Multimodal imaging characteristics of retinal diseases associated with COVID-19 / 中华眼底病杂志

Objective:To observe the multimodal imaging features of retinal diseases associated with COVID-19.Methods:A retrospective case study. Sixteen patients (30 eyes) of retinal diseases associated with COVID-19 admitted to the Ophthalmology Department of the Second People's Hospital of Zhengzhou in December 2022 were included in the study. There were 5 males and 11 females, with the mean age of (26.69±9.88) years; 14 patients were bilateral and 2 patients were unilateral. The time of ocular symptoms after the diagnosis of COVID-19 was (2.63±0.89) days. All patients underwent the examinations of best corrtected visual acuity (BCVA), fundus color photography (FP), infrared fundus photography (IR), optical coherence tomography (OCT). Fluorescein fundus angiography (FFA) was performed in 2 patients (4 eyes). There were 20 eyes with acute macular neuroretinopathy (AMN), including 6 eyes with cotton wool spots; 10 eyes with Purtscher-like retinopathy (PLR). The BCVA of the patients was 0.1-1.0. No obvious abnormality was found in anterior segment examination. The features of FP, IR and OCT were analyzed retrospectively.Results:In 20 eyes of AMN, irregular reddish brown lesions in the central or paracentral area of the macula in 14 eyes; FP showed no obvious abnormality in 6 eyes; IR showed irregular map like low reflection in the central or paracentral area of macular in all eyes; OCT showed hyperreflectivity in outer plexiform layer and outer nuclear layer, hyporeflectivity in the ellipsoid zone and photoreceptor layers in all eyes; no abnormal fluorecence was observed in 2 eyes examined by FFA. In 10 eyes with PLR, cotton wool spots and retinal hemorrhage were observed in the posterior pole and/or peripapillary area, and the peripheral retina was generally normal, Purtscher spot was found in 5 eyes and macular edema in 4 eyes; OCT showed strong reflex signal in neuroepithelial layers, edema in neuroepithelial layers in 6 eyes; in the 2 eyes examined by FFA, fluorescein leakage from the retinal vein wall was observed, the posterior pole and peripapillary area retinal arteriole occlusions showed patchy hypofluorescence, the fluorescence was obscured by retinal hemorrhage below at inferior retina.Conclusions:For AMN associated with COVID-19, IR can show the lesion contour, OCT shows lesions in the outer retina. PLR associated with COVID-19 are usually at the posterior pole and/or peripapillary area in FP, OCT shows neurocortical edema.

Correlation between vaccination doses and duration of positive nucleic acid or antigen tests among COVID-19 patients / 中华全科医师杂志

Objective:To investigate the relationship between vaccination doses and the duration of positive nucleic acid or antigen tests in Corona Virus Disease 2019 (COVID-19) patients during omicron epidemic.Methods:A cross-sectional study was conducted from December 26 to December 31, 2022 among COVID-19 patients from all community health service centers in 16 districts of Beijing municipality selected by multi-stage stratified cluster quota sampling method. A questionnaire was used to collect the basic information, vaccination doses, results of nucleic acid or antigen tests of all subjects. The subjects were divided into 5 groups according to the doses of COVID-19 vaccination: the non-vaccination group, the 1, 2, 3 and 4 doses vaccination group. The relationship between vaccination doses and the duration of positive nucleic acid or antigen tests was analyzed by univariate and multivariate logistic regression models.Results:A total of 10 506 COVID-19 cases were included in the study with the age of (43.3±13.7) years. The duration of positive nucleic acid or antigen tests was longer than 7 days in 59.4%(276/465), 51.5%(67/130), 50.6%(355/701), 46.1% (3 464/7 520) and 39.2%(662/1 690) of non-vaccination, and 1, 2, 3, 4 dose vaccination groups, respectively ( P<0.001). Multivariate logistic regression analysis showed that compared with non-vaccination patients, the vaccination dose was an independent protective factor for duration of positive nucleic acid or antigen tests>7 days, and the OR values were 0.7 (95% CI 0.5-0.9, P=0.015), 0.6 (95% CI 0.5-0.8, P<0.001) and 0.5 (95% CI 0.4-0.6, P<0.001) for 2, 3 and 4 doses of vaccination, respectively. Conclusion:The vaccination doses are independently related to the duration of positive nucleic acid or antigen tests in COVID-19 patients and the risk is gradually decreases with the increasing vaccination doses.

Clinical Effect of Tiaoxin Formula in Treatment of Patients with Coronary Heart Disease and Anxiety/Depression and Its Impact on Serum 5-HT， β-TG and MPO Levels / 中国实验方剂学杂志

ObjectiveTo explore the clinical effect of Tiaoxin formula in the treatment of patients with coronary heart disease and anxiety/depression and its impact on serum levels of 5-hydroxytryptamine （5-HT）， β- thromboglobulin （β-TG） and myeloperoxidase （MPO）. MethodA total of 66 patients with coronary heart disease and anxiety/depression were randomly divided into the Tiaoxin formula group and Deanxit group， 33 cases in each group. Both groups were given fundamental western treatment for coronary heart disease. Additionally， the Deanxit group was treated with flupentixol and melitracen tablets and the Tiaoxin formula group was treated with Tiaoxin Formula. The treatment lasted 8 weeks. Before and after treatment， the changes of clinical efficacy， Patient Health Questionnaire （PHQ-9）， Generalized Anxiety Disorder （GAD-7） scale， Seattle Angina Questionnaire （SAQ）， heart rate variability， and serum 5-HT， β-TG and MPO levels， and incidence of adverse reactions in the two groups were observed. ResultThere was no significant difference in the baseline indexes of patients in the two groups， and thus the two groups were comparable. After treatment for 8 weeks， the total effective rate for traditional Chinese medicine （TCM） syndromes in the Tiaoxin Formula group was 87.88% （29/33） higher than 63.64% （21/33） in the Deanxit group （Z=-2.653， P<0.05）. Compared with those before treatment， the PHQ-9 and GAD-7 scores of the two groups were decreased at week 4 and 8 of treatment （P<0.05）， and there was no statistical difference between two groups. And the SAQ dimension scores of the two groups were increased at week 4 and 8 of treatment （P<0.05）. Compared with the Deanxit group， the Tiaoxin Formula group had elevation in two dimension scores： Physical limitation and angina stability （P<0.05）. Compared with the conditions before treatment， the serum 5-HT level in the two groups were increased， while the β-TG and MPO levels were lowered （P<0.05）， and there was no distinct difference between two groups. In addition， the standard deviation of normal-to-normal intervals （SDNN） and standard deviation of average normal-to-normal intervals （SDANN） of the heart rate variability in the Tiaoxin formula group were elevated after treatment （P<0.05）， which were more significant than those of the Deanxit group （P<0.05）. During the treatment period， the incidence of adverse drug reactions in the Tiaoxin formula group was lower than that in the Deanxit group （P<0.05）， and no adverse events were observed in the two groups. ConclusionTiaoxin formula was effective for the treatment of patients with coronary heart disease accompanied by anxiety and depression， which improved the clinical symptoms， increased serum 5-HT levels， and decreased serum β-TG and MPO levels， and had few adverse reactions and high safety for patients， showing a high clinical value.

The expression and function of PD-L1 in CD133(+) human liver cancer stem-like cells / 中华肿瘤杂志

Objective: To investigate the expression of programmed death protein-ligand 1 (PD-L1) in liver cancer stem-like cells (LCSLC) and its effect on the characteristics of tumor stem cells and tumor biological function, to explore the upstream signaling pathway regulating PD-L1 expression in LCSLC and the downstream molecular mechanism of PD-L1 regulating stem cell characteristics, also tumor biological functions. Methods: HepG2 was cultured by sphere-formating method to obtain LCSLC. The expressions of CD133 and other stemness markers were detected by flow cytometry, western blot and real-time quantitative polymerase chain reaction (RT-qPCR) were used to detect the expressions of stemness markers and PD-L1. The biological functions of the LCSLC were tested by cell function assays, to confirm that the LCSLC has the characteristics of tumor stem cells. LCSLC was treated with cell signaling pathway inhibitors to identify relevant upstream signaling pathways mediating PD-L1 expression changes. The expression of PD-L1 in LCSLC was down regulated by small interfering RNA (siRNA), the expression of stem cell markers, tumor biological functions of LCSLC, and the changes of cell signaling pathways were detected. Results: Compared with HepG2 cells, the expression rate of CD133 in LCSLC was upregulated [(92.78±6.91)% and (1.40±1.77)%, P<0.001], the expressions of CD133, Nanog, Oct4A and Snail in LCSLC were also higher than those in HepG2 cells (P<0.05), the number of sphere-formating cells increased on day 7 [(395.30±54.05) and (124.70±19.30), P=0.001], cell migration rate increased [(35.41±6.78)% and (10.89±4.34)%, P=0.006], the number of transmembrane cells increased [(75.77±10.85) and (20.00±7.94), P=0.002], the number of cloned cells increased [(120.00±29.51) and (62.67±16.77), P=0.043]. Cell cycle experiments showed that LCSLC had significantly more cells in the G(0)/G(1) phase than those in HepG2 [(54.89±3.27) and (32.36±1.50), P<0.001]. The tumor formation experiment of mice showed that the weight of transplanted tumor in LCSLC group was (1.32±0.17)g, the volume is (1 779.0±200.2) mm(3), were higher than those of HepG2 cell [(0.31±0.06)g and (645.6±154.9)mm(3), P<0.001]. The expression level of PD-L1 protein in LCSLC was 1.88±0.52 and mRNA expression level was 2.53±0.62, both of which were higher than those of HepG2 cells (P<0.05). The expression levels of phosphorylation signal transduction and transcription activation factor 3 (p-STAT3) and p-Akt in LCSLC were higher than those in HepG2 cells (P<0.05). After the expression of p-STAT3 and p-Akt was down-regulated by inhibitor treatment, the expression of PD-L1 was also down-regulated (P<0.05). In contrast, the expression level of phosphorylated extracellular signal-regulated protein kinase 1/2 (p-ERK1/2) in LCSLC was lower than that in HepG2 cells (P<0.01), there was no significant change in PD-L1 expression after down-regulated by inhibitor treatment (P>0.05). After the expression of PD-L1 was knockdown by siRNA, the expressions of CD133, Nanog, Oct4A and Snail in LCSLC were decreased compared with those of siRNA-negative control (NC) group (P<0.05). The number of sphere-formating cells decreased [(45.33±12.01) and (282.00±29.21), P<0.001], the cell migration rate was lower than that in siRNA-NC group [(20.86±2.74)% and (46.73±15.43)%, P=0.046], the number of transmembrane cells decreased [(39.67±1.53) and (102.70±11.59), P=0.001], the number of cloned cells decreased [(57.67±14.57) and (120.70±15.04), P=0.007], the number of cells in G(0)/G(1) phase decreased [(37.68±2.51) and (57.27±0.92), P<0.001], the number of cells in S phase was more than that in siRNA-NC group [(30.78±0.52) and (15.52±0.83), P<0.001]. Tumor formation in mice showed that the tumor weight of shRNA-PD-L1 group was (0.47±0.12)g, the volume is (761.3±221.4)mm(3), were lower than those of shRNA-NC group [(1.57±0.45)g and (1 829.0±218.3)mm(3), P<0.001]. Meanwhile, the expression levels of p-STAT3 and p-Akt in siRNA-PD-L1 group were decreased (P<0.05), while the expression levels of p-ERK1/2 and β-catenin did not change significantly (P>0.05). Conclusion: Elevated PD-L1 expression in CD133(+) LCSLC is crucial to maintain stemness and promotes the tumor biological function of LCSLC.

Research on antitumor effects of small molecule inhibitors of deubiquitinases: new progress and new ideas / 药学学报

The abnormality of ubiquitin proteasome pathway is an important factor leading to the imbalance of protein homeostasis. In this process, the deubiquitinase responsible for removing the ubiquitin chain of protein substrate is very important. Its abnormal activity or expression can cause the functional changes of key oncogenic/tumor suppressor proteins, which directly or indirectly lead to the occurrence, development and malignant evolution of tumors. Based on this, the discovery and research of small molecule inhibitors targeting deubiquitinases have become a hot field of anti-tumor candidate drugs. This review will focus on the regulatory effect and mechanism of ubiquitin proteasome pathway, especially deubiquitinase on tumor, introduce the application of deubiquitinase small molecule inhibitors in tumor treatment, and discuss the research status and latest progress of small molecule inhibitors, so as to provide ideas for the research of new anti-tumor strategies based on deubiquitinase.

18F-FDG PET/CT imaging of crossed cerebellar diaschisis induced by supratentorial tumors / 中华行为医学与脑科学杂志

Objective:To investigate the mechanism of crossed cerebellar diaschisis(CCD) induced by supratentorial tumors and the characteristics of 18F-FDG PET/CT imaging. Methods:Eighty-six patients with supratentorial tumors who underwent 18F-FDG PET/CT whole-body imaging from January 2017 to June 2021 were retrospectively analyzed.Placement, number, size, SUVmax, CT values, relationship with basal ganglia, edema, and cerebellar asymmetry index (AI) were observed and recorded.The imaging differences between patients with CCD and patients without CCD were compared, and the correlations between SUVmax, maximum diameter and cerebellar AI were analyzed.SPSS 21.0 software was used for statistical analysis.Chi-square test, independent sample t-test and Pearson correlation analysis were used for data statistics. Results:Among the 86 patients, 14 were patients with CCD and 72 were patients without CCD.The incidence of CCD was 16.3%.There were statistically significant differences in whether the primary lesions involved the basal ganglia region between patients with CCD and patients without CCD ( χ2=7.637, P=0.006). The cerebellar AI ((0.27±0.09), (0.05±0.02), t=6.847, P=0.003)and maximum diameter of primary lesions((3.98±1.09)cm, (2.36±1.61)cm, t=2.011, P=0.040) in patients with CCD were both larger than those in patients without CCD.There was a significant positive correlation between cerebellar AI and the maximum diameter of primary lesions in patients with CCD ( r=0.375 P=0.028). Conclusion:18F-FDG PET/CT imaging can assist in the diagnosis of crossed cerebellar diaschisis.The primary lesion of supratentorial tumor involving the basal ganglia is more likely to cause crossed cerebellar diaschisis, and the size of the primary lesion is correlated with cerebellar AI.

Comparative study on the axial length measurement with A-scan on different postures for difficult measuring eyes / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To provide guidance for more accurate measurement of axial length(AL)of difficult measuring eyes by comparing the differences in the AL of the patient's difficult measuring eye with three methods of the sitting position, supine position A-scan and Lenstar 900(Lenstar, LS900). METHODS: Clinical case-control study. We selected 102 cases(102 eyes)including cataract patients with combined silicone oil filled, vitreous hemorrhage or retinal detachment and patients with dislocation of the lens or IOL in Zhengzhou Second Hospital from May 2019 to September 2020. AL were measured using LS900 and A-scan on sitting position and supine position respectively, and the results of the three methods were statistically analyzed.RESULTS: The detection rates of LS900 and A-scan axial measurement were 83% and 100% respectively. Three methods of A scan in sitting position, supine position and LS900 to measure the overall AL, silicone oil group, lens dislocation group and vitreous hemorrhage group, the differences were statistically significant(P&#x003C;0.001), The mean values of AL measured by overall A-scan, supine positions of silicone oil group, supine position of lens dislocation group and vitreous hemorrhage group were statistically significant differences with LS900 measurement(all P&#x003C;0.05), while there was no statistical difference between the results of the overall sitting position and the difficult measuring eye groups' sitting position compared with the LS900 measurement of AL. The three measurements showed good consistency within the 95% consistency range, but the result of A-scan on sitting position was closer to LS900.CONCLUSION: Changing the conventional decubitus position to the sitting position can improve the accuracy of the measurement results and provide clinicians with more reliable guidance for the treatment of patients with difficult measuring eyes of A-scan axial measurement, especially in diseases with altered ocular structure.

Effect of Suanzaoren Tang on Learning， Memory and Expression of Proteins Related to Hippocampal Synaptic Plasticity in PCPA-induced Insomnia Rat Model / 中国实验方剂学杂志

ObjectiveTo observe the effects of Suanzaoren Tang on the behavior， growth-associated protein-43 （GAP-43）， postsynaptic density protein-95 （PSD-95）， and synaptophysin Ⅰ （SynⅠ） of insomniac rats induced by p-chlorophenylalanine （PCPA）， and to investigate the mechanism of Suanzaoren Tang in improving the behavior of the insomniac rats. MethodSeventy-two SD rats were randomly assigned into 6 groups （12 rats in each group）： control group （normal saline）， PCPA （0.35 g·kg-1·d-1） group， estazolam （2.7×10-4 g·kg-1·d-1） group， and low-， medium-， and high-dose （3.25， 7.5， 15 g·kg-1·d-1， respectively） Suanzaoren Tang groups. The rat model of insomnia was established by intraperitoneal injection of PCPA and then the rats were administrated with corresponding drugs for 7 continuous days. The Morris water maze and Y-maze were used to test the learning and memory functions， and the open field to test anxiety. Histopathological changes in the hippocampus were observed via hematoxylin-eosin （HE） staining. The mRNA and protein levels of GAP-43， PSD-95， and SynⅠ in hippocampus were determined by real-time fluorescence quantitative polymerase chain reaction (Real-time PCR)， Western blot， and immunohistochemistry （IHC）. ResultCompared with the control group， the PCPA group showcased long escape latency， shortened time in the quadrants， and decreased times of crossing the platform in Morris water maze， decreased alternation correct rate was significantly Y-maze， and increased distance， mean velocity， and time in center of the open field test （P<0.01）. Furthermore， the PCPA-treated rats showed obvious pathological damage in the hippocampus and down-regulated mRNA and protein levels of GAP-43， PSD-95， and SynⅠ in hippocampus （P<0.01）. Compared with the PCPA group， the treatments with estazolam and different doses of Suanzaoren Tang improved the rat performance in Morris water maze， Y-maze， and open field test （P<0.05， P<0.01）， alleviated the hippocampal damage， and up-regulated the mRNA and protein levels of GAP-43， PSD-95， and SynⅠ （P<0.05， P<0.01）. ConclusionSuanzaoren Tang may alleviate the learning and memory disorders and anxiety in PCPA-induced insomnia rat model by up-regulating the mRNA and protein levels of hippocampal synaptic plasticity-associated proteins GAP-43， PSD-95， and SynⅠ.

Herbal Textual Research on Menthae Haplocalycis Herba in Famous Classical Formulas / 中国实验方剂学杂志

In this paper， the name， origin， producing area and other aspects of Menthae Haplocalycis Herba in the famous classical formulas were carried out by consulting herbal literature， medical books， prescription books in the past dynasties and related modern documents. Through the textual research， it can be seen that the name of Bohe was used as the correct name in the mainstream of the past dynasties， and there were still multiple synonyms， most of which originated from the false transmission of dialectal accent， producing area and efficacy. There are many varieties recorded in the literature of the past dynasties such as Bohe， Longnao Bohe， Hubohe and Shibohe. According to the textual research， Bohe， Longnao Bohe and Yebohe are consistent with Mentha haplocalyx， whcih is the mainstream variety. Longnao Bohe is named for its form of producing area， Shibohe is Mosla chinensis， Daye Bohe is Agastache rugosa， and Nanbohe is M. crispata. Menthae Haplocalycis Herba has been widely planted since Tang dynasty. It was mainly grown in Jiangsu， Zhejiang， Jiangxi and Sichuan in Ming and Qing dynasties， and Jiangsu is the genuine production area. Its quality is best if it has dry body， no roots， many leaves， green color and strong smell. In ancient times， the stems and leaves of Menthae Haplocalycis Herba were often picked and dried in summer and autumn， which is basically the same as the records of modern times when the stems and leaves are luxuriant in summer and autumn， or when the flowers bloom to three rounds， they are picked in sunny days and cut in different times， and then dried in the sun or in the shade， and the raw products was often used as medicine in ancient and modern times. Before the Song dynasty， Menthae Haplocalycis Herba was recorded as pungent and warm. Until the Song dynasty， it was written as “extremely cool” in Lyuchanyan Bencao. It may have been thought in the early stage that it was similar to several warm herbs， such as Perilla frutescens， Stachys japonica， Elsholtzia ciliata and M. chinensis in appearance， all of which have the function of Xinsan， so it was recorded as warm. Since the Qing dynasty， Menthae Haplocalycis Herba has been recorded as cool property in the mainstream materia medica， Menthae Haplocalycis Herba recorded as pungent and cool in the 2020 edition of Chinese Pharmacopoeia， and its effect is to dissipate wind heat， clear the head， relieve the pharynx and so on， the records of efficacy in ancient and modern times are basically the same. Based on the research results， it is suggested that raw products of M. haplocalyx should be selected when developing the famous classical formulas containing Menthae Haplocalycis Herba.

Herbal Textual Research on Mori in Famous Classical Formulas / 中国实验方剂学杂志

Through consulting the ancient herbs， medical books and modern literature， this paper made textual research on the name， origin， producing area， quality evaluation， collection and processing of medicinal materials of Sang （Mori Folium， Mori Cortex， Mori Ramulus， Mori Fructus） in famous classical formulas， in order to provide a basis for the development of famous classical formulas containing medicinal materials of Sang. According to the research， Mori Folium and Mori Cortex were first used as medicines in Shengnong Bencaojing ， Mori Ramulus was first used as medicine in Jinxiaofang， and Mori Fructus was first used as medicine in Xinxiu Bencao. Before the Tang dynasty， there were Nyusang and Shansang. Since Tang dynasty， there were many sources of medicinal materials of Sang， including Baisang （Morus alba）， Jisang （M. australis）， Shansang （M. mongolica）， etc. According to textual research， the mainstream varieties were M. australis， M. alba and their cultivated varieties. In modern times， according to the relevant information and the Chinese Pharmacopoeia， M. alba is the original base. In ancient times， the origin of mulberry changed with the development of sericulture， mulberry has been widely planted since the Song dynasty. In the Ming and Qing dynasties， mulberry has been planted most in Jiangsu and Zhejiang. In modern times， they are mainly produced in Jiangsu， Zhejiang， Anhui， Hunan and other places. In recent years， due to the related policies and strategies such as "moving silkworms from east to west"， the center of silkworm breeding has gradually transferred to the west. As for the quality evaluation and harvesting and processing of mulberry medicinal materials， Most of the ancient and modern records of Mori Folium are the same. They are harvested after frost， and dried after removing impurities. The quality is better when the leaves are large and thick， yellowish green， holding prickly hands and undergoing frost. The harvesting period of Mori Cortex is slightly different in ancient and modern records. Ancient books record that it can be harvested all the year round， but in modern times， it is mostly harvested from late autumn to the next spring. The processing methods include removing soil and fibrous roots， scraping off yellow-brown rough skin， peeling off white skin and drying in the sun. The quality is better when they are white， thick， flexible， free of rough skin and full of powder. There are few records about the collection， processing and quality evaluation of Mori Ramulus and Mori Fructus in ancient Chinese herbal books. According to modern literature， Mori Ramulus is usually collected in late spring and early summer， with leaves removed， slightly dried， sliced while fresh， and dried in the sun. The best quality of Mori Ramulus is fine and tender with the yellow and white section. Mori Fructus is harvested from April to June when the fruit turns red， and dried in the sun， or slightly steamed and dried in the sun， and it is better to be big， dark purple， oily and thick. There are many processing methods of mulberry medicinal materials. Ancient books record stir frying， baking， burning and steaming of Mori Folium， in modern times， there is honey-roasted method， but most of them are used as raw products. In ancient materia medica， Mori Cortex has firing method， baking method， stir-frying method， honey-fried method， etc. In modern times， there are stir-fried and honey-fried methods， and most of them are used as raw products. Ancient books record that Mori Ramulus has cutting and frying methods， while modern ones have cutting， frying， wine-processed and bran-processed methods. Processing methods of Mori Fructus are consistent in ancient and modern times， and they are mostly dried after being cleaned or steamed. Based on the research results， it is suggested that M. alba should be selected as mulberry medicinal materials in the famous classical formulas， and appropriate medicinal parts and processing methods can be selected according to the indications of the famous classical formulas.

The predictive value of dynamic changes of coagulation function for the occurrence and progression of isolated distal deep vein thrombosis of lower limbs in patients with acute brain injury / 中华危重病急救医学

Objective:To analyze risk factors for the occurrence and progression of isolated distal deep vein thrombosis (IDDVT) of lower limbs, and to explore the predictive value of dynamic changes of coagulation index D-dimer on the occurrence and progression of IDDVT in acute brain injury (ABI) patients during perioperative period.Methods:A retrospective case-control study was conducted. Perioperative ABI patients admitted to department of neurocritical care unit (NCCU) of the First Affiliated Hospital of University of Science and Technology of China from September 2019 to May 2020 were enrolled. Patients' baseline characteristics, disease characteristics, treatment approaches, outcomes and coagulation function index at 1, 2-4, 5-7 and > 7 days post operation were analyzed between patients with IDDVT and patients with progressive IDDVT. Risk factors for IDDVT occurrence and progression were identified by multivariate Logistic regression. Receiver operating characteristic curve (ROC curve) were drawn to assess the predictive value of coagulation indexes for IDDVT occurrence and progression.Results:A total of 164 ABI patients were enrolled. Most of the patients were elderly [age was 60 (51, 69) years], male [99 cases (60.4%)], and severe cases [Glasgow coma score (GCS) at admission was 6 (5, 8)]. The rates of IDDVT occurrence and progression were 61.6% (101 cases) and 16.8% (17 cases), respectively, the rate of proximal deep venous thrombosis (DVT) was 12.8% (21 cases). Compared with the IDDVT group (101 patients), patients without IDDVT group were younger (years: 55±13 vs. 62±13), length of intensive care unit (ICU) stay were shorter (days: 12±6 vs. 15±7), body mass index (BMI) and GCS at admission were higher [59 patients, BMI (kg/m 2): 23±5 vs. 19±8, GCS scores: 7±2 vs. 6±2], the differences were statistically significant (all P < 0.05). Compared with patients with IDDVT progression group, male patients were fewer [61.9% (52/84) vs. 88.2% (15/17)], the proportion of transfusion of red blood cell and anticoagulant therapy were lower [8.3% (7/84) vs. 29.4% (5/17) and 47.6% (40/84) vs. 94.1% (16/17)], the proportion of cerebral herniation was higher [42.9% (38/84) vs. 11.8% (2/17)] in patients without IDDVT progressive group. All of the differences were statistically significant (all P < 0.05). D-dimer were increased in two groups of whether IDDVT occurrence or not over time. D-dimer peaked on 5-7 days after surgery in IDDVT occurrence group, and then decreased. D-dimer peaked at > 7 days after surgery in patients without IDDVT. With time, D-dimer were increased in groups of whether IDDVT progression or not, both peaked at 5-7 days postoperation, and then decreased. Compared with non-IDDVTgroup, D-dimer was significantly increased in IDDVT group from 2-4 days after surgery [mg/L: 4.1 (2.3, 8.0) vs. 2.4 (1.7, 3.4), P < 0.05], and lasted until 5-7 days [mg/L: 5.5 (3.3, 11.4) vs. 3.9 (2.6, 5.8), P < 0.05]. Compared with IDDVT group, D-dimer was significantly increased in IDDVT progressive group from 2-4 days [mg/L: 11.2 (4.7, 20.0) vs. 3.7 (2.1, 6.8), P < 0.05], and lasted until 7 days [mg/L: 11.0 (3.0, 18.9) vs. 4.1 (2.6, 6.5), P < 0.05]. Multivariate Logistic regression analysis showed that age > 60 years [odds ratio ( OR) = 3.43, 95% confidence interval (95% CI) was 1.69-6.96, P = 0.001], GCS score at admission > 8 ( OR = 0.35, 95% CI was 0.17-0.76, P = 0.008), length of ICU stay > 13 days ( OR = 2.25, 95% CI was 1.08-4.70, P = 0.031) were risk factors for IDDVT. Gender ( OR = 0.19, 95% CI was 0.02-0.71, P = 0.019), transfusion of red blood cell ( OR = 6.50, 95% CI was 1.33-31.94, P = 0.021), cerebral herniation ( OR = 0.18, 95% CI was 0.37-0.90, P = 0.036) were risk factors for IDDVT profression. ROC curve analysis showed that age and D-dimer at 5-7 days were predicators of IDDVT [the area under curve ROC (AUC) were 0.68 and 0.72, 95% CI were 0.60-0.75 and 0.64-0.80, both P value were 0.000 1]. When the cut-off value of age was 60 years old and the D-dimer was 5.4 mg/L, the sensitivity were 60.6% and 54.4%, specificity were 71.2% and 80.9%, respectively, positive predictive value were 78.7%, 84.5%, negative predictive value were 51.2%, 48.1%, respectively. The elevation of D-dimer to 3.9 times at days 5-7 compared with day 1 of NCCU stay was a predicator of IDDVT progression (AUC = 0.81, 95% CI was 0.71-0.88, P = 0.000 1). The sensitivity, specificity, positive predictive value and negative predictive value were 76.5%, 74.6%, 41.9% and 93.0%, respectively. Conclusions:IDDVT occurrence and progressiveare common in severe ABI patients during perioperative period. The dynamic change of D-dimer, especially at days 5-7, is a valuable predictor of IDDVT progressionin ABI patients, which is helpful for guiding implementation of deep vein ultrasound of lower limb.

A comparative study of ARIMA and LSTM models in predicting hospital discharge number / 公共卫生与预防医学

Objective To fit and predict the monthly discharge number of a specialist hospital using Autoregressive Integrated Moving Average model (ARIMA) and Long Short-Term Memory Neural Network model (LSTM), and compare the prediction effects of the two models. Methods ARIMA and LSTM models were constructed based on the monthly discharge number of a specialist hospital from 2013 to 2018. The resulting models were then used to predict the monthly discharge numbers in 2019, which were compared with actual data. The mean absolute percentage error (MAPE) was used to evaluate the prediction effect of these two models. Results The MAPE values of ARIMA and LSTM compared to actual data in 2019 were 7.90% and 14.26%, respectively. Conclusion The prediction effect of ARIMA was better than that of LSTM. The prediction results of ARIMA showed that the number of patients discharged from the specialist hospital in 2019 was increasing, which fit well with the actual data.

Progress in research of epidemiologic feature and control of SARS-CoV-2 Delta variant / 中华流行病学杂志

SARS-CoV-2 Delta variant has the characteristics of stronger infectivity, higher viral load, and shorter incubation period, posing new challenges to the prevention and control of COVID-19 pandemic. SARS-CoV-2 Delta variant was first discovered in India, then quickly spread in many countries and has gradually become one of the main epidemic strains worldwide. Local epidemics caused by SARS-CoV-2 Delta variant also occurred in several provinces in China. This article summarizes the progress in research of etiological characteristics, transmission characteristics or possible mechanism and epidemiological characteristics of SARS-CoV-2 Delta variant, and the protective effects of vaccines and control measures against SARS-CoV-2 Delta variant in order to provide references for the effective prevention and control of COVID-19 epidemic caused by SARS-CoV-2 Delta variant.

Correlation of retinopathy and serum cystatin C in patients with primary hypertension / 中国基层医药

Objective To analyze the features of hypertensive retinopathy (HRP),and to evaluate the correlation of serum cystatin C (Cys-C) and retinopathy in patients with primary hypertension.Methods From July 2015 to October 2017,280 cases of primary hypertension in the Second People's Hospital of Ji'nan were recruited to receive fundus examination by funduscopy and eye-ground photography.Based on the findings,4 groups were established according to Chinese Ophthalmology (Third Edition) classification standard,normal,mild,moderate and malignant four levels.Clinical courses were monitored and Cys-C levels were determined.Results There were 204 cases of HRP,accounting for 72.86％.Compared with that of the normal fundus group (0.76 ±0.12)mg/L,the serum Cys-C level of the mild HRP group was (0.82 ± 0.19)mg/L,the difference was statistically significant (t =2.424,P ＜ 0.05).The serum Cys-C levels of the moderate HRP group and severe HRP group were (2.37 ± 0.13) mg/L and (3.24 ± 0.45) mg/L,respectively,the differences were statistically significant compared with that of the control group (t =80.917,42.153,all p ＜ 0.01).Conclusion The severity of HRP is positively correlated with Cys-C.

The role of specific carbohydrate diet in pediatric inflammatory bowel disease / 中华实用儿科临床杂志

Nutrition treatment plays an important role in the treatment and follow - up management of pediatric inflammatory bowel disease (IBD). The theory of specific carbohydrate diet(SCD),first presented in 1951,is a strict diet limitation focused on the sorts of carbohydrate:monosaccharide is the only kind of carbohydrate that is permitted, disaccharide and most complex carbohydrate like polysaccharide and starch are eliminated,intake of protein and fat is not limited,and processed meat and other processed food are cut down appropriately. Currently,mechanism of SCD diet′s treatment efficacy on IBD is not elucidated clearly. The hypothesis of this theory is:(1)Bowel inflammation of IBD patients leads to the decline of disaccharidase′s function,thus glucose,galactose and fructose are the only kinds of car-bohydrate that can be absorbed. (2)Occurrence of IBD is related to the disorder of bowel bacteria. The change of diet may regulate the bowel bacteria,which may be helpful to the symptoms of IBD. Retrospective case studies and case re-ports preliminarily indicated the efficacy of SCD in improving pediatric IBD symptoms and maintenance of clinical re-mission. However,high level evidence is still required to support the hypothesis. The limitation of carbohydrate by SCD would be the clue for the diet of pediatric IBD patients. However,the menu should be formulated according to the eating habits and the available food,as well as the requirement of the growth and development in children.

Nutritional risk screening of inpatient children with singer-center gastroenterological diseases in Sichuan province / 中华实用儿科临床杂志

Objective To evaluate the application of clinical Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP),and to investigate the nutritional risks of inpatient children with gastroenterological diseases in Sichuan province and their associated clinical characteristics and the features of hygiene economics.Methods STAMP was utilized for nutrition screening of inpatient children with gastroenterological diseases in Chengdu Women and Children's Central Hospital from January 2015 to March 2017.All the enrolled children were divided into 3 groups according to the STAMP scores:low risk group (LR group),moderate risk group (MR group) and high risk group (HR group).Clinical and economic data were compared among 3 groups.Results A total of 3 672 assessments were accomplished,including 2 372 times for males and 1 300 times for females (＜ 2 years old:2 021 times,2-5 years old:803 times,＞5 years old:848 times).Among them,147 children were identified as LR(4.00％),2 296 children as MR (62.53％),and 1 229 children as HR (33.47％).Statistically significant differences were observed among 3 groups in average length of hospital stay (P ＜0.001),the total cost at hospital (P ＜0.001),drug cost (P ＜ 0.001),antibiotic use (x2 =21.66,P ＜ 0.001),parenteral nutrition administration (x2 =46.43,P ＜ 0.001),blood products use (x2 =45.00,P ＜ 0.001),while there was no significant difference in re-admissions for over 3 times (P ＞ 0.05).Malnutrition rate was 4.08％ (6/147 cases) in LR group,2.05％ (47/2 296 cases) in MR group and 31.90％ (392/1 229 cases) in HR group,respectively,and among them 146 patients were diagnosed as severe malnutrition.Digestive tract infections were the most common diseases in MR group(66.33％,1 523/2 296 cases) and HR group(68.27％,839/1 229 cases).Moreover,children with stomatitis,gastrointestinal postoperation,acute pancreatitis,inflammatory bowel disease,esophageal diseases,digestive malformations,cyclic vomiting,malnutrition,and acute intestinal obstruction were all in HR group.Conclusions Nutritional risk is likely to raise the burden of disease.STAMP is applicabile clinically when it is utilized for nutrition risk screening of inpatient children with gastroenterological diseases in Sichuan province and provides evidence for nutrition support treatment.

Value of multi-phase enhanced MRI combined with histogram analysis of apparent diffusion coefficient in differential diagnosis of intrahepatic biliary cystadenoma and intrahepatic biliary cystadenocarcinoma / 中华放射学杂志

Objective To investigate the value of quantitative multi-phase enhanced MRI combined with histogram analysis of ADC in differential diagnosis of intrahepatic biliary cystadenoma (HBCA) and intrahepatic biliary cystadeno carcinoma (HBCAC). Methods Twenty-five patients with pathologically confirmed intrahepatic biliary cystic tumor (HBCT), including 16 cases of HBCA and 9 cases of HBCAC, were retrospectively analyzed. All the patients underwent upper abdominal MR plain scan and multi-phase enhanced scan. The MRI findings of the lesions were observed. The peak contrast enhancement ratio (pCER) of the lesions in the arterial phase, portal venous phase and delayed phase was calculated. ADC histogram analysis was performed and the quantitative parameters were acquired, including the average,standard deviation, median, kurtosis, skewness, and the 10th, 30th,70th, 90th percentile. Qualitative parameters were compared using Fisher exact test. The continuous variables with normal distribution and homogeneous variance were compared by independent sample t test. The continuous variables with skewed distribution were compared by Mann-Whitney U test. The ROC curve analysis was used to evaluate the differential diagnostic ability of the variables with significant differences between HBCA and HBCAC patients.Results There was a statistically significant difference between HBCA and HBCAC in terms of gender, age and whether there was bile duct dilatation or mural nodules (all P<0.05). However, the maximum diameter, high signal intensity of the cystic fluid on T1WI and septa of the lesions were not statistically significant (all P>0.05). The pCER of arterial phase, portal venous phase and delayed phase of HBCAC patients were higher than those of HBCA patients (all P<0.05).The standard deviation of ADC value of HBCAC group was higher than that of HBCA group, while the kurtosis and the 10th percentile were lower than those of HBCA group, and the differences were statistically significant between the two groups (all P<0.05). When the 10th percentile value of ADC histogram was≤ 2.060 × 10-3 mm2/s, the area under the ROC curve of discriminating between HBCA and HBCAC was the largest (0.861), and the diagnostic accuracy, sensitivity and specificity were 84.0 % and 77.8 % and 87.5 %, respectively. Conclusion Quantitative multi-phase enhanced MRI combined with histogram analysis of ADC had certain value for the differential diagnosis of HBCA and HBCAC, and the 10th percentile of the ADC histogram had the best diagnostic efficiency.

Differentiation and Treatment Thinking of Infertility from “Disease Prevention” to“Pregnancy Relying on Regulating Menstruation” / 中国中医药信息杂志

Ovarian function is the basis of female reproduction. Due to various causes of ovarian function, manstruation, menstrual cramps and infertility may appear. For infertility caused by ovaries, if the roots are traced, the roots may be low ovarian function. The idea of "disease prevention" should be throughout the treatment. "Pregnancy relying on regulating menstruation" theory should be followed, with a purpose to realize the early identification and early treatment.

Safety and immunogenicity evaluation of 60μg recombinant hepatitis B vaccine (Saccharomyces Cerecisiae) in population aged 16 and above / 预防医学

Objective To evaluate the safety of 60μg recombinant hepatitis B vaccine(Saccharomyces Cerecisiae)in healthy population over 16 years old and immunogenicity in non-responders.Methods A total of 4345 eligible subjects over 16 years old were selected and vaccinated with 60 μg recombinant hepatitis B vaccine, including 3415 participants who have never been vaccined before and 930 non-responders. All participants were monitored for any adverse events occurring within 30 min after each injection and instructed to record selected injection-site reactions and systemic reactions on the day of vaccination and the subsequent 28 days. Blood samples were collected from non-responders at pre-vaccination and one month after vaccination,in order to determine anti-HBs levels,positive rates of anti-HBs and the mean geometric titre(GMT)of anti-HBs.Results Among 4345 vaccinated participants,16.39 % of them reported at least one injection-site or systemic adverse reaction. The most common injection-site and systemic adverse reactions were Grade 1 adverse reactions with the incidence of 15.12 %(657/4345)and 4.05%(176/4345)respectively. No serious adverse events were observed. Among 930 non-responders,the positive rate of anti-HBs was 87.03 % with active responder of 76.74 %(551 / 718)and the GMT of anti-HBs was 479.28 mIU / ml. The positive rate of anti-HBs was not associated with gender or age (P>0.05). The GMT of anti-HBs demonstrated significant differences between female and male(560.66 mIU / mL VS. 404.91 mIU / mL,P<0.05),but there was no significant differences in different age groups (P>0.05).Conclusion 60μg recombinant hepatitis B vaccine was safe for healthy adults above 16 years and had good immunity efficacy among non-responders who had no or low response to standard immunization regimen of hepatitis B vaccine.

Efficacy and hemodynamic analysis of complex symptomatic middle cerebral artery stenosis after Solitaire stent implantation / 中国脑血管病杂志

Objective To analyze the efficacy and hemodynamic changes in patients with complex symptomatic middle cerebral artery stenosis after Solitaire AB stent implantation.Methods From June 2013 to June 2016,7 consecutive patients with complex symptomatic middle cerebral artery stenosis treated with Solitaire stents at the Department of Neurology,the Third People's Hospital of Hubei Province were enrolled retrospectively.The stenosis rate ≥70% was confirmed by digital subtraction angiography (DSA).Of the 7 patients,5 were male and 2 were female,with an average age of 70±8 years.The general data of the patients were documented,including clinical symptoms,modified Rankin scale(mRS)score,stenosis degree,vascular pathways LMA classification and Mori typing for stenosis,and postoperative residual stenosis or restenosis.The hemodynamic parameters at day 1,7,and 3 months before and after procedure were compared.Results All patients were successfully implanted with the Solitaire AB stents.(1) Of the 7 patients,the Mori type A of stenosis lesions was in 4 cases,B in 2 cases,and C in 1 case.The LMA typing of vascular approaches were Type Ⅲ in 3 cases,type Ⅱ in 4 cases.The preoperative stenosis rate was 80±7%,the residual stenosis rate was 24±13%,and there were no operation-related complications.No ischemic events occurred during the follow-up period.(2) Before stent implantation and at 1 d,7 d,and 3 months after procedure,the peak systolic velocity (PSV) were 297±41,144±34,145±27,and 143±40 cm/s,respectively,the end diastolic velocity (EDV) were 159±22,68±16,68±14,and 66±17 cm/s,respectively,and the pulse index (PI) were 0.67±0.06,0.80±0.08,0.80±0.07,and 0.82±0.06,respectively.PSV,EDV,and PI at 1 d,7 d,and 3 months were improved compared with before procedure (all P0.05).Conclusions Initial analysis showed that no procedure-related complications were observed in the treatment of vascular tortuosity and complex middle cerebral artery stenosis with the Solitaire stents.The short-term curative effect is exact;However,it still needs to be validated further.