Objective To investigate the metabolic features of obesity-driven endometrial cancer (EC). Methods A retrospective nested case-control study was conducted using clinical data retrieved from the hospital electronic medical record system for 315 patients diagnosed with EC between March 2020 and November 2024. Patients were stratified into an obesity-driven EC group (BMI≥28 kg/m², n=102) and a non-obesity EC group (BMI<28 kg/m², n=213) based on body mass index (BMI). Blood samples collected at the time of EC diagnosis were obtained from the hospital-standardized biobank and were assayed for metabolic indicators. Univariate and multivariate logistic regression analyses were performed to assess the impact of metabolic indicators on obesity-driven EC. Receiver operating characteristic (ROC) curves were generated to assess the discriminatory performance of these biomarkers. Results Among 315 EC patients, 102 (32.38%) were classified as obesity-driven EC. Compared to the non-obese EC group, the obesity-driven EC group showed significantly higher proportions of FIGO stage III-IV disease, type I histology, low-grade tumors , BMI, serum leptin, RETN, and triglycerides (TG) levels, together with lower adiponectin (ADPN) levels (all P<0.01). Multivariate logistic regression identified elevated BMI (OR=16.094), increased serum leptin (OR=1.370), decreased ADPN (OR=0.495), and elevated RETN (OR=1.285) as independent predictors of obesity-driven EC (all P<0.01). ROC analysis demonstrated that serum leptin, ADPN, and RETN exhibited areas under the curve (AUC) of 0.847, 0.822, and 0.812, respectively, indicating good discriminatory capacity. Conclusions The metabolic signature of obesity-driven EC is characterized by an imbalance in adipocyte-derived cytokines, specifically elevated serum leptin and RETN concomitant with reduced ADPN. Measurement of these biomarkers may aid in the identification of obesity-driven EC.

Objective To analyze the potential fatigue categories of patients with chronic heart failure (CHF), and explore their correlation with clinical indicators and prognosis, laying a theoretical foundation for the development of stratified management strategies. Methods This study enrolled 110 patients diagnosed with CHF at Taihe Hospital between January 2021 and October 2023. Latent Profile Analysis (LPA), a person-centered statistical approach, was employed to identify distinct latent classes of fatigue among the patient cohort. Comparative analyses of clinical data and prognostic outcomes were conducted across these fatigue classes, and multinomial logistic regression was utilized to ascertain the determinants of fatigue heterogeneity. Results The LPA results indicated that a three-class model (low, moderate, and high fatigue groups) provided the optimal fit, as demonstrated by the lowest values for the akaike information criterion (AIC; 6 977.902), bayesian information criterion (BIC; 7 058.563), and sample-adjusted BIC (aBIC; 6 988.798). The model exhibited high classification reliability, with an entropy value of 0.831, average posterior probabilities on the main diagonal exceeding 90%, and cross-classification probabilities of ≤7.5%. The cohort was classified into a low-fatigue group (n=27, 24.55%; mean total score=42.39±6.83), a moderate-fatigue group (n=49, 44.55%; mean total score=61.67±6.93), and a high-fatigue group (n=34, 30.91%; mean total score=77.91±6.56). Multinomial logistic regression analysis revealed that the insomnia severity index (ISI; OR=2.845) and the generalized anxiety disorder-7 (GAD-7; OR=1.892) were significant correlates of the high-fatigue profile. Furthermore, ejection fraction (OR=0.650、0.505) and the multidimensional scale of perceived social support (MSPSS; OR=0.785、0.209) were identified as significant factors associated with both the moderate- and high-fatigue profiles (all P<0.05). Over a one-year follow-up period, prognostic outcomes exhibited a significant gradient across the groups. The low-fatigue group demonstrated the lowest rates of all-cause mortality (3.70%), rehospitalization for heart failure (14.81%), and composite endpoint events (death or rehospitalization, 18.52%). These rates were intermediate in the moderate-fatigue group (10.20%, 24.49%, and 30.61%, respectively) and were substantially elevated in the high-fatigue group (26.47%, 50.00%, and 61.76%, respectively). The differences between the groups were statistically significant (all P<0.01). Conclusions The heterogeneity of fatigue in patients with CHF can be distinctly classified into three characteristic subgroups: low, moderate, and high. Psychological symptoms, such as insomnia and anxiety, alongside diminished levels of social support, are significantly correlated with a higher degree of fatigue. Moreover, the high-fatigue group is associated with the poorest prognosis. Individualized management should be implemented based on fatigue stratification to improve clinical outcomes.

Objective To investigate the incidence and influencing factors of extrauterine growth restriction (EUGR) among late preterm infants classified as appropriate for gestational age (AGA). Methods A total of 236 late preterm AGA infants admitted to Hefei Maternal and Child Health Hospital and the Second Affiliated Hospital of Anhui Medical University from June 2022 to June 2024 were enrolled using a random number table selection method. Descriptive analysis was performed to assess the incidence of EUGR. Univariate and multivariate logistic regression analyses were conducted to examine the associations between baseline characteristics and the occurrence of EUGR. Results Of the 236 neonates evaluated, 58 cases exhibited EUGR, yielding an incidence rate of 24.58%. Compared with the non-EUGR group, the EUGR group demonstrated a significantly higher prevalence of gestational complications, male sex, very low birth weight (VLBW), low birth weight (LBW), neonatal complications, and feeding intolerance, as well as a prolonged time to achieve full enteral feeding (all P<0.01). Multivariate logistic regression analysis revealed that gestational complications (OR=5.005, P<0.05), male sex (OR=5.427, P<0.05), VLBW at birth (OR=185.089, P<0.05), LBW at birth (OR=4.120, P<0.05), duration to full enteral feeding (OR=1.315, P<0.05), neonatal complications (OR=2.598, P<0.05), and feeding intolerance (OR=4.805, P<0.05) were independent risk factors for EUGR. Conclusions This study demonstrates a relatively high incidence of EUGR among late preterm AGA infants. Factors including gestational complications, sex, birth weight, time to achieve full enteral feeding, neonatal complications, and feeding intolerance are closely associated with the development of EUGR. These findings underscore the necessity for enhanced monitoring and targeted interventions for high-risk populations in order to optimize extrauterine growth and developmental outcomes in this vulnerable cohort.

Objective To analyze the epidemiological characteristics of comorbidities in chronic obstructive pulmonary disease (COPD) and to investigate their association with exercise tolerance and symptom burden. Methods This study included patients diagnosed with COPD at the Xinhua Hospital of the Huainan Xinhua Medical Group between January 2022 and December 2024. A self-administered questionnaire was used to collect data on patient demographics, lifestyle, and behavioral habits. Comorbidities were defined according to the International Classification of Diseases, Tenth Revision (ICD-10). Exercise tolerance was assessed using the 6-Minute Walk Test (6MWT), and symptom burden was evaluated with the COPD Assessment Test (CAT) and the modified Medical Research Council (mMRC) dyspnea scale. A point-biserial correlation analysis was performed to determine the relationship between comorbidities and measures of exercise tolerance and symptom burden. Results Of the 506 COPD patients included, 415 (82.02%) presented with at least one comorbidity. The prevalence of comorbidities was significantly higher in males (88.82%) compared to females (71.78%) (P<0.01). The three most prevalent comorbidities were hypertension (n=289, 57.11%), ischemic heart disease (n=165, 32.61%), and bronchiectasis (n=117, 23.12%). The comorbid group had a mean age of 61.25±7.73 years, a longer disease duration, and included 40 patients (9.64%) classified as GOLD stage 4. In the comorbid group, 240 patients (57.83%) had a 6MWT distance of less than 150 meters, 203 patients (48.92%) had a CAT score between 21 and 30, and 212 patients (51.08%) were at mMRC grade 3. In contrast, within the non-comorbid group, 84 patients (92.31%) achieved a 6MWT distance between 150 and 450 meters, 43 patients (47.25%) had CAT scores in the 21-30 range, and 35 patients (38.46%) were at mMRC grade 2. The 6MWT was negatively correlated with the presence of comorbidities (r=-0.327, P<0.01), while CAT and mMRC scores were positively correlated with comorbidities (r=0.210 and r=0.223, respectively; both P<0.01). Conclusions Comorbidity is highly prevalent among patients with COPD and exhibits a gender-based disparity. The presence of comorbidities adversely affects patients' exercise tolerance and increases their symptom burden. These findings underscore the necessity for chronic disease management strategies to prioritize the management of comorbidities to improve patient quality of life.

Objective To analyze the relationship between different obesity indices and elevated blood pressure (BP) among 12-17-year-old students in Huai'an, Jiangsu Province, and to evaluate the predictive value of different obesity indicators for elevated BP. Methods Utilizing data from the 2022 Jiangsu Provincial Student Common Diseases and Health Risk Factors Surveillance Program, a stratified cluster random sampling method was employed to measure height, weight, waist circumference (WC), and BP in adolescents aged 12-17 in Huai'an. Binary logistic regression was used to analyze the associations between body mass index (BMI), WC, waist-to-height ratio (WHtR), and elevated BP. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive performance of individual and combined obesity indices. Results Among 5 681 adolescents, 995 (17.51%) exhibited elevated BP. Analysis of covariance revealed that obese, high-WC, and abdominal obesity groups had significantly higher systolic and diastolic BP levels (all P<0.05). The prevalence of elevated BP was also significantly higher in these groups (all P<0.01). Binary logistic regression demonstrated positive associations between BMI, WC, WHtR, and elevated BP risk (all P<0.01). ROC analysis showed that BMI, WC, and WHtR all had area under the curve (AUC) values >0.67 (all P<0.001). BMI emerged as the strongest single predictor (AUC: 0.727 in males, 0.684 in females, 0.709 overall; all P<0.05). No statistically significant improvement in AUC was observed when combining BMI with WC, WHtR, or both (all P>0.05). Conclusions Among adolescents in Huai'an, BMI, WC, and WHtR were positively associated with elevated BP. BMI demonstrated superior predictive performance as a single indicator, with no additional benefit from combining it with WC or WHtR. These findings suggest that BMI alone may suffice for BP risk stratification in this population.

Objective To analyze the cognitive attitudes regarding preventive treatment among latent tuberculosis infection patients in the Xinjiang Uygur Autonomous Region (Xinjiang), with the aim of providing a scientific basis for further promotion of preventive treatment in the region. Methods Individuals with LTBI were selected from close contacts of patients with active tuberculosis residing in high and medium-low burden areas of Xinjiang. A structured questionnaire survey was administered. Univariate and multivariate analyses were conducted to identify factors influencing the willingness of LTBI patients to accept preventive therapy. Results A total of 655 LTBI patients were enrolled in this study, with a male-to-female ratio of 1∶1.20 and a mean age of (50.59 ± 18.30) years. Of the participants, 76.03% (n=498) demonstrated good knowledge of key tuberculosis control information, including LTBI-related knowledge. Significant variations in knowledge levels were observed across different occupational groups, educational backgrounds, geographical origins, participation in health education activities, and willingness to accept preventive therapy (all P<0.05). Among those with better knowledge, 80.52% (n=401) expressed willingness to receive preventive therapy. Univariate analysis indicated that gender, age group, educational attainment, annual household income, place of origin, and participation in relevant health education activities were all significantly associated with willingness to accept preventive therapy (all P<0.05). Multivariate logistic regression analysis revealed that individuals who didn't have participate in relevant health education activities (OR=0.457), aged ≥65 years (OR=0.302), with a junior college degree or above (OR=0.120), and with annual household income greater than 60, 000 yuan (OR=0.368) were less likely to accept preventive therapy. The main concerns among those with good knowledge regarding preventive therapy were: fear of being mistakenly perceived as having active tuberculosis (42.17%), concerns about potential adverse effects during preventive therapy (34.34%), and worries about disruptions to normal life, social interactions, and work (28.31%). Conclusions The overall level of knowledge regarding LTBI and its prevention is relatively low among individuals in Xinjiang;however, acceptance of preventive treatment is significantly higher among those with greater knowledge. Therefore, enhancing the dissemination and popularization of tuberculosis prevention and control knowledge among individuals with LTBI is likely to facilitate greater acceptance of preventive therapy in this population.

Objective This study aimed to investigate the current dietary patterns of hypertensive patients and explore the impact of these patterns on blood pressure control, thereby providing evidence for developing appropriate nutritional management strategies for hypertensive patients. Methods A multi-stage, stratified random sampling method was employed between January 2020 and January 2025 to recruit hypertensive patients through hospitals. The dietary patterns of the participants were assessed using the Dietary Approaches to Stop Hypertension (DASH) score and a Food Frequency Questionnaire (FFQ). Blood pressure control status was evaluated, and data on general demographic characteristics, blood glucose, and lipid levels were collected. A multivariate logistic regression model was utilized to analyze the association between dietary patterns and blood pressure control. Results A total of 798 hypertensive patients were initially recruited, with 21 (2.63%) excluded due to incomplete questionnaires, resulting in 777 patients for final analysis. The DASH score ranged from 14 to 46, with a mean of 29.11 ± 4.49. Adherence to specific dietary recommendations was as follows: 213 (27.41%) consumed ≥500 g/d of fruits and vegetables; 187 (24.07%) consumed <5 g/d of sodium; 371 (47.75%) consumed ≥300 g/d of fish; 473 (60.88%) consumed 40-75 g/d of meat; 235 (30.24%) consumed ≥25 g/d of legumes and nuts; 304 (39.12%) consumed ≤20 g/d of cooking oil; and 483 (62.16%) consumed 250-400 g/d of grains and tubers. Among the 777 patients, 186 (23.94%) had well-controlled blood pressure, whereas 591 (76.06%) exhibited poor control. Multivariate logistic regression analysis identified several independent factors influencing blood pressure control (all P<0.05): age (45 to <65 years: OR=3.647; ≥65 years: OR=3.691), residential area (rural: OR=2.680), BMI (>24.0 kg/m²: OR=2.607), alcohol consumption (≤15 g/d: OR=1.825; >15 g/d: OR=3.330), fruit and vegetable intake (<500 g/d: OR=4.455), sodium intake (≥5 g/d: OR=2.742), legume and nut intake (<25 g/d: OR=2.968), cooking oil consumption (>20 g/d: OR=1.691), and the DASH score (OR=0.886). Conclusions The dietary patterns of hypertensive patients are significantly associated with blood pressure control. A low DASH score, insufficient fruit and vegetable consumption, and high sodium intake are major risk factors for poorly controlled hypertension. These findings underscore the need for targeted dietary structure optimization and enhanced nutritional interventions to improve blood pressure management.

Objective To investigate the prevalence, awareness, treatment, and control rates of diabetes mellitus (DM) among adults in Puyang, Henan Province, and to provide scientific evidence for diabetes prevention and management. Methods A multistage stratified cluster sampling method was employed in a chronic disease and risk factor surveillance survey across four counties/districts of Puyang City. Permanent residents aged 18 years and older were included as study participants. χ²-tests and χ²-trend tests were used to analyze differences in rates across demographic groups and age trends. Multivariable logistic regression models were applied to identify influencing factors. Results A total of 12 373 permanent residents aged ≥18 years were included. The overall diabetes prevalence was 13.82% (age-standardized rate: 13.49%). Among individuals with diabetes, the awareness, treatment, and control rates were 48.19%, 45.85%, and 32.75%, respectively (standardized rates: 35.01%, 32.15%, and 27.23%). These rates exhibited a significant upward trend with increasing age (all P<0.05). Multivariable logistic regression analysis revealed the following risk factors for diabetes: age (OR=1.830, 3.249, 5.667, 8.194), urban residents (OR=1.243), alcohol consumption (OR=1.182), excessive red meat consumption (OR=1.246), overweight (OR=1.369), obesity (OR=1.909), hypertension (OR=2.215) and family history of diabetes (OR=2.511) (all P<0.05). Increased age (OR=3.333, 4.532, 6.911, 11.221), urban residents (OR=1.271), hypertension patients (OR=1.499), family history of diabetes (OR=2.293) were associated with high awareness rate (all P<0.05). Increased age (OR=3.141, 5.140, 8.374, 13.368), urban residents (OR=1.358), hypertension patients (OR=1.484), family history of diabetes (OR=2.413) were associated with high treatment rate (all P<0.05). Better glycemic control was observed in individuals aged ≥55 years (OR=1.826, 2.399, P<0.05). Conclusions Puyang exhibits a high prevalence of diabetes among adults, coupled with suboptimal awareness, treatment, and control rates. Targeted health education interventions should prioritize younger age groups and rural populations to improve diabetes detection, management, and outcomes.

Objective To investigate the risk factors associated with pediatric dry eye disease (DED) and to formulate effective preventive measures. Methods A cross-sectional, stratified, cluster random sampling method was employed between February and October 2024. The study sample comprised 496 students from two primary and two secondary schools in the Yingzhou District of Fuyang City. Three classes were randomly selected from each school, totaling 12 classes. All participants underwent questionnaire surveys and ophthalmic examinations to ascertain the prevalence of pediatric DED and to inform the development of prevention and control strategies. Results A total of 492 participants were included in the final analysis. The prevalence of DED among the pediatric population was 17.89% (88/492). Among the 88 diagnosed cases, a higher proportion was observed in the 13-18 age group, accounting for 62.50% (55/88). The predominant symptoms reported were ocular dryness (81 cases, 92.05%), foreign body sensation (76 cases, 86.36%), eye strain (70 cases, 79.55%), and photophobia (46 cases, 52.27%). Other reported manifestations included a burning sensation in the eyes (35 cases, 39.77%), fatigue (32 cases, 36.36%), fluctuating vision (26 cases, 29.55%), and ocular redness (25 cases, 28.41%). Logistic regression analysis identified several significant risk factors for pediatric DED in this region: age (OR=1.885), passive smoking exposure (OR=2.085), non-academic screen time (OR=2.277), insufficient sleep duration (OR=2.270), meibomian gland dysfunction (MGD, OR=9.492), allergic conjunctivitis (AC, OR=3.534), and refractive error (OR=2.189) (all P<0.05). Conclusions This study establishes that age, passive smoking, extended non-academic screen time, insufficient sleep, MGD, AC, and refractive error are significant contributing factors to the development of DED in children. These findings provide an empirical basis for the formulation of targeted preventive strategies, encompassing behavioral modifications, environmental optimization, and health monitoring, to mitigate the burden of pediatric dry eye disease.

Objective To analyze the risk factors associated with the incidence of ovarian cancer in a high-risk population and to construct a nomogram model to optimize existing screening pathways. Methods This study retrospectively analyzed data from 550 individuals at high risk for ovarian cancer who were seen at the Shanghai First Maternity and Infant Hospital between January 2020 and October 2021. The cohort was randomly divided into a training set (n=385) and a validation set (n=165) at a 7∶3 ratio. Patients in the training set were subsequently categorized into an occurrence group and a non-occurrence group based on confirmed ovarian cancer diagnosis following a 36-month follow-up period. Univariate and multivariate logistic regression analyses were conducted to identify independent predictors for the development of ovarian cancer in the training set. A nomogram was constructed using R software. The model's performance was evaluated through internal and external validation using Receiver Operating Characteristic (ROC) curves, calibration curves, the Hosmer-Lemeshow goodness-of-fit test, and Decision Curve Analysis (DCA). Results There were no statistically significant differences in the distribution of baseline characteristics, such as age, BMI, and family history of ovarian cancer, between the training and validation sets (P>0.05). Both univariate and multivariate logistic regression analyses identified elevated levels of carbohydrate antigen 125 (CA125) (>35 U/mL; OR=4.705), carbohydrate antigen 199 (CA199) (>37 U/mL; OR=3.322), and human epididymis protein 4 (HE4) (pmol/L; OR=12.272), a high-risk classification on the risk of ovarian malignancy algorithm (ROMA) index (OR=7.615), and low levels of the Pulsatility Index (PI) (OR=3.646) and resistance index (RI) (OR=2.475) as independent risk factors for ovarian cancer incidence in the high-risk population (all P<0.05). The evaluation and validation of the predictive nomogram demonstrated excellent discriminatory power, with an area under the curve (AUC) of 0.930 (95% CI: 0.887-0.973) in the training set and 0.921 (95% CI: 0.861-0.981) in the validation set. Furthermore, the calibration curves and the Hosmer-Lemeshow test signified a high degree of model calibration (Training set: R²=0.576, χ²=11.347, P=0.124; Validation set: R²=0.539, χ²=6.603, P=0.471). Decision Curve Analysis indicated that the model offered a substantial net benefit across a wide range of threshold probabilities (0.00-0.91 in the training set and 0.00-0.74 in the validation set). Conclusions CA125, CA199, HE4, the ROMA index, PI, and RI are significant predictors for the development of ovarian cancer in high-risk individuals. The nomogram constructed based on these factors can accurately predict the risk of ovarian cancer. Therefore, its application for risk stratification may serve as a valuable tool to facilitate precision clinical screening for ovarian cancer.

Objective To comprehensively investigate the progress, hotspots and frontiers of Monkeypox virus (MPXV) over the past decade through bibliometric methods. Methods Publications related to MPXV from 2015 to 2024 were retrieved from the Web of Science Core Collection. CiteSpace 6.2.R3 was employed to conduct a visual analysis of publication outputs, institutions, authors, and keywords. Results A total of 2 265 articles were included. Prior to 2022, research output remained limited; however, a surge in publications occurred following 2022, reflecting heightened global scholarly attention. The Centers for Disease Control and Prevention (CDC) in the United States (151 publications) emerged as the most prolific institution, while University College London exhibited the highest citation impact (73.09 citations per article). Mccollum AM (49 publications) from the United States was the most productive author. High-frequency keywords included "Monkeypox virus" "public health" "men who have sex with men (MSM)" "molecular docking" and "deep learning". Keyword clustering analysis identified 12 distinct clusters. Burst detection revealed emerging terms such as "global health" and "computational modeling, " highlighting the increasing integration of information technology in MPXV research. Conclusions Current research on MPXV has expanded rapidly, yet collaboration among authors and institutions remains limited, with no dominant core research network yet established. Research hotspots primarily focus on epidemiological characteristics, infectious disease modeling, vaccine development, and applications of information technology, particularly in the development of high-reliability diagnostic assays, vaccines, and antiviral therapeutics.