Xuzhou Cancer Hospital

​ Altered homeostasis of the ocular surface microenvironment is a hallmark of dry eye disease (DED). The alpha-7 nicotinic acetylcholine receptor (α7nAChR) plays a key role in DED pathophysiology. In this study, we established a rabbit model of DED using scopolamine hydrobromide (Scop) to determine the effect of electroacupuncture (EA) on ocular surface damage in DED and to explore its underlying mechanisms.​ Methods: New Zealand White rabbits (1.5-2.0 kg) were subcutaneously administered Scop for 21 days prior to EA treatment. After 35 days, the homeostasis of the ocular surface microenvironment was evaluated using the Schirmer I test (SIT), tear break-up time (BUT), corneal fluorescein (FL) staining, and measurement of tear osmolarity. The expression levels of ACh, α7nAChR, and high mobility group box 1 (HMGB1) were detected via histopathological examination of the cornea, lacrimal glands, and conjunctiva, combined with immunohistochemistry and western blotting. Additionally, protein chip technology was used to determine the expression levels of downstream factors.​ Results: EA stimulation significantly improved the homeostasis of the ocular surface microenvironment, as evidenced by increased SIT values and BUT, reduced corneal FL intensity, and decreased tear osmolarity. It also alleviated pathological damage to the cornea, conjunctiva, and lacrimal glands; upregulated the expression of ACh and α7nAChR; and downregulated the expression of HMGB1 and related inflammatory factors. However, these changes were reversed following administration of α-Bungarotoxin.​ Conclusion: EA stimulation improves ocular surface homeostasis and reduces inflammation in DED, potentially via activation of the α7nAChR signaling pathway, which in turn inhibits the expression of HMGB1 and inflammatory factors.​.

The neutrophil count-to-high-density lipoprotein cholesterol ratio (NHR), a composite biomarker of lipid metabolism and inflammation, has been regarded as an indicator for predicting clinical outcomes in patients suffering from acute cardiovascular and cerebrovascular disorders. However, the association between the NHR and 28-day all-cause mortality in the sepsis population remains unclear. Our study population comprised 1018 sepsis patients in the Medical Information Mart for Intensive Care IV (MIMIC-IV V2.2) database who were grouped into tertiles based on their NHRs. In this study, curve fitting and 2-piecewise regression models were utilized to analyze the dose-response relationship between the Log NHR and 28-day mortality. The mean age of the participants in the study cohort was 65.0 ± 15.7 years, and 56.3% were men. The 28-day mortality rates for the NHR tertiles were 15% (51), 13.3% (45), and 18.2% (62). By investigating the Log NHR and 28-day mortality, we observed a clear U-shaped relationship. Threshold saturation analysis revealed that when Log NHR below 1.87 (NHR 6.50), with each 1-unit increase in the Log NHR, the risk of 28-day mortality significantly decreased (HR = 0.61, 95% confidence interval: 0.37, 1.01, P = .0526). Conversely, the logNHR for 28-day mortality increased beyond 1.87 (HR = 1.72, 95% confidence interval: 1.18, 2.51; P = .0045). Stratified by age, our analysis revealed nuanced variations in the Log NHR and 28-day mortality association across different age groups. This study revealed a robust U-shaped relationship between the Log NHR and 28-day all-cause mortality in the sepsis population, with a critical threshold of Log NHR = 1.87 (NHR 6.50). This risk is influenced by age.

BackgroundAtherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide. This study aimed to investigate the contributions of acquired risk factors to ASCVD across different genetic risk groups.MethodsThis study included 430,191 participants aged 40 − 69 from the UK Biobank cohort. Population-attributable fractions (PAFs) of 25 acquired risk factors (including four socioeconomic determinants, three psychosocial factors, five lifestyles, nine cardiometabolic factors, and four clinical comorbidities) for coronary artery disease (CAD), ischemic stroke (IS), and peripheral artery disease (PAD) were assessed across three genetic risk groups (low, moderate, and high). The contributions of 25 risk factors to ASCVD were ranked by PAFs within each genetic risk group.ResultsA total of 32,908 CAD events, 6,819 IS events, and 5,560 PAD events occurred during a median follow-up of 13.8 years. The associations between acquired risk factors and ASCVD varied across the three genetic risk groups, with the most significant diversity observed in the associations between cardiometabolic factors and CAD (PInteraction < 0.001). In addition, the associations of psychosocial factors with CAD and IS decreased with increasing genetic risk (both PInteraction =0.018). Cardiometabolic factors were the leading contributors to ASCVD incidence across all genetic risk groups (PAF for CAD: 48.5%−56.5%; IS: 35.5%−45.5%; PAD: 48.1%−52.0%), with hypertension being the predominant factor in all groups. Still, the contributions of certain cardiometabolic factors (e.g., overweight/obesity, high low-density lipoprotein cholesterol, and elevated C-reactive protein) to ASCVD varied by genetic risk. Socioeconomic determinants ranked second in contribution to ASCVD across different genetic risk levels (CAD: 6.0%−11.9%; IS: 4.8%−12.8%; PAD: 23.6%−33.4%), which was primarily driven by less education. Socioeconomic determinants (CAD: 9.0% vs. 6.0%; IS: 12.8% vs. 4.8%; PAD: 33.4% vs. 23.6%) and psychosocial factors (CAD: 3.5% vs. 2.5%; IS: 7.6% vs. 0.0%; PAD: 4.9% vs. 4.8%) contributed more to ASCVD in the low genetic risk groups than in the high genetic risk groups. The PAFs of lifestyles were relatively consistent across different genetic risk groups. Although the associations between clinical comorbidities and ASCVD were the strongest, their contributions to ASCVD were relatively small (CAD: 2.7%%−4.9%; IS: 1.7%−4.9%; PAD: 9.3%−10.4%).ConclusionsThis study provides comprehensive information regarding the genetic risk-specific contributions of acquired risk factors to ASCVD. Prioritizing risk factors based on genetic predisposition may help to promote precise and efficient prevention of ASCVD.Graphical abstractSupplementary InformationThe online version contains supplementary material available at 10.1186/s12872-025-05312-4.

AimTo explore latent categories of complication risk perception in young and middle-aged patients with T2DM, and to examine their relationship with self-management behavior.MethodsA cross-sectional study was conducted between September 2024 and March 2025, involving 316 young and middle-aged patients with type 2 diabetes mellitus from the endocrinology department of a tertiary hospital in Jiangsu Province, China. Data were collected via a general information questionnaire, the Diabetes Risk Perception Scale, and the Diabetes Self-Management Behavior Scale. Latent profile analysis identified distinct complication risk perception groups, while logistic regression was performed to identify factors influencing different categories. Self-management Behavior scores were compared across subgroups.ResultsComplication risk perception in young and middle-aged patients with T2DM was divided into three latent categories: the Low Risk Perception-Optimism Bias Group (43.7%, n=138), the Overall Medium Risk Perception Group (42.1%, n=133), and the High Risk Perception-Worry Group (14.2%, n=45). Logistic regression indicated that education level, employment status, disease duration, complications, and the occurrence of hypoglycemia within a week were all significantly associated with the risk perception categories (p < 0.05). Significant differences in self-management behavior scores were observed among the different risk perception categories (p < 0.05). Specifically, patients in the High Risk Perception-Worry Group attained the highest total score (M = 2.54, SD = 0.56), while those in the Low Risk Perception-Optimism Bias Group scored the lowest (M = 2.02, SD = 1.12).ConclusionThree latent categories of complication risk perception were identified in young and middle-aged patients with T2DM, and their self-management behaviors differed significantly across these categories. Clinicians should provide targeted interventions based on the risk characteristics of each category to improve self-management behaviors.

BackgroundRisk-adapted colorectal cancer (CRC) screening has the potential to balance effectiveness with resource demands, yet evidence comparing it with established methods remains limited. This study aims to compare outcomes of risk-adapted CRC screening with colonoscopy and fecal immunochemical test (FIT) strategies.MethodsWe adopted a hybrid methodology combining real-world data from a population-based CRC screening randomized controlled trial (TARGET-C) with projections from a validated Markov-based microsimulation model (MIMIC-CRC). The TARGET-C trial enrolled 19,582 participants aged 50–74 years from 6 centers in China, randomized in a 1:2:2 ratio into 3 groups. After applying the exclusion criteria, the final analysis included 3883 participants in the one-time colonoscopy group, 7793 in the annual FIT group, and 7697 in the risk-adapted screening group. In the latter group, screening allocation was determined by a composite risk score incorporating age, sex, family history of CRC, smoking status, and body mass index, with high-risk participants referred for colonoscopy and low-risk participants for FIT. The primary outcome was detection rates of advanced neoplasm (CRC and advanced adenoma) over 4 rounds. Secondary outcomes included screening participation, colonoscopy demand, and costs from a societal perspective. Long-term effectiveness and cost-effectiveness were modeled over 15 years using MIMIC-CRC.ResultsAcross 4 rounds, overall participation rates (attending at least one screening round) were 42.3% (colonoscopy), 99.8% (FIT), and 92.5% (risk-adapted). Detection rates of advanced neoplasms were 2.8%, 2.3%, and 2.6%, respectively, with no significant differences (P > 0.05). Colonoscopies needed to detect 1 advanced neoplasm were 15.4, 7.9, and 9.3, respectively. From a societal perspective, the cost for detecting 1 advanced neoplasm was 15,341, 21,754, and 24,300 Chinese Yuan, respectively. Over 15 years, risk-adapted screening reduced incidence by 16.7% and mortality by 21.5% compared with no screening, slightly less effective than colonoscopy (24.6% and 24.8%, respectively). Under observed real-world adherence, colonoscopy was the most cost-effective; under perfect full adherence, risk-adapted screening was the most cost-effective.ConclusionsIn this population-based CRC screening trial, risk-adapted screening, colonoscopy, and FIT demonstrated comparable effectiveness, but differed in participation rates, resource utilization, and cost-effectiveness. Risk-adapted screening could serve as a complementary approach to established strategies, particularly when health resources are limited.Trial registrationChinese Clinical Trial Registry (ChiCTR1800015506).Supplementary InformationThe online version contains supplementary material available at 10.1186/s40779-025-00671-7.