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Background: Coronary artery lesions are the most important complications of Kawasaki disease. Approximately 25–30% of untreated patients develop coronary artery disease, which can lead to long‐term cardiovascular sequelae. Aim: The aim of this study is to evaluate the risk factors for coronary artery lesions in Kawasaki disease and to construct a nomogram for predicting the likelihood of developing such lesions. Methods: Data from 599 patients between January 2012 and June 2020 were reviewed retrospectively. Patients were randomly assigned to the training set (n = 450) and the validation set (n = 149). A comparison of clinical features and laboratory data was performed, followed by multivariate logistic regression analysis to identify independent risk factors and develop the nomogram. The predictive efficiency of the nomogram was evaluated using the calibration curve, area under the receiver operating characteristic curve (AUC), C‐index, and decision curve analysis (DCA). Results: Intravenous immunoglobulin (IVIG) resistance, delayed IVIG treatment, C‐reactive protein, and neutrophil/lymphocyte ratio were identified as independent risk factors for the development of coronary artery lesions. The nomogram was constructed based on these four variables. The calibration curve of the nomogram showed a high degree of agreement between the predicted probability and the actual probability. The AUC of the nomogram in the training and validation set was 0.790 and 0.711, respectively. In addition, DCA revealed that the nomogram provided a significant net benefit, further supporting its clinical utility. Conclusions: The constructed nomogram demonstrates a strong and reliable performance in predicting coronary artery lesions, which enables clinicians to make timely and tailored clinical decisions. [ABSTRACT FROM AUTHOR]

Pleural contact in lung cancers does not always imply pleural invasion (PI). This study was designed to determine whether specific invasive CT characteristics or iodine uptake can aid in the prediction of PI. The sample population comprised patients with resected solid lung adenocarcinomas between April 2019 and May 2022. All participants underwent a contrast enhanced spectral CT scan. Two proficient radiologists independently evaluated the CT features and iodine uptake. Logistic regression analyses were employed to identify predictors for PI, via CT features and iodine uptake. To validate the improved diagnostic efficiency, accuracy analysis and ROC curves were subsequently used. A two-tailed P value of less than 0.05 was considered statistically significant. We enrolled 97 consecutive patients (mean age, 61.8 years ± 10; 48 females) in our study. The binomial logistic regression model revealed that a contact length > 10 mm (OR 4.80, 95% CI 1.92, 11.99, p = 0.001), and spiculation sign (OR 2.71, 95% CI 1.08, 6.79, p = 0.033) were independent predictors of PI, while iodine uptake was not. Enhanced sensitivity (90%) and a greater area under the curve (0.73) were achieved by integrating the two aforementioned CT features in predicting PI. We concluded that the combination of contact length > 10 mm and spiculation sign can enhance the diagnostic performance of PI. [ABSTRACT FROM AUTHOR]

Background: To assess the anxiety and depression levels in patients with Posner-Schlossman syndrome (PSS) and to determine the potential risk factors. Methods: In this cross-sectional study, a total of 195 participants, including 93 PSS patients and 102 healthy controls were recruited. Sociodemographic and clinical information were collected for all participants. Hospital Anxiety and Depression scale (HADS) was administered to evaluate the anxiety and depression levels. Visual function (VF) and quality-of-life (QOL) questionnaires were administered to assess variables potentially associated with anxiety and depression. Results: Increased anxiety level was observed in 22 (23.7%) PSS patients as compared to 10 (9.8%) of controls (P = 0.009). While the frequency of depression between the two groups was not significantly different (P = 0.349). The mean anxiety and depression scores were 6.98 ± 4.20 and 6.44 ± 3.66 in PSS patients as compared to 6.67 ± 3.21 (P = 0.564) and 5.96 ± 2.93 (P = 0.311) in controls. Logistic regression analysis showed mental well-being was significantly associated with anxiety (odds ratio [OR] = 0.920, 95% confidence interval [CI] = 0.881–0.962, P < 0.001) and depression (OR = 0.959, CI = 0.926–0.994, P = 0.023) in PSS patients. Conclusion: More patients with PSS may experience anxiety as compared to healthy controls. Mental well-being is an independent risk factor for anxiety and depression. It is important for ophthalmologists to be aware of these factors and should pay more attention on mental health when PSS is managed in clinic. [ABSTRACT FROM AUTHOR]

Background: Currently, many detection methods have high sensitivity to the diagnosis of lung cancer. However, some postoperative patients with pulmonary nodules are eventually diagnosed as having benign nodules. The ideal evaluation of an individual with a pulmonary nodule would expedite therapy for a malignant nodule and minimize testing for those with a benign nodule. Methods: This case–control study is designed to explore the relationship between ACE1 rs4646994 polymorphism and the risk of lung cancer in patients with pulmonary nodules, for which 400 individuals with lung cancer and benign pulmonary nodules were included. A DNA extraction kit was used to extract DNA from peripheral blood. The relationship between ACE1 rs4646994 and the risk of lung cancer in patients with pulmonary nodules was determined by the chi-square test, logistic regression analysis and cross analysis. Results: The results showed that after adjusting for age and gender confounding factors, the risk of lung cancer in patients with pulmonary nodules carrying the DD genotype was more than three times that of the I carriers (II + ID) genotype (OR = 3.035, 95% CI, 1.252–7.356, p = 0.014). There was no significant difference between lung squamous cell carcinoma and lung adenocarcinoma in the polymorphism of ACE1 rs4646994 (p > 0.05). We also found that the ACE1 rs4646994 DD genotype frequency was inversely correlated with the risk of EGFR mutation in lung adenocarcinoma patients. Conclusions: Our study indicated that ACE1 rs4646994 polymorphism increases the risk of lung cancer in patients with pulmonary nodules from China. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the clinical characteristics and multimodal biometric parameters from ultrasound biomicroscopy (UBM) and IOL Master biometry of patients with acute secondary angle-closure due to lens subluxation (ASAC-LS), acute primary angle-closure (APAC), and cataract. Methods: This retrospective study included 22 eyes with ASAC-LS, 27 eyes with APAC, and 39 eyes with cataract. Gender, age, affected eye, best corrected visual acuity, axial length, central corneal thickness, and anterior chamber depth (ACD) assessed by UBM and IOL Master were measured and compared between the three groups. In addition, we compared the ratio of ACD (ACD ratio) and the difference of ACD (ACD difference) measured by the two instruments. Logistic regression analysis was conducted to evaluate the predictive factors for lens subluxation. Receiver operating characteristic (ROC) curves were plotted to obtain a suitable cutoff value of biometric parameters to separate ASAC-LS cases from APAC and cataract cases. Results: In the ASAC-LS group, the median (interquartile range [IQR]) ACD measured by IOL Master was 2.47 (IQR 1.85–2.92) mm while the median ACD measured by UBM was 3.11 (IQR 2.60–3.76) mm. The difference of ACD measured by the two instruments was statistically significant in the ASAC-LS group (P < 0.001) whereas the differences were not statistically significant in the APAC group (P = 0.521) and cataract group (P = 0.204). Subsequent pairwise comparison revealed that only the ACD difference (0.40 [IQR 0.22–1.08] mm) and ACD ratio (1.18 [IQR 1.07–1.40]) in the ASAC-LS group were significantly different from those in the APAC group (ACD difference 0.02 [IQR 0.01–0.07] mm; ACD ratio 1.01 [IQR 1.00–1.04]) and cataract group (ACD difference 0.09 [IQR 0.01–0.14] mm; ACD ratio 1.03 [IQR 1.00–1.04]) (all P < 0.001). The ACD difference and ACD ratio were significantly associated with lens subluxation in the multivariate logistic regression analysis (P < 0.001 and P = 0.001, respectively). Additionally, the ROC curve analysis showed that the ACD difference at 0.235 mm and the ACD ratio at 1.080 were the respective cut-off values for lens subluxation, with a sensitivity of 77.3% and specificity of 100.0%. Conclusion: Our findings provide a new option for identifying lens subluxation. Specifically, combining the ACD from UBM and IOL Master may be helpful for differential diagnosis of ASAC-LS. [ABSTRACT FROM AUTHOR]

Phosphatidylinositol 3-kinase (PI3K) and protein kinase B (AKT) are involved in the clearance of Mycobacterium tuberculosis (MTB) by macrophages. This study aimed to investigate the effects of polymorphisms in the PI3K/AKT genes and the gene-smoking interaction on susceptibility to TB. This case-control study used stratified sampling to randomly select 503 TB patients and 494 control subjects. Logistic regression analysis was used to determine the association between the polymorphisms and TB. Simultaneously, the marginal structure linear dominance model was used to estimate the gene-smoking interaction. Genotypes GA (OR 1.562), AA (OR 2.282), and GA + AA (OR 1.650) at rs3730089 of the PI3KR1 gene were significantly associated with the risk to develop TB. Genotypes AG (OR 1.460), GG (OR 2.785), and AG + GG (OR 1.622) at rs1130233 of the AKT1 gene were significantly associated with the risk to develop TB. In addition, the relative excess risk of interaction (RERI) between rs3730089 and smoking was 0.9608 (95% CI: 0.5959, 1.3256, p < 0.05), which suggests a positive interaction. We conclude that rs3730089 and rs1130233 are associated with susceptibility to TB, and there was positive interaction between rs3730089 and smoking on susceptibility to TB. [ABSTRACT FROM AUTHOR]

Background: The morbidity and mortality of colorectal cancer (CRC) remain high, posing a serious threat to human life and health. The early diagnosis and prognostic evaluation of CRC are two major challenges in clinical practice. MTUS1 is considered a tumour suppressor and can play an important role in inhibiting cell proliferation, migration, and tumour growth. Moreover, the expression of MTUS1 is decreased in different human cancers, including CRC. However, the biological functions and molecular mechanisms of MTUS1 in CRC remain unclear. Methods: In the present study, data from The Cancer Genome Atlas (TCGA) database were analysed using R statistical software (version 3.6.3.) to evaluate the expression of MTUS1 in tumour tissues and adjacent normal tissues using public databases such as the TIMER and Oncomine databases. Then, 38 clinical samples were collected, and qPCR was performed to verify MTUS1 expression. We also investigated the relationship between MTUS1 expression and clinicopathological characteristics and elucidated the diagnostic and prognostic value of MTUS1 in CRC. In addition, the correlation between MTUS1 expression and immune infiltration levels was identified using the TIMER and GEPIA databases. Furthermore, we constructed and analysed a PPI network and coexpression modules of MTUS1 to explore its molecular functions and mechanisms. Results: CRC tissues exhibited lower levels of MTUS1 than normal tissues. The logistic regression analysis indicated that the expression of MTUS1 was associated with N stage, TNM stage, and neoplasm type. Moreover, CRC patients with low MTUS1 expression had poor overall survival (OS). Multivariate analysis revealed that the downregulation of MTUS1 was an independent prognostic factor and was correlated with poor OS in CRC patients. MTUS1 expression had good diagnostic value based on ROC analysis. Furthermore, we identified a group of potential MTUS1-interacting proteins and coexpressed genes. GO and KEGG enrichment analyses showed that MTUS1 was involved in multiple cancer-related signalling pathways. Moreover, the expression of MTUS1 was significantly related to the infiltration levels of multiple cells. Finally, MTUS1 expression was strongly correlated with various immune marker sets. Conclusions: Our results indicated that MTUS1 is a promising biomarker for predicting the diagnosis and prognosis of CRC patients. MTUS1 can also become a new molecular target for tumour immunotherapy. [ABSTRACT FROM AUTHOR]

Background. This study explored the relationship between thyroid-associated antibodies, immune cells, and hypothyroidism to establish a predictive model for the incidence of hypothyroidism in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Methods. A total of 170 patients with NPC treated at the Cancer Hospital of University of Chinese Academy of Sciences between January 2015 and August 2018 were included. The complete blood count, biochemical, coagulation function, immune cells, and thyroid-associated antibodies tested before radiotherapy were evaluated. A logistic regression model was performed to elucidate which hematological indexes were related to hypothyroidism development. A predictive model for the incidence of hypothyroidism was established. Internal verification of the multifactor model was performed using the tenfold cross-validation method. Results. The univariate analysis showed that immune cells had no statistically significant differences among the patients with and without hypothyroidism. Sex, N-stage, antithyroid peroxidase antibody (TPO-Ab), antithyroglobulin antibody (TG-Ab), thyroglobulin (TG), and fibrinogen (Fb) were associated with hypothyroidism. Males and early N-stage were protective factors of thyroid function, whereas increases in TPO-Ab, TG-Ab, TG, and Fb counts were associated with an increased rate of hypothyroidism incidence. The multivariate analysis showed that TPO-Ab, TG-Ab, TG, and Fb were independent predictors of hypothyroidism. The comprehensive effect of the significant model, including TPO-Ab, TG-Ab, TG, and Fb counts, represented the optimal method of predicting the incidence of radiation-induced hypothyroidism (AUC = 0.796). Tenfold cross-validation methods were applied for internal validation. The AUCs of the training and testing sets were 0.792 and 0.798, respectively. Conclusion. A model combining TPO-Ab, TG-Ab, TG, and Fb can be used to screen populations at a high risk of developing hypothyroidism after radiotherapy. [ABSTRACT FROM AUTHOR]

Background: We investigated the risk factors of radiation-induced thyroid dysfunction, then combined the clinical factors and optimum thyroid dosimetric parameters to predict the incidence rate of hypothyroidism (HT) and to guide individualized treatment.Methods: A total of 206 patients with histologically proven nasopharyngeal carcinoma (NPC) treated at the Cancer Hospital of the University of Chinese Academy of Sciences between January 2015 and August 2018 were included. Dose-volume histogram (DVH) data, including mean dose, absolute volume, V20, V25, V30, V35, V40, V45, V50, V55, and V60 were extracted and used as dosimetric parameters. A logistic regression analysis model was built to identify predictors related to HT occurring within 2 years.Results: Sex, N stage, thyroid volume, mean thyroid dose, and thyroid V20 and V50 were significantly different between patients with and without HT. Logistic regression analysis showed that N stage, thyroid volume, and thyroid V50 were independent predictors of HT. The radiosensitivity of the thyroid decreased as the thyroid volume increased. Patients with N stage > 1 had significantly higher HT incidence (37.38%) than patients with N stage ≤1 (13.11%). The incidence of HT was 54.55% in patients with thyroid V50 > 24% and was 34.15% in patients with thyroid V50 ≤ 24%.Conclusions: The incidence of HT is significantly associated with N stage, thyroid volume, and thyroid V50. More attention should be paid to patients with NPC with thyroid volume ≤ 12.82 cm3 and advanced N stage disease. [ABSTRACT FROM AUTHOR]

Background and Objectives: The main purpose of this study was to evaluate the associations between salty food preference and osteoporosis (OP) in general Chinese men.Methods and Study Design: We conducted a largescale, community-based, cross-sectional study to estimate the associations by using self-report questionnaire to evaluate the salty food preference. The total of 1,092 men was available to data analysis in this study. Multiple regression models controlling for confounding factors to include salty food preference variables were employed to explore the relationships for OP.Results: We found negative correlations between preference for salty food and T-score (p=0.006). Multiple regression analysis showed that the preference for salty food was significantly positively associated with OP (p<0.05 for all). The men with preference for salty food habits had a higher prevalence of OP.Conclusion: The findings indicated that salty food preference was independently and significantly associated with OP. The prevalence of OP was more frequent in Chinese men preferring salty food habits. [ABSTRACT FROM AUTHOR]

Purpose: We aim to assess the longitudinal association between baseline estimated cerebrospinal fluid pressure (CSFP) and 5-year incident primary open angle glaucoma (POAG) in a population-based sample of Bai Chinese living in rural China. Methods: Among the 2133 Bai Chinese aged 50 years or older who had participated in the baseline examination of the Yunnan Minority Eye Study, 1520 (71.3%) attended the follow-up examination after five years and 1485 were at risk of developing POAG. Participants underwent comprehensive ophthalmic examinations at both baseline and follow-up surveys. CSFP in mmHg was estimated as 0.55 × body mass index (kg/m2) + 0.16 × diastolic blood pressure (mmHg)-0.18 × age (years)-1.91. Glaucoma was defined using the International Society of Geographical and Epidemiological Ophthalmology Classification criteria. Multivariate logistic regression models were established to determine the association between baseline CSFP and incident POAG. Results: After a mean follow-up time of 5 years, 19 new cases of POAG were detected, with an incidence rate of 1.3% (95% confidence interval, 0.7–1.9%). In multivariate logistic regression analysis, after adjusting for age, gender, education, intraocular pressure, central corneal thickness, hypertension and diabetes, no significant associations, nor any trends, were evident between baseline estimated CSFP and incident POAG. The association between estimated CSFP per mmHg increase in baseline and 5-year incidence of POAG was also non-significant, with adjusted relative risk of 0.96 (P = 0.11) in multivariate analysis. Conclusions: This longitudinal cohort study does not support previously observed cross-sectional association between estimated CSFP and POAG in population-based studies. [ABSTRACT FROM AUTHOR]

Background: Few studies have investigated the association between body mass index (BMI) and breast cancer with consideration to estrogen/progesterone/human epidermal growth factor type 2 receptor status (ER/PR/HER2) in the breast tissue among Chinese pre- and post-menopausal women. Methods: Four thousand two hundred and eleven breast cancer patients were selected randomly from seven geographic regions of China from 1999 to 2008. Demographic data, risk factors, pathologic features, and biological receptor status of cases were collected from the medical charts. Chi-square test, fisher exact test, rank-correlation analysis, and multivariate logistic regression model were adopted to explore whether BMI differed according to biological receptor status in pre- and post-menopausal women. Results: Three thousand two hundred and eighty one eligible cases with BMI data were included. No statistically significant differences in demographic characteristics were found between the cases with BMI data and those without. In the rank-correlation analysis, the rates of PR+ and HER2+ were positively correlated with increasing BMI among post-menopausal women (rs BMI, PR+ = 0.867, P = 0.001; rs BMI, HER2+ = 0.636, P = 0.048), but the ER+ rates did not vary by increasing BMI. Controlling for confounding factors, multivariate logistic regression models with BMI<24 kg/m2 as the reference group were performed and found that BMI≥24 kg/m2 was only positively correlated with PR+ status among post-menopausal breast cancer cases (adjusted OR = 1.420, 95% CI: 1.116–1.808, Wald = 8.116, P = 0.004). Conclusions: Post-menopausal women with high BMI (≥24 kg/m2) have a higher proportion of PR+ breast cancer. In addition to effects mediated via the estrogen metabolism pathway, high BMI might increase the risk of breast cancer by other routes, which should be examined further in future etiological mechanism studies. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to understand the association between clinical characteristics, medical management, and functional outcomes in Chinese patients with nontraumatic intracerebral hemorrhage ( ICH). Methods The China National Stroke Registry ( CNSR) was a prospective cohort study that included 132 Chinese hospitals. Logistic regression was used to determine the risk factors associated with poor outcomes at 3, 6, and 12 months, post- ICH onset. Results Three thousand two hundred fifty five ICH patients with follow-up information up to 1 year post- ICH were included in this study. 49.1%, 47.1%, and 46.0% of ICH patients had poor outcomes at 3, 6, and 12 months, respectively. Age, admission systolic blood pressure, admission Glasgow Coma Score, hematoma volume, withdrawal of support, and complication of gastrointestinal hemorrhage were associated with poor outcomes at 3 and 12 months. Stroke unit care was associated with good outcome at 3 months. Intensive care unit ( ICU)/Neurology ICU care was associated with poor outcome at 3 months. Conclusion This is the first report of long-term functional outcomes in ICH patients from mainland China. Our study elucidates the risk factors that may influence functional outcomes post- ICH and therefore facilitate the development of management strategies to improve ICH care in China. [ABSTRACT FROM AUTHOR]

Background: Data on the pharmacological management of acute agitation in schizophrenia are scarce. The aim of this study is to investigate the prescription practices in the treatment of agitation in Chinese patients with schizophrenia. Methods: We conducted a large, multicenter, observational study in 14 psychiatry hospitals in China. Newly hospitalized schizophrenia patients with the PANSS-EC total score ≥ 14 and a value ≥4 on at least one of its five items were included in the study. Their drug treatments of the first 2 weeks in hospital were recorded by the researchers. Results: Eight hundred and 53 patients enrolled in and 847 (99.30%) completed the study. All participants were prescribed antipsychotics, 40 (4.72%) were prescribed benzodiazepine in conjunction with antipsychotics and 81 were treated with modified electric convulsive therapy (MECT). Four hundred and 12 (48.64%) patients were prescribed only one antipsychotic, in the order of olanzapine (120 patients, 29.13%), followed by risperidone (101 patients, 24.51%) and clozapine (41 patients, 9.95%). About 435 (51.36%) participants received antipsychotic polypharmacy, mostly haloperidol + risperidone (23.45%), haloperidol+ olanzapine (17.01%), olanzapine+ ziprasidone (5.30%), haloperidol + clozapine (4.37%) and haloperidol + quetiapine (3.90%). Binary logistic regression analysis suggests that a high BARS score (OR 2.091, 95%CI 1.140–3.124), severe agitation (OR 1.846, 95%CL 1.266–2.693), unemployment or retirement (OR 1.614, 95%CL 1.189–2.190) and aggressiveness on baseline (OR 1.469, 95%CL 1.032–2.091) were related to an increased antipsychotic polypharmacy odds. Male sex (OR 0.592, 95%CL 0.436–0.803) and schizophrenia in older persons (age ≥ 55 years, OR 0.466, 95%CL 0.240–0.902) were less likely to be associated with antipsychotic polypharmacy. Conclusion: The present study demonstrates that monotherapy and polypharmacy display equally common patterns of antipsychotic usage in managing agitation associated with schizophrenia in China. The extent and behavioral activities of agitation and several other factors were associated with polypharmacy. [ABSTRACT FROM AUTHOR]

Background: Mechanical thrombectomy has been proven as a standard care for moderate to severe ischemic stroke with anterior large vessel occlusion (LVO); however, whether it is equally effective in mild ischemic stroke (MIS) is controversial.Methods: In this retrospective study, a total of 177 Chinese patients presenting with MIS (NIHSS ≤8) and LVO between January 2014 and September 2017 from seven comprehensive stroke centers were identified. Odds of good outcome with endovascular thrombectomy versus medical treatment were obtained by logistic regression analysis and propensity-score matching method, and a meta-analysis pooled results from six studies (n = 733).Results: Good outcome (mRS: 0-1) was 58.2% (46/79) in the thrombectomy and 46.9% (46/98) in the medical group, which showed no statistical significance before adjustment (P = 0.13; OR = 1.57, 95% CI: 0.86 to 2.86). The adjusted ORs of thrombectomy versus medical group were 3.23 (95% CI, 1.35 to 7.73; P = 0.008) by multivariable logistic analysis, 2.78 (1.12 to 6.89; P = 0.02) by propensity score matching analysis, and 3.20 (1.22 to 8.37; P = 0.01) by propensity score matching analysis with additional adjustments, respectively. Thrombectomy treatment did not result in excessive mortality or symptomatic intracranial hemorrhage after adjustments. The meta-analysis did not confirm the associations between good outcome and endovascular treatment.Conclusions: The current study indicates that endovascular thrombectomy is associated with good functional outcome in MIS patients with LVO, and without additional risk of symptomatic intracranial hemorrhage and mortality. Although the meta-analysis failed to demonstrate its superiority compared to medical treatment, randomized clinical trials are needed. [ABSTRACT FROM AUTHOR]