The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture

BackgroundThe world continues to face major health risks through childhood malnutrition and rickets and anemia which hinder the development of physical and mental and immune system functions. The public health system needs to study determinants of health problems and their effective solutions.MethodsOur research team evaluated 96 studies, which include 153,694 participants from the Middle East and Africa and South and Southeast Asia and high-latitude regions through systematic review. The research team searched for studies in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar. The research team included observational studies and RCTs and cohort studies and individual participant data meta-analyses in their investigation. The study team evaluated research quality and bias risk through the use of Jadad scale and GRADE system and standard evaluation tools. The research team conducted random-effects meta-analyses to combine hazard ratio data while they used funnel plots and Egger’s test to check for publication bias.ResultsThe study found that Childhood Nutritional Rickets and Vitamin D/Calcium Status showed strong associations with low calcium and vitamin D intake (HR 1.51, 95% CI 1.26–1.82; I2 = 88%). The research team found that three programs which included Childhood Malnutrition Prevention and Micronutrient Supplementation and Maternal/Early Childhood Nutrition Programs showed protective effects (HR 0.80, 95% CI 0.77–0.84; I2 = 0%; HR 0.91, 95% CI 0.86–0.96; I2 = 22%; HR 0.85, 95% CI 0.78–0.93; I2 = 53%). The research team used long-term observational studies to demonstrate persistent malnutrition without significant pooled effects (HR 0.96, 95% CI 0.90–1.01; I2 = 10%). Publication bias was found in Groups 1–4 (Egger’s p < 0.001–0.001), publication bias was not found in Group 5 (p = 0.054).ConclusionThe combination of calcium and vitamin D supplements with targeted micronutrients and integrated maternal-child programs effectively decreases rickets and malnutrition while it enhances global growth rate. The implementation of programs requires specific contextual understanding for achieving the best health results in children.

This retrospective cohort study aims to describe the treatment patterns and evaluate survival outcomes in patients aged 70 years or older with metastatic non-small cell lung cancer (mNSCLC), and to identify independent prognostic factors for overall survival (OS). We retrospectively reviewed medical records of 298 patients aged ≥70 years with mNSCLC diagnosed between June 2021 and December 2024. Patients were categorized into an active anti-tumor therapy (ATT) group and a best supportive care (BSC) group for descriptive purposes. Key clinical data, including molecular biomarker status (EGFR, ALK, PD-L1) and Geriatric Nutritional Risk Index (GNRI), were collected for a subset of patients. A multivariate Cox proportional-hazards model was used to identify independent prognostic factors for OS across the entire cohort. Of the 298 patients, 93 (31.2%) received ATT and 205 (68.8%) received BSC. The decision for ATT was significantly associated with better baseline ECOG performance status (ECOG-PS) and fewer comorbidities, indicating profound selection bias. The median OS was 18.0 months in the ATT group and 6.0 months in the BSC group. This difference is descriptive and cannot be interpreted as a treatment effect due to the baseline imbalances. Within the ATT group, treatment modalities included chemotherapy (n = 54), targeted therapy (n = 11), and combination therapy (n = 28). In the multivariate analysis of the entire cohort, better ECOG PS (0–1 vs. 4: HR = 0.28, P < 0.01), fewer comorbidities (0 vs. ≥3: HR = 0.17, P < 0.001), higher GNRI (≥ 98 vs. <92: HR = 0.55, P = 0.02), and adenocarcinoma histology (vs. non-adenocarcinoma: HR = 0.68, P = 0.04) were independent predictors of longer OS. In this real-world cohort of elderly mNSCLC patients, treatment selection was heavily influenced by baseline health status. Independent prognostic factors for longer survival were better performance status, lower comorbidity burden, better nutritional status (higher GNRI), and adenocarcinoma histology. These findings underscore the importance of comprehensive geriatric and nutritional assessment in this population and highlight the need for prospective trials to guide treatment decisions.

We constructed a risk-stratification model based on lipid-related biomarkers derived from ML models to predict ACS in hospitalized patients, which could assist in identifying patients with high discriminatory capacity.

Study design Network Meta-Analysis. Objective To comprehensively compare the clinical efficacy and safety of anterior controllable antedisplacement and fusion (ACAF), anterior cervical corpectomy and fusion (ACCF), and laminoplasty (LP) for treating multilevel cervical ossification of the posterior longitudinal ligament (OPLL). Methods PubMed, Cochrane Library, Embase, and Web of Science were systematically searched (inception to April 1, 2025) for clinical studies comparing at least two of ACAF, ACCF, or LP for multilevel (≥2 segments) cervical OPLL. Data on surgical parameters, neurological function (Japanese Orthopaedic Association [JOA] score, JOA recovery rate, Visual Analog Scale [VAS]), biomechanics (cervical curvature, Cobb angle, Range of Motion [ROM], Neck Disability Index [NDI]), and complications were extracted. A frequentist network meta-analysis using a multivariate random-effects model was performed. Treatments were ranked using the surface under the cumulative ranking curve (SUCRA). Results Thirty-one non-randomized studies involving 2616 patients were included (ACAF: 585; ACCF: 875; LP: 1156). NMA showed ACAF and ACCF achieved significantly better postoperative JOA scores and recovery rates than LP ( p &lt; 0.05). ACAF showed the highest probability of being the most effective treatment for postoperative VAS score (vs ACCF &amp; LP, p &lt; 0.05) and maintenance of cervical curvature/Cobb angle (vs ACCF &amp; LP, p &lt; 0.05). LP had the shortest operative time ( p &lt; 0.05). Regarding safety, ACAF was associated with the lowest probability of total complications (SUCRA 99.7%), with significantly lower risks of cerebrospinal fluid (CSF) leakage versus ACCF ( p &lt; 0.05), and C5 palsy and axial pain versus LP ( p &lt; 0.05). LP had the lowest risk of dysphagia ( p &lt; 0.05). Subgroup analysis suggested ACAF’s benefits, particularly in neurological outcome, are more pronounced in patients with severe stenosis (occupying ratio ≥60%). Conclusion Based on current observational evidence, ACAF appears to be a promising option for multilevel cervical OPLL, particularly for patients with severe stenosis. ACCF provides effective neurological decompression but carries a higher CSF leak risk than ACAF. LP, while having shorter operative times, results in inferior neurological and biomechanical outcomes compared to anterior approaches. Surgical decisions require individualized assessment based on patient and OPLL characteristics.However, these findings should be interpreted with caution due to the predominance of non-randomized studies and potential selection bias.

IntroductionAlterations in the blood metabolome are closely associated with sepsis, while the gut microbiota (GM) plays a crucial role in modulating both sepsis progression and circulating metabolites. However, whether the effects of the GM on sepsis are mediated through blood metabolites remains unclear.MethodsTo determine whether the effects of the GM on sepsis are mediated through blood metabolites, we performed a two-sample Mendelian randomization (MR) analysis combined with a two-step MR framework to identify potential metabolic mediators. Comprehensive bioinformatics analyses were integrated to construct interaction networks using Cytoscape, and pharmacodynamic experiments were conducted in a murine sepsis model.ResultsWe identified 23 GM taxa and 169 blood metabolites significantly associated with sepsis. Two-step MR analysis revealed that 15 metabolites mediated the causal relationships between 12 GM taxa and sepsis, with mediation proportions ranging from 3.70% to 13.70%. A total of 131 potential molecular targets were predicted for these metabolites, and network analysis highlighted five key metabolites and seven central targets. Molecular docking demonstrated strong binding affinities between these metabolites and their targets. Notably, gulonic acid (GA) and 4-hydroxyphenylacetic acid (4-HPA), driven by Lentisphaerae, Lentisphaeria, and Victivallales, significantly improved survival and attenuated organ injury and inflammation in septic mice.DiscussionCollectively, this study provides evidence supporting a causal role of the GM in sepsis, which mediated in part by blood metabolites. These findings highlight the therapeutic potential of targeting both the GM and GM-driven metabolites as novel interventions for sepsis.

BackgroundAutoimmune liver diseases (AILD) are a heterogeneous group of chronic inflammatory conditions characterized by progressive hepatic fibrosis. While liver stiffness measurement (LSM) has emerged as a valuable non-invasive assessment tool, its clinical utility and associated factors in AILD populations remain incompletely characterized, particularly in understudied ethnic populations.MethodsThis cross-sectional study enrolled 200 participants from January 2023 to January 2024, comprising 79 patients with AILD and 121 healthy controls from two tertiary hospitals in Kashgar region. All participants underwent comprehensive clinical assessment, biochemical evaluation, and LSM using transient elastography. Fibrosis staging in the AILD cohort was performed using a composite clinical algorithm incorporating clinical manifestations of portal hypertension, ultrasonographic features, biochemical indices, and available histopathology (n = 23, 29.1%). Correlation and multivariate regression analyses were used to identify factors independently associated with LSM values.ResultsPatients with AILD demonstrated significantly elevated LSM compared to controls (13.7 vs. 5.6 kPa, P < 0.001) with marked female predominance (83.5% vs. 47.9%, P < 0.001). LSM demonstrated a strong correlation with the clinically defined fibrosis stage, with values progressively increasing from stage S1 (10.2 kPa) to S4 (19.8 kPa). Multivariable analysis identified fibrosis stage (P = 0.003) and direct bilirubin (P = 0.045) as independent predictors of LSM values, whereas albumin demonstrated a strong inverse correlation (ρ=-0.67, P < 0.001). No significant differences in LSM were observed across the AILD subtypes after adjusting for the fibrosis stage (P = 0.36).ConclusionsLSM is strongly associated with clinically defined disease severity in patients with AILD. Integration with clinical parameters, including hepatic synthetic function and cholestatic markers, may enhance its clinical utility. However, validation against histological staging and in diverse populations is required before definitive conclusions regarding diagnostic accuracy can be made.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12876-025-04577-5.

BackgroundHepatocellular carcinoma (HCC) is a aggressive cancer associated with high morbidity and mortality globally. Reliable biomarkers are urgently needed to enhance diagnostic accuracy and survival outcomes in patients with HCC. This study aimed to evaluate the prognostic value of cleavage stimulation factor subunit 1 (CSTF1) in HCC.MethodsCSTF1 expression in different cancer types, including HCC, was analyzed using data from The Cancer Genome Atlas. Immunohistochemistry was performed to assess CSTF1 expression in clinical samples. Logistic regression analyses were used to evaluate associations between CSTF1 expression and the clinical characteristics of patients with HCC. Furthermore, Gene Ontology, Kyoto Encyclopedia of Genes and Genomes, and gene set enrichment analysis (GSEA) were performed to identify signaling pathways and biological functions linked to differentially expressed genes. The prognostic significance of CSTF1 in HCC was assessed via the Kaplan-Meier method and Cox univariate and multivariate analyses. Immune cell infiltration was investigated through single-sample GSEA and the CIBERSORT algorithm. Three nomograms were constructed to predict overall survival (OS), disease-specific survival (DSS), and progression free interval (PFI) rates at 1, 3, and 5 years after diagnosis.ResultsCSTF1 expression was elevated in HCC cases and closely correlated with multiple clinical features. Elevated CSTF1 expression was strongly associated with various cancer-related pathways and the immune microenvironment. The Kaplan-Meier analysis revealed that elevated CSTF1 expression predicts poorer prognostic outcomes in individuals with HCC. CSTF1 hypermethylation was also related to poor patient outcomes. The constructed nomograms for OS, DSS, and PFI achieved concordance indices of 0.631, 0.719 and 0.787, respectively.ConclusionThese findings suggest that CSTF1 can serve as a novel prognostic biomarker for HCC. Evidence from immunohistochemistry and bioinformatics analyses supports CSTF1 as a prognostic indicator and a potential therapeutic target. This discovery could enhance diagnostic precision and improve survival outcomes for patients with HCC.

Alzheimer's disease (AD), the leading cause of dementia, is characterized by amyloid beta accumulation and tau pathology propagation. Nanomedicine, a discipline enabling targeted drug delivery with precision, holds significant promise in the treatment of neurodegenerative diseases. This review explores the diagnostic and therapeutic applications of nanomaterials in neurodegenerative diseases, particularly AD, emphasizing their properties and their role in modulating pathogenic proteins. Advances in the development of novel anti-AD nanomedicines and their clinical progress are also highlighted. Despite the growing potential of nanotechnology in AD therapy, a definitive cure remains elusive. The review further addresses the current challenges in the field of AD nanomedicines and outlines future research directions to propel their development.