The National Health and Nutrition Examination Survey (NHANES) in the United States is a research program designed to assess the health and nutritional status of adults and children in the country. Due to its adoption of a complex sampling design, it is imperative to correctly apply the weights provided by NHANES to ensure the accuracy and external validity of research results. This article first introduces the relevant concepts of the NHANES database and its weights, followed by a practical demonstration of weight selection, calculation, and implementation in the R programming language. It further discusses the significance of using weights in NHANES data and systematically showcases how to perform weighted analysis based on R, providing a valuable reference for relevant researchers.
ObjectiveTo investigate the effect of curcumin on the expression regulation of endogenousβ-glucoronidase (β-GD) induced by lipopolysaccharide (LPS).Methods① Human normal intrahepatic biliary epithelial cell line (HiBEpiC) cells in the logarithmic growth phase were divided into blank control group (0 h group) and 7 different stimulation time groups. The cell density was adjusted to 1×104/mL, and the cells were stimulated with 100 mg/mL LPS for 1, 3, 6, 18, and 24 hours respectively, including another two groups where the cells were cultured with LPS-free medium for 18 and 24 hours after LPS stimulation for 24 h. ② HiBEpiC cells in the logarithmic growth phase were divided into blank control group, LPS+low, medium, and high concentration curcumin group. The cell density was adjusted to 1×104/mL. In the blank control group, cells were not stimulated with any reagent; in the LPS group, cells were stimulated with 100 mg/mL LPS, in the other three groups, the cells were stimulated with 100 mg/mL LPS and simultaneously 20, 40, and 80 μmol/L curcumin, respectively, for 24 hours. The expressions of c-myc and endogenous β-GD were detected by Western blot method.Results① The expressions of endogenous β-GD and c-myc in HiBEpiC cells gradually increased with the prolongation of treatment time by LPS, and the expression levels of β-GD and c-myc at each time point group were significantly different from those in the 0 h group (P<0.05). ② There were significant difference between any two groups of the blank control group, LPS group, LPS+low concentration of curcumin group, LPS+medium concentration of curcumin group, and LPS+high concentration of curcumin group (P<0.05).ConclusionCurcumin is able to inhibit the increased expression of endogenous β-GD induced by LPS, possibly via inhibiting expression of c-myc.
ObjectiveTo evaluate the predictive value of critical illness scores for hospital mortality of severe respiratory diseases in respiratory intensive care unit (ICU).MethodsThe clinical data of the patients who needed intensive care and primary diagnosed with respiratory diseases from June, 2001 to Octomber, 2012 were extracted from MIMIC-Ⅲ database. The Acute Physiology Score (APS) Ⅲ, Simplified Acute Physiology Score (SAPS) Ⅱ, Oxford Acute Severity of Illness Score (OASIS), Logistic Organ Dysfunction System (LODS), Systemic Inflammatory Response Syndrome (SIRS) and Sequential Organ Failure Assessment (SOFA) were calculated according to the requirements of each scoring system. ICU mortality was set up as primary outcome and receiver operating characteristic (ROC) analysis was performed to evaluate the predictive performances by comparing the areas under ROC curve (AUC). According to whether they received invasive mechanical ventilation during ICU, the patients were divided into two groups (group A: without invasive mechanical ventilation group; group B: with invasive mechanical ventilation group). The AUCs of six scoring systems were calculated for groups A and B, and the ROC curves were compared independently.ResultsA total of 2988 patients were recruited, male accounted for 49.4%, median age was 67 (55, 79), and ICU mortality was 13.2%. The AUCs of SAPSⅡ, LODS, APSⅢ, OASIS, SOFA and SIRS were 0.73 (0.70, 0.75), 0.71 (0.68, 0.73), 0.69 (0.67, 0.72), 0.69 (0.67, 0.72), 0.67 (0.64, 0.70) and 0.58 (0.56, 0.62). Subgroup analysis showed that in group A, the AUCs of OASIS, SAPSⅡ, LODS, APSⅢ, SOFA and SIRS were 0.81 (0.76, 0.85), 0.80 (0.75, 0.85), 0.77 (0.72, 0.83), 0.75 (0.70, 0.80), 0.73 (0.68, 0.78) and 0.63 (0.56, 0.69) in the prediction of ICU mortality; in group B, the AUCs of SAPSⅡ, APSⅢ, LODS, SOFA, OASIS and SIRS were 0.68 (0.64, 0.71), 0.67 (0.63, 0.70), 0.65 (0.62, 0.69), 0.62 (0.59, 0.66), 0.62 (0.58, 0.65) and 0.57 (0.54, 0.61) in the prediction of ICU mortality. The results of independent ROC curve showed that the AUC differences between groups A and B were statistically significant in terms of OASIS, SAPSⅡ, LODS, APSⅢ and SOFA, but there were no significant differences in SIRS.ConclusionsThe predictive values of six critical illness scores for ICU mortality in respiratory intensive care are low. Lack of ability to predict ICU mortality of patients with invasive mechanical ventilation should hold primary responsibility.
ObjectiveTo compare the disease burden of cancers and the effectiveness of prevention and control strategies among elderly populations (aged ≥65 years) between China and the United States (US). MethodsUsing data from the GLOBOCAN 2022 database, we extracted age-standardized incidence rates (ASIR), age-standardized mortality rates (ASMR), and mortality-to-incidence ratio (M/I) for major cancer types in both countries. Joinpoint regression analysis was used to examine the temporal trends in incidence rates of the US (from 2000 to 2017) and China (from 2002 to 2017). ResultsAmong Chinese elderly populations, the overall ASIR was 1109.4 per 100000, lower than that in the US of 1754.4 per 100000. However, the ASMR in China was 779.0 per 100000, higher than that in the US of 664.4 per 100000. The M/I were 0.70 for China and 0.38 for the US. Cancer incidence rates among the elderly in both China and the United States were showing an overall downward trend. By cancer type, China faced a relatively heavy burden from lung cancer, colorectal cancer, stomach cancer, and liver cancer. In contrast, the US demonstrated high incidence but low mortality for prostate and breast cancers, reflecting advantages in its screening and treatment systems. ConclusionThe differences in the disease burden of cancers among the elderly populations between China and the US reflect a combination of factors, including the two countries’ stages of economic development, the progression of cancer spectrum shifts, and differences in the prevalence of major risk factors. It is recommended that China prioritize lung cancer, colorectal cancer, stomach cancer, and liver cancer, strengthen targeted screening and primary-care management, and establish a full-cycle system encompassing "prevention, screening, diagnosis, treatment, and rehabilitation" to narrow the gap in prevention and control effectiveness between China and the US.
ObjectiveTo introduce a new type thoracic vest designed according to the incision characteristics of female patients undergoing totally thoracoscopic cardiac surgery.MethodsSixty-one female patients undergoing totally thoracoscopic cardiac surgery from February 2019 to May 2020 in our department were enrolled. All female patients had hypermastia and (or) mastoptosis which covered the incision. They were randomly divided into a research group (group A, n=32) and a control group (group B, n=29). The group A used the new type thoracic vest, while the group B used the traditional single shoulder belt. The degree of satisfaction, visual analogue scale (VAS) score 24 hours after the thoracic drainage tube removed, the average time-consuming of dressing change, dressing frequency and the incision infection rate were compared between two groups.ResultsThe degree of satisfaction in the group A was higher than that of the group B (P<0.001). The VAS scores of pain, average time-consuming of dressing change and dressing frequency in the group A were less or lower than those of the group B (P<0.001). There was no statistical difference in the incision infection rate between the two groups (P=0.214), but incision infection rate of the group A was lower than that of the group B.ConclusionThe new type thoracic vest seems to be more beneficial for patients than traditional single shoulder belt. It is easy to use, increases the psychological satisfaction of patients, reduces the pain and the incision infection and improves work efficiency, which is worthy of clinical application.