Risk factors of childhood systemic lupus erythematosus with thyroid dysfunction / 中华儿科杂志

Objective: To investigate the risk factors of childhood systemic lupus erythematosus (SLE) with thyroid dysfunction and to explore the relationship between thyroid hormone and kidney injury of lupus nephritis (LN). Methods: In this retrospective study, 253 patients who were diagnosed with childhood SLE and hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2019 to January 2021 were enrolled in the case group, and 70 healthy children were the control cases. The patients in the case group were divided into the normal thyroid group and the thyroid dysfunction group. Independent t-test, χ2 test, and Mann-Whitney U test were used for comparison between the groups, Logistic regression analysis was used for multivariate analysis, and Spearman correlation. Results: A total of 253 patients, there were 44 males and 209 females in the case group, and the age of onset was 14 (12, 16) years; a total of 70 patients, 24 males and 46 females were in the control group, and the age of onset was 13 (10, 13) years. The incidence of thyroid dysfunction in the case group was higher than that in the control group (48.2% (122/253) vs. 8.6% (6/70), χ²=36.03, P<0.05). Of the 131 patients, there were 17 males and 114 females in the normal thyroid group, and the age of onset was 14 (12, 16) years. Of the 122 patients in the thyroid dysfunction group, 28 males and 94 females were in the thyroid dysfunction group, and the age of onset was 14 (12, 16) years. Of the 122 had thyroid dysfunction, including 51 cases (41.8%) with euthyroid sick syndrome, 25 cases (20.5%) with subclinical hypothyroidism, 18 cases (14.8%) patients with sub-hyperthyroidism, 12 cases (9.8%) with hypothyroidism, 10 cases (8.2%) with Hashimoto's thyroiditis, 4 cases (3.3%) with hyperthyroidism, and 2 cases (1.6%) with Graves disease. Compared to patients with normal thyroid function, the serum level of triglyceride, total cholesterol, urine white blood cell, urine red blood cell, 24 h urine protein, D-dimer, and fibrinogen, ferritin and systemic lupus erythematosus disease activity Index-2000 (SLEDAI-2K) score were higher in patients with thyroid dysfunction (Z=3.07, 3.07, 2.48, 3.16, 2.40, 3.99, 2.68, 2.55, 2.80, all P<0.05), while the serum level of free thyroxine and C3 were lower in thyroid disfunction patients (10.6 (9.1, 12.7) vs. 11.3 (10.0, 12.9) pmol/L, and 0.46 (0.27, 0.74) vs. 0.57 (0.37, 0.82) g/L, Z=2.18, 2.42, both P<0.05). The higher level of triglyceride and D-dimer were the independent risk factors for childhood SLE with thyroid dysfunction (OR=1.40 and 1.35, 95%CI 1.03-1.89 and 1.00-1.81, respectively, both P<0.05). There were 161 patients with LN in the case group, all of which were conducted with renal biopsies, including 11 cases (6.8%) with types Ⅰ LN, 11 cases (6.8%) with typesⅡLN, 31 cases (19.3%) with types Ⅲ LN, 92 cases (57.1%) with types Ⅳ LN, and 16 cases (9.9%) with types Ⅴ LN. There were significant differences in the level of free triiodothyronine and thyroid stimulating hormone among different types of kidney pathology (both P<0.05); compared with types I LN, the serum level of free triiodothyronine was lower in types Ⅳ LN (3.4 (2.8, 3.9) vs. 4.3 (3.7, 5.5) pmol/L, Z=3.75, P<0.05). The serum level of free triiodothyronine was negatively correlated with the acute activity index score of lupus nephritis (r=-0.228, P<0.05), while the serum level of thyroid stimulating hormone was positively correlated with the renal pathological acute activity index score of lupus nephritis (r=0.257, P<0.05). Conclusions: There is a high incidence of thyroid dysfunction in childhood SLE patients. The higher SLEDAI and more severe renal damage were found in SLE patients with thyroid dysfunction compared to these with normal thyroid functions. The risk factors of childhood SLE with thyroid dysfunction are the higher level of triglyceride and D-dimer. The serum level of thyroid hormone is possibly related to the kidney injury of LN.

Development of Multifunctional and Multipoint Fixed Support Drainage Device for Digestive Tract / 中国医疗器械杂志

OBJECTIVE@#To discuss the development of a multifunctional and multipoint fixed support drainage device for the digestive tract, as well as the effect of its application on animal experimental models and patients.@*METHODS@#The digestive tract multifunctional and multipoint fixed support drainage device is designed according to the requirements of the various gastrointestinal surgery and interventional procedures. It has metal flaps and airbags to achieve multi point fixation. The cuffs and shears are used to achieve endoscopic removal. And through different tube diameters and lengths, surgeons can achieve different surgical purposes.@*RESULTS@#A multifunctional and multipoint fixed support drainage device for the digestive tract was successfully designed and developed. The application experiment of the winged pancreatico-intestinal supporting drainage tube on animal models and patients, showed lower drainage fluid amylase level, faster amylase recovery speed, and better perioperative safety.@*CONCLUSIONS@#The support drainage device has the characteristics of simple operation, firm fixation, and good controllability of removal. It is an ideal choice among support drainage tubes in gastrointestinal surgery and interventional operations.

Comparative analysis of clinical efficacy between posterior percutaneous endoscopic discectomy and anterior cervical discectomy and fusion in the treatment of cervical spondylotic radiculopathy / 中国骨伤

OBJECTIVE@#To explore the clinical efficacy of posterior percutaneous endoscopic discectomy(PPECD) in the treatment of cervical spondylotic radiculopathy.@*METHODS@#A total of 56 patiens with single segment cervical spondylotic radiculopathy from December 2017 to October 2020, were randomly divided into observation group and control group. In observation group, there were 16 males and 11 females, including 8 cases of C4,5, 13 cases of C5,6 and 6 cases of C6,7 performed posterior percutaneous endoscopic discectomy, aged from 34 to 61 years old with an average of (51.15±6.29) years old. In control group, there were 19 males and 10 females with single segment cervical spondylotic radiculopathy including 10 cases of C4,5, 14 cases of C5,6 and 5 cases of C6,7 performed anterior cervical discectomy and fusion, aged from 40 to 65 years old with an average of (53.24±5.31) years old. The operative time, intraoperative blood loss, postoperative time of lying in bed and length of postoperative hospital stay were recorded. Visual analogue scale(VAS) and neck disability index(NDI) were used to evaluate the clinical efficacy. Cervical plain films or MRIs, CTs were taken for re-visiting patients.@*RESULTS@#All patients were followed up more than 2 years. The observation group patients were followed up, the duration ranged from 24 to 42 months with an average of (30.48±4.91) months. The control group patients were followed up, the duration ranged from 25 to 47 months, with an average of (32.76±4.53) months. Compared with control group, operative time, intraoperative blood loss, postoperative time of lying in bed and length of postoperative hospital stay were decreased(P<0.05). Compared with pre-operation, VAS of neck and upper limb and NDI at the latest follow-up between two groups were significantly improved(P<0.05). Compared with control group, VAS of neck and upper limb at 1 day after operation in observation group were significantly reduced(P<0.05). There was no significant difference in VAS of neck and upper limb and NID at 1, 3 months and the latest follow-up after operation between two groups(P>0.05). In the observation group, one patient's deltoid muscle strength was weakened to grade 4 after operation, and returned to normal after 12 weeks of conservative treatment. In control group, there was 1 case of postoperative adjacent spondylosis with symptoms of spinal compression after 2 years operation, then underwent cervical artificial intervertebral disc replacement. And there was 1 case of dysphagia after operation in control group and improved after 1 year. There was no significant difference in incidence of complications between two groups.@*CONCLUSION@#PPECD has advantages of shortening operative time, decreasing intraoperative blood loss, reducing postoperative time of lying in bed and length of postoperative hospital stay. However, applicable age range of patients and long-term clinical efficacy needs further study.

Effect of electroacupuncture on proliferation of hippocampal neural stem cells in young mice with Alzheimer's disease / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) on the proliferation of endogenous neural stem cells in the hippocampus of young mice with Alzheimer's disease (AD), so as to explore its mechanisms underlying improvement of AD.@*METHODS@#Forty 1.5-month-old APP/PS1 transgenic male mice were randomly divided into an EA group and a model group, 20 mice in each group, and other 20 C57BL/6J male mice of the same age were used as the normal control group. EA (intermittment wave 10 Hz, 2 mA) was applied to "Baihui" (GV 20), "Fengfu" (GV 16) and "Shenshu" (BL 23) for 20 min, once a day, 6 days a week for 16 weeks. H.E. staining was used to assess histopathological changes of neurons of the hippocampal dentate gyrus. Immunohistochemical stain was used to detect the expression of 5-bromodeoxyuridine (BrdU)-positive in the hippocampus, and immunofluorescence double-labeled technique was used to detect the number of proliferated positive neurons of hippocampal neural stem cells. The expression levels of brain derived neurotrophic factor (BDNF) and Nestin mRNA and protein were detected by using real-time PCR and Western blot, separately.@*RESULTS@#The immunoactivity of BrdU, and the expression levels of BDNF and Nestin mRNA and protein in the hippocampus in the model group were significantly lower than in the normal control group (P<0.01, P<0.05), and considerably higher in the EA group than in the model group (P<0.01, P<0.05). The number of BrdU/NeuN dual labeled neurons was slightly increased in the model group than in the normal control group (P>0.05), and evidently increased in the EA group relevant to the model group (P<0.05), suggesting a proliferation of hippocampal neural stem cells. After modeling, the neurons of hippocampal dentate gyrus were arranged loosely and irregularly and their structure was fuzzy, with an appearance of different degrees of nuclear pyknosis, whereas in the EA group, the neuronal contour was clear and the nuclear structure was relatively distinct.@*CONCLUSION@#EA can activate the proliferation of neural stem cells in the hippocampus in AD mice, which may contribute to its function in improving the neuronal structure by upregulating the expression of BDNF.

Clinical Efficacy of Modified Zengyetang Against Slow Transit Constipation Due to Qi-Yin Deficiency and Its Effect on Gastrointestinal Function / 中国实验方剂学杂志

Objective:To observe the clinical effect of modified Zengyetang in treating slow transit constipation （STC） due to Qi-Yin deficiency and its effect on gastrointestinal function. Method:One hundred and thirty eligible patients were randomly divided into a control group （<italic>n</italic>=65， 6 cases dropped out or were lost to follow-up and 59 completed the trial） and a treatment group （<italic>n</italic>=65， 3 cases dropped out or were lost to follow-up and 62 completed the trial）. Patients in the control group received oral mosapride citrate dispersible tablets， 5 mg per time， three times per day， while those in the treatment group were treated with modified Zengye Tang， one bag per day， for four successive weeks. The main symptom constipation， the Patient Assessment of Constipation Symptoms （PAC-SYM）， and traditional Chinese medicine （TCM） syndrome scores， colonic transit， as well as motilin （MTL）， vasoactive intestinal peptide （VIP）， and substance P （SP） levels before and after treatment were recorded， together with the frequency of spontaneous complete bowel movements （SCBMs） per week and STC recurrence during treatment. Result:The clinical efficacy （95.16%） of the treatment group was higher than that （81.36%） of the control group （<italic>χ</italic>²=5.631 4， <italic>P</italic><0.05）， whereas the recurrence rate （30.65%） of the treatment group was significantly lower than that （57.63%） of the control group （<italic>χ</italic>²=8.941 1， <italic>P</italic><0.01）. After treatment， the main symptom constipation， three sub-scale and total PAC-SYM， and TCM syndrome scores in the treatment group were obviously decreased as compared with those in the control group （<italic>P</italic><0.01）. The proportions of residual markers at 24， 48， and 72 h in the treatment group declined in contrast to those in the control group （<italic>P</italic><0.01）. The frequency of SCBMs per week in the 2^nd， 3^rd， and 4^th weeks of the treatment group was higher than that in the control group （<italic>P</italic><0.01）. Compared with the control group after treatment， the treatment group exhibited significantly elevated MTL and SP but lowered VIP （<italic>P</italic><0.01）. Conclusion:Modified Zengyetang relieves the clinical symptoms， regulates gastrointestinal hormone secretion， increases the frequency of SCBMs， enhances colonic transit， and decreases the recurrence of patients with STC due to Qi-Yin deficiency.

Protective function of electroacupuncture on young mouse model of Alzheimer's disease and proteomic study / 中国针灸

OBJECTIVE@#To screen protein target in prevention and treatment with electroacupuncture (EA) for Alzheimer's disease (AD) and explore the potential mechanism of EA in prevention of AD.@*METHODS@#A total of 40 APP/PS1 transgenic young male mice, 1.5-month old, were randomized into an EA group and a model group, 20 mice in each one, and 20 C57BL/6J mice were chosen as the normal control group. After adaptive housing for 1 week, the mice in the EA group were stimulated with EA at "Baihui" (GV 20), "Fengfu" (GV 16) and "Shenshu" (BL 23), with intermittent wave, 10 Hz in frequency and 2 mA in electric intensity. EA was given once daily, 20 min each time. There was 1 day at interval after EA for 6 days each week. Totally, the intervention lasted for 16 weeks. On day 3 after the end of EA intervention, Morris water maze test was adopted to detect learning and memory abilities of mice in each group. After water maze test, the label-free method was used to measure the difference expressions in cerebral cortex and hippocampus. Using Western blot method, the expressions of guanylate binding protein beta 5 (GNB 5) and histone-H 3 in cerebral cortex and hippocampus were verified. Using immunohistochemical method, the expressions of amyloid beta protein (Aβ) in cerebral cortex and hippocampus were detected.@*RESULTS@#Compared with the normal control group, the escape latency (on day 2, 3 and 4) was prolonged, the frequency of crossing platform and the duration of platform stay were decreased in the mice of the model group (@*CONCLUSION@#The intervention with EA effectively prevents from the decline of learning and memory ability and the formation of Aβ senile plaques in cerebral cortex and hippocampus in young mouse models of AD after growing up. Besides, EA plays a regulatory function for protein expression differences induced by AD model.

Deep Natural Image Reconstruction from Human Brain Activity Based on Conditional Progressively Growing Generative Adversarial Networks / 神经科学通报·英文版

Brain decoding based on functional magnetic resonance imaging has recently enabled the identification of visual perception and mental states. However, due to the limitations of sample size and the lack of an effective reconstruction model, accurate reconstruction of natural images is still a major challenge. The current, rapid development of deep learning models provides the possibility of overcoming these obstacles. Here, we propose a deep learning-based framework that includes a latent feature extractor, a latent feature decoder, and a natural image generator, to achieve the accurate reconstruction of natural images from brain activity. The latent feature extractor is used to extract the latent features of natural images. The latent feature decoder predicts the latent features of natural images based on the response signals from the higher visual cortex. The natural image generator is applied to generate reconstructed images from the predicted latent features of natural images and the response signals from the visual cortex. Quantitative and qualitative evaluations were conducted with test images. The results showed that the reconstructed image achieved comparable, accurate reproduction of the presented image in both high-level semantic category information and low-level pixel information. The framework we propose shows promise for decoding the brain activity.

Analysis on related factors of myocardial fibrosis in patients with hypertrophic cardiomyopathy / 中华心血管病杂志

Objective: To investigate the related factors of myocardial fibrosis in patients with hypertrophic cardiomyopathy. Methods: Patients with hypertrophic cardiomyopathy, hospitalized in the First People's Hospital of Yunnan Province from January 2016 to May 2020, were included in this cross-sectional study. Patients were divided into delayed enhancement positive group (fibrosis group) and non-delayed enhancement group (non-fibrosis group). According to the maximum left ventricular end diastolic wall thickness (LVMWT), patients in the fibrosis group was further divided into mild hypertrophy group, moderate hypertrophy group and severe hypertrophy group. The baseline clinical data of patients were collected by medical record management system. All enrolled patients underwent cardiac magnetic resonance imaging (CMR). The presence and location of myocardial fibrosis were identified by CMR gadolinium contrast delayed enhancement (LGE). The range of LGE (LGE%) was calculated by visual analysis. The levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) in peripheral blood were measured . Results: A total of 48 patients ( age (46.4±14.3) years, 42 (87.5%) males) were enrolled. There were 34 LGE positive cases (fibrosis group) and 14 LGE negative cases (non-fibrosis group). Compared with non-fibrosis group, patients in fibrosis group were younger (P=0.038) and prevalence of NYHA grade Ⅲ/Ⅳ was higher (P=0.00). Compared with non-fibrosis group, patients in fibrosis group had thicker LVMWT (P= 0.008), higher left ventricular mass index(LVMI) (P=0.001), higher left ventricular end diastolic volume (LVEDV) (P=0.043), lower left ventricular ejection fraction (LVEF) and cardiac index (CI) (all P <0.05). The levels of NT-proBNP and cTnI were significantly higher in fibrosis group than in non-fibrosis group (2 760.5 (1 503.4, 3 783.6) ng / L vs. 861.3 (552.2, 1 092.8) ng / L, P=0.002; 0.970 (0.448, 1.684)μg / L vs. 0.147 (0.033, 0.251)μg / L, P=0.041).In fibrosis group, there were 15 cases of mild hypertrophy (mild hypertrophy group), 10 cases of moderate hypertrophy (moderate hypertrophy group), and 9 cases of severe hypertrophy (severe hypertrophy group). The LGE% and NT-proBNP and cTnI increased in proportion with increasing myocardial hypertrophy (P<0.05). LGE% was negatively correlated with age (r=-0.618, P=0.011), and positively correlated with NT-proBNP and cTnI levels (r=0.271, P=0.010; r=0.111,P=0.013, respectively), and positively correlated with LVEDV, LVMWT and LVMI (r=0.438, P=0.09; r=0.735, P=0.001; r=0.532, P=0.034, respectively). Conclusions: In patients with hypertrophic cardiomyopathy, the extent of myocardial fibrosis increases with the increase of myocardial hypertrophy. Myocardial fibrosis is negatively correlated with age, and positively correlated with NT-proBNP and cTnI, as well as LVEDV, LVMWT and LVMI in this patient cohort.

Effects of electroacupuncture with different courses on the synaptic structure and synaptic function-related proteins in mice with radiation-induced brain injury / 生理学报

The aim of the present study was to investigate the effects of different courses of electroacupuncture on synaptic structure and synaptic function-related proteins expression in the hippocampal CA1 region of radiation-induced brain injury mice. Sixty C57BL/6J male mice were randomly divided into control group, radiation-induced brain injury model group, 1-week electroacupuncture group (EA1), 2-week electroacupuncture group (EA2), 3-week electroacupuncture group (EA3), and electroacupuncture-control (EA-Ctrl) group. The mice in model group were exposed to X-ray irradiation (8 Gy, 10 min) to establish radiation-induced brain injury model. The mice in EA groups were acupunctured at electroacupuncture points (Baihui, Fengfu and bilateral Shenshu) for 1 week, 2 weeks and 3 weeks respectively after radiation. Immunohistochemistry was used to observe synaptic structure in hippocampal CA1 region. The expressions of brain-derived neurotrophic factor (BDNF), synapsin-1 and postsynaptic density 95 (PSD95) in the hippocampal CA1 region of each group were detected by RT-PCR and Western blotting. The results showed that the nuclear gap in model and EA-Ctrl groups was significantly decreased compared to control group, however nucleus to cytoplasm ratio was significantly increased. The synaptic cleft, postsynaptic density (PSD) thickness, the mitochondrial surface density, volume density and specific surface area were significantly reduced. Compared with model group, the nucleus to cytoplasm ratio of EA2 group was significantly decreased, the PSD thickness and mitochondrial volume density were significantly increased; the nuclear gap of EA3 group was significantly increased, nucleus to cytoplasm ratio was significantly decreased, synaptic cleft and PSD thickness were significantly increased, and the mitochondrial surface density and specific surface area were all increased significantly. In addition, compared with the control group, the gene and protein expressions of BDNF, synapsin-1 and PSD95 in the hippocampal CA1 region of the model group and EA-Ctrl group were significantly decreased. However, compared with the model group, the gene expression of synapsin-1 in EA groups was significantly up-regulated, the gene expression of BDNF in EA1 and EA2 groups was significantly up-regulated, and the gene expression of PSD95 in EA2 group was significantly up-regulated. Moreover, the protein expressions of BDNF, synapsin-1 and PSD95 of EA groups were significantly up-regulated compared with the model group. These results indicate that the synaptic structure and the expression of synaptic function-related proteins in hippocampal CA1 region were injured by radiation exposure, whereas electroacupuncture intervention can significantly improve the synaptic structure and function damage caused by radiation.

Effect of polysaccharides from seeds of Vaccaria segetalis in alleviating urinary tract infection induced bladder injury by inhibiting NLRP3 inflammasome / 中国中药杂志

To study the mechanism of polysaccharides from seeds of Vaccaria segetalis( PSV) in the treatment of bacterial cystitis through the NLRP3 inflammasome pathway. The rat model of urinary tract infection was used and treated with PSV,and the urine and bladders were collected. The level of interleukin-10( IL-10) in rat urine was detected by enzyme linked immunosorbent assay( ELISA). Western blot and immunofluorescence staining were used to detect the expressions of sonic hedgehog( SHH) and NLRP3 inflammasome [NOD-like receptor thermoprotein domain 3( NLRP3),apoptosis associated speck like protein( ASC) and pro-caspase-1]. The expression of Toll-like receptor pathway was detected by RT-PCR. The death of 5637 cells induced by uropathogenic Escherichia coli( UPEC) and lactate dehydrogenase( LDH) release were evaluated using live/dead staining. The results showed that in the rat bladder,the expressions of SHH,NLRP3 inflammasomes and Toll-like receptors were significantly up-regulated,and NLRP3 inflammasomes were significantly activated by UPEC infection. The administration with PSV could significantly increase the concentration of IL-10 in urine,inhibit the expressions of SHH,NLRP3 inflammasomes and Toll-like receptors in bladder,and inhibit the activation of NLRP3 inflammasomes. A large number of 5637 cells were dead after UPEC infection and caused LDH production. PSV could significantly inhibit the death of 5637 cells and the release of LDH. In conclusion,PSV could inhibit the expression and activation of NLRP3 inflammasomes by inhibiting the Toll-like receptor pathway,thereby mitigating the bladder injury.

Electroacupuncture improves learning-memory ability possibly by suppressing apoptosis and down-regulating expression of apoptosis-related proteins in hippocampus and cerebral cortex in immature mice with Alzheimer's disease / 针刺研究

OBJECTIVE: To investigate the effect of electroacupuncture (EA) at "Baihui"(GV20), "Fengfu"(GV16) and bilateral "Shenshu"(BL23) on learning-memory ability, apoptosis in the hippocampus and expression of Aβ, Caspase 3, Bax and Bcl-2 proteins in the hippocampus and cerebral cortex in immature mice with Alzheimer's disease (AD), so as to explore its mechanism underlying improvement of AD. METHODS: Forty APP/PS1 transgenic male young mice were equally randomized into model and EA groups and 20 C57BL/6J male young mice were used as the normal control. EA (10 Hz, about 2 mA) was applied to GV20-BL23 and GV16-BL23 for 20 min, once daily, 6 days a week for 16 weeks. The Morris water maze swimming test was used to evaluate the animals' learning-memory ability. Congo red staining and immunohistochemical staining were used to detect senile plaques in the hippocampus (dentate gyrus) and cerebral cortex tissues. Terminal deoxynucleotidyl transferase-mediated dUTP Nick-end Labeling (TUNEL) was used to detect the cellular apoptosis of hippocampus. The expression levels of apoptosis related factors Caspase 3, Bax and Bcl-2 were detected by Western blot. RESULTS: After modeling, the escape latency of place navigation test of Morris water maze swimming tasks was significantly increased (P0.05). CONCLUSION: EA of GV20, GV16 and BL23 can effectively improve the learning-memory ability in AD mice, which may be related to its function in inhibiting neuronal apoptosis in the hippocampus and down-regulating the expression levels of Aβ, Caspase 3 and Bax proteins in both hippocampus and cerebral cortex.

Current Status of Etiology, Epidemiology, Clinical Manifestations and Imagings for COVID-19

Coronavirus disease 2019 (COVID-19) is a transmissible respiratory disease that was initially reported in Wuhan, China in December 2019. With the alarming levels of COVID-19 spread worldwide, the World Health Organization characterized COVID-19 as a pandemic. Over the past several months, chest CT has played a vital role in early identification, disease severity assessment, and dynamic disease course monitoring of COVID-19. The published data has enriched our knowledge on the etiology, epidemiology, clinical manifestations, and pathologic findings of COVID-19. Additionally, as the imaging spectrum of the disease continues to be defined, extrapulmonary infections or other complications will require further attention. This review aims to provide an updated framework and essential knowledge with which radiologists can better understand COVID-19.

Infection Control and Management Strategy for COVID-19 in the Radiology Department: Focusing on Experiences from China

Coronavirus disease 2019 (COVID-19) is a new infectious disease rapidly spreading around the world, raising global public health concerns. Radiological examinations play a crucial role in the early diagnosis and follow-up of COVID-19. Cross infection among patients and radiographers can occur in radiology departments due to the close and frequent contact of radiographers with confirmed or potentially infected patients in a relatively confined room during radiological workflow. This article outlines our experience in the emergency management procedure and infection control of the radiology department during the COVID-19 outbreak.

Tube Voltage, DNA Double-Strand Breaks, and Image Quality in Coronary CT Angiography

Objective@#To evaluate the effects of tube voltage on image quality in coronary CT angiography (CCTA), the estimated radiationdose, and DNA double-strand breaks (DSBs) in peripheral blood lymphocytes to optimize the use of CCTA in the era of lowradiation doses. @*Materials and Methods@#This study included 240 patients who were divided into 2 groups according to the DNA DSB analysismethods, i.e., immunofluorescence microscopy and flow cytometry. Each group was subdivided into 4 subgroups: thosereceiving CCTA only with different tube voltages of 120, 100, 80, or 70 kVp. Objective and subjective image quality wasevaluated by analysis of variance. Radiation dosages were also recorded and compared. @*Results@#There was no significant difference in demographic characteristics between the 2 groups and 4 subgroups in eachgroup (all p > 0.05). As tube voltage decreased, both image quality and radiation dose decreased gradually and significantly.After CCTA, γ-H2AX foci and mean fluorescence intensity in the 120-, 100-, 80-, and 70-kVp groups increased by 0.14, 0.09,0.07, and 0.06 foci per cell and 21.26, 9.13, 8.10, and 7.13 (all p 0.05). @*Conclusion@#The 100-kVp tube voltage may be optimal for CCTA when weighing DNA DSBs against the estimated radiationdose and image quality, with further reductions in tube voltage being unnecessary for CCTA.

Recommendation for an oral mucosal contouring method in nasopharyngeal carcinoma patients receiving tomotherapy / 中华放射肿瘤学杂志

Objective@#To evaluate the value of two oral mucosal contouring methods for predicting acute radiation-induced oral mucositis (A-ROM) in nasopharyngeal carcinoma (NPC) patients.@*Methods@#A total of 150 AJCC 7th stage Ⅱ-IVB NPCs receiving radical tomotherapy (TOMO) in Zhejiang Cancer Hospital from 2017 to 2019 were included in this prospective observational study. Oral cavity contour (OCC) and mucosal surface contour (MSC) were applied to delineate the oral mucosal structure. A-ROM grade was prospectively assessed and recorded weekly according to RTOG scoring criteria. The prediction value of two methods for A-ROM was statistically compared.@*Results@#The incidence rate of ≥3 grade A-ROM was 33.3%. In univariate analysis, V5, V10, V15, V45, V50, V55, V60, V65 and V70 of OCC and V5, V10, V50, V55, V60, V65, V70 and Dmean of MSC were significantly correlated with the risk of ≥3 grade A-ROM (all P<0.05). In binary logistic regression analysis, gender and smoking were significantly associated with the incidence of ≥3 grade A-ROM by using OCC (male vs. female: OR=0.141, 95%CI=0.037-0.538, P=0.004; smoking vs.non-smoking: OR=5.109, 95%CI=1.413-18.470, P=0.013). For MSC, gender, smoking, N stage and MSC- V55 were the independent predictors (male vs. female: OR=0.129, 95%CI=0.032-0.519, P=0.004; smoking vs.non-smoking: OR=4.448, 95%CI=1.224-16.164, P=0.023; N stage: OR=2.291, 95%CI=1.268-4.137, P=0.006; MSC-V55: OR=1.432, 95%CI=1.008-2.033, P=0.045). The cutoff value of MSC-V55 was 7.70%, the area under ROC curve was 0.754, the sensitivity and specificity were 0.680 and 0.740, retrospectively (all P<0.001).@*Conclusions@#Compared with OCC, MSC yields a higher prediction accuracy for the severity of A-ROM in nasopharyngeal carcinoma patients receiving TOMO treatment.

Progress of residual inflammatory cardiovascular risk / 医学研究生学报

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality in the world. Although the comprehensive control of cardiovascular disease risk factors has achieved remarkable progress in recent years, the incidence of cardiovascular events is still high after the control of traditional risk factors such as low density lipoprotein cholesterol, blood pressure and blood glucose, collectively referred to as cardiovascular residual risk. Inflammation is a central driver of atherosclerosis and the ultimate rupture of plaque, as well as an important cause of residual cardiovascular risk. Therefore, this article reviews the formation, assessment and treatment of residual inflammatory cardiovascular risk.

Expression of interleukin-23 and interleukin-17 in the aqueous humor of patients with diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the correlation between the concentrations of interleukin-23(IL-23)and interleukin-17(IL-17)in the ocular aqueous humor(AH)at the different degrees of diabetic retinopathy(DR)patients. <p>METHODS: From June 2016 to June 2019, 70 patients(70 eyes)for age related cataract surgery were enrolled in Hubei Yichang Central People's Hospital. All cases were graded into 4 groups, includingⅠ group(20 cases): the control group(patients without diabetes), Ⅱ group(18 cases): diabetic patients without retinopathy, Ⅲ group(17 cases): diabetic patients with non-proliferative diabetic retinopathy, Ⅳ group(15 cases): diabetic patients with proliferative diabetic retinopathy. The levels of IL-23 and IL-17 in AH of the four groups were tested by Enzyme-linked immunosorbent assay(ELISA)and statistically analyzed by ANOVA respectively. The correlations between IL-17 and IL-23 were calculated by Person correction analysis.<p>RESULTS: The concentration of IL-23 in Ⅰgroup was low(22.18±5.48pg/mL),while those in Ⅱ(37.63±4.52pg/mL), Ⅲ(45.06±4.64pg/mL), Ⅳ(68.89±6.11pg/mL)groups respectively were higher. The IL-17 level inⅠ, Ⅱ, Ⅲ, Ⅳ groups were 4.69±2.03, 6.83±1.02, 9.52±1.30, 10.89±1.26pg/mL respectively. Comparison of IL-23 and IL-17 within four groups revealed: both were increased in Ⅱ group initially, and raised along with the progression of DR. According to the correlation analysis, the expression level of IL-17 of DM was typical positively correlated with IL-23.<p>CONCLUSION:The over-expression of IL-23 and IL-17 may have a synergistic effect on the occurrence and development, and the IL-23/IL-17 pathway might be associated with the severity of DR by aggravating the inflammatory response of retina. These results indicated that IL-23-IL-17 axis could be a new target for the early diagnosis and treatment of DR.

Silicon oil removed combined with external-route microsurgery for retinal detachment in silicon oil tamponaded eyes / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the efficacy of silicon oil removal combined with external-route microsurgery in treating of retinal detachment in selected eyes with silicone oil tamponaded. <p>METHODS: This was a retrospective observational case series. 21 cases(21 eyes)had undergone minimally invasive vitrectomy combined with silicone oil tamponade for various vitreoretinal diseases firstly. Because of retinal detachment recurrent, external-route microsurgery combined with oil extracted was performed between July 2014 and July 2018 secondly. The retinal reattachment rate, visual outcome, intraocular pressure and postoperative complications were investigated. <p>RESULTS: After 4 to 12(5.48±1.53)mo follow-up period, the retinal reattachment rate was 90%(19/21 cases). Further vitrectomy surgeries were needed for other 2 eyes. The final best corrected visual acuity(BCVA)≥0.4 was in 4 eyes, 0.06-0.3 was in 9 eyes and ≤0.05 was in 8 eyes, which had significant difference contrasted to that of preoperation(<i>t</i>=3.58, <i>P</i><0.05). Macular epiretinal membrane, second glaucoma and complicated cataracts were found in 1, 2 and 5 eyes respectively. There hadn't other serious complications postoperatively. <p>CONCLUSION: The external-route microsurgery was also suitable for retinal detachment in silicone oil filled eyes which were PVR≤C1 and the roles located in the equator region or front even. This way was simple, convenient and effective. The rate of secondary vitrectomy with silicone oil tamponade also can be reduced.

School bullying and its influencing factors in higher vocational college students in western Hunan province / 中国学校卫生

Objective@#To understand current situation and influencing factors of school bullying among left-behind and non left-behind students in vocational colleges in western Hunan, and to provide reference for the prevention and control of campus bullying in vocational colleges in poverty-stricken areas.@*Methods@#A multi-stage stratified random cluster sampling method was used to select 1 241 students from higher vocational colleges in Xiangxi for questionnaire survey. The survey included basic demographic characteristics, health-related behaviors and school bullying. Associcted factors were compared among students with and without school bullying by using the χ2 test and Logistic regression.@*Results@#The reported rate of school bullying in vocational colleges was 41.82%. The reported rate of left-behind students (45.05%) was higher than that of non-left-behind students (39.21%). The difference was statistically significant (χ2=4.29,P<0.05). Multivariate unconditional Logistic regression showed that male students and good parental relationship negatively associated with school bullying among left-behind students(OR=0.55，0.47). While rural students, 5 years of senior vocational, smoking, drinking, and game addiction were positively associated with school bullying among left-behind students(OR=1.93,2.57,2.51,3.95,4.73); good relationship with mothers was associated with less school bullying(OR=0.40), while smoke, drinking and game addiction was associated with more school bullying among non left-behind students(OR=1.86,2.32，3.81)(P<0.05).@*Conclusion@#School bullying among students in higher vocational colleges in western Hunan is highly prevalent. The reporting rate among left-behind students is higher than that of non-left-behind students. Due to different factors, joint intervention measures by government, schools and families should be carried out as soon as possible.

Chest CT--The gatekeeper to COVID-19 / 医学研究生学报

In December 2019, an outbreak of pneumonia associated with a novel coronavirus (SARS-CoV-2）emerged in Wuhan and spread rapidly throughout China and beyond. As the first-line imaging modality, thin-section chest CT is easy to perform, fast, available. Combined with epidemiological history and clinical manifestations, positive CT findings can highly suggest the early diagnosis of Coronavirus Disease 2019 (COVID-19) with high sensitivity, so that timely isolation and intervention can be implemented for suspected and confirmed patients. CT can also help assess the disease severity, and surveil disease course, so as to guide clinical decision and provide prognostic information. This paper outlines the CT imaging features of COVID-19 and highlights the value of chest CT in its diagnosis and treatment with the reference to the official documents and latest researches.