Dual antiplatelet therapy in stent-assisted coil embolization of unruptured intracranial aneurysms: a comparison of ticagrelor and clopidogrel / 国际脑血管病杂志

Objective:To compare the safety and efficacy of ticagrelor and clopidogrel in dual antiplatelet therapy for stent-assisted embolization of unruptured intracranial aneurysms.Methods:Patients with unruptured intracranial aneurysms received stent-assisted embolization in the Department of Neurosurgery, Linyi People's Hospital from January 2021 to June 2022 were retrospectively included. According to the preprocedural dual antiplatelet therapy scheme, they were divided into aspirin+clopidogrel group (clopidogrel group) and aspirin+ticagrelor group (ticagrelor group). The incidence of ischemic and bleeding events was compared between the clopidogrel group and the ticagrelor group at 3 months after procedure. Multivariate logistic regression model was used to analyze independent risk factors for postprocedural ischemic and bleeding events. Results:A total of 195 patients were included. Their age was 58.15±10.11 years and 75 were males (38.5%). There was no statistically significant difference in the incidence of bleeding events (12.8% vs. 5.9%) and ischemic events (14.9% vs. 18.8%) at 3 months after procedure between the ticagrelor group ( n=94) and the clopidogrel group ( n=101). Multivariate logistic regression analysis showed that smoking (odds ratio [ OR] 6.085; 95% confidence interval [ CI] 1.589-13.012; P=0.019], hypertension ( OR 4.547, 95% CI 1.589-13.012; P=0.005), aneurysm at the branch vessel ( OR 3.089, 95% CI 1.122-8.504; P=0.029), and the use of flow diverter ( OR 3.111, 95% CI 1.062-9.110; P=0.038) were the independent risk factors for postprocedural ischemic events. Triglycerides might be an independent risk factor for postprocedural bleeding events ( OR 1.435, 95% CI 0.989-2.082; P=0.057), but did not reach statistical significance. Conclusions:In dual antiplatelet therapy for stent-assisted embolization of unruptured intracranial aneurysms, ticagrelor and clopidogrel have the same safety and efficacy.

Progress on Prevention and Treatment of Cerebral Small Vascular Disease Using Integrative Medicine / 中国结合医学杂志

Cerebral small vessel disease (CSVD) is a senile brain lesion caused by the abnormal structure and function of arterioles, venules and capillaries in the aging brain. The etiology of CSVD is complex, and disease is often asymptomatic in its early stages. However, as CSVD develops, brain disorders may occur, such as stroke, cognitive dysfunction, dyskinesia and mood disorders, and heart, kidney, eye and systemic disorders. As the population continues to age, the burden of CSVD is increasing. Moreover, there is an urgent need for better screening methods and diagnostic markers for CSVD, in addition to preventive and asymptomatic- and mild-stage treatments. Integrative medicine (IM), which combines the holistic concepts and syndrome differentiations of Chinese medicine with modern medical perspectives, has unique advantages for the prevention and treatment of CSVD. In this review, we summarize the biological markers, ultrasound and imaging features, disease-related genes and risk factors relevant to CSVD diagnosis and screening. Furthermore, we discuss IM-based CSVD prevention and treatment strategies to stimulate further research in this field.

A single-center study on the distribution and antibiotic resistance of pathogens causing bloodstream infection in patients with hematological malignancies / 中华血液学杂志

Objective: To study the incidence of bloodstream infections, pathogen distribution, and antibiotic resistance profile in patients with hematological malignancies. Methods: From January 2018 to December 2021, we retrospectively analyzed the clinical characteristics, pathogen distribution, and antibiotic resistance profiles of patients with malignant hematological diseases and bloodstream infections in the Department of Hematology, Nanfang Hospital, Southern Medical University. Results: A total of 582 incidences of bloodstream infections occurred in 22,717 inpatients. From 2018 to 2021, the incidence rates of bloodstream infections were 2.79%, 2.99%, 2.79%, and 2.02%, respectively. Five hundred ninety-nine types of bacteria were recovered from blood cultures, with 487 (81.3%) gram-negative bacteria, such as Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. Eighty-one (13.5%) were gram-positive bacteria, primarily Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecium, whereas the remaining 31 (5.2%) were fungi. Enterobacteriaceae resistance to carbapenems, piperacillin/tazobactam, cefoperazone sodium/sulbactam, and tigecycline were 11.0%, 15.3%, 15.4%, and 3.3%, with a descending trend year on year. Non-fermenters tolerated piperacillin/tazobactam, cefoperazone sodium/sulbactam, and quinolones at 29.6%, 13.3%, and 21.7%, respectively. However, only two gram-positive bacteria isolates were shown to be resistant to glycopeptide antibiotics. Conclusions: Bloodstream pathogens in hematological malignancies were broadly dispersed, most of which were gram-negative bacteria. Antibiotic resistance rates vary greatly between species. Our research serves as a valuable resource for the selection of empirical antibiotics.

Research progress on health risks of aerosol microorganisms / 上海预防医学

Aerosol microorganisms are important constituents of aerosols. They participate in physical and chemical reactions in the air and are also closely related to disease transmission and human health. With the SARS-CoV-2 pandemic， aerosol microorganisms have become a public health topic of great concern. Studying the composition and influencing factors of the air microbiome therefore has significant public health implications. Due to the limitations of traditional technologies for sampling and determination， the aerosol microbiome has not been fully understood. However， with the development and maturity of high-throughput sequencing technology， the aerosol microbiome has shown promising research prospects. This article reviews the composition， characteristics， detection methods and influencing factors of aerosol microorganisms， providing basic knowledge for further research on the air microbiome. In-depth research on microbial aerosols has significant implications on urban air quality control， national security and public health.

Associations of TNF-RII rs1061622 With Post-Traumatic Stress Disorder and Their Interplays on Serum Lipids Levels in Adolescents

Objective@#To verify effects of rs1061622 at tumor necrosis factor-α receptor II (TNF-RII) gene (TNF-RII) on post-traumatic stress disorder (PTSD) and its interactive effects with PTSD on serum lipids levels in adolescents. @*Methods@#PTSD was measured by PTSD Checklist-Civilian Version (PCL-C) in 699 adolescent survivors at 6 months after Wenchuan earthquake in China. A polymerase chain reaction and restriction fragment length polymorphism assay were utilized for TNF-RII rs1061622 genotyping followed by verification using DNA sequencing. Serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol were tested using routine methods. @*Results@#G (deoxyguanine) allele carriers had higher PCL-C scores than TT (deoxythymidine) homozygotes in female subjects. Female adolescents had higher PCL-C scores than male subjects in TT homozygotes. Predictors of PTSD prevalence and severity were different between G allele carriers and TT homozygotes. Subjects with PTSD had lower TG, TG/HDL-C, TC/HDL-C, and higher HDL-C than adolescents without PTSD in male G allele carriers. G allele carriers had higher TG/HDL-C and TC/HDL-C than TT homozygotes in male adolescents without PTSD, and lower TG and TG/HDL-C in male PTSD patients. G allele carriers had higher TG than TT homozygotes only in female adolescents without PTSD. @*Conclusion@#These results suggest reciprocal actions of TNF-RII rs1061622 with other factors on PTSD severity, interplays of TNF-RII rs1061622 with PTSD on serum lipid levels, and novel treatment strategies for PTSD and comorbidities of PTSD with hyperlipidemia among adolescents with different genetic backgrounds of TNF-RII rs1061622 after experiencing traumatic events.

High-risk human papillomavirus negative cervical lesions in the cervical cancer screening population / 中国医师杂志

Objective:To investigate the incidence of high-risk human papillomavirus (hrHPV) negative cervical lesions in the screening population, and based on this, to preliminarily evaluate the potential harm (missed diagnosis) and benefits (reduced colposcopy referral) of HPV primary screening compared to combined screening so as to provide reference for the selection of cervical cancer primary screening methods.Methods:This study was a single center cross-sectional study. Women who underwent joint screening [hrHPV typing test combined with cervical liquid based cytology test (LCT)] at the Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 1, 2018 to December 31, 2019 were included in the cervical cancer screening. The proportion of hrHPV negative cytological abnormalities and cervical lesions in the population was analyzed and the theoretical colposcopy referral rate of the combined screening and HPV initial screening protocol was calculated. In the population with cervical pathological results, the number of colposcopy examinations required for the diagnosis of cervical intraepithelial neoplasia grade 2 and above (CIN2+ ) was calculated.Results:A total of 35 321 screened women were included. The overall incidence of hrHPV infection, LCT abnormalities and severe LCT abnormalities in the population was 17.13%(6 051/35 321), 18.07%(6 384/35 321), and 3.97%(1 402/35 321), respectively. The negative rate of hrHPV in women with severe cervical cytology abnormalities was as high as 51.28%(719/1 402), and in CIN2+ lesions diagnosed by cervical biopsy, hrHPV negative accounted for 7.15% (49/685). The theoretical colposcopy referral rates for combined screening and initial HPV screening were 11.28%(3 985/35 321) and 8.33%(2 943/35 321), respectively, with an average diagnosis of CIN2+ requiring 3.51 and 2.81 colposcopy examinations, respectively.Conclusions:In the opportunistic screening population, the proportion of hrHPV negative CIN2+ lesions cannot be ignored, and the HPV initial screening strategy may cause missed diagnosis of these lesions. However, compared to combined screening, HPV initial screening has the potential to improve the efficiency of colposcopy. These results suggest that we should carefully choose the HPV initial screening plan.

Challenges in screening and early detection of gynecologic malignancies / 中国医师杂志

The cancer burden caused by gynecological malignancies poses a serious threat to the health of women in China. Screening and early diagnosis are the key means to reduce the incidence rate and mortality of cancer. This article aims to briefly summarize the current status and challenges of screening and early diagnosis of three common female reproductive tract malignancies (cervical cancer, endometrial cancer, and ovarian cancer), in order to clarify the current stage and future direction of efforts.

Study on the construction and teaching exploration for virtual simulation experiment of whole process of infant nutritional status evaluation / 中华医学教育探索杂志

Infant nutritional status evaluation is a basic experimental skill in the experimental teaching of nutrition and food hygiene. The construction of this virtual simulation experiment can solve the problems of activeness and poor coordination of infants and young children in the actual operation of the experiment. And based on the application of this virtual simulation project, the experimental teaching method of preventive medicine was explored. This experiment adopted online and offline mixed teaching method, which enriches teaching measures and strengthens the standardized process of infant nutritional status evaluation. After 3 semesters of practice from spring 2018 to spring 2020, the proportion of students who achieved excellent grades was 30.09% (34/113), 56.02% (279/498) and 66.79% (1 080/1 617), respectively, which increased significantly year by year ( Ptrend < 0.001). Among all the 2 228 students, 1 983 students (89%) believed that this experimental teaching could better cultivate the ability of autonomous learning. Through the study of virtual simulation experiments, students have improved their subjective initiative, and laid a foundation for the improvement of students' overall quality and the requirements of school elite education.

The status and trend of child growth failure (CGF) burden in children aged < 5 years in China / 公共卫生与预防医学

Objective To analyze the status and trend for the mortality and DALY rates of child growth failure (CGF) in children aged < 5 years in China from 1990 to 2019, so as to provide a scientific basis for CGF prevention and control. Methods The mortality and DALY rates of CGF in children aged < 5 years from 1990 to 2019 were obtained from GBD 2019. The changes of these indicators with the years in China , the United States, Japan, Russia, India and the global were compared and analyzed. Results In 2019, the mortality of child wasting, child stunting and child underweight in children aged < 5 years in China were 9.62/100 000, 1.23/100 000, and 1.29/100 000 respectively, the mortality rates were 867.50/100 000 , 129.23/100 000 , and 112.87/100 000 rescpectively, higher than those of the United States, Japan, and Russia, and far lower than those of India and the global. The disease burden of three types of CGF were all higher in males than females, and higher in children aged < 1 years than children aged 1-4 years. From 1990 to 2019, the mortality and DALY rates of CGF in children aged < 5 years in China decreased from 300.41/100 000 and 26 445.38/100 000 to 10.49/100 000 and 943.57/100 000, respectively. China had the largest drop rate compared with all analyzed countries. As for children aged < 5 years in China, the DALY rate of lower respiratory infection ranked first in all the diseases caused by CGF. Conclusion From 1990 to 2019, the disease burden of CGF in children aged < 5 years has shown a significant decrease in China , but it is still far behind the developed countries. In the future, more attention should be paid to the problems of child growth in hope of reducing the mortality and DALY rates of CGF.

Epidemiological characteristics analysis and incidence trend prediction of gonorrhea in Hubei Province in 2010-2021 / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics and incidence trend of gonorrhea in Hubei Province, and to provide reference for scientific formulation of prevention and control measures. Methods Based on the surveillance data of gonorrhea from 2010 to 2021, three-way distribution and ARIMA model were used for data analysis and incidence prediction. Results From 2010 to 2021, the reported incidence rate fluctuated between 3.01/100 000-7.07/100 000, and the average annual reported incidence rate was 4.62/100 000. The reported incidence rate showed the characteristics of “first fall and then rise, and then fall and rise again”, and the peak incidence period was from June to December. The male to female ratio of reported cases was 5.78:1, and the number of reported cases in the age group of 20-39 years old accounted for 62.43% of the total number of cases. The reported cases were mainly housework and unemployed, farmers, and unknown occupation. The severity of the regional incidence was divided into 5 categories by the Q-type clustering, and the most serious category included Shennongjia Forest District, Huangshi City, and Wuhan City. The ARIMA model predicted the incidence rate to be in good agreement with the actual incidence rate, with a predicted number of 3 343 cases in 2022. Conclusion At present, gonorrhea in Hubei Province is still at a high prevalence level. There are obvious differences in gender, age, occupation, and regional distribution. The ARIMA model is suitable for predicting the incidence of gonorrhea, and it is predicted that the incidence will increase slightly in 2022.

Spatial clustering and dynamic change of mumps in Hubei Province in 2010-2020 / 公共卫生与预防医学

Objective To explore spatial clustering of mumps in Hubei Province during 2010-2020, and to provide evidence for mumps prevention and control. Methods The surveillance data of mumps during 2010-2020 in Hubei Province was obtained from the national infectious diseases reporting information system. Trend surface analysis and spatial autocorrelation analysis of mumps incidences at county/district levels were performed using ArcGIS10.5 software. Results Mumps incidence rates in Hubei Province during 2010-2018 ranged from 8.70 per 100 000 to 44.99 per 100 000. The trend surface analysis showed that mumps incidences gradually decreased from west to east, and was low in the middle and high at the north-south direction. Global spatial autocorrelation showed that there were positive spatial correlations in every year except 2012 and 2014 (Morans I> 0, P <0.05). Local autocorrelation analysis showed that the hotspots of mumps incidences varied every year from 2010 to 2020. Conclusions According to the spatial analysis, mumps incidences had obvious spatial clustering in Hubei Province. The hotspots were mainly concentrated in the northwestern region of Hubei, but the hot spots also extended to the urban areas of eastern, central and northern Hubei. It is necessary to take appropriate prevention and control measures in the high-incidence areas.

Tie2 Expressing Monocytes/Macrophages in Human Tumors / 肿瘤防治研究

Tie2 expressing monocytes/macrophages (TEMs) are a subtype of monocytes or macrophages which expressing tyrosine kinase receptor Tie2. They can exist in peripheral blood and tissues of both human and mouse. TEMs can participate in the formation of tumor microenvironment by accelerating tumor angiogenesis, lymphangiogenesis and immunosuppression. At present, TEMs have been found to have potential diagnostic and prognostic guiding significance for a variety of tumors, and they are expected to provide new directions and strategies for tumor therapy. This paper reviews the research progress of TEMs in tumor.

A new approach to spare organs at risk for breast cancer radiotherapy-half field segmented VMAT delivery technique / 中华放射医学与防护杂志

Objective:To explore a new technology that can protect the lungs and heart better by utilizing the dose distribution attributes of the half-field and the characteristics of the VMAT (volumetric modulated arc therapy) technology.Methods:A three-dimensional water tank was used to measure the dose of symmetrical field and half field edge and analyze them comparatively. A total of 50 patients with left breast cancer receiving the postoperative radiotherapy were selected. Among them, 25 patients were performed conserving surgery and 25 patients were performed radical mastectomy. After the operation, all the patients received the prescription dose of 50 Gy in 25 fractions. Based on the Eclipse system, the symmetrical field continuous arc VMAT technology and the semi-field segmented arc VMAT technology were used to design the plan. Besides, the dose suitability data and the treatment efficiency of target areas and organs at risk were compared and analyzed.Results:The radiation size of half-field did not increase with the increased depth in the water mode. The symmetric field gradually enlarged due to the angle of tensor factor, increased to about 2 cm at the depth of 30 cm, and the delivery dose in the half-field was lower than that in the symmetric field. The closer the field edge is, the more obvious it is. Compared with the symmetric field continuous arc plan, the half-field segmental arc VMAT plan significantly improved the delivery dose of the lungs and heart ( t=-4.11, -4.42, P=0.00), in which the mean values of V5, V30, and Dmean for the whole structure of the heart were reduced by 52.5%, 65.5%, and 47%, respectively. The left anterior descending coronary artery, which was closely related to the target area, had a decrease of more than 20%. The mean values of V5, V10, V20, and Dmean of the affected lung were reduced by 21.6%, 24.8%, 25.0%, and 23.2%, respectively. The mean values of the doses of other endangered healthy organs, and the execution time of half-field segment arc plan were also better than the continuous arc plan. Conclusions:For breast cancer radiotherapy, the combination of half-field and VMAT can give full play to the advantages of half-field and VMAT, and significantly reduce the irradiated dose of the heart, affected lung, and healthy side of the breast.

Correlation between the early dynamic changes of lymphocyte and severity of disease in coronavirus disease 2019 patients / 中华危重病急救医学

Objective:To explore the relationship between the dynamic changes of lymphocytes in the early stage (within 72 hours of admission) and the severity of disease in patients with coronavirus disease 2019 (COVID-19).Methods:A retrospective study was conducted. The clinical data of COVID-19 patients admitted in Wenzhou Central Hospital from January 17, 2020 to February 14, 2020 were collected and analyzed. According to whether there was lymphopenia on the first day of admission [lymphocyte count (LYM) < 0.8×10 9/L], whether the difference between LYM on the third day and the first day of admission (ΔLYM) was less than 0, the patients were divided into four groups: the first group was LYM normal on the first day of admission, ΔLYM ≥ 0; the second group was LYM normal on the first day of admission, ΔLYM < 0; the third group was lymphopenia on the first day of admission, ΔLYM ≥ 0; the fourth group was lymphopenia on the first day of admission, ΔLYM < 0. The study endpoint was the development of severe/critically ill patients within 30 days after admission. Severe/critical standard referred to classification of Diagnosis and treatment protocol for coronavirus disease 2019 (trial version 5, revised edition). The differences in general information, laboratory results, and probability of developing severe/critical were compared among the four groups. Cox regression analysis was used to analyze the correlation between the early dynamic changes of lymphocytes and the probability of severe illness; and the Kaplan-Meier survival curve was drawn to assess the probability of severe illness in patients with different LYM groups. Results:A total of 104 patients with COVID-19 were enrolled, and 21 patients developed to severe/critical cases within 30 days of onset (accounting for 20.2%; 17 severe cases and 4 critical cases). There were significant differences in age ( F = 5.061, P = 0.003), white blood cell count (WBC) on the first day of admission ( Z = 10.850, P = 0.013), C-reactive protein (CRP) on the first day of admission ( Z = -4.449, P < 0.001), LYM on the first day of admission ( Z = 43.132, P < 0.001), LYM on the third day of admission ( Z = 40.340, P < 0.001), and the occurrence of severe/critical illness ( χ2 = 18.645, P < 0.001) among the four groups. Patients in groups 3 and 4 were older; patients in group 3 had the lowest WBC and LYM on the first day of admission; patients in group 4 had the highest CRP on the first day of admission, the lowest LYM on the third day of admission, and high proportion of severe/critical cases. Regarding the probability of severe/critically ill patients within 30 days of admission, univariate Cox regression analysis showed that the probability of severe/critical patients in group 4 was 12.7 times higher than that in group 1 [hazard ratio ( HR) = 12.732, 95% confidence interval (95% CI) was 3.951-41.025, P < 0.001]; age, CRP, albumin (ALB) and lymphocyte grouping were included in multivariate Cox regression analysis, the probability of severe/critically ill patients in group 4 was 6.4 times that of group 1 ( HR = 6.398, 95% CI was 1.757-23.301, P = 0.005); however, there was no difference in the probability among the group 1, 2 and 3. Kaplan-Meier survival curve showed that the probability of severe/critically ill patients in group 4 was significantly higher than that in groups 1, 2 and 3 (Log-Rank test: χ2 = 42.617, P < 0.001). Conclusions:Early lymphocyte dynamics change is related to the severity of patients with COVID-19. Patients with low LYM on the first day and continued decrease within 72 hours of admission have a higher probability to develop into severe/critically cases.

The feasibility and effectiveness of sentinel lymph node detection in ovarian neoplasms: a systematic review / 中国医师杂志

Objective:To evaluate the feasibility and effectiveness of sentinel lymph node (SLN) detection in the ovarian neoplasms.Methods:A search of the literature describing ovarian SLN was performed using China National Knowledge Infrastructure (CNKI), WANFANG DATA, VIP, PubMed, Embase, web of science, Cochrane library from 2000.01.01 to 2020.07.29. The quality evaluation and data extraction of the included literature were conducted, and the development rate, sensitivity and negative predictive value of SLN were calculated.Results:Eight prospective single-arm studies were included, with heterogeneity I2=57.41%>50%, and the P<0.1. A total of 96 patients with ovarian cancer [Stage International Federation of Gynecology and Obstetrics (FIGO)Ⅰ-Ⅱ] were included, of whom 93 completed systematic pelvic and para-aortic lymphadenectomy after SLN detection. The most common tracers were technetium-99m radioactive colloid ( 99Tc m), blue dye or indocyanine green (ICG), and the most common injection sites were the infundibulopelvic ligaments and the proper ovarian ligaments. The SLN detection rate was 88.5%(85/96) and the average number was 2-3. SLN was found in the ipsilateral or contralateral regions of the tumor, 40.8%(31/76) was found only in the para-aortic, 14.5%(11/76) was found only in the pelvic, and 44.7%(34/76) was found only in the para-aortic and pelvic region. The sensitivity was 90.9%(10/11) and the negative predictive value was 98.8%(82/83) of lymph node metastasis. Conclusions:SLN detection for ovarian neoplasms is feasible, and whether it can effectively predict lymph node status of ovarian cancer still needs large sample, multi-center, prospective clinical studies to further verify.

Thinking about lymphadenectomy for gynecological malignant tumor / 中国医师杂志

Lymph node metastasis represents a common way of distant spread of gynecologic malignancies and an independent risk factor of poor prognosis of patients. The pelvic and paraaortic lymphadenectomy is a critical part of the surgical treatment of gynecologic cancer, which potentially improves the survival outcomes of patients through clarifying the node status to guide the subsequent management and/or removal of positive nodes to reduce the tumor burden. However, when we make a decision about lymphadenectomy, we should balance the related survival benefits and morbidities impacting the long-term quality of life. It is noteworthy that the principles of lymph node management are varied between different types and different stages of tumors characterized with different clinical features. Moreover, the sentinel lymph node biopsy, which has been emerging as a promising alternative to traditional systematic lymph node dissection, provides new options while bringing new issues. Here, based on the latest progress in relevant fields, we attempt to figure out the distinct features and unanswered questions in the management of lymph nodes of patients with cervical cancer, endometrial cancer, and ovarian cancer, which may trigger meaningful thoughts regarding related clinical decision.

Developmental characteristics of event-related potentials P3a and P3b on attention cognitive function in school-age children / 中华行为医学与脑科学杂志

Objective:To investigate the characteristics of event-related potentials(ERPs)P300 in the development of attention cognitive function of school-age children.Methods:A total of 180 school-age children were divided into 3 groups according to their ages (7-8 years old group with 48 cases, 9-10 years old group with 44 cases and 11-12 years old group with 48 cases). All of the participants completed an Oddball task, and their behavioral data, P3a and P3b components of ERPs were analyzed by SPSS 21.0.Results:(1)The differences of hit numbers(49(47.25, 50), 50(49, 50), 50(50, 50) ), correct reaction time((533.37±56.94) ms, (486.91±61.12) ms, (411.55±51.97) ms), and Omission errors (2(1, 4), 2(1, 3), 1(0, 2) ) among the three groups were statistically significant( F/χ 2=20.635, 54.477, 13.169, all P<0.01). (2)There was a main effect of age( F=3.884, P=0.023) and an interaction effect between age and condition( F=3.314, P=0.038) on the amplitude of P3a, while the main effect of condition was not significant( F=0.111, P=0.740). The amplitude of P3a component in 11-12 years old group ((11.02±6.00)μV) was significantly larger than that of 7-8 years old group ((7.36±4.48)μV) and 9-10 years old group ((7.76±5.17)μV, both P<0.05). However, there was no significant interaction effect between age and condition on P3a latency, P3b amplitude and latency ( P>0.05). Conclusion:P3a may be a sensitive indicator of cognitive function in school-age children, and the age of 11-12 years old is a sensitive period for the development of children's attention orientation and selection ability, which may be related to the development of brain network.

Research progress of Phyllanthi Fructus and prediction of its Q-markers / 中国中药杂志

Phyllanthi Fructus, a unique Chinese and Tibetan medicinal plant with both edible and medical values, has high potential of cultivation and development. The resources of Phyllanthi Fructus in China are rich, mainly distributed in Yunnan, Sichuan, Fujian, Guangdong, Guangxi, etc. Phyllanthi Fructus is widely used in the clinical practice of Chinese medicine and plays an important role in Tibetan medicine, Uyghur medicine, Yi medicine, and Mongolian medicine. Phyllanthi Fructus mainly contains phenolic acids,tannins, terpenes, sterols, fatty acids, flavonoids, amino acids and other compounds. Modern pharmacological studies show that Phyllanthi Fructus has antioxidant, anticancer, blood lipid-lowering, liver protective, antimicrobial, anti-inflammatory, and immune regulatory activities. In this paper, the research status of Phyllanthi Fructus was reviewed from the aspects of herbal textual research,chemical composition, and pharmacological action. The quality markers(Q-markers) of Phyllanthi Fructus were predicted and analyzed from the aspects of biogenic pathway, specificity and measurability of chemical components, efficacy, properties, new clinical uses, drug-food homology, and transformation of polyphenols. The results will provide a scientific basis for the quality control, quality evaluation, and standard formulation of Phyllanthi Fructus.

Synergistic effect of sarcopenia and osteoporosis on spinal osteoporotic fracture in patients with rheumatoid arthritis / 中华风湿病学杂志

Objective:To investigate the synergistic effect of sarcopenia and osteoporosis on the occurrence of spinal osteoporotic fracture (OPF) in patients with rheumatoid arthritis (RA).Methods:A total of 389 hospitalized RA patients and 156 age and sex-matched normal subjects (control group) were recruited. Dual energy X-ray absorptiometry (DEXA) method was used to measure bone mineral density (BMD) of lumbar spine and hip, and bioelectrical impedance method was applied to determine skeletal muscle mass of limbs. X-ray examination of spin was conducted and spinal OPF was diagnosed according to semi-quality method. Student's t test was used for comparison of measurement date between the two groups, χ2 test was used for comparison of intergroup rates, and Logistic Regression(Backward LR) method was used for multivariate Regression analysis of binomial classification data. Results:BMD of all test sites in RA patients was significantly lower than that in the control group ( P<0.01). The incidence of total OP in RA group was significantly higher than that in the control group [(32.9% vs 12.8%), χ2=22.706, P<0.01]. A total of 84 patients with RA developed spinal OPF, with an incidence of 21.6% which was higher than that in the control group [(3.8%), χ2=25.439, P<0.01]. The incidence of sarcopenia in RA was 54.8%, significantly higher than that in the control group [(9.6%), χ2=93.241, P<0.01]. The incidence of sarcopenia combined with osteoporosis in RA group (28.5%) was significantly higher than that in the control group [(5.8%), χ2=118.110, P<0.01]. Comparison of the incidence of spinal OPF in RA patients among groups with different bone mass (normal bone mass, osteopenia, osteoporosis) showed that the incidence of spinal OPF among these groups was statistically different ( χ2=43.373, P<0.01), and the incidence of spinal OPF increased along with the decrease of bone mass ( χ2=43.003, P<0.01). The incidence of spinal OPF in RA patients with sarcopenia (27.2%, 58/213) was significantly higher than that in RA patients without sarcopenia [(14.8%, 26/176), χ2=8.833, P=0.003]. All participants were divided into three groups: group 1=no OP and sarcopenia, group 2=with sarcopenia or OP, group 3=both sarcopenia and OP. Difference of incidence of spine OPF in RA patients among three groups was statistically significant ( χ2=33.832, P<0.01), and the incidence of spinal OPF raised gradually in group 1 and 3, ( χ2=37.164, P<0.01). Incidences of sarcopenia, OP and spinal OPF in RA treated with glucocorticoid (GC) were higher than those in RA without GC ( P<0.05, P<0.01). Results of logistic regression showed advanced age[ OR(95% CI)=1.069(1.038, 1.101), P<0.01], usage of GC [ OR(95% CI)=3.169(1.679, 5.984), P<0.01] and sarcopenia combined with OP [ OR(95% CI)=2.113(1.430, 3.124), P<0.01] were risk factors for spinal OPF in RA patients. Conclusion:Incidences of sarcopenia, OP and spinal OPF in RA patients are higher than that in normal controls. Sarcopenia and OP have a synergistic effect on spinal OPF in RA patients.

Comments on the debate about laparoscopic surgery for early-stage cervical cancer / 中国医师杂志

In the past two decades,laparoscopic surgery has been increasingly used in the treatment of early-stage cervical cancer because of equal survival and faster recovery compared to abdominal surgery.Recently,a phase Ⅲ randomized controlled clinical trial revealed unexpected results that minimally invasive surgery was associated with significantly increased risks for tumor recurrence and death in patients with early-stage cervical cancer,causing a great debate worldwide.Herein,we highlighted the key points in the debate and tossed out several ideas on how to face and deal with the controversy.