Wuqing District People's Hospital

BackgroundThis study aimed to explore the knowledge, attitude, and practice (KAP) of oral nutritional supplementation in patients undergoing radiotherapy for head-and-neck cancer.Materials and methodsA multicenter cross-sectional study was conducted from December 2023 to July 2024 across five medical institutes. Demographic data and KAP scores were collected and assessed using a self-developed validated questionnaire. A threshold of ≥70.0% of the maximal scores was established to define good knowledge, a positive attitude, and active practice.ResultsA total of 437 valid questionnaires were analyzed; the majority of participants were men (70.71%) and aged between 41 and 60 years (50.11%). The median knowledge score was 4 (range: 0–10; possible range: 0–20), the median attitude score was 34 (range: 30–39; possible range: 10–50), and the median practice score was 15 (range: 13–17; possible range: 4–20). The knowledge score exhibited a positive correlation between both attitude (r = 0.379, p < 0.001) and practice (r = 0.395, p < 0.001) scores; attitude and practice scores were also positively correlated (r = 0.363, p < 0.001). Structural equation modeling showed that knowledge had a direct positive effect on attitude (β = 0.613, p < 0.001) and practice (β = 0.807, p < 0.001), while attitude had a direct effect on practice (β = 0.614, p < 0.001).ConclusionThe findings indicate that patients with head-and-neck cancer undergoing radiotherapy exhibit poor knowledge and unfavorable attitudes toward oral nutritional supplements, despite displaying proactive practices. Considering the positive correlation among KAP, the provision of personalized medical education is essential for effective disease management.

This review provides a comprehensive analysis of the potential of functional food active ingredients in cancer prevention and therapy. It outlines the multifaceted anticancer mechanisms of bioactive compounds—such as polyphenols, carotenoids, omega-3 fatty acids, phytosterols, alkaloids, isothiocyanates, polysaccharides, phenolic acids, flavonols, and amide-bearing compounds—which include antioxidant and anti-inflammatory activities, induction of apoptosis and autophagy, modulation of the tumor microenvironment, interference with cell cycle regulation and signaling pathways, and regulation of cancer-related microRNA expression. The review further discusses the synergistic effects of these compounds when combined with conventional treatments like radiotherapy and chemotherapy, highlighting their role in enhancing efficacy and mitigating side effects. Despite promising preclinical data, challenges such as poor bioavailability, dose-dependent safety concerns, and the need for large-scale randomized clinical trials and regulatory standardization remain. Proposed future directions include advanced nanodelivery systems, eutectic technologies, and precision nutrition strategies, which together could accelerate the translation of these natural compounds from the laboratory to clinical application. Ultimately, the integration of functional food active ingredients into comprehensive cancer care may offer novel, safer, and more personalized approaches to oncologic treatment and prevention.

The clearance of digoxin in obese patients with renal impairment is reduced, leading to elevated serum concentrations and increased risks of digoxin toxicity. However, the exact mechanism of such alterations in obese patients remains unclear. Previous studies have suggested that the organic anion transporting polypeptide 4c1 (Oatp4c1, Slco4c1) mediates the elimination of digoxin at the basal membrane of the proximal tubule (PT), indicating its potential role in the pharmacokinetic changes in obese patients. This study aims to investigate the effects of a high-fat diet HFD on digoxin pharmacokinetics and transporter expression in mouse models and further analyze its significance by detecting the expression of transporters in human renal tissue samples. First, HFD-induced obese mouse model was established. Mice were intraperitoneally injected with digoxin, and 24-hour urine samples and blood samples at five time points were collected. Pharmacokinetic evaluation was performed using liquid chromatography-tandem mass spectrometry. Renal pathological changes and the expression of digoxin transporters (Oatp4c1 and P-glycoprotein (P-gp)) were assessed using histological staining, Western blots (WB), as well as quantitative polymerase chain reaction (qPCR). Human renal pathologic alterations and expression of transporter proteins showed consistency with the results of animal experiments. To explore the potential use of gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA) as a marker for Oatp4c1 function, drug interactions between digoxin and Gd-EOBDTPA were assessed in mice. HFD-induced obese mice showed significant increases in body weight, blood glucose, and triglyceride, along with elevated blood concentration of digoxin, increased areas under the curve, reduced renal clearance rate (CLr), and prolonged half-life (t1/2). Histological staining revealed proximal tubular epithelial cell detachment and slight fibrosis in the kidney of the HFD group, with decreased expression of villin, the protein marker for PT. Immunofluorescent staining and Western blots for digoxin transporters showed a significant reduction of Oatp4c1 and P-gp proteins, suggesting that the renal elimination of digoxin was affected by the reduced level of Oatp4c1 and P-gp proteins. Co-administration of digoxin and Gd-EOB-DTPA resulted in a reduced clearance of Gd-EOB-DTPA, suggesting that both share the same transporter. The blood concentration of Gd-EOB-DTPA was higher (77.5%) in the HFD group. Renal magnetic resonance imaging (MRI) intensity was lower in the HFD group after Gd-EOB-DTPA administration compared to the Chow group. Obesity-induced kidney damage results in decreased Oatp4c1 and P-gp expression and function in PT, resulting in a reduction of digoxin renal clearance. The inhibition of Gd-EOB-DTPA clearance by digoxin co-administration and the increased Gd-EOB-DTPA blood concentration in the HFD group both suggest its potential use in characterizing the Oatp4c1 function in vivo.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown a reduction in major adverse cardiovascular events (MACE) among patients with type 2 diabetes mellitus (T2DM). However, its efficacy on cerebrovascular events is yet to be well established among diabetic and non diabetic patients. We sought to evaluate the efficacy of GLP-1 RAs on stroke risk among its different types in patients with and without Diabetes. We performed a systematic literature search on PubMed, EMBASE, and ClinicalTrials.gov for relevant randomized controlled trials (RCTs) from inspection until 15th July 2024, without any language restrictions. Odds ratios (OR) and 95% confidence intervals (CI) were pooled using a random-effect model, and a p-value of<0.05 was considered statistically significant. A total of 11 RCTs with 85,373 patients were included (43,339 in GLP-1 RA and 42,034 in the placebo group) in the analysis. The mean age of the patients in GLP-1 RAs and the placebo groups was 63.5 and 63.1years, respectively. Pooled analysis of primary and secondary endpoints showed that GLP-1 RAs significantly reduced the risk of incidence of stroke by 15% (OR, 0.85(95%CI: 0.77-0.93), P<0.001) and nonfatal stroke by 13% (OR, 0.87(95%CI: 0.79-0.95), P<0.001) compared with placebo. However, the risk of fatal stroke (OR, 0.94(95%CI: 0.75-1.17), P=0.56) was comparable between both groups of patients. Similarly, the risk of serious adverse events such as cerebrovascular accident (OR, 0.75(95%CI: 0.57-1.00), P=0.05), hemorrhagic stroke (OR, 0.82(95%CI: 0.42-1.60), P=0.57, and ischemic stroke (OR, 0.85(95%CI: 0.64-1.13), P=0.26) was comparable between GLP-1RAs and placebo. Treatment with GLP-1 receptor agonists has beneficial effects in reducing the risk of stroke, and nonfatal stroke in patients with and without diabetes. However, no such effect was observed for fatal stroke.

Incorporating ultralow loading of nanoparticles into polymers has realized increases in dielectric constant and breakdown strength for excellent energy storage. However, there are still a series of tough issues to be dealt with, such as organic solvent uses, which face enormous challenges in scalable preparation. Here, a new strategy of dual in situ synthesis is proposed, namely polymerization of polyethylene terephthalate (PET) synchronizes with growth of calcium borate nanoparticles, making polyester nanocomposites from monomers directly. Importantly, this route is free of organic solvents and surface modification of nanoparticles, which is readily accessible to scalable synthesis of polyester nanocomposites. Meanwhile, uniform dispersion of as ultralow as 0.1 wt% nanoparticles and intense bonding at interfaces have been observed. Furthermore, the PET-based nanocomposite displays obvious increases in both dielectric constant and breakdown strength as compared to the neat PET. Its maximum discharged energy density reaches 15 J cm-3 at 690 MV m-1 and power density attains 218 MW cm-3 under 150 Ω resistance at 300 MV m-1, which is far superior to the current dielectric polymers that can be produced at large scales. This work presents a scalable, safe, low-cost, and environment-friendly route toward polymer nanocomposites with superior capacitive performance.

Recent studies have shown that cellular levels of polyamines (PAs) are significantly altered in neurodegenerative diseases. Evidence from in vivo animal and in vitro cell experiments suggests that the cellular levels of various PAs may play important roles in the central nervous system through the regulation of oxidative stress, mitochondrial metabolism, cellular immunity, and ion channel functions. Dysfunction of PA metabolism related enzymes also contributes to neuronal injury and cognitive impairment in many neurodegenerative diseases. Therefore, in the current work, evidence was collected to determine the possible associations between cellular levels of PAs, and related enzymes and the development of several neurodegenerative diseases, which could provide a new idea for the treatment of neurodegenerative diseases in the future.

This study aims to explore how flexible inventory management affects financial performance from the perspective of quick adjustments of inventory deviations, in which firm growth and firm size are moderators. Using the empirical data collected from 1953 listed manufacturing enterprises in China from 2005 to 2021, this research employs the moderation model combined with the three-way interaction analysis to test hypotheses. The results reveal that the relationship between inventory flexibility and financial performance is positive, while firm growth weakens this relationship. Furthermore, firm size reduces the negative moderating effect of firm growth on the relationship between inventory flexibility and financial performance. This paper contributes to a better understanding of the role of quick adjustments in flexible inventory management. From a developing country perspective, this study identifies the important relationships between inventory flexibility, firm growth, firm size and financial performance. The findings will be of interest to both emerging and other developing countries.

A bibliometric analysis was conducted using VOSviewer and CiteSpace to examine studies published between 2009 and 2023 on the utilization of artificial intelligence (AI) in chronic obstructive pulmonary disease (COPD). On March 24, 2024, a computer search was conducted on the Web of Science (WOS) core collection dataset published between January 1, 2009, and December 30, 2023, to identify literature related to the application of artificial intelligence in chronic obstructive pulmonary disease (COPD). VOSviewer was utilized for visual analysis of countries, institutions, authors, co-cited authors, and keywords. CiteSpace was employed to analyze the intermediary centrality of institutions, references, keyword outbreaks, and co-cited literature. Relevant descriptive analysis tables were created using Excel2021 software. This study included a total of 646 papers from WOS. The number of papers remained small and stable from 2009 to 2017 but started increasing significantly annually since 2018. The United States had the highest number of publications among countries/regions while Silverman Edwin K and Harvard Medical School were the most prolific authors and institutions respectively. Lynch DA, Kirby M. and Vestbo J. were among the top three most cited authors overall. Scientific Reports had the largest number of publications while Radiology ranked as one of the top ten influential journals. The Genetic Epidemiology of COPD (COPDGene) Study Design was frequently cited. Through keyword clustering analysis, all keywords were categorized into four groups: epidemiological study of COPD; AI-assisted imaging diagnosis; AI-assisted diagnosis; and AI-assisted treatment and prognosis prediction in the COPD research field. Currently, hot research topics include explainable artificial intelligence framework, chest CT imaging, and lung radiomics. At present, AI is predominantly employed in genetic biology, early diagnosis, risk staging, efficacy evaluation, and prediction modeling of COPD. This study's results offer novel insights and directions for future research endeavors related to COPD.