Mental health difficulties and related factors in Chinese children and adolescents during the COVID-19 pandemic: a cross-sectional study

Abstract Objective: To examine the mental health status and related factors in children and adolescents, and to assess age groups and sexes differences in factors influencing mental health. Methods: This cross-sectional study was performed on Chinese children aged 6-18 years from November 2021 to January 2022. Mental health difficulties were accessed by the Strengths and Difficulties Questionnaire. Multivariate logistic regression was used to analyze factors associated with mental health status. Multiple linear regression was used to evaluate factors associated with the scores of the Strengths and Difficulties Questionnaire. Results: The prevalence of mental health difficulties was 12.98% (n =1348). Age (OR, 0.909, [95%CI, 0.830-0.996]), sex (OR, 1.424, [95%CI, 1.033-1.963]) and screen time on weekdays ("≥2" h/d vs "< 1" h/d: OR, 2.001, [95%CI, 1.300-3.080]) were related factors for mental health difficulties. For children (year ≤ 12), the strongest related factor for mental health difficulties was screen time on weekdays ("≥ 2" h/d vs "< 1" h/d: OR, 1.821 [95%CI, 1.203-2.755]). The risk of mental health difficulties in females with ≥ 2 h/d screen time on weekends was 3.420 times higher than those with < 1 h/d (OR, 3.420, [95%CI, 1.923-6.081]). Conclusion: The prevalence of mental health difficulties among children and adolescents was relatively high. The lower age, female sex and excessive screen time were associated with a higher risk of mental health difficulties. The factors influencing mental health varied by different age groups and sexes. Thus, specific measures for different age groups and sexes should be adopted to mitigate the impact.

Expression and Clinical Significance of KIF11,β-catenin and GSK-3β in Cervical Cancer / 医学研究杂志

Objective To investigate the expression of kinesin family member 11(KIF11),β-catenin and glycogen synthase ki-nase-3β(GSK-3β)in cervical cancer and its clinical significance.Methods The expression of KIF11,β-catenin and GSK-3β in 102 cases of cervical cancer,52 cases of high-grade squamous intraepithelial lesion(HSIL)and 46 cases of low-grade squamous intra-epithelial lesion(LSIL)and 40 cases of chronic cervicitis were detected by immunohistochemistry,to analyze the relationship between the expression of the three indicators and the clinicopathological characteristics of cervical cancer patients,and to analyze the correlation be-tween the three indicators.COX proportional hazards model was used to analyze the prognostic factors of cervical cancer patients.Results With the progression of cervical lesions,the positive rates of KIF1 1 and β-catenin increased gradually,while the positive rates of GSK-3β decreased gradually(P＜0.05).The positive expressions of KIF11,β-catenin and GSK-3β in cervical cancer tissues were significantly different in International Federation of Gynecology and Obstetrics(FIGO)stage,differentiation degree and lymph node metastasis(P＜0.05),but there was no significant difference among different ages and pathological types(P＞0.05).The expression level of KIF11 was positively correlated with β-catenin(r=0.461,P＜0.05),and the expression level of β-catenin was negatively correlated with GSK-3β(r=-0.692,P＜0.05).The expression level of KIF11 was negatively correlated with GSK-3β(r=-0.336,P＜0.05).The average survival time of patients with positive expression of KIF11 and β-catenin was shorter than that of pa-tients with negative expression,and the average survival time of patients with positive expression of GSK-3 β was longer than that of pa-tients with negative expression of GSK-3β.COX regression analysis showed that FIGO stage,lymph node metastasis,KIF11 and β-catenin were independent risk factors for the prognosis of cervical cancer patients,and GSK-3β was an independent protective factor.Conclusion KIF11,β-catenin and GSK-3β are abnormally expressed in the tissues of cervical cancer patients.KIF11 may be in-volved in the regulation of Wnt/β-catenin pathway in the development of cervical cancer.The combined detection of KIF11 may provide a new reference for the diagnosis and prognosis of cervical cancer.

Association between age of life adversity and insulin resistance in girls with precocious puberty / 中国学校卫生

Objective@#To investigate the association between early life adversity(ELA) and the triglycerideglucose (TyG) index for an indicator of insulin resistance among girls with precocious puberty, so as to provide scientific basis for effective prevention and intervention measures.@*Methods@#From July 2020 to September 2021, girls with precocious puberty were recruited from the childrens health clinic of Anhui Provincial Childrens Hospital. Among them, 150 girls with complete blood indicators and questionnaire information were included. Both parental reports and child selfreports were combined to assess ELA exposure. Fasting blood samples were collected to evaluate thetyg index. According to the ELA score classification, girls were classified into 3 groups for 0, 1 and >2, multiple linear regression analysis were conducted to examine the association between ELA exposure and TyG index in girls with precocious puberty.@*Results@#Precocious pubertal girls subjectively reported high rates of ELA exposure, with an average ELA score of (1.07±1.17) and an average TyG level of (7.99±0.49). A single adverse association was found that the exposure of girls with precocious puberty to a lack of warm nurturing was significantly positively correlated with the TyG index (β=0.26, 95%CI=0.03-0.50, P<0.05). Multiple linear regression analysis showed that girls in the ELA≥2 group had a 0.24 increase in TyG levels compared to girls who did not experience ELA (β=0.24, 95%CI=0.04-0.43). After controlling for covariates such as child age, mothers age, fathers age, physical activity, screen time, birth weight, birth method (including natural and cesarean sections), perceived stress, BMI standardized Zscore, and parental assessment SDQ score, The association remained significant after controlling for covariates and was independent of BMI (β=0.25, 95%CI=0.04-0.46)(P<0.05).@*Conclusions@#Cumulative early life adversity in girls with precocious puberty is significantly positively correlated with the TyG index. It should early identify the girls exposed to high ELA for precocious puberty and timely intervent to improve their glucose metabolism function.

Therapeutic effect of PD-1 monoclonal antibody combined with cisplatin or gemcitabine chemotherapy in a mouse xenograft model with KRAS mutant non-small cell lung cancer A549 cells / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨程序性死亡受体-1（PD-1）单抗联合顺铂或吉西他滨在KRAS基因突变非小细胞肺癌（NSCLC）A549细胞移植瘤小鼠模型治疗中的作用。方法：构建免疫系统-肿瘤双人源化A549细胞小鼠移植瘤模型，将60只小鼠按随机数字表法分成6组（10只/组），分别为对照组（200 μL/kg PBS）、PD-1单抗组（20 mg/kg PD-1单抗）、顺铂组（3 mg/kg顺铂）、PD-1单抗+顺铂组（20 mg/kg PD-1单抗+3 mg/kg顺铂）、吉西他滨组（30 mg/kg吉西他滨）和PD-1单抗+吉西他滨组（20 mg/kg PD-1单抗+30 mg/kg吉西他滨）。TUNEL和DAPI双染色法检测移植瘤组织中细胞凋亡水平，测量移植瘤体积和质量并计算肿瘤生长抑制率，免疫组化法检测移植瘤微血管密度（MVD）。结果：成功构建免疫系统-肿瘤双人源化NSCLC A549细胞小鼠移植瘤模型，PD-1单抗+顺铂组移植瘤的细胞凋亡率、肿瘤生长抑制率均最高，移植瘤体积、质量和MVD均最小，与其他5组小鼠比较差异均有统计学意义（均P<0.05）。结论：顺铂与PD-1单抗具有协同活性，而吉西他滨拮抗PD-1单抗的治疗作用。提示PD-1单抗联合顺铂对KRAS突变NSCLC A549细胞移植瘤小鼠的疗效更好。

Effect of recombinant human thrombopoietin on platelets in rats with D-galactosamine salt-induced acute liver failure / 中华危重病急救医学

Objective:To evaluate the effects of recombinant human thrombopoietin (rhTPO) on platelet count (PLT) and liver function in acute liver failure (ALF) rats by observing the dynamic changes of PLT, thrombopoietin (TPO) and liver function during ALF.Methods:Twenty-four male Sprague-Dawley (SD) rats were divided into model group, TPO group and interleukin-11 (IL-11) group using a random number table method, with eight rats in each group. All rats were intraperitoneally injected with D-galactosamine (D-GalN, 1?500 mg/kg, dosed within 72 hours) to induce the ALF model. After modeling, rats in TPO group was received subcutaneous injection of 15 μg/kg of rhTPO for 5 days, and rats in IL-11 group was received subcutaneous injection of 0.45 mg/kg of IL-11 for 5 days. Venous blood samples were collected before and at 1, 3, 5, 7 and 12 days after molding for whole blood cell detection. The level of TPO in serum was detected by enzyme-linked immunosorbent assay (ELISA). Liver function indexes including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and albumin (ALB) were measured before and at 1, 3 and 5 days after modeling. The rats were sacrificed 12 days after the modeling, and the pathological changes of liver tissue were observed by hematoxylin-eosin (HE) staining.Results:Two rats in each group died within 24-48 hours after modeling. HE staining showed that all three groups of ALF rats showed large flake necrosis of hepatocytes, disorder of hepatic lobular structure, mesh scaffold collapse, hepatic sinus congestion and hemorrhage, and flake infiltration of inflammatory cells on day 12 after modeling. The levels of serum ALT, AST and TBil of rats in each group were significantly increased 1 day after modeling and then decreased. The level of ALB decreased significantly on the first day after modeling and then increased, but there was no significant difference in the trend of liver function indexes among the three groups. PLT in the three groups decreased rapidly on day 1 after modeling, and then recovered gradually with the improvement of liver function. The PLT of the TPO group rose to the peak value 7 days after molding and was significantly higher than that of the model group [PLT (×10 9/L): 1?673.3±347.5 vs. 855.3±447.0, P < 0.05], while there was no significant difference between the IL-11 group and the model group [PLT (×10 9/L): 1?350.3±386.6 vs. 855.3±447.0, P > 0.05]. The level of serum TPO of the three groups increased significantly on day 1 after modeling, then decreased, and dropped to the lowest value on day 5, but there was no significant difference in the trend of serum TPO level among the three groups. Conclusions:PLT in ALF rats decreased rapidly in the early stage and recovered gradually with the improvement of liver function, and the serum TPO level increased first and then decreased. Injection of rhTPO can significantly increase PLT in ALF rats, but has no significant effect on liver function and survival rate.

Influencing factors of depressive symptoms among rural elderly patients with chronic diseases / 预防医学

Objective@#To investigate the influencing factors of depressive symptoms among rural elderly patients with chronic diseases in China, so as to provide insights into depression prevention and control among the rural elderly patients with chronic diseases.@*Methods@#The basic demographics, health status, and lifestyle of rural residents at ages of 65 years and older who had at least one chronic disease were retrieved from The Chinese Longitudinal Healthy Longevity Survey (CLHLS) database in 2018, and participants' depressive symptoms were assessed with The Center for Epidemiological Studies Depression-10 (CES-D-10) scale. Factors affecting the depressive symptoms were identified with a multivariable logistic regression model. @*Results@#Totally 5 146 rural elderly patients with chronic diseases were enrolled, including 2 373 men (46.11%) and 2 773 women (53.89%). The prevalence of depressive symptoms was 27.13%. Multivariable logistic regression analysis identified having two and more children (OR=0.614, 95%CI: 0.387-0.975), living alone (OR=1.450, 95%CI: 1.192-1.764), life satisfaction (general, OR=1.933, 95%CI: 1.651-2.264; low, OR=5.366, 95%CI: 3.488-8.254), self-assessed health status (general, OR=2.697, 95%CI: 2.284-3.185; poor, OR=5.338, 95%CI: 4.262-6.685), disability in instrumental activities of daily living (OR=1.592, 95%CI: 1.328-1.908), sleep duration (normal, OR=0.502, 95%CI: 0.429-0.586; too long, OR=0.494, 95%CI: 0.405-0.603), exercise (OR=0.721, 95%CI: 0.607-0.856), watching TV (OR=0.787, 95%CI: 0.664-0.933), and gardening activities (OR=0.781, 95%CI: 0.626-0.975) as factors affecting depressive symptoms among rural elderly patients with chronic diseases.@*Conclusions@#The prevalence of depressive symptoms was 27.13% among rural elderly patients with chronic diseases. Number of children, living style, life satisfaction, health status, sleep duration, exercise, watching TV, and gardening activities are associated with the development of depressive symptoms among rural elderly patients with chronic diseases.

Differential expression profiles analysis of DNA methylation between “disease” and “syndrome” in coronary heart disease-induced unstable angina patientswith Qi deficiency and blood stasis syndrome / 数字中医药（英文）

Objective@#To explore the differential expression profiles of DNA methylation sites/regions and potential molecular mechanisms in the peripheral blood of coronary heart disease (CHD)-induced unstable angina pectoris patients with or without Qi deficiency and blood stasis syndrome, and to provide scientific evidence for the conbination of disease and syndrome.@*Methods@#According to the pre-determined inclusion and exclusion criteria, the study subjects were enrolled and divided into two groups namely CHD-induced unstable angina group (G group) and healthy control group (J group) to conduct “disease” analysis, while G group was further divided into Qi deficiency and blood stasis syndrome group (case group) and non-Qi deficiency blood stasis syndrome group (control group) to perform “syndrome” analysis. The general data and clinical information of the study subjects were collected. The peripheral venous blood was extracted on an empty stomach, and the Illumina Infinium MethylationEPIC BeadChip (850K methylation chip) was used to detect the differential expressionprofiles of DNA methylation in each group, ChAMP software (V 2.14.0) was used for the differential methylation data analysis, with a threshold of the adjusted P value (adj.P.val) < 0.01. Gene Ontology (GO) and Kyoto Encyclopedia of Genomes (KEGG) were employed for the functional and pathway enrichment analyses of related mapped genes.@*Results@#A total of 263 differentially methylated CpG positions (DMPs) were screened out between G and J groups, including 191 hypermethylated positions such as cg05845204 and cg08906898, and 72 hypomethylated positions such as cg26919182 and cg13149459. These positions were mainly mapped to 148 genes encompassing RNA binding motif protein 39 (RBM39), acetyl-CoA acyltransferase 2 (ACAA2), protein phosphatase 1 regulatory subunit 12B (PPP1R12B), and the dual-specificity tyrosine phosphorylation-regulated kinase 2 (DYRK2). GO functional enrichment analysis revealed that the genes of the DMPs were primarily enriched in protein localization to chromosomes, regulation of cell morphogenesis, negative regulation of calcium-mediated signals, etc. KEGG pathway analysis suggested that the genes were mainly enriched in fatty acid metabolism and endocytosis pathways. In addition, a total of 23 differential methylation regions (DMRs) were identified, with overlapping genes such as transmembrane protein 232 (TMEM232), ribosomal protein large P1 (RPLP1), peroxisomal biogenesis factor 10 (PEX10), and forkhead box N3 (FOXN3) recognized. It was found that GO functions were mainly enriched in the negative regulation of Ras protein signal transduction, small GTPase-mediated signal transduction, negative regulation, etc. A total of 1 703 differential methylation sites were screened out between case and control groups, including 444 increased methylation positions such as cg05573767 and 1 259 decreased methylationpositions such as cg19938535, and cg03893872. These positions were mapped to 1 108 genes such as ribosomal protein S6 kinase A2 (RPS6KA2), leucine rich repeat containing 16A (LRRC16A), and hedgehog acyltransferase (HHAT). According to the GO functional enrichment analysis, the genes relating to the DMPs were mainly enriched in biological functions such as transmembrane receptor protein serine/threonine kinase signaling pathway and axonogenesis. The KEGG pathway enrichment analysis suggested the involvement of Rap1 signaling pathway, adenosine 5’-monophosphate-activated protein kinase (AMPK) signaling pathway, etc. A total of 21 DMRs were identified, including 22 overlapping genes such as mucin 4 (MUC4), three prime repair exonuclease 1 (TREX1), and LIM homeobox 6 (LHX6). GO analysis demonstrated that the genes primarily participated in molecular functions such as positive regulation of transmembrane transport, regulation of fatty acid metabolism, and copper ion binding.@*Conclusion@#This study reveals the methylation patterns of DMPs and DMRs in patients with Qi deficiency and blood stasis syndrome caused by CHD-induced unstable angina pectoris. Potential epigenetic regulation of fatty acid metabolism, Rap1 signaling, and other molecular functions are involved in the development of CHD between the "disease" and "syndrome".

A consensus on the management of allergy in kindergartens and primary schools / 中国学校卫生

Abstract@#Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

Social functioning characteristics of children with co occurrence of attention deficit hyperactivity disorder and oppositional defiant disorder / 中国学校卫生

Objective@#To explore the social functioning characteristics of children with co ocurrence of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) for intervention reference.@*Methods@#The Chinese Version of Swanson Nolan and Pelham, Version IV Scale-Parent Form(SNAP-IV), the Chinese Version of Weiss Functional Impairment Scale-Parent(WFIRS-P), and the Questionnaire-Children with Difficulties (QCD) were applied to 192 children with ADHD, 243 children with co occurrence of ADHD and ODD, who firstly visited the Department of Children Psychological Health of Zhuhai Maternal and Child Health Care Hospital, and 118 healthy control children from a school in Zhuhai.@*Results@#The scores of attention deficit factor in SNAP-Ⅳ scale of children in three groups were[1.9(1.7, 2.1), 1.8(1.6, 1.9), 1.0(0.6, 1.2)], the scores of hyperactive impulsivity were[1.8(1.4, 2.1), 1.6(1.1, 1.8), 0.7(0.2, 1.0)] the scores of oppositional defiant were[1.6(1.5, 1.9), 1.0(0.8,1.1), 0.8(0.5, 1.0)], the differences were statistically significant( H=268.44, 237.97, 418.66, P <0.01). The dimensions and total scores of the three groups of children s WFIRS-P scale were family[0.8(0.6, 1.1), 0.6(0.3, 0.8), 0.3(0.1, 0.6)]; learning and school[0.8(0.5, 1.1), 0.8(0.5, 1.0), 0.3(0.1, 0.5)]; life skills[1.0(0.7, 1.2), 0.8(0.6, 1.0), 0.6(0.4, 0.8)]; self management [1.0(0.3, 1.0), 0.7(0.3, 1.0), 0.3(0.0, 0.7)]; social activities [0.7(0.4, 1.0), 0.6(0.3, 0.9), 0.3(0.0, 0.4 )]; adventure activities[0.3(0.2, 0.5), 0.2(0.1, 0.4), 0.1(0.0, 0.2)]; the total score[0.8(0.6, 1.0), 0.6(0.5, 0.8), 0.4( 0.2 , 0.6)], the difference between the groups was statistically significant( H=108.82, 122.45, 60.17, 40.58, 96.17, 76.57, 138.30, P <0.01). The difference between the QCD scale scores of children in the three groups was statistically significant[30.0( 24.0 , 37.0), 32.0(27.0, 40.0), 47.0(37.0, 52.3), H=124.65, P <0.01). Multiple regression analysis showed that attention deficit, and oppositional defiant symptoms were associated with both the total WFIRS-P score and the QCD score of children( R 2= 0.40 , 0.25, P <0.05).@*Conclusion@#Children with co occurrence of ADHD and ODD have more severe deficits in all dimensions of social functioning than children with ADHD, which might be associated with attention deficit and oppositional defiant symptoms.

Nerolidol inhibits malignant biological behaviors of melanoma cells by regulating the Wnt-β-catenin pathway / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨橙花叔醇通过Wnt-β-catenin通路抑制黑色素瘤A-375和WM-115细胞恶性生物学行为的分子机制。方法: 体外培养黑色素瘤细胞A-375和WM-115，用不同浓度的橙花叔醇处理，采用SRB法和克隆形成实验、FCM术、Transwell实验和细胞划痕实验、DCFH-DA染色法、qPCR和WB法分别检测橙花叔醇对A-375和WM-115细胞的增殖能力、细胞周期和凋亡、迁移能力、活性氧（ROS）水平和Wnt-β-catenin通路及其下游相关基因和相关蛋白表达的影响。利用ULCAN和GEPIA2数据库分析黑色素瘤中Wnt-β-catenin通路的激活与患者预后的关系。结果：与对照组比较，橙花叔醇处理组A-375和WM-115细胞的增殖能力受明显抑制（均P<0.01）、细胞周期阻滞于G2/M期（P<0.05或P<0.01）、细胞凋亡率增加（均P<0.01）、迁移能力降低（P<0.05或P<0.01）、ROS水平升高（均P<0.01）、Wnt-β-catenin通路被抑制而其下游基因和蛋白表达明显上调（均P<0.01）。数据库数据分析显示，WNT1基因高表达患者OS低于低表达患者（P<0.01）。结论：橙花叔醇通过上调A-375和WM-115细胞中ROS水平影响Wnt-β-catenin通路，从而抑制其恶性生物学行为；Wnt-β-catenin通路可能是黑色素瘤治疗的潜在靶点。

Application of LASSO and its extended method in variable selection of regression analysis / 中华预防医学杂志

Multicollinearity is an important issue affecting the results of regression analysis. LASSO developed in recent years has great advantages in selecting explanatory variables, processing high-dimensional data, and solving multicollinearity problems. This method adds a penalty term to the model estimation, which can compress the regression coefficients of some unnecessary variables to zero and then remove them from the model to achieve the purpose of variable screening. This paper focuses on the LASSO method and compares it with optimal subsets, ridge regression, adaptive LASSO, and elastic net results. It is found that both LASSO and adaptive LASSO have good performance in solving independent variable multicollinearity problems and enhancing model interpretation and prediction accuracy.

Analysis on the diagnostic value of ABUS combined with DBT in dense type of intra-mammary breast cancer / 中国医学装备

Objective:To explore the diagnostic value of automatic breast ultrasound imaging system(ABUS)combined with digital breast tomosynthesis(DBT)for dense type of intra-mammary breast cancer.Methods:A total of 96 patients with dense type of intra-mammary breast cancer who admitted to hospital were selected,and all patients completed ABUS and DBT examinations within 1 week before they underwent the invasive operations such as puncture and surgery.Taking pathological results as the gold standard,the diagnostic values of ABUS and DBT for dense type of intra-mammary breast cancer were analyzed.Results:A total of 96 lesions were detected out from 96 patients by pathological examination.Based on the pathological results as the gold standard,the sensitivity,specificity and area under curve(AUC)value of ROC of ABUS were respectively 77.32%,82.53%and 0.711(95%CI:0.635～0.792)in diagnosing dense type of intra-mammary breast cancer.The sensitivity,specificity and AUC value of DBT were respectively 81.59%,80.23%and 0.734(95%CI:0.612～0.776)in diagnosing that.The sensitivity,specificity and AUC of ABUS combined with DBT were respectively 89.38%,92.46%and 0.787(95%CI:0.659～0.824)in diagnosing that.Conclusion:ABUS combined with DBT is beneficial to improve the clinical detection rate of dense type of intra-mammary breast cancer,and reduce the missed diagnosis of tumor without company of calcification lesion.

Twelve-week treadmill endurance training in mice is associated with upregulation of interleukin-15 and natural killer cell activation and increases apoptosis rate in Hepa1-6 cell-derived mouse hepatomas

Regular exercise reduces the risk of malignancy and decreases the recurrence of cancer. However, the mechanisms behind this protection remain to be elucidated. Natural killer (NK) cells are lymphocytes of the innate immune system, which play essential roles in immune defense and effectively prevent cancer metastasis. Physical exercise can increase the activity of NK cells. Interleukin-15 (IL-15) is the best-studied cytokine activator of NK cells, and it was shown to have many positive functional effects on NK cells to improve antitumor responses. The aim of this study was to clarify the possible important mechanisms behind endurance exercise-induced changes in NK cell function, which may be highly correlated with IL-15. An animal model was used to study IL-15 expression level, tumor volume, cancer cell apoptosis, and NK cell infiltration after treadmill exercise. Although IL-15 was highly expressed in skeletal muscle, treadmill exercise further elevated IL-15 levels in plasma and muscle (P<0.05). In addition, tumor weight and volume of tumor-bearing mice were decreased (P<0.05), and liver tumor cell apoptosis was increased after 12 weeks of treadmill exercise (P<0.05). NK cell infiltration was upregulated in tumors from treadmill exercise mice, and the level of interferon-gamma (IFN-γ) and IL-15 were higher than in sedentary mice (P<0.05). The study indicated that regular endurance training can reduce cancer risk, which was related to increased IL-15 expression, activation of the immune killing effect of NK cells, and promotion of tumor cell apoptosis, which can ultimately control tumor growth.

The efficacy of bleomycin sclerotherapy in the treatment of lymphatic malformations: a review and meta-analysis

Abstract Objective At present, bleomycin has been widely used in the treatment of Lymphatic Malformations (LMs). This study aims to perform a meta-analysis to investigate the effectiveness and influencing factors of bleomycin in the treatment of LMs. Methods We conducted a systematic review and meta-analysis to clarify the relationship between bleomycin and LMs. PubMed, ISI Web of Science and MEDLINE were searched. Results A total of 21 studies (including 428 cases) about bleomycin sclerotherapy for LMs were included in the current meta-analyses. We calculated pooled effective rate and 95% Confidence Interval (95% CI) using random effects model to evaluate the relations between bleomycin and LMs. The results suggested that the effective rate of bleomycin was the combined effective rate was 84.0% (95% CI 0.81‒0.87) and ranged from 39% (95% CI 0.22‒0.56) to 94% (95% CI 0.87-1.02). The heterogeneity among the studies was substantial (I2 = 61.7%, p = 0.000). In subgroup analyses, it was observed that among retrospective study and prospective study, the estimated effective rate was 80.0% (95% CI 0.76‒0.84) and 91.0% (95% CI 0.85‒0.97), respectively. In terms of the dosage, the combined effective rates of weight-based group and fixed-dose group were 86% (95% CI 0.83‒0.90) and 74.0% (95% CI 0.66‒0.82), respectively. There was no significant publication bias in Egger's test (p = 0.059, 95% CI −3.81 to 0.082), but Begg's test did (p = 0.023), and the funnel plot is asymmetric. Conclusion Our study suggested that bleomycin was safe and effective in the treatment of LMs and was primarily dose dependent.

Influence of functional training on teaching table tennis to college students / Influência do treinamento funcional no ensino de tênis de mesa em estudantes universitários / Influencia del entrenamiento funcional en la enseñanza de tenis de mesa en estudiantes universitarios

ABSTRACT Introduction: Contemporary table tennis teaching lacks attention to global abilities; some studies suggest that functional training can supply the demands of the high level of sport competition. Objective: Study the effect of functional training on teaching table tennis to college students. Methods: A controlled random selection was carried out (n=40), in which the experimental group (n=20) chose a functional training program. In contrast, the control group (n=20) participated in the teaching of traditional table tennis skills. The training frequency was one hour daily, three times a week, lasting six weeks. Table tennis-specific fitness was assessed before and after the experiment. Data were cataloged and statistically analyzed. Results: On the manual skills index, the experimental group's score increased from 63,194 to 79,683 points after the experiment, and the control group's score increased from 64,788 to 68,775 points after the experiment. In the regression index, the experimental group score increased from 63.645 to 78.614, and the control group score increased from 64.152 to 70.574. Conclusion: The functional training mode proposed in this paper can rapidly improve the competitive level of table tennis and improve the competitive performance of its practitioners. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O ensino contemporâneo no tênis de mesa carece de atenção em habilidades globais, alguns estudos sugerem que o treinamento funcional possa suprir as demandas requisitadas pelo alto nível de competição esportiva. Objetivo: Estudar o efeito do treinamento funcional sobre o ensino do tênis de mesa nos estudantes universitários. Métodos: Foi realizada uma seleção randômica controlada (n=40), na qual o grupo experimental (n=20) escolheu um programa de treinamento funcional, enquanto o grupo de controle (n=20) participou do ensino das habilidades tradicionais do tênis de mesa. A frequência do treinamento foi de uma hora diária, três vezes por semana, com duração de seis semanas. A aptidão física específica do tênis de mesa foi avaliada antes e depois do experimento. Os dados foram catalogados e analisados estatisticamente. Resultados: No índice de habilidades manuais, a pontuação do grupo experimental aumentou de 63.194 para 79.683 pontos após o experimento, e a pontuação do grupo de controle aumentou de 64.788 para 68.775 pontos após o experimento. No índice de retrocesso, a pontuação do grupo experimental aumentou de 63.645 para 78.614, e a pontuação do grupo de controle aumentou de 64.152 para 70.574. Conclusão: O modo de treinamento funcional proposto neste artigo pode melhorar rapidamente o nível competitivo do tênis de mesa e melhorar o desempenho competitivo de seus praticantes. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La enseñanza contemporánea en tenis de mesa carece de atención en habilidades globales, algunos estudios sugieren que el entrenamiento funcional puede suplir las demandas requeridas por el alto nivel de competición deportiva. Objetivo: Estudiar el efecto del entrenamiento funcional en la enseñanza del tenis de mesa en estudiantes universitarios. Métodos: Se realizó una selección aleatoria controlada (n=40), en la que el grupo experimental (n=20) eligió un programa de entrenamiento funcional, mientras que el grupo de control (n=20) participó en la enseñanza de las habilidades tradicionales del tenis de mesa. La frecuencia del entrenamiento fue de una hora diaria, tres veces por semana, con una duración de seis semanas. Se evaluó la forma física específica del tenis de mesa antes y después del experimento. Los datos se catalogaron y analizaron estadísticamente. Resultados: En el índice de habilidades manuales, la puntuación del grupo experimental aumentó de 63,194 a 79,683 puntos después del experimento, y la del grupo de control aumentó de 64,788 a 68,775 puntos después del experimento. En el índice de regresión, la puntuación del grupo experimental aumentó de 63,645 a 78,614, y la del grupo de control, de 64,152 a 70,574. Conclusión: El modo de entrenamiento funcional propuesto en este artículo puede mejorar rápidamente el nivel competitivo del tenis de mesa y mejorar el rendimiento competitivo de sus practicantes. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Benzodiazepines Refusal During Dispensing Process Among Patients Diagnosed With Depression or Schizophrenia in Malaysia

@#Introduction: Benzodiazepines (BZDs) are commonly prescribed to psychiatric patients. However, there have been few studies evaluating BZD refusal among patients with psychiatric disorders during the dispensing process. Thus, this study aimed to determine 1) the factors associated with BZD refusal during the dispensing process and to determine 2) the association between BZD refusal and psychiatric medication adherence among patients diagnosed with depression or schizophrenia. Method: This study was conducted at the Specialist Clinic Pharmacy, Jerantut Hospital, Malaysia, from May 2018 to June 2018. BZD refusal status was determined after the dispensing process, and general information on BZD was determined using a questionnaire developed by the researchers. Medication adherence was assessed using the Malaysian Medication Adherence Scale (MALMAS). Results: Overall, 75 patients with psychiatric disorders participate in the study. Participants had been on BZD treatment for a mean of 32.8± 21.6 months. The BZD refusal rate was 38.7%. BZD refusal was significantly associated with several factors. A one-year increase in age resulted in increased odds of BZD refusal by 1.16 times (95% CI 1.05-1.27). Other factors were male gender (OR,9.14; 95% CI, 1.17-71.27), being single (OR,15.07; 95% CI, 1.12-184.28), the diagnosis of schizophrenia (OR,13.45; 95% CI, 1.75-10.33) and not having history of illicit drug use (OR,20.63; 95% CI, 2.49-171.0). Medication adherence was not associated with BZD refusal. Conclusion: BZD refusal was significantly associated with demographic factors such as increased age, male gender and being single and diagnosis factors namely schizophrenia diagnosis and not having history of illicit substance use. Thus, the need for BZD in these groups of patients should be reviewed regularly.

Preparation of Fe3O4@SW-MIL-101-NH2 for selective pre-concentration of chlorogenic acid metabolites in rat plasma,urine,and feces samples / 药物分析学报

An innovative sandwich-structural Fe-based metal-organic framework magnetic material(Fe3O4@SW-MIL-101-NH2)was fabricated using a facile solvothermal method.The characteristic properties of the material were investigated by field emission scanning electron microscopy,transmission electron mi-croscopy(TEM),energy-dispersive X-ray spectroscopy,Fourier transform infrared spectroscopy,X-ray powder diffraction,vibrating sample magnetometry,and Brunauer-Emmett-Teller measurements.Fe3O4@SW-MIL-101-NH2 is associated with advantages,such as robust magnetic properties,high specific surface area,and satisfactory storage stability,as well as good selective recognition ability for chlorogenic acid(CA)and its metabolites via chelation,hydrogen bonding,and π-interaction.The results of the static adsorption experiment indicated that Fe3O4@SW-MIL-101-NH2 possessed a high adsorption capacity toward CA and its isomers,cryptochlorogenic acid(CCA)and neochlorogenic acid(NCA),and the adsorption behaviors were fitted using the Langmuir adsorption isotherm model.Then,a strategy using magnetic solid-phase extraction(MSPE)and ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF MS/MS)was developed and suc-cessfully employed for the selective pre-concentration and rapid identification of CA metabolites in rat plasma,urine,and feces samples.This work presents a prospective strategy for the synthesis of magnetic adsorbents and the high-efficiency pretreatment of CA metabolites.

Progress in diagnosis and treatment of gangrenous cholecystitis / 中华外科杂志

Gangrenous cholecystitis is a kind of acute cholecystitis, whose course of disease progresses rapidly, early diagnosis is difficult and mortality is high, and clinicians are prone to misdiagnosis and missed diagnosis in clinical work.However, gangrenous cholecystitis has been ignored in various guidelines.This paper systematically summarized the pathogenesis, pathological manifestations, epidemiology, clinical diagnosis and treatment of gangrenous cholecystitis, hoping to provide a complete and clear diagnosis and treatment process for clinicians.

Etiology and clinical characteristics of fever of unknown origin in 357 pediatric patients / 中华儿科杂志

Objective: To explore the etiologies and clinical characteristics of fever of unknown origin (FUO) and to provide clues for early diagnosis of FUO. Methods: The data about etiology, age, sex, clinical course, length of hospital stays and the expression levels of inflammatory factors in fever phase of 357 pediatric inpatients who were diagnosed with FUO in Children's Hospital of Fudan University from 1 January 2016 to 31 December 2020 were collected and retrospectively analyzed. Participants were grouped into infectious disease, inflammatory disease, malignancy and others and according to the classification of diseases and also grouped into those aged<1 year, 1-<3 years,3-<6 years, 6-<12 years and 12-<18 years. Comparisons between groups were performed using the Mann-Whitney U test, Kruskal-Wallis H test and χ² test. Results: Among the 357 patients (217 males and 140 females). The age of onset was 3.9 (1.3, 9.2) years and visiting age was 5.1 (2.0, 9.3) years. The time-consuming of diagnosis was 94 (66, 213) days. The hospital stay was 8 (6, 14) days. The most frequently identified cause of FUO was infectious diseases (163 cases, 45.7%), followed by non-infectious inflammatory diseases (133 cases, 37.2%), malignancy (21 cases, 5.9%) and others (40 cases, 11.2%). The patients at younger age were more likely to be attacked by malignancy, oncologic diagnoses, and others, nevertheless patients at older age were more likely to be attacked by non-infectious inflammatory diseases oppositely (9.8 (3.6, 11.5) vs. 3.0 (1.2, 7.0), 2.3 (1.0, 5.2), 0.9 (0.5, 1.8) years, U=41.30, 15.94, 37.08, all P<0.01);106 (65%) patients were male, and 57 (35%) patients were female. This result indicated that boys were more susceptible to infectious diseases (χ²=14.73, P<0.01). Analysis of inflammatory factors in serum among 103 patients, interleukin (IL)-6 level in 40 infectious diseases patients (9 (2, 38) ng/L) was significantly lower than those of 6 tumor patients (89 (64, 599) ng/L) and 57 non-infectious inflammatory diseases patients (25 (8, 78) ng/L, U=51.05, 15.70, both P<0.05), no significant difference was observed in IL-2, IL-4, IL-10, tumor necrosis factor α and interferon among the groups (all P>0.05). The patients grouped into those aged 1-<3 years and 3-<6 years were more likely to be attacked by infectious diseases (51.3% (59/115) and 57.1% (40/70)), while patients grouped into those aged 6-<12 years and 12-<18 years were more likely to be attacked by non-infectious inflammatory diseases (55.6% (65/117) and 72.4% (21/29)). Conclusions: Infectious disease is still the main cause of FUO in children and the boys are more susceptible to infectious diseases. However, the morbidity of non-infectious inflammatory diseases increases to number 1 in FUO of children over 6 years of age.

Peer victimization on early onset of breast development:mediation effects of morning cortisol and body fat / 中国学校卫生

Objective@#To explore the relationship and potential mechanism between peer victimization and early onset of breast development in girls, and to provide new strategies for precocious puberty prevention.@*Methods@#A total of 950 girls aged (9.0±1.2) years participated in this survey in Ma anshan City in China. Revised Bully/Victim Questionnaire (BVQ) was used. Each girl was assessed on breast Tanner stage by one female pediatric endocrinologist. All the girls collected morning awakening saliva sample with Salivette at home. Body fat percentage (%BF) was derived from Bioelectrical Impedance Analyzer (BIA) measurements.The association between peer bullying and early breast development was analyzed by stepwise Logistic regression.The mediation coefficient was estimated using the Logistic regression.@*Results@#Totally 23.2% (220/950) of all the girls reported being victimized at school. More girls reported peer victimization had early breast onset (24.1%,53) compared with girls with no victimization experience ( 13.7 %,100). Logistic regression analyses indicated that peer victimization was associated with early onset of breast development ( OR=1.74, 95%CI =1.16-2.59) after body fat and awakening cortisol adjusted. Mediation analysis showed that high cortisol and high fat both had indirect effects in the association between peer victimization and early onset of breast development.Mediating analysis showed that both high cortisol level and high body fat rate had indirect effects between peer bullying and early breast development, and the mediating effect values were 0.37 and 0.45,respectively.@*Conclusion@#Peer victimization significantly correlated with early onset of breast development among girls, which might be mediated through HPA axis hyperactivity and high adiposity.