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Associations between parental adherence to healthy lifestyles and cognitive performance in offspring:A prospective cohort study in China

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Chinese Medical Journal 2024年第6期137卷 683-693页

作者： Rongxia Lv Yuhui Huang Siyi Huang Shiyi Wu Siwen Wang Guangyu Hu Yanan Ma Peige Song Jorge E.Chavarro S.V.Subramanian Chunling Lu Zhihui Li Changzheng Yuan School of Public Health the Second Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiang 310058China department of Nutrition Harvard T.H.Chan School of Public HealthBostonMA 02115USA Institute of Medical Information/Center for Health Policy and Management Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China department of biostatistics and epidemiology School of Public HealthChina Medical UniversityShenyangLiaoning 110122China department of Social and Behavioral Sciences Harvard T.H.Chan School of Public HealthBostonMA 02115USA Division of Global Health Equity Brigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115USA department of Global Health and Social Medicine Harvard Medical SchoolBostonMA 02115USA Vanke School of Public Health Tsinghua UniversityBeijing 100084China department of Global Health and Population Harvard T.H.Chan School of Public HealthBostonMA 02115USA

Background:Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring’s cognitive development during early childhood.This study aimed to investigate the prospective associations between overall parental lifestyle and offspring’s cognitive performance during adolescence and young adulthood in China.Methods:We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies.A healthy parental lifestyle score(ranged 0-5)was constructed based on the following five modifiable lifestyle factors:Smoking,drinking,exercise,sleep,and diet.Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring’s fluid and crystallized intelligence in subsequent years(2012,2014,2016,and 2018).Results:Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence(multivariable-adjusted β=0.53,95%confidence interval[CI]:0.29-0.77)and overall crystallized intelligence(multivariable-adjusted β=0.35,95%CI:0.16-0.54)than those in the bottom tertile of parental healthy lifestyle scores.The results were similar after further adjustment for the offspring’s healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status.Additionally,maternal and paternal healthy lifestyle scores were independently associated with better offspring’s cognitive performance,with significant contribution observed for paternal never-smoking,weekly exercise,and diversified diet.When both parents and offspring adhered to a healthier lifestyle,we observed the highest level of the offspring’s overall crystallized intelligence.Conclusions:Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring’s cognitive performance during adolescence and early adulthood,regardless of socioeconomic status.These findings highlight the potential cognitive benefits of promoting healthy lif

关键词： Cohort study Parental healthy lifestyle Offspring Cognitive performance Intelligence Adolescence

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Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients—the ECMO quality improvement action(EQIA)study:a national cohort study in China from 2017 to 2019

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Frontiers of Medicine 2024年第2期18卷 315-326页

作者： Wei Cheng Jieqing Chen Xudong Ma Jialu Sun Sifa Gao Ye Wang Longxiang Su Lu Wang Wei Du Huaiwu He Yujie Chen Zunzhu Li Qi Li Jianhua Sun Hongbo Luo Jinbang Liu Guangliang Shan Bing Du Yanhong Guo Dawei Liu Chang Yin Xiang Zhou on behalf of the China National Critical Care Quality Control Center-the ECMO quality improvement action(EQIA)study department of Critical Care Medicine State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing100730China Information Center department/department of Information Management State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalPeking Union Medical College&Chinese Academy of Medical SciencesBeijing100730China department of Medical Administration National Health Commission of the People’s Republic of ChinaBeijing100044China School of Population Medicine and Public Health Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100730China department of epidemiology and biostatistics Institute of Basic Medicine SciencesChinese Academy of Medical Sciences(CAMS)&School of Basic MedicinePeking Union Medical CollegeBeijing100730China National Institute of Hospital Administration National Health Commission of the People’s Republic of ChinaBeijing100044China 不详

This cohort study was performed to explore the influence of intensive care unit(ICU)quality on in-hospital mortality of veno-venous(V-V)extracorporeal membrane oxygenation(ECMO)-supported patients in China.The study involved all V-V ECMO-supported patients in 318 of 1700 tertiary hospitals from 2017 to 2019,using data from the National Clinical Improvement System and China National Critical Care Quality Control Center.ICU quality was assessed by quality control indicators and capacity parameters.Among the 2563 V-V ECMO-supported patients in 318 hospitals,a significant correlation was found between ECMO-related complications and prognosis.The reintubation rate within 48 hours after extubation and the total ICU mortality rate were independent risk factors for higher in-hospital mortality of V-V ECMO-supported patients(cutoff:1.5%and 7.0%;95%confidence interval:1.05–1.48 and 1.04–1.45;odds ratios:1.25 and 1.23;P=0.012 and P=0.015,respectively).Meanwhile,the V-V ECMO center volume was a protective factor(cutoff of≥50 cases within the 3-year study period;95%confidence interval:0.57–0.83,odds ratio:0.69,P=0.0001).The subgroup analysis of 864 patients in 11 high-volume centers further strengthened these findings.Thus,ICU quality may play an important role in improving the prognosis of V-V ECMO-supported patients.

关键词： veno-venous extracorporeal membrane oxygenation in-hospital mortality high-volume centers quality control intensive care unit capacity parameters

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Muscle strength deficits are associated with low bone mineral density in young pediatric cancer survivors:The iBoneFIT project

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Journal of Sport and Health Science 2024年第3期13卷 419-427页

作者： Andres Marmol-Perez Jose J.Gil-Cosano Esther Ubago-Guisado Francisco J.Llorente-Cantarero Juan Francisco Pascual-Gázquez Kirsten K.Ness Vicente Martinez-Vizcaino Jonatan R.Ruiz Luis Gracia-Marco department of Physical Education and Sports Faculty of Sport SciencesSport and Health University Research Institute(iMUDS)University of GranadaGranada 18011Spain department of epidemiology and cancer Control St.Jude Children's Research HospitalMemphisTN 38105USA department of Communication and Education Loyola University AndalusiaSeville 41704Spain Biosanitary Research Institute ibs.GranadaGranada 18012Spain Maimonides Biomedical Research Institute of Cordoba(IMIBIC) Cordoba 14004Spain CIBEROBN Biomedical Research Networking Center for Physiopathology of Obesity and NutritionCarlos III Health InstituteMadrid 28029Spain department of Specific Didactics Faculty of EducationUniversity of CordobaCordoba 14071Spain Pediatric and adolescent hematology and oncology service Pediatrics and Pediatric Surgery Clinical Management UnitVirgen de las Nieves University HospitalGranada 18014Spain Health and Social Research Center Universidad de Castilla-La ManchaCuenca 13001Spain

Background Pediatric cancer survivors are at increased risk of muscle weakness and low areal bone mineral density(aBMD).However,the prevalence of muscle strength deficits is not well documented,and the associations of muscle strength with aBMD are unknown in this population.Therefore,this study aimed to investigate the prevalence of upper-and lower-body muscle strength deficits and to examine the associations of upper-and lower-body muscle strength with age-,sex,and race-specific aBMD Z-scores at the total body,total hip,femoral neck,and lumbar spine.Methods This cross-sectional study included 116 pediatric cancer survivors(12.1±3.3 years old,mean±SD;42.2%female).Upper-and lower-body muscle strength were assessed by handgrip and standing long jump test,respectively.Dual‑energy X‑ray absorptiometry was used to measure aBMD(g/cm2).Associations between muscle strength and aBMD were evaluated in multivariable linear regression models.Logistic regression was used to evaluate the contribution of muscle strength(1-decile lower)to the odds of having low aBMD(Z-score≤1.0).All analyses were adjusted for time from treatment completion,radiotherapy exposure,and body mass index.Results More than one-half of survivors were within the 2 lowest deciles for upper-(56.9%)and lower-body muscle strength(60.0%)in comparison to age-and sex-specific reference values.Muscle strength deficits were associated with lower aBMD Z-scores at all sites(B=0.133–0.258,p=0.001–0.032).Each 1-decile lower in upper-body muscle strength was associated with 30%–95%higher odds of having low aBMD Z-scores at all sites.Each 1-decile lower in lower-body muscle strength was associated with 35%–70%higher odds of having low aBMD Z-scores at total body,total hip,and femoral neck.Conclusion Muscle strength deficits are prevalent in young pediatric cancer survivors,and such deficits are associated with lower aBMD Z-scores at all sites.These results suggest that interventions designed to improve muscle strength in this vulnerable population may have the added ben

关键词： Bone health Childhood cancer DXA Lean mass Resistance training

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Developing fertility control for rodents: a framework for researchers and practitioners

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Integrative Zoology 2024年第1期19卷 87-107页

作者： Giovanna MASSEI Jens JACOB Lyn A.HINDS Botstiber Institute for Wildlife Fertility Control Department of Environment and GeographyUniversity of YorkHeslingtonYorkUK Rodent Research Institute for Epidemiology and Pathogen DiagnosticsJulius Kühn–Institute(JKI)Federal Research Institute for Cultivated PlantsMünsterGermany CSIRO Health and Biosecurity CanberraACTAustralia

Fertility control is often heralded as a humane and effective technique for management of overabundant wildlife,including rodents.The intention is to reduce the use of lethal and inhumane methods,increase farm productivity and food security as well as reduce disease transmission,particularly of zoonoses.We developed a framework to guide researchers and stakeholders planning to assess the effectiveness of a potential contraceptive agent for a particular species.Our guidelines describe the overarching research questions which must be sequentially addressed to ensure adequate data are collected so that a contraceptive can be registered for use in broad-scale rodent management.The framework indicates that studies should be undertaken iteratively and,at times,in parallel,with initial research being conducted on(1)laboratory-based captive assessments of contraceptive effects in individuals;(2)simulation of contraceptive delivery using bait markers and/or surgical sterilization of different proportions of afield-based or enclosure population to determine how population dynamics are affected;(3)development of mathematical models which predict the outcomes of different fertility control scenarios;and(4)implementation of large-scale,replicated trials to validate contraceptive efficacy under various management-scalefield situations.In some circumstances,fertility control may be most effective when integrated with other methods(e.***.some culling).Assessment of non-target effects,direct and indirect,and the environmental fate of the contraceptive must also be determined.Developing fertility control for a species is a resource-intensive commitment but will likely be less costly than the ongoing environmental and economic impacts by rodents and rodenticides in many contexts.

关键词： captive studies field applications modeling oral contraceptive delivery population management rodents

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Understanding the educational inequalities in suicide attempts and their mediators:a Mendelian randomisation study

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General Psychiatry 2024年第1期37卷 133-142页

作者： Jiahao Zhu Houpu Liu Rui Gao Lilu Ding Jing Wang Ye Yang Dan Zhou Yingjun Li department of epidemiology|and Health Statistics School of Public HealthHangzhou Medical CollegeHangzhouZhejiangChina Vanderbit Genetics Institute Vanderbilt University Medical CenterNashvilleTennesseeUSA School of Public Health and the Second Afliated Hospital Zhejiang University Schol of MedicineHangzhouZhejiangChina

Background Educational inequalities in suicide have become increasingly prominent over the past decade.Elucidating modifiable risk factors that serve as intermediaries in the impact of low educational attainment on suicide has the potential to reduce health disparities.Aims To examine the risk factors that mediate the relationship between educational attainment and suicide attempts and quantify their contributions to the mediation effect.Methods We conducted a two-sample Mendelian randomisation(MR)analysis to estimate the causal effect of educational attainment on suicide attempts,utilising genome-wide association study summary statistics from the Integrative Psychiatric Research(iPSYCH;6024 cases and 44240 controls)and FinnGen(8978 cases and 368299 controls).We systematically evaluated 42 putative mediators within the causal pathway connecting reduced educational attainment to suicide attempts and employed two-step and multivariable MR to quantify the proportion of the mediated effect.Results In the combined analysis of iPSYCH and FinnGen,each standard deviation(SD)decrease in genetically predicted educational attainment(equating to 3.4 years of education)was associated with a 105%higher risk of suicide attempts(odds ratio(OR):2.05;95%confidence interval(Cl):1.81 to 2.31).0f the 42 risk factors analysed,the two-step MR identified five factors that mediated the association between educational attainment and suicide attempts.The respective proportions of mediation were 47%(95%Cl:29%to 66%)for smoking behaviour,36%(95%Cl:0%to 84%)for chronic pain,49%(95%Cl:36%to 61%)for depression,35%(95%Cl:12%to 59%)for anxiety and 26%(95%Cl:18%to 34%)for insomnia.Multivariable MR implicated these five mediators collectively,accounting for 68%(95%Cl:40%to 96%)of the total effect.Conclusions This study identified smoking,chronic pain and mental disorders as primary intervention targets for attenuating suicide risk attributable to lower educational levels in the European population.

关键词： effect. random inequalities

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Prevalence and risk evaluation of cardiovascular disease in the newly diagnosed prostate cancer population in China: A nationwide, multi-center, population-based cross-sectional study

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中华医学杂志(英文版) 2024年第11期137卷 2024 Apr 12页

作者： Zhang Weiyu Liu Huixin Liu Ming Ying Shi Yuan Renbin Zeng Hao Zhang Zhenting Han Sujun Si Zhannan Hu Bin Wen Simeng Xu Pengcheng Yu Weimin Chen Hui Wang Liang Lin Zhitao Dai Tao Lin Yunzhi Xu Tao Hospital Tianjin China department of Urology Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China National cancer Center Beijing China National Clinical Research Center for cancer Beijing China department of Urology Liaoning Cancer Hospital Shenyang Liaoning China department of Urology The Second Hospital of Tianjin Medical University Tianjin China Tianjin Institute of Urology Tianjin Medical University Tianjin China department of Urology Lu’an Affiliated Hospital of Anhui Medical University Lu’an Anhui China department of Urology Renmin Hospital of Wuhan University Wuhan Hubei China department of Urology Harbin Medical University Affiliated Cancer Hospital Harbin Heilongjiang China department of Urology Peking University People’s Hospital Beijing China department of Urology The Second Hospital of Dalian Medical University Dalian Liaoning China department of Urology Surgery Fujian Cancer Hospital Fuzhou Fujian China department of Urology Surgery Hunan Cancer Hospital Changsha Hunan China department of Urology Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou Fujian China department of Clinical epidemiology and biostatistics Peking University People’s Hospital Beijing China department of Urology Beijing Hospital National Center of Gerontology Beijing China Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing China department of Urology Wuhan Union Hospital Huazhong University of Science &amp Technology Wuhan Hubei China department of Urology The Third People’s Hospital of Chengdu Chengdu Sichuan China department of Urology West China Hospital of Sichuan University Chengdu Sichuan China department of Urologic Oncology Tianjin Medical University Cancer Institute &amp

Background: Cardiovascular disease (CVD) has emerged as the leading cause of death from prostate cancer (PCa) in recent decades, bringing a great disease burden worldwide. Men with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy (ADT). The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in China.Methods: Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience sampling. CVD was defined as myocardial infarction, arrhythmia, heart failure, stroke, ischemic heart disease, and others. CVD risk was estimated by calculating Framingham risk scores (FRS). Patients were accordingly divided into low-, medium-, and high-risk groups.χ2 or Fisher’s exact test was used for comparison of categorical variables.Results: A total of 4253 patients were enrolled in the present study. A total of 27.0% (1147/4253) of patients had comorbid PCa and CVD, and 7.2% (307/4253) had two or more CVDs. The enrolled population was distributed in six regions of China, and approximately 71.0% (3019/4253) of patients lived in urban areas. With imaging and pathological evaluation, most PCa patients were diagnosed at an advanced stage, with 20.5% (871/4253) locally progressing and 20.5% (871/4253) showing metastasis. Most of them initiated prostatectomy (46.6%, 1983/4253) or regimens involving ADT therapy (45.7%, 1944/4253) for prostate cancer. In the present PCa cohort, 43.1% (1832/4253) of patients had hypertension, and half of them had poorly controlled blood pressure. With FRS stratification, as expected, a higher risk of CVD was related to aging and metabolic disturbance. However, we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without ADT. This was in accordance with clinical practice, i.e., aged patients or patients at advanced oncological stages were inclined to

关键词： Prostate cancer Castration Cardiovascular disease Prevalence Cardiovascular risk

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An Asynchronous Variational Integrator for Contact Problems Involving Elastoplastic Solids

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Acta Mechanica Solida Sinica 2024年第2期37卷 305-315页

作者： Zongwu Niu Zixiao Wang Yongxing Shen University of Michigan-Shanghai Jiao Tong University Joint Institute Shanghai Jiao Tong UniversityShanghai200240China School of Agriculture and Biology Shanghai Jiao Tong UniversityShanghai200240China department of biostatistics Johns Hopkins Bloomberg School of Public HealthBaltimoreMaryland21205USA

Simulations of contact problems involving at least one plastic solid may be costly due to their strong nonlinearity and requirements of stability.In this work,we develop an explicit asynchronous variational integrator(AVI)for inelastic non-frictional contact problems involving a plastic solid.The AVI assigns each element in the mesh an independent time step and updates the solution at the elements and nodes asynchronously.This asynchrony makes the AVI highly efficient in solving such bi-material problems.Taking advantage of the AVI,the constitutive update is locally performed in one element at a time,and contact constraints are also enforced on only one element.The time step of the contact element is subdivided into multiple segments,and the fields are updated accordingly.During a contact event,only one element involving a few degrees of freedom is considered,leading to high efficiency.The proposed formulation is first verified with a pure elastodynamics benchmark and further applied to a contact problem involving an elastoplastic solid with non-associative volumetric hardening.The numerical results indicate that the AVI exhibits excellent energy behaviors and has high computational efficiency.

关键词： Asynchronous variational integrator Plasticity Contact Computational efficiency Finite element method

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Omics approaches in asthma research:Challenges and opportunities

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Chinese Medical Journal Pulmonary and Critical Care Medicine 2024年第1期2卷 1-9页

作者： Molin Yue Shiyue Tao Kristina Gaietto Wei Chen department of biostatistics School of Public HealthUniversity of PittsburghPittsburghPA 15224USA Division of Pediatric Pulmonary Medicine UPMC Children’s Hospital of PittsburghUniversity of PittsburghPittsburghPA 15224USA

Asthma,a chronic respiratory disease with a global prevalence of approximately 300 million individuals,presents a significant societal and economic burden.This multifaceted syndrome exhibits diverse clinical phenotypes and pathogenic endotypes influenced by various factors.The advent of omics technologies has revolutionized asthma research by delving into the molecular foundation of the disease to unravel its underlying mechanisms.Omics technologies are employed to systematically screen for potential biomarkers,encompassing genes,transcripts,methylation sites,proteins,and even the microbiome components.This review provides an insightful overview of omics applications in asthma research,with a special emphasis on genetics,transcriptomics,epigenomics,and the microbiome.We explore the cutting-edge methods,discoveries,challenges,and potential future directions in the realm of asthma omics research.By integrating multi-omics and non-omics data through advanced sta-tistical techniques,we aspire to advance precision medicine in asthma,guiding diagnosis,risk assessment,and personalized treatment strategies for this heterogeneous condition.

关键词： Asthma Genomics Transcriptomics Epigenomics Metagenomics Multi-omics integration

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The emerging role of mesenchymal stem cell-derived extracellular vesicles to ameliorate hippocampal NLRP3 inflammation induced by binge-like ethanol treatment in adolescence

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Neural Regeneration Research 2025年第4期20卷 1153-1163页

作者： Susana Mellado María JoséMorillo-Bargues Carla Perpiñá-Clérigues Francisco García-García Victoria Moreno-Manzano Consuelo Guerri María Pascual department of Physiology School of Medicine and DentistryUniversity of ValenciaValenciaSpain Bioinformatics and biostatistics Unit Príncipe Felipe Research CenterValenciaSpain Neuronal and Tissue Regeneration Laboratory Príncipe Felipe Research CenterValenciaSpain

Our previous studies have reported that activation of the NLRP3(NOD-,LRR-and pyrin domain-containing protein 3)-inflammasome complex in ethanol-treated astrocytes and chronic alcohol-fed mice could be associated with neuroinflammation and brain damage.Mesenchymal stem cell-derived extracellular vesicles(MSC-EVs)have been shown to restore the neuroinflammatory response,along with myelin and synaptic structural alterations in the prefrontal cortex,and alleviate cognitive and memory dysfunctions induced by binge-like ethanol treatment in adolescent mice.Considering the therapeutic role of the molecules contained in mesenchymal stem cell-derived extracellular vesicles,the present study analyzed whether the administration of mesenchymal stem cell-derived extracellular vesicles isolated from adipose tissue,which inhibited the activation of the NLRP3 inflammasome,was capable of reducing hippocampal neuroinflammation in adolescent mice treated with binge drinking.We demonstrated that the administration of mesenchymal stem cell-derived extracellular vesicles ameliorated the activation of the hippocampal NLRP3 inflammasome complex and other NLRs inflammasomes(e.g.,pyrin domain-containing 1,caspase recruitment domain-containing 4,and absent in melanoma 2,as well as the alterations in inflammatory genes(interleukin-1β,interleukin-18,inducible nitric oxide synthase,nuclear factor-kappa B,monocyte chemoattractant protein-1,and C–X3–C motif chemokine ligand 1)and miRNAs(miR-21a-5p,miR-146a-5p,and miR-141-5p)induced by binge-like ethanol treatment in adolescent mice.Bioinformatic analysis further revealed the involvement of miR-21a-5p and miR-146a-5p with inflammatory target genes and NOD-like receptor signaling pathways.Taken together,these findings provide novel evidence of the therapeutic potential of MSC-derived EVs to ameliorate the hippocampal neuroinflammatory response associated with NLRP3 inflammasome activation induced by binge drinking in adolescence.

关键词： adolescence binge-like ethanol treatment extracellular vesicles hippocampus mesenchymal stem cells neuroinflammation NOD-,LRR-and pyrin domain-containing protein 3(NLRP3)

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Risk factors,prognostic factors,and nomograms for distant metastasis in patients with diagnosed duodenal cancer:A population-based study

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1384-1420页

作者： Jia-Rong Shang Chen-Yi Xu Xiao-Xue Zhai Zhe Xu Jun Qian department of Oncology Jiangsu Province Hospital of Chinese MedicineThe Affiliated Hospital of Nanjing University of Chinese MedicineNanjing 210000Jiangsu ProvinceChina department of Proctology Nanjing Hospital of Chinese MedicineNanjing 210000Jiangsu ProvinceChina department of Digestive cancer Surgery Jiangsu Province Hospital of Chinese MedicineThe Affiliated Hospital of Nanjing University of Chinese MedicineNanjing 210000Jiangsu ProvinceChina

BACKGROUND Duodenal cancer is one of the most common subtypes of small intestinal cancer,and distant metastasis(DM)in this type of cancer still leads to poor prognosis.Although nomograms have recently been used in tumor areas,no studies have focused on the diagnostic and prognostic evaluation of DM in patients with primary duodenal cancer.AIM To develop and evaluate nomograms for predicting the risk of DM and person-alized prognosis in patients with duodenal cancer.METHODS Data on duodenal cancer patients diagnosed between 2010 and 2019 were extracted from the Surveillance,epidemiology,and End Results database.Univariate and multivariate logistic regression analyses were used to identify independent risk factors for DM in patients with duodenal cancer,and univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors in duodenal cancer patients with DM.Two novel nomograms were established,and the results were evaluated by receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA).RESULTS A total of 2603 patients with duodenal cancer were included,of whom 457 cases(17.56%)had DM at the time of diagnosis.Logistic analysis revealed independent risk factors for DM in duodenal cancer patients,including gender,grade,tumor size,T stage,and N stage(Pcancer patients with DM,including age,histological type,T stage,tumor grade,tumor size,bone metastasis,chemotherapy,and surgery(Pcancer.CONCLUSION The two nomograms are expected as effective tools for predicting DM risk in duodenal cancer patients

关键词： Duodenal cancer Distant metastasis Nomogram Risk factors Prognostic factors

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