (20–76 years old) who were referred for 21‐HPV genotype array diagnostic from five regions of Dali Bai Autonomous Prefecture between February 2013 and May 2016. Statistical methods used included a the χ2 test, Fisher's exact test, t test, and logistic regression. Overall HPV prevalence in the study population was 7.6%. HPV‐52, HPV‐58, HPV‐18, HPV‐81, and HPV‐16 were the most prevalent genotypes in the study area, and notably, the prevalence of HPV‐58 was significantly higher among women in Heqing County than that in other regions. Univariate analysis showed that husband's age, region, fertility status, and parity were potential factors associated with HPV infection. Multivariate logistic regression analysis revealed that Heqing County was an independent risk factor for HPV infection among women in the Dali area, moreover, Yi women showed the highest risk for HPV infections. Overall, our finding emphasizing the urgent need for an HPV screening and prevention program in Heqing County and Yi women. We also suggest that HPV‐related health education should be provided not only to women, but also to men, to reduce the risk of infection in women. Highlight: The HPV prevalence was 7.6% among Han, Yi, and Bai women in various regions of Dali Bai Autonomous Prefecture, Yunnan Province, China.HPV‐52, HPV‐58, HPV‐18, HPV‐81, and HPV‐16 were the most prevalent genotypes in the study area.Heqing County was an independent risk factor for HPV infection among women in the Dali area, and the prevalence of HPV‐58 was significantly higher among women in Heqing County than that in other regions.Yi women showed the highest risk for HPV infections. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to evaluate the therapeutic effect of laser vaporization for vaginal intraepithelial neoplasia ( VAIN) after hysterectomy in Chinese women and to identify factors affecting persistence/recurrence. Material and Methods Twenty-eight VAIN patients after hysterectomy due to cervical intraepithelial neoplasia (group 1) and 11 VAIN patients due to cervical cancer (group 2) were reviewed retrospectively. All patients were treated with at least one episode of laser vaporization between 2010 and 2011, and then followed up every 3 months for at least 1 year. Cox regression analysis was used to identify independent factors predicting persistence/recurrence. Results All VAIN patients achieved remission after two episodes of laser treatment, with 85.7% complete regression in group 1 and 54.5% in group 2. The first episode of the treatment had a significantly higher success rate in group 1 than in group 2 (46.2% vs 0.0%). All patients had no recurrence during a mean follow-up time of 22.8-27.8 months (range 12-39 months). However, infection persisted in 21 (61.8%) of 34 human-papillomavirus-positive patients after laser vaporization. Severity of VAIN was the only significant independent predictor of persistence/recurrence after one episode of the treatment (adjusted odds ratio, 4.08; 95% confidence interval, 1.28-12.96; P = 0.017). Laser treatments were well tolerated with no major side-effects. Conclusion Laser vaporization may be a useful option for the treatment of VAIN after hysterectomy. However, a follow-up is required to assess the long-term efficacy of laser treatment. [ABSTRACT FROM AUTHOR]

Background: To evaluate the conditions of palliative chemotherapy in terminally ill patients with advanced non-small cell lung cancer (NSCLC), and to discuss the potential factors that affect the prognosis of these patients. Methods: All 205 terminally ill patients with advanced NSCLC, who died in our hospital during the period from 2006 to 2010, were included in the study. Basic information was collected and details for the treatment of patients, related to overall survival, were evaluated. Results: One hundred and fifty-nine out of 205 patients (77.6%) were treated with palliative chemotherapy. Of these, 59.7% patients were treated with palliative chemotherapy in the last three months and 27.7% patients in the last one-month, prior to their expiration, respectively. In addition, 22.0% of the 159 patients were treated with palliative chemotherapy for the first time in the last three months and 10.1% in the last month of their final days. We have shown that patients treated with palliative chemotherapy in their last three and final month had a shorter overall survival rate than those patients who were not treated with palliative chemotherapy. Conclusion: A large proportion of patients with advanced NSCLC received palliative chemotherapy near the end of their life. However, our results were not in favor of palliative chemotherapy in the last three or final month of life. [ABSTRACT FROM AUTHOR]

Aim To assess the associations of oral hygiene and periodontal health with chronic obstructive pulmonary disease ( COPD) exacerbations. Material and Methods In total, 392 COPD patients were divided into frequent and infrequent exacerbation (≥2 times and <2 times in last 12 months) groups. Their lung function and periodontal status were examined. Information on oral hygiene behaviours was obtained by interview. Results In the univariate analysis, fewer remaining teeth, high plaque index ( PLI) scores, low tooth brushing times, and low regular supra-gingival scaling were significantly associated with COPD exacerbations (all p-values <0.05). After adjustment for age, gender, body mass index, COPD severity and dyspnoea severity, the associations with fewer remaining teeth ( p = 0.02), high PLI scores ( p = 0.02) and low tooth brushing times ( p = 0.008) remained statistically significant. When stratified by smoking, fewer remaining teeth ( OR = 2.05, 95% CI: 1.04-4.02) and low tooth brushing times ( OR = 4.90, 95% CI: 1.26-19.1) among past smokers and high PLI scores ( OR = 3.43, 95% CI: 1.19-9.94) among never smokers were significantly associated with COPD exacerbations. Conclusions Fewer remaining teeth, high PLI scores, and low tooth brushing times are significant correlates of COPD exacerbations, indicating that improving periodontal health and oral hygiene may be a potentially preventive strategy against COPD exacerbations. [ABSTRACT FROM AUTHOR]