Novel mutation in SCO2 of patients with high myopia from Enshi Tujia and Miao Autonomous Prefecture of China / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the pathogenic variants of the SCO2(OMIM 604272)gene in patients with high myopia from Enshi Tujia and Miao Autonomous Prefecture of China.METHODS: A total of 384 patients with high myopia whose spherical refractive error was ≤ -6.00 D and whose axial length was ≥26.00 mm in at least one eye were recruited. DNA was extracted by the phenol-chloroform method from 5 mL of peripheral venous blood. Sanger sequencing was performed to identify pathogenic variants in exon 2 of SCO2. The detected variants were evaluated via in silico prediction software. A total of 288 people from the same district were included as the normal control cohort.RESULTS: Seven variants were detected, namely, four synonymous variants(c.201C>T/p.=, c.576C>T/p.=, c.633A>C/p.=, c.780T>C/p.=.), two missense variants(c.187A>G/p.Ile63Val, c.59G>C/p.Arg20Pro)and one nonsense variant(c.544C>T/p.Gln182*). The two missense variants were not damaging, as predicted by PolyPhen2, SIFT and Provean. The novel nonsense variant(c.544C>T/p.Gln182*)cannot be found in the 1000 Genomes Project and was not identified in 288 normal controls. Variant Taster suggested that the nonsense variant site was conserved.CONCLUSION: The newly identified nonsense mutation may be responsible for high myopia of the patients in our cohort. SCO2 is associated with high myopia, while the incidence of SCO2 variants in high myopia in this cohort was as low as 1/384; the nonsense mutation may be a scarce variant of high myopia in the Enshi Tujia and Miao Autonomous Prefecture of China.

The Emotion-Regulation Benefits of Implicit Reappraisal in Clinical Depression: Behavioral and Electrophysiological Evidence / 神经科学通报·英文版

Major depressive disorder (MDD) is characterized by emotion dysregulation. Whether implicit emotion regulation can compensate for this deficit remains unknown. In this study, we recruited 159 subjects who were healthy controls, had subclinical depression, or had MDD, and examined them under baseline, implicit, and explicit reappraisal conditions. Explicit reappraisal led to the most negative feelings and the largest parietal late positive potential (parietal LPP, an index of emotion intensity) in the MDD group compared to the other two groups; the group difference was absent under the other two conditions. MDD patients showed larger regulatory effects in the LPP during implicit than explicit reappraisal, whereas healthy controls showed a reversed pattern. Furthermore, the frontal P3, an index of voluntary cognitive control, showed larger amplitudes in explicit reappraisal compared to baseline in the healthy and subclinical groups, but not in the MDD group, while implicit reappraisal did not increase P3 across groups. These findings suggest that implicit reappraisal is beneficial for clinical depression.

Clinical characteristics and genetic analysis of four patients with central hypothyroidism due to IGSF1 gene variants / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical manifestations and genetic characteristics of patients with congenital central hypothyroidism due to variants of IGSF1 gene.@*METHODS@#Clinical data, results of genetic testing, and follow-up of four patients admitted to Children's Hospital of Soochow University during 2017 to 2021 were retrospectively analyzed.@*RESULTS@#All of the four patients were males. Patient 1 had presented neonatal jaundice, patients 2 and 3 were admitted for growth retardation during childhood, and thyroid function test indicated slightly low free thyroxine (FT4), patient 4 was found to have reduced FT4 in the neonatal period. Genetic testing revealed that all of the four patients have harbored pathogenic variants of the IGSF1 gene, which were all inherited from their mothers. The thyroid functions in all patients were well controlled with oral levothyroxine and regular follow-up.@*CONCLUSION@#Pathogenic variants of the IGSF1 gene probably underlay the congenital central hypothyroidism with a variety of clinical manifestations, and genetic testing can facilitate the diagnosis at an early stage.

Application of a comprehensive risk assessment method for occupational disease hazards of employers in occupational health classification management of wooden furniture manufacturing factories / 环境与职业医学

Background The contradiction between science and operability has always existed in the model of classified occupational health supervision and management. Comprehensive risk assessment method for occupational disease hazards of employers provides risk grading and classification for occupational health management, and it's a new attempt to explore classification supervision and law enforcement. Objective To apply a comprehensive risk assessment method for occupational disease hazards of employers to estimate health risk level of wood furniture enterprises, discuss its advantages and disadvantages, and provide a basis for improving the classified management of occupational health. Methods Seven typical factories were selected in counties with highly concentrated wooden furniture manufacturing. Occupational health field investigation and testing were carried out to estimate occupational disease hazard risk level (Ⅰ, Ⅱ, and Ⅲ). A self-rated checklist was applied to score occupational health management status by interviewing employers, one by one, and to determine occupational health management status grade (A, B, and C) by the score. Thus, a comprehensive risk level (Class A, Class B, and Class C) of a specific factory was obtained from a matrix of occupational disease hazard risk level and management status grade. Risk verification was carried out based on any abnormality reported by regular occupational physical examination in past 3 years. Results Defects in occupational health management were identified in all 7 factories, among which 6 were grade C with key nonconformities (poor), and 1 was grade B (medium). Disqualified occupational disease hazards were found in 6 of 7 factories, and the workstation-specific disqualified rates were 26.09% (12/46) for noise, 14.71% (5/34) for wood dust (hard), and 12.50% (1/8) for xylene. Level Ⅱ (medium) of occupational disease hazard risk was estimated in 5 of 7 factories, while level Ⅲ (high) in 2 factories. All 7 factories were class C (high risk) accessed by the comprehensive risk assessment method for occupational disease hazards. The occupational health surveillance documents showed 636 batches of regular occupational physical examination were ordered by the 7 employers, and a total of 37 workers from 5 factories reported abnormalities in physical examination, among which 3 workers reported dust exposure and 34 workers reported noise exposure. Conclusion The comprehensive risk assessment method for occupational disease hazards of employers is not able to perform with satisfaction in occupational health classification of wooden furniture manufacturing factories yet. It is necessary to expand the pilot to improve this assessment method and develop an efficient supervision mechanism to ensure the authenticity of the data before it is popularized and applied in classified occupational health management.

Efficacy evaluation of radiofrequency thermocoagulation and pulse radiofrequency for the ganglion impar in treating primary perineal pain / 西安交通大学学报(医学版)

【Objective】 To compare the efficacy of radiofrequency thermocoagulation and pulsed radiofrequency for the ganglion impar in treating primary perineal pain. 【Methods】 We analyzed 79 patients with primary perineal pain who underwent radiofrequency thermocoagulation (group A) and pulsed radiofrequency (group B) in the ganglion impar from January 2020 to March 2022. VAS, excellent and good rates, sleep quality, postoperative medication usage, complications, and recurrence were evaluated before and 24 h, 1 W, 1 M, 3 M and 6 M after operation. The differences between the two groups were compared. 【Results】 The VAS score of group A gradually decreased at each level after operation, and the VAS score of group B gradually increased after 24 hours of operation. The differences between the two groups began to appear 1 week after operation, and the differences further increased with the extension of time (P<0.001). In six months after follow-up, the excellent and good rates of group A (86%) was significantly higher than that of group B (22%). In addition to postoperative perineal skin numbness, group A was superior to group B in improving sleep, postoperative oral medication (pregabalin and opioids), and disease recurrence (P<0.05). 【Conclusion】 Radiofrequency thermocoagulation for the ganglion impar can improve the quality of life by reducing pain, improving the excellent and good rates, improving sleep, and reducing recurrence a medication. The effect is better than that of pulsed radiofrequency.

Analysis of laboratory characteristics and evaluation of prognostic value of patients with NPM1 mutated acute myeloid leukemia / 中华检验医学杂志

Objective:To analyze the clinical and laboratory characteristics of acute myeloid leukemia (AML) patients with NPM1 mutation, and to explore the prognostic factors.Methods:A total of 77 AML patients with NPM1 gene mutation admitted to Hebei Yanda Ludaopei Hospital from May 1st 2012 to December 31st 2021 were enrolled in the study, including 34 male and 43 female patients. The median age was 40 (3, 68) years old. Patients were selected and divided into 4 groups according to the morphological FAB classification. There were 29 cases (37.7%) of M1 type, 13 cases (16.9%) of M2 type, 23 cases (29.9%) of M4 type, and 12 cases (15.5%) of M5 type. The clinical characteristics, bone marrow/peripheral blood cell morphology, immunophenotype, cytogenetics, molecular biology and overall survival of different groups were retrospectively analyzed, and the risk factors affecting the prognosis of AML were also explored. Cox multivariate regression was used to analyze the clinical influencing factors of survival and prognosis.Results:The white blood cell counts were highest in M4 and M5 patients and lowest in M2 patients, while no significant difference in the red blood cell, hemoglobin, and platelet counts( P>0.05). Morphologically, there were significant differences in the percentage of blasts and blasts with cup-like nuclei on bone marrow (BM) and peripheral blood (PB). The proportion of blasts in BM and PB was the highest in M1 and the lowest in M2 ( P<0.001). The positive rate of blasts with cup-like nuclei was the highest in M1 and the lowest in M5 of BM ( P<0.001), while the highest in M2 and the lowest in M5 of PB ( P=0.006). The scores of myeloperoxidase and chloroacetate esterase were all the highest in M1 and the lowest in M5 ( P<0.001, 0.001, respectively). In terms of molecular biology, the occurence rate of blasts combined with DNMT3A mutation was the highest in M4 and the lowest in M2 ( P=0.044), while those combined with FLT3-ITD mutation was the highest in M4 and the lowest in M5 ( P=0.002). In immunophenotype, there were significant differences in the expression positivities of seven antigens including HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO ( P<0.05). Multivariate COX regression analysis showed that no recurrence after treatment ( P<0.001), complete remission after treatment ( P=0.015) and transplantation ( P<0.001) were correlated with overall survival (OS). No recurrence after treatment ( P=0.033), transplantation ( P=0.027), no mutation of FLT3-ITD ( P=0.040), and hemoglobin concentration ( P=0.023) were associated with relapse-free survival (RFS). Survival analysis by Kaplan-Meier curve showed that there was no significant difference in survival time between the M1, M2, M4 and M5 groups in OS and RFS. Conclusion:There were significant differences in the white blood count, the percentage of blasts and blasts with cup-like nuclear morphology, cytochemical staining (MPO integration, CE integration and percentage of NAS-DCE), gene mutation (DNMT3A and FLT3-ITD) and immunophenotypes (HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO) between the four groups. The multivariate analysis revealed that no recurrence after treatment and transplantation were independent prognostic factors in NPM1 mut AML patients. On the other hand, FLT3-ITD mutation and hemoglobin concentration were associated with RFS and complete remission after treatment was associated with OS in the entire NPM1 mut cohort.

Study of extracting key plane of 11-13 + 6 weeks normal fetal palate by three-dimensional ultrasound based on artificial intelligence / 中华超声影像学杂志

Objective:To explore the feasibility of extracting the key plane of the normal fetal palate on the 11-13 + 6 week from tomography ultrasonography imaging based on artificial intelligence. Methods:The fetal volume datas of 235 cases of 11-13 + 6 week normal fetal were collected from the Department of Ultrasound in the Luohu District People′s Hospital of Shenzhen and Huazhong University of Science and Technology Union Shenzhen Hospital from May 2020 to April 2021. The data acquisition was completed by sonographers A and B by using the GE Voluson E10 color Doppler ultrasound diagnostic instrument. All datas were marked offline by sonographer C. Tomographic imaging was performed on all included data by sonographer D, the tomographic images were saved and the time-consuming was recorded, and the datas of the sonographer group were obtained. The labeled data were randomly divided into the training set and test set for model transfer learning and testing.The 4-fold cross-validation was adopted to record the test set image output by the model and the time consumption to obtain the intelligent group data. A senior sonographer performed image analysis on the two groups of data images. The feasibility of the intelligent model was verified by comparing the score of the plane of retronasal triangle(RTP), the acquisition rate of RTP, the acquisition rate of the fault, and the time-consuming difference between the sonographer group and the intelligent group. Results:①There was no significant difference in the overall distribution of RTP scores between the sonographer group and intelligent group [5 (5, 6) points vs 5 (5, 6) points, Z=0.355, P=0.722]. The RTP acquisition rate of the sonographer group and intelligent group was not statistically significant (78.72% vs 76.60%, χ 2=0.55, P=0.458). The consistency and correlation of RTP obtained by the two groups were high (Kappa=0.645, φ=0.646, both P<0.001). ②The effective layers of the sonographer group were 9 (8, 9) and the intelligent group was 8 (7, 9). The fault acquisition rate of the doctor group was higher than that of the intelligent group (78.72% vs 68.51%, χ 2=12.52, P=0.001). The consistency and correlation of the two groups in obtaining faults were media (Kappa=0.503, φ=0.521, both P<0.001). ③The time-consuming of the intelligent group was significantly lower than that of the sonographer group [1.50 (1.23, 1.75)s vs 26.94 (22.28, 30.48)s, Z=11.440, P<0.001]. Conclusions:This research model can quickly and accurately realize the extraction and tomography of the key plane of the normal fetal palate on the 11-13 + 6 week.

Analysis of influencing factors of dental fluorosis in children based on logistic regression and classification tree model / 中华地方病学杂志

Objective:To analyze the influencing factors of dental fluorosis of children in the drinking-water-borne endemic fluorosis (referred to as drinking-water-borne fluorosis) areas with qualified drinking water.Methods:In 2020 and 2021, the cluster sampling method was used to select the children aged 8 to 12 years old from the drinking-water-borne fluorisis areas with qualified drinking water in Tianjin City for water and urine fluoride detection, dental fluorosis examination and questionnaire survey, and logistic regression and classification tree model were used to analyze the influencing factors of dental fluorosis in children.Results:A total of 3 795 cases children aged 8 to 12 years old were investigated, and 1 001 cases of dental fluorosis were detected, and the detection rate of dental fluorosis was 26.38% (1 001/3 795). The results of logistic analysis showed that age [odds ratio ( OR) = 1.193, 95% confidence interval ( CI): 1.115 - 1.277], high urinary fluoride (1.84 - 19.40 mg/L, OR = 1.510, 95% CI: 1.169 - 1.952) and the number of permanent residents at home ≥6 ( OR = 1.377, 95% CI: 1.090 - 1.739) were risk factors of dental fluorosis in children; and the mother's with higher education level (college degree or above, OR = 0.664, 95% CI: 0.441 - 0.999), the years of water improvement ≥5 years (5 - < 10 years, OR = 0.193, 95% CI: 0.157 - 0.238; ≥10 years, OR = 0.254, 95% CI: 0.193 - 0.333) were protective factors of dental fluorosis in children. The results of classification tree model analysis showed that the years of water improvement contributed the most to the prevalence of dental fluorosis among children in the drinking-water-borne fluorisis areas with qualified drinking water, followed by age, number of permanent residents at home and urinary fluoride. The area under the receiver operating characteristic curve (AUC) of logistic regression model and classification tree model were 0.730 (95% CI: 0.711 - 0.748) and 0.721 (95% CI: 0.702 - 0.739), respectively, with good fitting effect. Conclusion:The detection rate of children's dental fluorosis in the drinking-water-borne fluorosis areas with qualified drinking water is mainly related to the years of water improvement, age, the number of permanent residents at home and urinary fluoride.

Screening the effective components in treating dampness stagnancy due to spleen deficiency syndrome and elucidating the potential mechanism of Poria water extract / 中国天然药物

Poria is an important medicine for inducing diuresis to drain dampness from the middle energizer. However, the specific effective components and the potential mechanism of Poria remain largely unknown. To identify the effective components and the mechanism of Poria water extract (PWE) to treat dampness stagnancy due to spleen deficiency syndrome (DSSD), a rat model of DSSD was established through weight-loaded forced swimming, intragastric ice-water stimulation, humid living environment, and alternate-day fasting for 21 days. After 14 days of treatment with PWE, the results indicated that PWE increased fecal moisture percentage, urine output, D-xylose level and weight; amylase, albumin, and total protein levels; and the swimming time of rats with DSSD to different extents. Eleven highly related components were screened out using the spectrum-effect relationship and LC-MS. Mechanistic studies revealed that PWE significantly increased the expression of serum motilin (MTL), gastrin (GAS), ADCY5/6, p-PKAα/β/γ cat, and phosphorylated cAMP-response element binding protein in the stomach, and AQP3 expression in the colon. Moreover, it decreased the levels of serum ADH, the expression of AQP3 and AQP4 in the stomach, AQP1 and AQP3 in the duodenum, and AQP4 in the colon. PWE induced diuresis to drain dampness in rats with DSSD. Eleven main effective components were identified in PWE. They exerted therapeutic effect by regulating the AC-cAMP-AQP signaling pathway in the stomach, MTL and GAS levels in the serum, AQP1 and AQP3 expression in the duodenum, and AQP3 and AQP4 expression in the colon.

Roles of the SoxC family in tumor development and its clinical significance / 国际肿瘤学杂志

SoxC transcription factors are a group of important protein molecules involved in gene transcription, translation and expression, which can regulate gene expression by specifically binding to corresponding target genes or proteins. The SoxC gene family has unique molecular structure features. Its members Sox4, Sox11 and Sox12 are abnormally expressed in a variety of tumors, and can be used as diagnostic and prognostic markers for different tumors. Investigating the pathogenic mechanisms of the SoxC transcription factor family and their clinical significance can increase the evidence for SoxC as a therapeutic target for tumors.

A case-control study of risk factors for gastritis, gastric intraepithelial neoplasia and gastric cancer in patients with gastroscopic biopsies in Shihezi, Xinjiang / 中华消化内镜杂志

Objective:To explore the risk factors involved in gastritis, gastric intraepithelial neoplasia (GIN) and gastric cancer in Shihezi area.Methods:A total of 7 110 Han nationality patients who underwent gastroscopy at the First Affiliated Hospital of Shihezi University School of Medicine from January 2012 to December 2016 were selected as the research subjects. The data of patients were obtained through medical records and questionnaires. After excluding diseases related to esophagus and duodenum, a total of 4 429 cases were included in the retrospective analysis. Of which, 4 249 were gastritis, 93 were GIN, and 87 were gastric cancer. χ2 test, rank-sum test or Fisher exact probability method were used to analyze the differences of various factors in gastritis, GIN and gastric cancer. Univariate and multivariate logistic regression analysis were used to screen the risk factors for gastritis progression to GIN and gastric cancer. Results:χ2 test and rank sum test showed that there were statistically significant differences in gender, age, history of digestive diseases and distribution of Helicobacter pylori ( HP) infection among the groups of gastritis, GIN and gastric cancer ( P<0.05). The proportion of HP infection decreased gradually with the disease severity. Multivariate logistic regression analysis showed that male ( P<0.001, OR=2.251, 95% CI: 1.461-3.470), elderly ( P<0.001, OR=4.829, 95% CI: 2.241-10.409), a family history of gastric cancer ( P=0.002, OR=3.227, 95% CI: 1.537-6.774) and a history of digestive diseases ( P=0.034, OR=1.644, 95% CI: 1.037-2.607) were independent risk factors for gastritis progression to GIN. Male ( P<0.001, OR=3.254, 95% CI: 2.026-5.225), middle-aged ( P=0.022, OR=2.688, 95% CI: 1.153-6.265) and elderly ( P=0.002, OR=4.734, 95% CI: 1.750-12.807) were independent risk factors for gastritis progression to gastric cancer. In stratified analysis to exclude age and gender, smoking ( P=0.028, OR=4.060, 95% CI: 1.160-14.202) was found to be a risk factor for gastritis progression to GIN in young adults, and obesity ( P=0.032, OR=3.869, 95% CI: 1.121-13.356) was found to be a risk factor for gastritis progression to gastric cancer in women. Conclusion:The degree of HP infection in gastric tissues is negatively correlated with the severity of gastric diseases, suggesting that HP infection may be an early event inducing gastric cancer. Male, the elderly, people with a family history of gastric cancer and a history of digestive diseases, and young smokers in Shihezi are more likely to develop GIN, and male, middle-aged, elderly, and obese women are at increased risk of gastric cancer.

Risk factors of venous thromboembolism in patients with severe traumatic brain injury / 中华创伤杂志

Objective:To investigate the risk factors of venous thromboembolism (VTE) in patients with severe traumatic brain injury (TBI).Methods:A retrospective case-control study was conducted for clinical data of 180 severe TBI patients admitted to West China Hospital, Sichuan University from July 2019 to July 2021, including 137 males and 43 females, aged 18-93 years [(50.8±18.2)years]. Glasgow Coma Scale (GCS) was 3-8 points [4 (3, 6)points].VTE was presented in 95 patients (thrombosis group), but was not seen in 85 patients (non-thrombosis group). Univariate analysis was used to detect the correlation of the following data with the occurence of VTE, inlcuding sex, age, body mass index (BMI), hypertension, diabetes, laboratory indicators measured on admission and at days 3-5 after admission [hemoglobin (Hb), platelet counts (PLT), antithrombin III, prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D)], tracheal intubation or not, operation or not, volume of intraoperative blood transfusion, operation time, anesthesia time, admission to ICU or not, mechanical ventilation or not, pharmacological prophylaxis or not, deep venous catheterization or not, parenteral nutrition or not, tracheal intubation time, tracheotomy or not, pneumonia, stress ulcer, blood transfusion or not and hospital stays. Multivariate Logistic regression analysis was used to identify the independent risk factors for VTE.Results:Univariate analysis showed that the occurence of VTE was correlated with sex, laboratory indicators measured on admission (TT, FIB, D-D), tracheal intubation, operation, intraoperative blood transfusion, operation time, anesthesia time, admission to ICU, mechanical ventilation, laboratory indicators measured at days 3-5 after admission (PLT, TT, FIB, D-D), deep venous catheterization, parenteral nutrition, tracheal intubation, tracheotomy, pneumonia, blood transfusion and hospital stays (all P<0.05 or 0.01), not with age, BMI, hypertension, diabetes, laboratory indicators measured at admission (Hb, PLT, antithrombin III, PT, APTT), laboratory indicators measured at days 3-5 after admission (Hb, antithrombin III, PT, APTT), pharmacological prophylaxis and stress ulcer (all P>0.05). Multivariate Logistic regression analysis showed that higher FIB on admission ( OR=1.27, 95% CI 1.04-1.56, P<0.05), tracheal intubation ≥7 days ( OR=2.98, 95% CI 1.40-6.33, P<0.01), tracheotomy ( OR=2.49, 95% CI 1.11-5.60, P<0.05), blood transfusion ( OR=2.75, 95% CI 1.25-6.06, P<0.05) and hospital stays >14 days ( OR=3.05, 95% CI 1.36-6.85, P<0.01) were significantly related to the occurence of VTE. Conclusion:Higher FIB on admission, tracheal intubation ≥7 days, tracheotomy, blood transfusion and hospital stays >14 days are independent risk factors for the occurence of VTE in severe TBI patients.

Association between body mass index and thyroid volume in children / 中华地方病学杂志

Objective:To understand the current status of overweight and obesity, the iodine nutrition level and goiter among children in Tianjin, and explore their relationships, so as to effectively adjust the prevention and control measures.Methods:From January 2019 to December 2020, one primary school was selected from all towns or streets in 16 districts of Tianjin, and non-boarding children aged 8 to 10 (age and gender balanced) were selected from each primary school. The number of children sampled in towns or streets in each district was as even as possible. Every year, 200 children from each district were investigated for height, weight, iodine of household edible salt, urinary iodine and thyroid volume. Body mass index (BMI) was calculated and its relationship with iodine nutrition level and goiter of children was analyzed.Results:A total of 6 552 children were investigated, and the median urinary iodine was 178.95 μg/L, the goiter rate was 2.15% (141/6 552). There was no significant difference in iodine content of household edible salt among children in different BMI groups ( P = 0.835), but the difference in thyroid volume was statistically significant ( P < 0.001). By constructing a restrictive cubic spline model, the risk of goiter in children of different age groups increased with increase of BMI ( P < 0.001 or P = 0.002). Conclusions:The BMI of children is closely related to thyroid volume. The influence of height and weight should be considered in diagnosis of goiter of children.

Analysis of staged two-way evaluation results of Milestones evaluation system on obstetrics and gynecology residents / 中华医学教育探索杂志

Objective:To evaluate the standardized residency training of obstetrics and gynaecology in Shengjing Hospital of China Medical University with Milestones evaluation system of obstetrics and gynecology, and to evaluate the feedback effect of the system.Methods:An improved Milestones evaluation form was developed to evaluate the self-evaluation and clinical tutor's scores, collect the results and make a statistical analysis of the 1-3 years standardized training residents of the Shengjing Hospital of China Medical University in September 2019. GraphPad Prism 8 software was used for data collection and statistical analysis, and Box-Plots software was used for drawing analysist. Descriptive statistics method was used for the general situation of the research objects. After the students' self-evaluation and tutor's scores passed the normal distribution and variance homogeneity test, paired t test was performed, and the scores of residents from different sources were analyzed by variance analysis. Results:A total of 164 residents of obstetrics and gynaecology were evaluated, and there were significant differences between self-evaluation and teacher's evaluation in medical knowledge, learning ability and system work ( P<0.05). The competency scores of the first year residents ranged from 3.003 to 4.556, and at the end of the course they increased to 4.921 to 5.974, showing statistically significant differences in each item compared with the first year ( P<0.001). After three years of training, residents from different sources showed significant improvement ( P<0.001). Conclusion:The Milestones evaluation system of the obstetrics and gynecology can be used for the training assessment and feedback of the residents in obstetrics and gynecology specialty. The self-assessment of residents helps to understand the level of self-assessment, and the teacher's evaluation helps to correct the bias generated by self-assessment. The systematic and staged Milestones evaluation system can instruct the clinical tutors to instruct the residents in accordance with their aptitude, and give feedback on the training effect of the residency training base.

Chinese Medicine in Regulating Signaling Pathways Related to Allergic Rhinitis： A Review / 中国实验方剂学杂志

Allergic rhinitis （AR）， a common disease in otolaryngology， is intractable with prolonged attack and greatly affects the daily life of patients. Western medicine adopts many therapeutic protocols， such as medication， immunotherapy， and surgery， and also shows disadvantages， including severe side effects and poor long-term curative effect. As reported by modern research， Chinese medicine has the characteristics of good safety， stable curative effect， multi-target and overall regulation， and has unique advantages in the prevention and treatment of AR. With the increasing clinical practice of Chinese medicine in the treatment of AR， scholars have carried out substantial basic research on the regulation of AR signaling pathways by monomers and Chinese medicinal compounds from molecule-cell-biology. To further explain the transduction mechanism of AR signaling pathways， this paper systematically summarized the research progress based on the studies of monomers and Chinese medicinal compounds to provide references for the in-depth research on the intervention of related signaling pathways by Chinese medicine. The conclusions were drawn as follows. The main signaling pathways involved included nuclear factor-kappa B （NF-κB） signaling pathway， TLR signaling pathway， interleukin （IL）-33/growth stimulation expressed gene 2 （ST2） signaling pathway， phosphoinositide 3-kinase/protein kinase B （PI3K/Akt） pathway， and mitogen-activated protein kinase （MAPK） pathway. As revealed， the signaling pathways involved in the treatment of AR by Chinese medicine interacted with each other and genes were not independent in exerting the effects. For example， TLR， as the upstream signal， affected the PI3K/Akt and MAPK signaling pathways， and NF-κB was the downstream substrate of PI3K/Akt， TLR， IL-33/ST2， and MAPK signaling pathways. It was found that IL-33/ST2， as a new signaling pathway， was correlated with the severity and prognosis of AR.

A benchmark dose analysis for children urinary fluoride and it's correlation with the prevalence of dental fluorosis / 公共卫生与预防医学

Objective To investigate the situation of drinking water fluorosis in Tianjin, to study the benchmark dose of urinary fluoride, and to provide a reference for the formulation of the standard for urinary fluoride. Methods Three fluorosis endemic areas were selected in Tianjin, and three villages in each area were selected in this study. The water fluoride was detected, and the prevalence of dental fluorosis and the urinary fluoride of children aged 8-12 years old were investigated. Results The prevalence of dental fluorosis and urinary fluoride content in children in the villages with water fluoride exceeding the standard were significantly higher than those in the villages with water fluoride qualified, and the difference was statistically significant (χ2=88.821, P＜0.001; Z=6.089, P＜0.001). The analysis of the prevalence of dental fluorosis in children showed that the younger the age, the lower the prevalence and severity of dental fluorosis (χ2trend=14.584, P2trend= 20.525, P2=0.736, P=0.391; χ2=3.649, P=0.456). There were significant differences in urinary fluoride between children with different ages and genders (H=14.768, P=0.011; Z=-2.526, P=0.012). According to the level of urinary fluoride, the children were divided into 5 groups. With the increase of urinary fluoride concentration, the prevalence of dental fluorosis gradually increased and the difference was statistically significant (χ2trend=16.348, P<0.001), showing a dose-effect relationship. Based on the prevalence of dental fluorosis in children, BMDS was used to calculate the BMD and BMDL, which were 2.20 mg/L and 1.54 mg/L, respectively. Conclusion The water reform and fluoride reduction in Tianjin has achieved certain results. There is a dose-effect relationship between urinary fluoride and prevalence of dental fluorosis in children, and the reference dose value is slightly higher than the current standard, suggesting that the current standard can be updated timely.

Reference value of surface radiation dose of digital radiography among adults in Beilun District / 预防医学

Objective@#To investigate the reference level of surface radiation dose of digital radiography (DR) among adult examinees in Beilun District, Ningbo City, so as to provide insights into the optimization of the parameters of DR systems and rational management of the radiation dose.@*Methods@#Based on the cloud imaging system covering 14 DR systems in 11 public hospitals in Beilun District, the diagnosis of adults receiving DR and DR systems check were collected from May 2020 to April 2021. The air kerma-area product ( PKA ) was selected as a measure, and the local diagnostic reference level ( LDRL ), the regional median dose ( RMD ), the regional lowest dose predicted level ( LDPL ) and the typical dose in the DR imaging room were defined using the quartile method according to the examination site, projection direction and radiography positions. The PKA value was transformed into incident air kerma ( Ka, e ), and compared with the recommended value in the Requirements for Radiological Protection in Diagnostic Radiology ( GBZ 130-2020 ).@*Results@#DR was performed among 133 065 person-times from May 2020 through April 2021 in Beilun District. The greatest RMD was found on abdomen AP DR in the supine position ( 120 μGy·m2 ), and the lowest RMD was seen on chest PA DR in the standing position ( 17 μGy·m2 ). The maximums of typical dose in the DR imaging room on chest PA ( 33 vs. 30 μGy·m2 ), abdomen AP ( 161 vs. 153 μGy·m2 ) and pelvis AP DR ( 164 vs. 162 μGy·m2 ) were greater than LDRL in the supine position, and the minimums of typical dose on chest PA ( 10 vs. 11 μGy·m2 ) and chest LAT DR ( 33 vs. 34 μGy·m2 ) were lower than LDPL in the standing position. Following transformation into Ka, e, the LDRL ranged from 0.27 to 3.80 mGy, and the maximums of typical dose ranged from 0.25 to 3.55 mGy, which was much lower than the recommended dose proposed in the national criteria.@*Conclusions@#The reference level of surface radiation dose of DR is established among adults in Beilun District, which is lower than the recommended dose in the national criteria of China. Such a reference level may be employed by medical institutions for optimization of the parameters of DR systems. Key words： digital radiography radiation dose diagnostic reference level air kerma-area product

Plant prime editing technique: a new genome editing tool for plants / 生物工程学报

The CRISPR/Cas9 based prime editing (PE) technique enables all 12 types of base substitutions and precise small DNA deletions or insertions without generating DNA double-strand breaks. Prime editing has been successfully applied in plants and plays important roles in plant precision breeding. Although plant prime editing (PPE) can substantially expand the scope and capabilities of precise genome editing in plants, its editing efficiency still needs to be further improved. Here, we review the development of PPE technique, and introduce structural composition, advantages and limitations of PPE. Strategies to improve the PPE editing efficiency, including the Tm-directed PBS length design, the RT template length, the dual-pegRNA strategy, the PlantPegDesigner website, and the strategies for optimizing the target proteins of PPE, were highlighted. Finally, the prospects of future development and application of PPE were discussed.

Relationship between postoperative delirium and preoperative modified frailty index in elderly patients undergoing colorectal cancer surgery / 中华麻醉学杂志

Objective:To evaluate the relationship between postoperative delirium and preoperative modified frailty index (mFI) score in elderly patients undergoing colorectal cancer surgery.Methods:The medical records of elderly patients of either sex, aged 65-90 yr, with primary tumor, without radiotherapy and chemotherapy before operation, with the expected operating time ≥ 2 h, undergoing colorectal cancer surgery under general anesthesia, were collected.The patients′ preoperative frailty was assessed using mFI scale.Primary outcome was the incidence of delirium within 7 days after operation, and delirium was assessed using Confusion Assessment Method.The preoperative baseline characteristics, BI score, mFI score and Mini-Mental State Examination were recorded; anesthesia-related information, surgery-related information, intraoperative adverse events, total volume of intraoperative fluid infused, blood loss, and urine output were recorded.The patients were divided into delirium group (D group) and non-delirium group (N group) according to whether delirium occurred or not, and logistic regression analysis was used to screen the risk factors for postoperative delirium in elderly patients with colorectal cancer.Results:A total of 370 patients were enrolled in this study, and the incidence of delirium was 10.8%.There were significant differences in age, ASA grading ratio, mFI score, anesthetic time and total volume of intraoperative fluid infused between group N and group D ( P<0.05). The results of multivariate logistic regression analysis showed that increased age and mFI were independent risk factors for the occurrence of postoperative delirium ( P<0.05). Conclusions:Increased mFI score and age are independent risk factors for postoperative delirium in elderly patients undergoing colorectal cancer.

Study on the mechanism of Poria cocos polysaccharides on the regulation of gluconeogenesis in liver of type 2 diabetic mellitus model rats / 中国药房

OBJECTIVE To investigate the effect and mechanism of Poria cocos polysaccharides on the regulation of blood glucose in type 2 diabetes mellitus （T2DM）model rats by phosphatidylinositol 3-kinase（PI3K）/protein kinase B （Akt）/forked box transcription factor O 1（FoxO1）pathway. METHODS SD rats were randomly divided into blank control group （no modeling ，no administration），model group （modeling，no administration ），metformin group （modeling，200 mg/kg）and P. cocos polysaccharide low-dose，medium-dose and high-dose groups （modeling，100，200，400 mg/kg），8 in each group. Except for blank control group ， other groups were given high fat diet combined with streptozotocin to construct the model of T 2DM rats. At the same time ， administration groups were given relevant dose of medicine intragastrically ，and blank control group and model group were given constant volume of water intragastrically ，once a day ，for consecutive 42 days. During the experiment ，general condition and bodyweight of rats were observed every day ；fasting blood glucose （FBG）of rats were collected ，and oral glucose tolerance test were conducted and area under curve （AUC）was calculated the day before last administration. After last medication ，the heart ，liver， kidney organ index were calculated ；the levels of HbA 1c，TC，TG，MDA，SOD，GSH-Px and hepatic glycogen content were detected. HE staining was used to observe the pathological changes of liver and pancreatic tissue ，and the pathological grade score was calculated. Western blot assay was used to detect the protein expressions of p-PI 3K，p-Akt，p-FoxO1， PEPCK and G 6Pase in liver tissues. RESULTS Compared with blank control group ，the rats of model group suffered cc1965@163.com from polydipsia ，polyphagia and polyuria ；the body weight ， the levels of SOD and GSH-Px ，the protein expressions of p-PI 3K，p-Akt and p-FoxO 1 were significantly decreased （P＜0.05）；liver and kidney organ index ，blood glucose level at 0，0.5 and 2 hours after intragastric administration of glucose solution ，AUC， FBG，HbA1c，serum levels of MDA ，TC，TG and hepatic glycogen content ，liver and pancreatic pathological grade score ，the protein expressions of PEPCK and G 6Pase were all increased significantly （P＜0.05）. Compared with model group ，the general condition of rats in P. cocos polysaccharide groups were all improved ，and all of above indicators had been reversed to varying degrees. CONCLUSIONS P. cocos polysaccharide can downregulate protein expressions of PEPCK and G 6Pase which are key enzymes of gluconeogenesis ，inhibit hepatic gluconeogenesis ，effectively decrease blood glucose levels and regulate glucolipid metabolism in T 2DM model rats by weakening oxidative stress and upregulating PI 3K/Akt/FoxO1 pathway.