Deepening the Action on Salt Reduction in China-suggestions on strategy and implementation plan / 中华预防医学杂志

Excessive sodium/salt intake is the leading dietary risk factor for the loss of healthy life in the Chinese population. The "Healthy China 2030" Action Plan set the goal of reducing salt intake by 20% by 2030. However, salt intake in China is still at a very high level in the world, with adults reaching 11 g/d, more than twice the recommended limit of 5 g/d. The current policies and action plans of China have targeted catering workers, children, adolescents, and home chefs in salt, oil, and sugar reduction actions. However, there are still obvious deficiencies in the coordinated promotion and implementation. This study, therefore, proposed a set of comprehensive strategies (named CHRPS that is composed of communication and education, salt reduction in home cooking, salt reduction in restaurants, reducing salt content in pre-packaged food, and surveillance and evaluation) and key implementation points for further deepening the salt reduction action in China. These strategies were developed based on the main sources of dietary sodium for Chinese residents, the status of "knowledge, attitude and practice" in salt reduction, evidence of effective intervention measures, existing policies and requirements, and the salt reduction strategies of the World Health Organization and experience from some other countries. As a scientific reference, the CHRPS strategies will help the government and relevant organizations quickly implement salt reduction work and facilitate the earlier realization of China's salt reduction goal.

Burden of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption in China / 中华流行病学杂志

Objective: To describe the prevalence of alcohol consumption and the burden of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption in adults aged ≥20 years in 31 provinces in China from 2005 to 2018. Methods: Data from several national representative surveys was used to estimate provincial alcohol exposure level of adults aged ≥20 years from 2005 to 2018 by using kriging interpolation and locally weighted regression methods. Global disease burden research method and data, and China's death cause surveillance data were used to calculate the population attributable fraction (PAF) of hemorrhagic stroke and hypertensive heart disease and the deaths due to alcohol consumption in men and women aged ≥20 years in 31 provinces in China. China census data of 2010 were used to calculate the attributable standardized mortality rate. Results: In 2005 and 2018, the prevalence of alcohol consumption was 58.7% (95%CI: 57.8%-59.5%) and 58.4% (95%CI: 57.6%-59.3%), respectively, in men and 17.0% (95%CI: 16.6%-17.4%) and 18.7% (95%CI:18.1%-19.3%), respectively, in women. The daily alcohol intake was 24.6 (95%CI: 23.8-25.3) g and 27.7 (95%CI: 26.8-28.7) g, respectively, in men and 6.3 (95%CI: 6.0-6.5) g and 5.3 (95%CI: 5.0-5.6) g, respectively, in women. Alcohol exposure level was higher in the provinces in central and eastern China than in western provinces. The lowest exposure level was found in northwestern provinces. From 2005 to 2018, the PAF of hemorrhagic stroke death due to alcohol consumption increased from 5.5% to 6.8%, the attributable deaths increased from 50 200 to 59 100, while the PAF of hypertensive heart disease death due to alcohol consumption increased from 7.0% to 7.7%, the attributable deaths increased from 15 200 to 29 300. The PAF of hypertensive heart disease and hemorrhagic stroke was higher in men than in women, and in central and eastern provinces than in western provinces. In 2018, the standardized mortality rates of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption were 4.58/100 000 and 2.11/100 000, respectively. Conclusions: The prevalence of alcohol consumption in men and daily alcohol intake of drinkers were relatively high in China, especially in eastern provinces. Alcohol exposure level was lower in women than in men. Regional measures should be taken to reduce the alcohol intakes in men and current drinkers in order to reduce the health problems caused by alcohol consumption.

Retrograde intrarenal surgery with holmium laser lithotripsy for the management of calyceal diverticular calculi / 中华泌尿外科杂志

Objective:To investigate the efficacy and safety of retrograde intrarenal surgery(RIRS) with holmium laser lithotripsy in the management of calyceal diverticular calculi.Methods:A retrospective analysis was performed on 56 patients with calyceal diverticular calculi admitted to Huashan Hospital of Fudan University from January 2017 to May 2020. The 56 cases included 25 males and 31 females. The average age was 37.4 (ranging 22-67) years. Calyceal diverticular stones were located in the upper pole of the kidney in 32 cases, middle pole in 16 case and lower pole in 8 cases, with 32 cases on the left side and 24 cases on the right side. Multiple stones occurred in 46 cases, and single stone in 10 cases. The mean diameter of stones was 11.5 (ranging 3.0-17.5)mm. All 56 patients had different degrees of lumbar pain and/or hematuria preoperatively. Among them, 17 patients received extracorporeal shock wave lithotripsy (ESWL) with failure. Moreover, 9 cases suffered with urinary infection. All 56 patients with calyceal diverticular calculi underwent retrograde flexible ureterorenoscopic Ho: YAG laser lithotripsy under general anesthesia. The flexible ureterorenoscope was advanced into the kidney through the ureteral access sheath, looking for the cervical orifice of calyceal diverticulum. After finding renal diverticulum, holmium laser was used to incise and expand the neck or weak part of the diverticulum. The diverticular calculi were fragmented into particles less than 3 mm. Larger fragments were removed through a nitinol stone basket one by one. A F6 D-J stent was indwelled. The intraoperative conditions, postoperative complication rate and stone free rate were statistically analyzed.Results:The calyceal diverticular calculi in all 56 patients were discovered, and the diverticulum orifice were identified in 48 patients(85.7%). 53 of them underwent calyceal diverticular calculi fragmentation successfully. Lithotripsy failed in 3 cases, as the calculi were incarcerated in the lower pole calyceal diverticulum with a long narrow neck and the limitation of flexure at the end of the flexible ureteroscope. Two of them underwent percutaneous nephrolithotomy instead due to the calculi located in the posterior calyx. In another one case, ESWL was performed as the calculi located in the anterior calyx. Of the 17 cases received unsuccessful ESWL, RIRS was successful in 16 cases (94.1%). The mean operative time was 68.1(ranging 37-105)min, and mean hospitalization was 1.8 (ranging 1-3)d. The complication rate was 15.1%(8/53). All of these complications were mild (Clavien Ⅰ-Ⅱ). No serious complications such as perforation of the renal pelvis and ureter or major bleeding were occurred. After mean postoperative follow-up of 6.3(ranging 3-12) months, the stone-free rate was 83.0% (44/53) after the first procedure. 7 cases with residual stones ≥4mm received a second procedure. Among them, 6 cases received flexible ureterorenoscopy and the other one received ESWL and external physical vibration lithecbole therapy. The stone-free rate and symptom remission rate was 92.5% (49/53) and 96.2% (51/53) respectively after the second procedure, and no recurrence of calyceal diverticular calculi was observed during the stage of fllow-up.Conclusions:RIRS with holmium laser lithotripsy in the treatment of calyceal diverticular calculi, using the body's natural cavities, is a minimally invasive, safe and efficient strategy with slight complications. RIRS with holmium laser lithotripsy is an optional treatment for calyceal diverticular calculi.

Malnutrition in Relation with Dietary, Geographical, and Socioeconomic Factors among Older Chinese / 生物医学与环境科学（英文）

Objective@#Nutrition is closely related to the health of the elderly population. This study aimed to provide a comprehensive picture of the nutrition status of elderly Chinese and its related dietary, geographical, and socioeconomic factors.@*Methods@#A total of 13,987 ≥ 60-year-old persons from the 2010-2013 Chinese National Nutrition and Health Survey were included to evaluate various aspects of malnutrition, including underweight, overweight or obesity, and micronutrient inadequacy.@*Results@#Overall, the prevalence of obesity, overweight, and underweight was 12.4%, 34.8%, and 5.7%, respectively, with disparities both geographically and socioeconomically. The prevalence of underweight was higher among the older old (≥ 75 years), rural residents and those with low income, with low education status, and residing in undeveloped West areas. More than 75% of the elderly do not meet the Dietary Reference Intakes for vitamins A, B @*Conclusions@#Obesity epidemic, inadequacy of micronutrient intake, and high prevalence of underweight and anemia in susceptible older people are the major nutrition challenges for the rapidly aging population in China.

Analysis on Mechanism of Astragali Radix in Treating IgA Nephropathy Based on Network Pharmacology and in Vitro Cell Experiment / 中国实验方剂学杂志

Objective:To explore the multi-component， multi-target and multi-pathway mechanism of Astragali Radix against immunoglobulin A nephropathy （IgAN） by network pharmacology， aiming to provide evidence for its basic research and clinical application. Method:The active chemical components and targets of Astragali Radix and targets associated with IgAN were obtained by literature mining and GeneCards， Traditinal Chinese Medicine Integrated Database （TCMID）， Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） databases. Cytoscape 3.7.1 software was used to draw network interaction diagrams. The key targets of Astragali Radix against IgAN were searched by network topology. Gene ontology （GO） analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway analysis involved in the targets were analyzed by different packages in R programming language. On this basis， cell experiments <italic>in vitro</italic> were carried out to verify the activation effect of astragaloside Ⅳ on phosphatidylinositol 3-kinase/protein kinase B/tumor suppressor gene protein 53 （PI3K/Akt/p53） signaling pathway of human mesangial cells. Result:A total of 25 active components and 49 ingredient-disease targets of Astragali Radix were screened. The GO enrichment analysis included 84 items， which were related to nuclear hormone receptor binding， nuclear receptor activity， deoxyribonucleic acid binding transcriptional activation activity and other aspects. The KEGG pathway enrichment analysis included 88 KEGG pathways， which were closely related to PI3K/Akt signaling pathway， hypoxia inducible factor-1 （HIF-1） signaling pathway， advanced glycation end product/receptor of advanced glycation end product （AGE/RAGE） signaling pathway and others. Cell experiments <italic>in vitro </italic>confirmed that astragaloside Ⅳ could effectively inhibit the platelet derived growth factor-BB （PDGF-BB）-induced proliferation of human mesangial cells by regulating PI3K/Akt/p53 signaling pathway. Conclusion:The active ingredients of Astragali Radix may play a role in the treatment of IgAN by acting on targets and pathways related to apoptosis， oxidative stress， inflammation response and others， providing ideas and directions for the new drug development and mechanism study of IgAN.

Association between Chinese Famine Exposure and the Risk of Overweight/Obesity and Abdominal Obesity in Laterlife: A Cross-sectional Study / 生物医学与环境科学（英文）

This study aimed to examine the association between famine exposure in different stages of life and the risk of overweight/obesity and abdominal obesity in laterlife. A total of 12,458 participants were categorized into non-exposure and four direct exposures, including fetal, childhood, adolescence, and adult exposure. Only risk of being overweight or obesity in adolescence exposure [odds ratio ( ), 1.45; 95% confidence interval ( ), 1.08-1.94] was significantly higher than in non-exposure. Childhood ( , 1.27; 95% , 1.05-1.54) and adolescence ( , 1.53; 95% , 1.15-2.05) exposures had significantly an increased risk of abdominal obesity compared with non-exposure. Additionally, different famine severity exposures had different influences on the development of overweight/obesity and abdominal obesity. Famine exposure in adolescence, which was a behavior formative period, can increase the risk of overweight/obesity and abdominal obesity in adulthood, specifically in famine severely affect area.

Association of Red Meat Usual Intake with Serum Ferritin and the Risk of Metabolic Syndrome in Chinese Adults: A Longitudinal Study from the China Health and Nutrition Survey / 生物医学与环境科学（英文）

Objective@#The present study aimed to investigate the association of red meat usual intake with metabolic syndrome (MetS), and explore the contribution of red meat usual intake to serum ferritin.@*Methods@#Based on the data from the longitudinal China Health and Nutrition Survey (CHNS), 2,797 healthy adults aged 18-75 years without hypertension, diabetes, and MetS were selected in 2009 as subjects and follow-up studies were carried out till 2015. We used the National Cancer Institute (NCI) method to estimate the usual intake of foods. Multivariable logistic regressions were performed to evaluate the association between red meat usual intake and the risk of MetS. Quantile regression analysis was used to study the relationship between red meat consumption and serum ferritin levels.@*Results@#After adjusting for potential confounders, red meat, and fresh red meat were positively associated with the risk of MetS ( = 1.41, 95% : 1.05-1.90 and = 1.37, 95% : 1.02-1.85, respectively). These relationships showed increasing trend ( < 0.05). The level of serum ferritin increased significantly with the number of MetS components ( < 0.05). The quantile regression analysis showed that red meat and fresh red meat usual intake had a significant positive association with serum ferritin levels across the entire conditional serum ferritin distribution ( < 0.05). Processed red meat did not exhibit a similar association.@*Conclusion@#Higher red meat usual intake was associated with an increased risk of MetS and elevated serum ferritin levels.

Analysis of the positive conversion rate of negative spouse and survival analysis on HIV sero－discordant couples / 中华疾病控制杂志

@#Objective To analyze the positive conversion rate of negative spouse and the survival analysis on HIV sero－discordant couples． Methods Data were collected from the case report database of the integrated AIDS prevention and control data and information system． HIV sero－discordant couples diagnosed between September 1，1997 and September 1，2018 were recruited into the cohort． The participants were divided into three groups as untreated subgroup，routine treatment subgroup and early treatment subgroup according to the situation when they started HIV treatment． The positive conversion rate of negative spouse and the survival were compared among the three subgroups． Ｒesults 598 HIV sero－discordant couples were recruited and the overall survival time of the three subgroups were 258. 92，4 987．17 and 862．25 person－year． The rate of positive conversion were 6. 18/100，0. 48/100 and 0. 23/100 person－year． Multivariate Cox regression model showed that the hazard ratio of routine treatment subgroup ( HＲ = 0. 052，95% CI: 0. 037－0. 074) and early treatment subgroup ( HＲ=0. 011，95% CI: 0. 003－0. 035) were lower than untreated subgroup． The risk of death of women was lower than that of men( HＲ=0. 667，95% CI: 0. 472－0. 944) ; the older the age，the higher the risk of death ( HＲ=1. 041，95% CI: 1. 026－1. 056) ; and the risk of death of the unemployed is higher than that of farmers ( HＲ=1. 571，95% CI: 1. 037－2. 381) ． Conclusion Targeted interventions methods and early antiviral therapy should be taken urgently for sero－discordant couples．

Clinical Efficacy of Jiwei Huangqi Guizhi Wuwutang Combined with Xingnao Kaiqiao Acupuncture on Shouder-hand Syndrome / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of Jiwei Huangqi Guizhi Wuwutang combined with Xingnao Kaiqiao acupuncture on shouder-hand syndrome (SHS), and its effect on neurogenic inflammatory factors and hemorheology. Method:One hundred and forty-eight patients were randomly divided into control group and observation group (74 cases). Both groups' patients got rehabilitation measures, such as diclofenac sodium sustained release tablets for two to four weeks, 75 min/time, 1 time/day, and patients with apparent swelling got prednisone acetate tablets for one to two weeks, 10 min/time, 1 time/day. And patients in control group got Xingnao Kaiqiao acupuncture, 1 time/day, 6 times/week. Control grouporal Naoxintong capsule 4 tablets/time,3 times/day, patients in observation group were added with Jiwei Huangqi Guizhi Wuwutang, 1 dose/day. The courses of treatment were 4 weeks. Before and after treatment, shoulder hand syndrome scale (SHSS), the upperextremities of the Fugl-meyer movement assessment (U-FMA), ability of daily life activities (ADL), Qi deficiency and blood stasis syndrome and clinical efficacy were scored, disappearing time of pain and swelling were recorded, and levels of calcitonin gene related peptide (CGRP), substance P (SP), bradykinin (BK) and hemorheology were detected. Result:The clinical efficacy in observation group was better than that in control group (Z=2.106, P<0.05). And scores of sensory, autonomic, motion according to SHSS scale and the total scale of SHSS were all lower than those in control group (P<0.01). Disappearing time of pain and swelling were shorten than those in control group (P<0.01). After treatment, scores of U-FMA and ADL were higher than those in control group (P<0.01), while score of syndrome of Qi deficiency and blood stasis was lower than that in control group (P<0.01). And level CGRP was higher than that in control group (P<0.01), and levels of SP and BK were lower than those in control group (P<0.01). After treatment, whole blood viscosity (high cut, low cut), plasma viscosity, fibrinogen and platelet aggregation rate were all lower than those in control group (P<0.05). Conclusion:In addition to the conventional western medicine therapy, Jiwei Huangqi Guizhi Wuwutang combined with Xingnao Kaiqiao acupuncture can reduce the severity of SHS and clinical syndromes of traditional Chinese medicine, shorten the course of disease, improve the motor function of upper limbs, inhibit the neurogenic inflammatory reaction, and improve the blood flow, the ability of daily life and the clinical efficacy of patients..

Manifestations of liver injury in 333 hospitalized patients with coronavirus disease 2019 / 中华消化杂志

Objective:To investigate the manifestations of liver injury in hospitalized patients with coronavirus disease 2019 (COVID-19), to investigate the prognosis indicators of the disease, and to provide the reference for clinical diagnosis and treatment.Methods:From January 10 to February 14, 2020, at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, the data of 333 hospitalized patients with COVID-19 were collected. The changes of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), indirect bilirubin (IBil) and albumin of the first liver function test after admission and the reexaminations of liver function test during hospitalization period in patients with liver injury were retrospectively analyzed. Student t test and Chi-square test were used for statistical analysis. Results:Liver injury occurred in 39.6% (132/333) of COVID-19 patients. There was no statistically significant difference in the rate of liver injury between patients in intensive care unit (ICU) and in general ward (45.6%, 26/57 vs. 38.4%, 106/276; χ2=1.026, P>0.05). 67.4% (89/132) of COVID-19 patients with liver injury presented with increased ALT or AST level on admission. During hospitalization, the level of ALT was higher than that of the first examination after admission ((60.28±50.44) U/L vs. (42.25±32.21) U/L), and the difference was statistically significant ( t=-3.230, P<0.05). The levels of ALT and AST of 71.2% (94/132) patients were both <80 U/L, which indicated that most of the patients showed mild liver injury. The patients with elevated level of TBil, DBil and IBil accounted for 3.9% (13/333), 5.4% (18/333) and 2.4% (8/333) of the COVID-19 patients, respectively. The albumin level of COVID-19 patients with liver injury during hospitalization was lower than that of the first examination after admission ((31.8±5.1) g/L vs. (33.7±5.4) g/L), and the difference was statistically significant ( t=2.712, P<0.05). The albumin levels at first examination on admission and reexamination during hospitalization of patients in ICU were both significantly lower than those of patients in general ward ((29.3±3.7) g/L vs. (34.8±5.1) g/L and (27.6±2.8) g/L vs. (32.9±5.1) g/L), and the differences were statistically significant ( t=4.928 and 4.783, both P<0.05). Conclusions:The incidence of liver injury in COVID-19 patients is high. A slight increase in aminotransferase levels is particularly common. Bilirubin abnormality is relatively rare and mild. The level of albumin may be one of the indicators for the severity and prognosis of COVID-19.

Effect of glycoside of short-horned epimedium Herb on the expressions of transforming growth factor β 1 and basic fibroblast growth factor induced membrane by Masquelet technology / 中国修复重建外科杂志

Objective: To observe the expressions of transforming growth factor β 1 (TGF-β 1) and basic fibroblast growth factor (bFGF) induced membrane by Masquelet technique in rats treated with glycoside of short-horned epimedium Herb, and to explore the effect of glycoside of short-horned epimedium Herb on Masquelet induced membrane. Methods: Sixty 3-month-old male Wistar rats were randomly divided into 3 groups with 20 rats in each group; a tibial bone defect (6 mm in length) model was established. The blank group (group A) was not treated; the control group (group B) and the experimental group (group C) were filled with vancomycin antibiotic bone cement in the drawing stage, and the bone cement was completely solidified. Group C was given perfused flavonoids glycoside of short-horned epimedium Herb (10 μmol/L) by gavage once a day (0.3 mL) from 1 day after operation, and groups A and B were given the same amount of normal saline by gavage. After operation, the recovery and wound healing of experimental animals were observed; at 4 weeks after operation, X-ray film was taken to observe the recovery of bone defect of proximal tibia; at 6 weeks after operation, the bone defect was observed, and the morphological changes and vascularization degree of granulation tissue and induction membrane tissue were observed; the expressions of TGF-β 1 and bFGF were observed by immunohistochemistry staining and ELISA detection. Results: The bone defect models of the 3 groups were established successfully, and there was no abnormality after operation. The incisions healed by first intention after operation. At 4 weeks after operation, X-ray films of proximal tibial defect showed that there was obvious space in group A, while bone cement was filled and Kirschner wire fixation was good in groups B and C. At 6 weeks after operation, the gross observation showed that the granulation tissue was filled in the defect area in group A; transparent membrane was formed in groups B and C, and microvessels were seen in some areas, and the microvessels in group C were significantly more than those in group B. Immunohistochemical staining showed that the expressions of TGF-β 1 and bFGF were negative in group A, but they were expressed in groups B and C, and the expressions of TGF-β 1 and bFGF in group B were significantly less than those in group C. ELISA detection showed that the expressions of TGF-β 1 and bFGF in group C were significantly higher than those in groups A and B ( P0.05). Conclusion: Glycoside of short-horned epimedium Herb can significantly increase the expressions of TGF-β 1 and bFGF, accelerate the process of osteogenesis, and contribute to bone shaping and reconstruction.

Effects of mild hypothermia on calmodulin expression and brain edema in the brain tissue of rats with traumatic brain injury / 医学研究生学报

Objective Mild hypothermia (MHT) can effectively protect the brain in traumatic brain injury (TBI). This study was to investigate the effects of MHT on the calmodulin (CAM) expression and brain edema in the rat model of TBI. Methods Ninety adult SD rats were randomly divided into a sham operation, a normal temperature and an MHT group of equal number. Immediately after TBI, the rats of the MHT group maintained at a rectal temperature of (32 ± 0.5) °C for 6 hours. Modified neurological severity scores (mNSS) were obtained from 6 rats in each group at 1, 3, 5 and 7 days after modeling, and the rest of the animals subjected to brain MRI at 6, 12, 24 and 48 hours and then killed for determination of the CAM gene transcription and protein expression in the brain tissue by real-time PCR, immunohistochemistry and Western blot. Results The mNSSs were significantly higher in the MHT and normal temperature groups than in the sham operation control (P < 0.05) at all time points, neurological severity markedly decreased in the MHT group compared with the normal temperature group (P < 0.05). At 6, 12, 24 and 48 hours, the expression of CAM mRNA was remarkably down-regulated in the MHT group (1.83 ± 0.19, 1.72 ± 0.12, 1.59 ± 0.06 and 1.60 ± 0.07) in comparison with the normal temperature group (2.76 ± 0.25, 2.49 ± 0.18, 2.04 ± 0.14 and 1.65 ± 0.09) (P < 0.05), even lower in the MHT than in the normal temperature group (P < 0.05), but higher in both of the two groups than in the sham operation group (P < 0.05). At 6, 12, 24 and 48 hours, the volume of brain edema was significantly reduced in the MHT group ([32.14 ± 4.52], [36.52 ± 4.10], [42.10 ± 4.38] and [46.25 ± 5.02] mm3) as compared with the normal temperature group ([48.56 ± 5.35], [53.13 ± 6.31], [59.23 ± 6.82] and [62.35 ± 7.25] mm3) (P < 0.05). Conclusion Mild hypothermia can improve the neurological function and reduce the CAM expression and brain edema in the brain tissue of rats with traumatic brain injury, which may be related to the neuroprotective effect of mild hypothermia.

Valproic acid inhibits the expressions of MMP-9 and AQP-4 proteins in the brain tissue of rats with traumatic brain injury / 医学研究生学报

Objective Few studies are reported on the protective effect of valproic acid (VPA) against traumatic brain injury (TBI) by down-regulating the protein expressions of matrix metalloproteinase-9 (MMP-9) and aquaporin-4 (AQP-4) in the brain tissue. This study aimed to investigate the neuroprotective effects of different doses of VPA against TBI in experimental rats. Methods We randomly divided 100 adult male rats into five groups of equal number, sham operation, TBI model, and low- (30 mg), medium- (150 mg) and high-dose (300 mg) VPA treatment. At 1, 3, 7 and 14 days after modeling by controlled cortex impact, we obtained the modified Neurological Severity Scores (mNSS), measured the VPA concentration in the venous blood, and then killed the rats and harvested the brain tissue for determination of the water content using the dry-wet method and the expressions of MMP-9 and AQP-4 by Western blot and immunohistochemistry. Results At 1, 3, 7 and 14 days after modeling, the mNSSs in the high-dose VPA group were 4.6 ± 1.3, 3.8 ± 1.3, 3.0 ± 0.7 and 1.8 ± 0.8, respectively, significantly lower than 8.4 ± 0.9, 7.0 ± 0.7, 5.8 ± 1.0 and 4.5 ± 1.3 in the TBI group (P < 0.05), decreasing in a time-dependent manner, with statistically significant difference between any two dose groups (P < 0.05). At 1, 3 and 7 days, the water contents in the brain tissue were (76.2 ± 0.7)%, (76.9 ± 1.7)% and (73.9 ± 1.3)% in the high-dose VPA group, significantly lower than (79.6 ± 0.8)%, (82.6 ± 0.8)% and (78.6 ± 0.7)% in the TBI group (P < 0.05), also decreasing in a time-dependent manner, with statistically significant difference between any two dose groups (P < 0.05). At 1 and 3 days, the expressions of MMP-9 and AQP-4 in the brain tissue were markedly down-regulated in the VPA groups in a dose-dependent manner as compared with those in the TBI group (P < 0.05), with statistically significant difference between any two dose groups (P < 0.05), and meanwhile immunohistochemistry showed large numbers of cells with positive expressions of MMP-9 and AQP-4, which were reduced with the increased dose of VPA. Conclusion VPA has a neuroprotective effect against TBI in rats by inhibiting the expressions of MMP-9 and AQP-4 proteins in the brain tissue and alleviating brain edema. Within the range of the doses studied, higher-dose VPA produces a better effect.

Efficacy of EEG biofeedback therapy in children with attention deficit hyperactivity disorder and its relationship with learning / 中华行为医学与脑科学杂志

Objective To investigate the efficacy of EEG biofeedback therapy in children with at-tention deficit hyperactivity disorder (ADHD) and its relationship with learning in EEG regulation. Methods Fifty-two children with ADHD who completed EEG biofeedback training from August 2015 to February 2019 entered the study according to the inclusion criteria. The children underwent standardized QEEG-based EEG biofeedback training. After 40 training sessions, the study was conducted. The children were divided into learners group (n=39) and non-learners group (n=13),and the difference between learners group and non-learners group in the improvement of ADHD symptoms before and after training was compared. Result-s After intervention,at the EEG level,the main effects of the number of interventions for θ wave,β wave, SMR and TBR(F(1,39)=538. 49,F (1,39)= 2 712. 6,F (1,39)= 7 429. 45,F (1,39)= 1. 887) were significant(P<0. 01). At the clinical efficacy level,the SNAP-IV attention deficit subscale (1. 84± 0. 59),hyperactivity/impulse subscale (0. 49±0. 30),opposite deficit resistance subscale ( 0. 96± 0. 44) and full scale (1. 07± 0. 28) significantly decreased after intervention compared with pre-intervention (respectively (2. 16±0. 56), (1. 70±0. 38),(1. 08±0. 38),(1. 63± 0. 32). The pre-and post-intervention SNAP-Ⅳ full scale and sub- scale scores of the learners group and the non-learners group were compared. Before intervention,the SNAP-Ⅳ subscale score and full scale were not significant differences between the learners and non-learners(all P>0. 05). After intervention,the attention deficit subscale score,hyper/impulsive subscale score,ODD sub-scale score(1. 74±0. 62 vs 2. 12± 0. 37,0. 48±0. 22 vs 0. 54±0. 48,0. 88± 0. 43 vs 1. 17± 0. 40) and total score of SNAP-Ⅳ scale(1. 01±0. 28 vs 1. 24±0. 18) in the learners were lower than those in the non-learn-ers, and the differences were significant except for the hyper/impulsive subscale ( P < 0. 05 ). Conclusion EEG biofeedback training can significantly improve EEG activity and ADHD symptoms in chil-dren with ADHD. EEG-regulated learners are more likely to improve ADHD symptoms than non-learners.

Clinical observation of three-needle therapy combined with acupuncture on complex regional pain syndrome after stroke / 中国针灸

OBJECTIVE@#To observe the clinical therapeutic effect of three-needle therapy combined with acupuncture on complex regional pain syndrome typeⅠ(CRPS-Ⅰ) after stroke.@*METHODS@#A total of 96 patients with CRPS-Ⅰ after stroke were randomized into an observation group and a control group, 48 cases in each one. In the control group, based on the routine treatment, acupuncture was applied at Neiguan (PC 6), Shuigou (GV 26), Sanyinjiao (SP 6) and other supplementary acupoints, once a day, 6 times a week for 3 weeks. Based on the treatment in the control group, three-needle therapy was added at coracoid process, greater tuberosity of humerus and infraglenoid tubercle, the muscular fascia was released by fan-shaped separation technique for 3-6 times, and the treatment was given once every 2 days, 3 times a week for 3 weeks. Visual analogue scale (VAS) score, hand swelling level, Fugl-Meyer assessment (FMA) score and Barthel index score were observed to evaluate the pain and swelling severity, motor function and living ability of patients before and after treatment.@*RESULTS@#① Compared before treatment, the VAS score, hand swelling level, the FMA score and the Barthel index after treatment and 40 days after treatment were improved in both of the two groups (0.05).@*CONCLUSION@# three-needle therapy combined with acupuncture can improve the pain severity and the motor function of affected limbs in patients with CRPS-Ⅰ after stroke, and the therapeutic effect may be sustained for a long term. However, the treatment seems to be ineffectual on extremity swelling.

Advance in Sensory Integration for Children (review) / 中国康复理论与实践

Sensory integration treatment (SIT) corrects sensory dysfunction by controlling and regulating sensory input in the environment. SIT was currently used more and more widely, especially for children with behavioral and developmental disabilities. Based on the published researches for children in the past five years, SIT may work well for the population with something such as sensory processing and attention deficit hyperactivity disorder. Other specific results were different in the studies, and difficult to conclude. The research should be improved in the dificiencies as small sample size, confusing dosage and terrible fidelity. Intervention planning for individuals requires the integration of the information with specific knowledge of the patient's needs, expert consensus and professional judgment.

Relationship between expression of RBM38 and distant metastasis and prognosis of breast cancer / 中华肿瘤杂志

Objective@#To investigate the relationship between the expression of RNA-binding protein 38 (RBM38) and distant metastasis and prognosis of breast cancer.@*Methods@#A total of 161 cases of breast cancer tissues were selected, and the expression of RBM38 was detected by immunohistochemical SP method. The relationship between the expression of RBM38 and the distant metastasis and prognosis of breast cancer patients were analyzed. Cox regression model was applied to analyze the influence factors of distant metastasis of breast cancer.@*Results@#Among the 161 breast cancer patients, high expression of RBM38 was observed in 85 cases and low expression was observed in 76 cases. Log rank test showed that the distant metastasis rate of RBM38 highly expressed group was significantly lower than that of RBM38 lowly expressed group (P=0.010), while the survival rate was significantly higher (P=0.009). Univariate Cox regression analysis showed that the pathological stage (P=0.001), axillary lymph node positive (P=0.001), and the expression of RBM38 (P=0.015) were dramatically related to the distant metastasis of breast cancer patients. Multivariate Cox regression analysis showed that positive axillary lymph node was an independent risk factor (RR=4.222, 95% CI: 1.235-14.432), and high expression of RBM38 was an independent protective factor (RR=0.328, 95% CI: 0.128-0.839) of distant metastasis of breast cancer patients.@*Conclusion@#High expression of RBM38 is positively related with low distant metastasis rate and good prognosis of breast cancer patients. Hence, high expression of RBM38 is an independent protective factor of distant metastasis.

Clinical effects of percutaneous endoscopic transforaminal decompression for the treatment of lumbar spinal stenosis / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate clinical effects of lumbar spinal stenosis by endoscopic transforaminal decompression, and to provide a theory basis for selection of surgical candidates.</p><p><b>METHODS</b>From June 2014 to January 2016, clinical data of 87 patients with lumbar spinal stenosis were retrospectively analyzed, including 45 males and 42 females, aged from 25 to 81 years old with an average of 55.14 years old; 8 cases on L₃,₄, 61 cases on L₄,₅, 18 cases on L₅S₁. All patients underwent percutaneous edoscopic transforaminal decompression. Clinical symptoms and nerve functions were evaluated by VAS, ODI before operation, 3 and 6 months after operation, MacNab scoring was used to evaluate clinical effects.</p><p><b>RESULTS</b>Postoperative incision of 87 patients healed well without complications, and obtained more than 6 months follow-up. VAS score before operation, 3 and 6 months after operation respectively were 63.88±8.56, 13.22±8.24, 6.83±9.43 respectively;ODI score before operation, 3 and 6 months after operation were 59.96±12.60, 9.08±10.55, 5.64±6.84 respectively. There was statistical significance in VAS and ODI score compared before operation and 3 and 6 months after operation. According to MacNab scoring, 41 cases obtained excellent results, 30 good, 7 moderate and 9 poor.</p><p><b>CONCLUSIONS</b>Percutenous endoscopic transforaminal decompression for lumbar spinal stenosis could reach good clinical effects if choosing appropriate indications. For patients with yellow ligament hypertrophy or combined with some ossified stenosis, insufficient decompression may result in poor therapeutic effects.</p>

Double-bundle versus single-bundle anterior cruciate ligament reconstruction with allogeneic tendon via single femoral tunnel / 中国组织工程研究

BACKGROUND: The anterior cruciate ligament (ACL) is an extremely important static structure that stabilizes the structure of the knee joint. Many scholars have found that an insufficient understanding of normal anatomical structure and biological characteristics of the ACL results in poor outcomes in the ACL reconstruction. OBJECTIVE: To compare the clinical effects of single-bundle and double-bundle single-tunnel techniques in ACL reconstruction with allogeneic tendon. METHODS: (1) Anatomy research: Six fresh knee joints were used for the experiments, and X-ray, CT and MRI were taken for each sample to confirm no osteoclasia, tumor and collapse of ACL. Then the ACL was stripped from the tibial bone and used to run hematoxylin-eosin staining and observe the fiber distribution of each piece of the ACL. (2) Clinical research: A total of 40 cases of ACL arthroscopic reconstruction were involved in this study, including 19 single-bundle ones and 21 double-bundle ones. The International Knee Documentation Committee 2000 subjective knee form (IKDC2000), Tegner and Lysholm evaluations were performed in all the patients. Paired t-test was used to analyze the IKDC, Tegner and Lysholm scores before operation and at follow-up time. RESULTS AND CONCLUSION: Anatomy research: From the view of anatomy, there was no evidence to support the double beams of the ACL at the tibial end by hematoxylin-eosin staining. Clinical research: Forty patients (40 knee joints) were successfully followed for over 12 months, and their joint range of motion was normal. The IKDC, Tegner and Lysholm scores were all improved in both two groups after the surgery, while the Larson scores were significantly higher in the double-bundle group than the single-bundle group. To conclude, the single-tunnel double-bundle ACL reconstruction is better to restore the knee stability than the single-bundle ACL reconstruction. This is an easy operation that has the merits of operating conveniently, restoring the normal anatomy of the tibial end, and exhibiting excellent short-term therapeutic effects. However, its long-term effects are uncertain.

Research evolution and hotspots of electroencephalogram (EEG) biofeedback in attention-deficit/hyperactivity disorder / 中国心理卫生杂志

Objective:To review the research hotspots and evolution of electroencephalogram (EEG) biofeedback in attention-deficit/hyperactivity disorder (ADHD) by knowledge mapping software.Methods:Based on web of science core collection database,we searched the literature with keywords (EEG biofeedback OR neurofeedback) AND (ADHD OR attention-deficit/hyperactivity disorder) in topic and time limit set before December 31,2015.319 literature were accepted,using the CiteSpace to depict the hot keywords,cited references and countries.Results:United States of America,Germany,Netherlands were top 3 countries in publishing papers of EEG biofeedback in ADHD.Based on burst of cited references,the research evolution of EEG biofeedback in ADHD could be divided into three stages.The hotspots of EEG biofeedback in ADHD were Slow Cortical Potentials protocol and double-blind placebo-controlled study.Conclusion:Future research should focus on the mechanism of EEG biofeedback and such known protocols for individualized treatment,or be designed along the lines of learning theory.