ObjectiveTo systematically review the dose-response relationship between body mass index (BMI) and the risk of stroke. MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CBM, VIP, WanFang Data and CNKI databases were electronically searched to collect studies on BMI and the risk of stroke from inception to December 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by using Stata 16.0 software, and the dose-response relationship between BMI and risk of stroke was analyzed by using restricted cubic spline function and generalized least squares estimation (GLST). ResultsA total of 19 studies involving 3 689 589 patients were included. The results of meta-analysis showed that compared with normal BMI, overweight (RR=1.28, 95%CI 1.19 to 1.39, P<0.01) and obesity (RR=1.41, 95%CI 1.15 to 1.72, P<0.01) had a higher risk of stroke. Dose-response meta-analysis suggested that there was no significant non-linear relationship between BMI and stroke risk (nonlinear test P=0.318), and linear trend showed that the risk of stroke increased by 4% for each unit increase in BMI (RR=1.04, 95%CI 1.03 to 1.05, P<0.01). ConclusionCurrent evidence suggests that increased BMI is associated with an increased risk of stroke. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To explore the factors which affect shared decision-making and develop strategies to get patients actively involved in clinical decision-making. Methods We conducted a survey on 566 patients of a Class A Hospital in Sichuan with group random sampling method. The data were collected by the use of anonymous selfadministered questionnaires. We used SPSS 10.0 to analyse the data. Results A total of 600 questionnaires were distributed at random, of which 565 were completed. There were 68% patients who had some knowledge of the disease, and 93% who were willing to participate in clinical decision-making. The patients’ biggest concerns were: treatment effect, cost and doctors’ skills. The biggest difficulties that patients worried about were: long-time waiting in out-patient departments and limited time to communicate with doctors. Conclusion As more and more patients would like to involve in shared decision-making, doctors need to provide patients with more choices and help them make a right decision in their treatment.
The β-secretase is one of prospective targets against Alzheimer's disease (AD). A three-dimensional quantitative structure-activity relationship (3D-QSAR) model of Hydroethylamines (HEAs) as β-secretase inhibitors was established using Topomer CoMFA. The multiple correlation coefficient of fitting, cross validation and external validation were r2=0.928, qloo2=0.605 and rpred2=0.626, respectively. The 3D-QSAR model was used to search R groups from ZINC database as the source of structural fragments. As a result, a series of R groups with relatively high activity contribution was obtained to design a total of 15 new compounds, with higher activity than that of the template molecule. The molecular docking was employed to study the interaction mode between the new compounds as ligands and β-secretase as receptors, displaying that hydrogen bond and hydrophobicity played important roles in the binding affinity between the new compounds and β-secretase. The results showed that Topomer CoMFA and Topomer Search could be effectively used to screen and design new molecules of HEAs as β-secretase inhibitors, and the designed compounds could provide new candidates for drug design targeting AD.
To analyze the current doctor-patient relationship and explore its underlying reasons. Evidence-based medicine may provide scientific evidence for the deepening of healthcare reforms as well as the improvement of social security system; provide abundant information for both sides of the doctor-patient relationship; improve medical quality and reduce medical costs, so as to establish a harmonious patient-oriented doctor-patient relationship .
ObjectiveTo investigate the causal relationship between gut microbiota and cholelithiasis using a two-sample Mendelian randomization method. MethodsThe genome-wide association studies (GWAS) data of gut microbiota from the MiBioGen study and the GWAS data of cholelithiasis from the FinnGen Biobank were utilized. Genetic variants significantly associated with the relative abundance of gut microbiota were identified as instrumental variables (IVs) based on a specified threshold. The inverse variance weighted (IVW) method was employed as the primary analytical approach, with results assessed based on the odds ratio (OR) and 95% confidence interval (CI). The robustness and reliability of the findings were ensured through quality control measures, including sensitivity analysis, assessment of heterogeneity, and evaluation for horizontal gene pleiotropy. ResultsClostridiumsensustricto1 [OR=1.160, 95%CI (1.023, 1.314), P=0.020], Coprococcus3 [OR=1.136, 95%CI (1.014, 1.272), P=0.028] and Peptococcus [OR=1.074, 95%CI (1.023, 1.128) , P=0.004] increased the risk of cholelithiasis. Bacilli [OR=0.897, 95%CI (0.818, 0.984), P=0.022], Family Ⅹ ⅢAD3011group [OR=0.908, 95%CI (0.830, 0.992), P=0.033] and Lactobacillales [OR=0.884, 95%CI (0.802, 0.974), P=0.013] were protective factors for cholelithiasis. ConclusionThe study has identified 6 kinds of specific gut microbiota that are causally linked to the development of cholelithiasis, providing new ideas for the diagnosis and treatment of cholelithiasis.
ObjectiveThyroid nodules are an exceptionally common thyroid disorder. Past studies suggested a possible link between thyroid diseases and breast neoplasms. However, few studies have delved into the causal relationship between thyroid nodules and breast neoplasms. This study conducted a Mendelian randomization (MR) analysis to further investigate the causal relationship between them. MethodsThis study was conducted using data sourced from genome-wide association study (GWAS) summary datasets. The study focused on thyroid nodules, benign breast tumors, and malignant breast cancers as the research objects, and relevant single nucleotide polymorphisms (SNPs) were selected as instrumental variables (IVs). The inverse-variance weighted (IVW) was primarily used to assess the causal relationship between thyroid nodules and breast neoplasms. Cochran’s Q test was employed to detect heterogeneity, while MR-Egger intercept and MR-PRESSO were used to test for pleiotropy. Sensitivity analysis was conducted using the leave-one-out method. ResultsThere was a significant causal relationship between thyroid nodules and malignant neoplasm of breast (OR=0.88, 95%CI 0.83 to 0.95, P<0.01), with no evidence of reverse causality between them (OR=1.01, 95%CI 0.99 to 1.03, P=0.16). No causal relationship was found between thyroid nodules and benign neoplasm of breast, as indicated by both forward MR analysis (OR=0.97, 95%CI 0.89 to 1.06, P=0.51) and reverse MR analysis (OR=0.97, 95%CI 0.92 to 1.04, P=0.40). Sensitivity analyses suggested that the study findings were accurate and reliable. ConclusionThe present study identifies thyroid nodules as a potential protective factor for malignant neoplasm of breast.
Medical behaviors involve multi level and multi subject legal relations. In the process of medical and nursing care, there are two categories of legal relations concerning medical behaviors. They are external and internal legal relations. External legal relations involve legal relations between hospitals, between physicians and patients and between major medical accidents and penalties; internal legal relations involve physicians, nurses and hospital authorities.
Objective To analyze the potential causal relationship between sunscreen/ultraviolet protection and the risk of non-Hodgkin lymphoma using a two sample Mendelian randomization (MR) study method. Methods The summary data of genome-wide association study was used to select three types of non-Hodgkin lymphoma, namely diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, T/NK cell lymphoma, and sunscreen/ultraviolet protection highly correlated genetic loci, namely single nucleotide polymorphism (SNP), as instrumental variables. The reverse variance weighting method was used as the main method for MR analysis, MR Egger and MR-PRESO were used to detect level pleiotropy, and leave-one-out method was used for sensitivity analysis to ensure the robustness of the results. Results A total of 132 SNPs were included in the analysis. The results of the inverse variance weighted analysis showed that sunscreen/ultraviolet protection increased the incidence of DLBCL [odds ratio=2.439, 95% confidence interval (1.109, 5.362), P=0.027]. The heterogeneity test results showed that there was no heterogeneity in the causal relationship between sunscreen/ultraviolet protection and DLBCL (P>0.05). The results of the horizontal pleiotropy test showed that SNP did not exhibit horizontal pleiotropy (P>0.05). The leave-one-out method showed that no SNP with a significant impact on the results was found. There was no causal relationship between sunscreen/ultraviolet protection and follicular lymphoma and T/NK cell lymphoma. Conclusion There is a positive causal relationship between sunscreen/ultraviolet protection and the incidence of DLBCL.
Objective To investigate the effects of QUE on proliferation and DNA synthesis of cultured retinal pigment epithelium(RPE) cells with or without EGF. Methods With or without EGF, cultured RPE cells were treated with QUE by various concentrations(200,100,50,1mu;mol/L) and with QUE 200mu;mol/L at different times(24-168 hr), cells proliferation and DNA synthesis were evaluated by cell count method and the uptake of thymidine. The viability of cells was determined by trypanblue exclusion. Results The best concentration of QUE which inhibits proliferation and DNA synthesis of PRE cells was 200mu;mol/L. The significant inhibition effect of QUE occurred at 48hr, and the best inhibition of QUE occurred at 96hr. QUE had more powerful effect of antiproliferation on RPE cells, and the viability of RPE cells was over85%. Conclusion The results suggested that QUE could inhibit the proliferation of RPE cells in a dose-dependent and time-dependent manner, especially inhibit the proliferation induced by EGF stimulating. QUE had no cyto-toxic effect on RPE cells cultured in vitro. (Chin J Ocul Fundus Dis,1999,15:27-29)