Effect of transcutaneous auricular vagus nerve stimulation on functional connectivity in the related brain regions of patients with depression based on the resting-state fMRI / 中国针灸

OBJECTIVE@#To explore the brain effect mechanism and the correlation between brain functional imaging and cognitive function in treatment of depressive disorder (DD) with transcutaneous auricular vagus nerve stimulation (taVNS) based on the resting-state functional magenetic reasonance imaging (rs-fMRI).@*METHODS@#Thirty-two DD patients were included in a depression group and 32 subjects of healthy condition were enrolled in a normal group. In the depression group, the taVNS was applied to bilateral Xin (CO15) and Shen (CO10), at disperse-dense wave, 4 Hz/20 Hz in frequency and current intensity ≤20 mA depending on patient's tolerance, 30 min each time, twice daily. The duration of treatment consisted of 8 weeks. The patients of two groups were undertaken rs-fMRI scanning. The scores of Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) and Wisconsin card sorting test (WCST) were observed in the normal group at baseline and the depression group before and after treatment separately. The differential brain regions were observed before and after treatment in the two groups and the value of degree centrality (DC) of fMRI was obtained. Their correlation was analyzed in terms of HAMD, HAMA and WCST scores.@*RESULTS@#The scores of HAMD and HAMA in the depression group were all higher than those in the normal group (P<0.05). After treatment, the scores of HAMD and HAMA were lower than those before treatment in the depression group; the scores of total responses, response errors and perseverative errors of WCST were all lower than those before treatment (P<0.05). The brain regions with significant differences included the left inferior temporal gyrus, the left cerebellar peduncles region 1, the left insula, the right putamen, the bilateral supplementary motor area and the right middle frontal gyrus. After treatment, the value of DC in left supplementary motor area was negatively correlated to HAMD and HAMA scores respectively (r=-0.324, P=0.012; r=-0.310, P=0.015); the value of DC in left cerebellar peduncles region 1 was negatively correlated to the total responses of WCST (r=-0.322, P=0.013), and the left insula was positively correlated to the total responses of WCST (r=0.271, P=0.036).@*CONCLUSION@#The taVNS can modulate the intensity of the functional activities of some brain regions so as to relieve depressive symptoms and improve cognitive function.

lncR-GAS5 upregulates the splicing factor SRSF10 to impair endothelial autophagy, leading to atherogenesis / 医学前沿

Long noncoding RNAs (lncRNAs) play a critical role in the regulation of atherosclerosis. Here, we investigated the role of the lncRNA growth arrest-specific 5 (lncR-GAS5) in atherogenesis. We found that the enforced expression of lncR-GAS5 contributed to the development of atherosclerosis, which presented as increased plaque size and reduced collagen content. Moreover, impaired autophagy was observed, as shown by a decreased LC3II/LC3I protein ratio and an elevated P62 level in lncR-GAS5-overexpressing human aortic endothelial cells. By contrast, lncR-GAS5 knockdown promoted autophagy. Moreover, serine/arginine-rich splicing factor 10 (SRSF10) knockdown increased the LC3II/LC3I ratio and decreased the P62 level, thus enhancing the formation of autophagic vacuoles, autolysosomes, and autophagosomes. Mechanistically, lncR-GAS5 regulated the downstream splicing factor SRSF10 to impair autophagy in the endothelium, which was reversed by the knockdown of SRSF10. Further results revealed that overexpression of the lncR-GAS5-targeted gene miR-193-5p promoted autophagy and autophagic vacuole accumulation by repressing its direct target gene, SRSF10. Notably, miR-193-5p overexpression decreased plaque size and increased collagen content. Altogether, these findings demonstrate that lncR-GAS5 partially contributes to atherogenesis and plaque instability by impairing endothelial autophagy. In conclusion, lncR-GAS5 overexpression arrested endothelial autophagy through the miR-193-5p/SRSF10 signaling pathway. Thus, miR-193-5p/SRSF10 may serve as a novel treatment target for atherosclerosis.

Functional exercise on patients after sports meniscus injury / Exercício funcional em pacientes após lesão esportiva de menisco / Ejercicio funcional en pacientes tras lesión deportiva de menisco

ABSTRACT Introduction Knee meniscus injury is a common sports injury, and minimally invasive surgery under knee arthroscopy has become an ideal method to treat meniscus injuries. This surgery rehabilitation has been improved, and several studies on the effects of functional exercise in the range of treatment are still inconclusive. Objective Study the functional exercise rehabilitation effects in patients after sports meniscus injury. Methods Twenty patients with meniscus-medial injury being operated on were selected, including eight men and 12 women. They were randomly divided into neuromuscular and strength training groups (11). Signs and symptoms were assessed before and eight weeks after treatment. JOA score indices and gait tests were compared. The impact of rehabilitation differences was evaluated in each group. Results Eight weeks after rehabilitation in both groups, the scores of the strength training group were higher than the neuromuscular group; the difference between the groups was statistically significant (P<0.05). Conclusion Functional exercise accelerates joint recovery, reflected in increased strength of adjacent muscles. The muscle and joint training effects on postoperative meniscus injury are worthy of recognition. The baropodometry revealed distinctions in walking patterns between different rehabilitation methods. From the perspective of this research, rehabilitation methods combined with proprioceptive exercises are complementary. Evidence Level II; Therapeutic Studies - Investigating the result.

RESUMO Introdução Lesão no menisco do joelho é uma lesão esportiva comum e a cirurgia minimamente invasiva sob artroscopia no joelho tornou-se um método ideal para tratar lesões no menisco. A reabilitação dessa cirurgia vem sendo aprimorada e vários estudos sobre os efeitos do exercício funcional no leque de tratamento ainda são inconclusivos. Objetivo Estudar os efeitos da reabilitação com exercício funcional em pacientes após a lesão esportiva do menisco. Métodos Foram selecionados 20 pacientes com lesão menisco-medial a serem operados, incluindo 8 homens e 12 mulheres. Divididos aleatoriamente em 2 grupos: grupo de treinamento neuromuscular e grupo de treinamento força (11). Sinais e sintomas foram avaliados antes do tratamento e 8 semanas após o tratamento, índices de score JOA e teste de marcha foram comparados, as diferenças do impacto da reabilitação em cada grupo foram avaliadas. Resultados Oito semanas após a reabilitação dos dois grupos, os escores do grupo de treinamento de força foram superiores aos do grupo neuromuscular, a diferença entre os grupos foi estatisticamente significante (P<0,05). Conclusão O exercício funcional acelera a recuperação das articulações, refletida no aumento da força dos músculos adjacentes. O efeito do treinamento muscular e articular na lesão do menisco pós-operatório é digno de reconhecimento. A baropodometria revelou distinções no padrão de marcha entre os diferentes métodos de reabilitação. Na perspectiva desta pesquisa, métodos de reabilitação combinados com exercícios proprioceptivos são complementares. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción La lesión de menisco de la rodilla es una lesión deportiva común y la cirugía mínimamente invasiva por artroscopia de rodilla se ha convertido en un método ideal para tratar las lesiones de menisco. La rehabilitación de esta cirugía ha sido mejorada y varios estudios sobre los efectos del ejercicio funcional en el rango de tratamiento aún no son concluyentes. Objetivo Estudiar los efectos de la rehabilitación con ejercicio funcional en pacientes tras una lesión de menisco deportiva. Métodos Se seleccionaron 20 pacientes con lesión de menisco-medial para ser operados, incluyendo 8 hombres y 12 mujeres. Se dividieron aleatoriamente en 2 grupos: grupo de entrenamiento neuromuscular y grupo de entrenamiento de fuerza (11). Se evaluaron los signos y síntomas antes del tratamiento y 8 semanas después del mismo, se compararon los índices de puntuación JOA y la prueba de marcha, y se evaluaron las diferencias del impacto de la rehabilitación en cada grupo. Resultados Ocho semanas después de la rehabilitación para ambos grupos, las puntuaciones del grupo de entrenamiento de fuerza fueron mayores que las del grupo neuromuscular, la diferencia entre los grupos fue estadísticamente significativa (P<0,05). Conclusión El ejercicio funcional acelera la recuperación de la articulación, lo que se refleja en el aumento de la fuerza de los músculos adyacentes. El efecto del entrenamiento muscular y articular en la lesión postoperatoria del menisco es digno de reconocimiento. La baropodometría reveló diferencias en el patrón de la marcha entre los diferentes métodos de rehabilitación. Desde la perspectiva de esta investigación, los métodos de rehabilitación combinados con los ejercicios propioceptivos son complementarios. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Circulating miRNA-1-3p as Biomarker of Accelerated Sarcopenia in Patients Diagnosed with Chronic Heart Failure

ABSTRACT Background: While sarcopenia is an important clinical finding in individuals diagnosed with chronic heart failure (CHF), efforts to identify a reliable biomarker capable of predicting the overall muscular and functional decline in CHF patients have been unsuccessful to date. Objectives: The objectives of this study were to study the diagnostic utility of MicroRNA (miRNA)-1-3p as a predictor of sarcopenia status in individuals diagnosed with CHF. Methods: In total, 80 individuals with heart failure exhibiting a left ventricular ejection fraction < 50% were enrolled in this study. All patients were analyzed to assess miR-1-3p expression levels, with body composition being evaluated through dual-energy X-ray absorptiometry and sarcopenia being defined based on the sum of appendicular lean muscle mass (ALM) divided by height in meters squared and handgrip strength (HGS). In addition, the activation of the Akt/mTOR signaling pathway was evaluated in these individuals. Results: In total, 40 of the enrolled patients (50%) exhibited sarcopenia. Sarcopenic patients presented with increased miR-1-3p expression levels as compared to non-sarcopenic individuals (1.69 ± 0.132 vs. 1.22 ± 0.106; p < 0.05). With respect to sarcopenic indices, appendicular skeletal mass index was most strongly correlated with miR-1-3p expression, which was also strongly correlated with HGS. High levels of Akt/mTOR signaling pathway components were expressed in sarcopenic individuals, highlighting a significant relationship between miR-1-3p activity and signaling through this pathway. Moreover, miR-1-3p was identified as a specific marker for sarcopenia in individuals with CHF. Conclusion: These results suggest that circulating miR-1-3p levels are related to Akt/mTOR pathway activation and can offer valuable insight into the overall physical capacity and muscular integrity of CHF patients as a predictor of sarcopenia.

Effectiveness of training on Taenia solium taeniasis and cysticercosis control knowledge among medical professionals in disease-elimination pilot areas of Henan Province / 中国血吸虫病防治杂志

Objective To investigate the changes in the awareness rate of Taenia solium taeniasis and cysticercosis control knowledge among medical professionals before and after training in Fangcheng County, a disease-elimination pilot area of Henan Province, so as to evaluate the effectiveness of the training. Methods Three townships in Fangcheng County were randomly selected as the study townships, including Dushu, Bowang and Yangji townships, while Erlangmiao, Yanglou and Xiaoshidian townships in the county were randomly selected as the control townships. The grassroots medical professionals in the study townships were given once training on T. solium taeniasis and cysticercosis control knowledge each year from 2016 to 2020, while those in the control townships were given no interventions. All village-level doctors and a part of township-level public health professionals were sampled from the study and control townships as intervention and control groups. The baseline and final assessments of the awareness of T. solium taeniasis and cysticercosis control knowledge were performed using questionnaire survey in intervention and control groups in 2016 and 2020, and the awareness of T. solium taeniasis and cysticercosis control knowledge was compared between the two groups. Results A total of 663 medical professionals were investigated in Fangcheng County from 2016 to 2020, including 474 participants in the intervention group and 189 participants in the control group. Results from the 2016 baseline survey showed that the awareness rate of T. solium taeniasis and cysticercosis control knowledge was 28.83% (47/163) among grassroots medical professionals in Fangcheng County, and there were no significant differences in the awareness between the intervention (32.47%, 25/77) and control groups (25.58%, 22/86) (χ2 = 0.939, P > 0.05), between men (30.50%, 43/141) and women (18.18%, 4/22) (χ2 = 1.406, P > 0.05) or between village- (31.39%, 43/137) and township-level medical professionals (15.38%, 4/26) (χ2 = 2.727, P > 0.05), while significant differences were found in the awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in terms of education levels (χ2 = 8.190, P < 0.05) and duration of working experiences (χ2 = 12.617, P < 0.05), and the awareness rate of T. solium taeniasis and cysticercosis control knowledge increased with education levels among medical professionals (χ2 = 6.768, P < 0.05). Only 5.52% (9/163) of the medical professionals had a history of diagnosis and therapy of T. solium taeniasis or cysticercosis, and only 1.23% (2/163) received training on T. solium taeniasis and cysticercosis control knowledge during the past 5 years. Results from the 2020 questionnaire survey showed a higher awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in the intervention group (93.55%, 116/124) than in the control group (46.60%, 48/103) (χ2 = 61.845, P < 0.05), and no significant differences were seen in the awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in terms of gender, level of medical professionals, duration of working experiences or history of diagnosis/therapy of T. solium taeniasis and cysticercosis in the intervention group (χ2 = 1.089, 0.140, 0.081 and 0.453, all P values > 0.05), while there was a significant difference in the awareness rate among medical professionals with different education levels (χ2 = 36.338, P < 0.05). In addition, the awareness rate of T. solium taeniasis and cysticercosis control knowledge significantly increased among medical professionals with various chracteristics in 2020 than in 2016. Conclusions In the low-prevalence areas of T. solium taeniasis and cysticercosis, long-term and persistent training may improve the awareness of T. solium taeniasis and cysticercosis control knowledge among grassroots medical professionals, which facilitates the timely identification of T. solium taeniasis and cysticercosis and the establishment of a sensitive disease surveillance system.

Evaluation of efficiency of different anti-cysticercus antibody test kits for serodiagnosis of cysticercosis / 中国血吸虫病防治杂志

Objective To evaluate the diagnostic efficiency of four anti-cysticercus IgG, IgG4 or IgM antibody test kits (enzyme-linked immunosorbent assay, ELISA) by different manufacturers, so as to provide insights into the epidemiological investigation and clinical detection of cysticercosis. Methods Forty serum samples from cerebral cysticercosis patients, 100 serum samples from healthy volunteers, 30 serum samples from paragonimiasis skrjabini patients, 17 serum samples from cystic echinococcosis and 19 serum samples from subcutaneous or cerebral sparganosis patients were collected and detected using anti-cysticercus IgG, IgG4 or IgM antibody test kits (brand A) and the anti-cysticercus IgG antibody test kit (brand B). The sensitivity, specificity and false negative rate of the four kits for detection of cysticercosis were estimated. Results The anti-cysticercus IgG, IgG4 or IgM antibody test kits (brand A) showed 95.00% (38/40), 87.50% (35/40), 7.50% (3/40) sensitivities and 98.00% (98/100), 100.00% (100/100) and 100.00% (100/100) for detection of cysticercosis, while the anti-cysticercus IgG antibody test kit (brand B) presented a 75.00% (30/40) sensitivity and 100.00% (100/100) specificity for detection of cysticercosis. The sensitivity for detection of cysticercosis was significantly higher by the anti-cysticercus IgG antibody test kit (brand A) than by the anti-cysticercus IgG antibody test kit (brand B) (χ2 = 6.28, P < 0.05); however, no significant difference was seen in the specificity by two kits (χ2 = 2.01, P > 0.05). The four ELISA kits showed overall false positive rates of 37.88% (25/66), 22.73% (15/66), 62.12% (41/66) and 15.15% (10/66) for detection of paragonimiasis, echinococcosis and sparganosis (χ2 = 37.61, P < 0.05), and the anti-cysticercus IgG antibody test kit (brand A) presented the highest overall false positive rate for detection of paragonimiasis, echinococcosis and sparganosis (χ2 = 7.56, P’ < 0.008), while a higher overall false positive rate was seen for detection of paragonimiasis, echinococcosis and sparganosis by the anti-cysticercus IgG antibody test kit (brand A) than by the anti-cysticercus IgG antibody test kit (brand B) (χ2 = 8.75, P’ < 0.008). The four ELISA kits showed false positive rates of 40.00% (12/30), 16.67% (5/30), 76.67% (23/30) and 13.33% (4/30) for detection of paragonimiasis (χ2 = 32.88, P < 0.05) and 21.05% (4/19), 26.32% (5/19), 73.68% (14/19) and 15.79% (3/19) for detection of sparganosis (χ2 = 19.97, P < 0.05), and the highest false positive rates were found by the anti-cysticercus IgM antibody test kit (brand A) for detection of paragonimiasis and sparganosis (all P’ < 0.008). However, the four ELISA kits showed comparable false positive rates of 52.94% (9/17), 29.41% (5/17), 23.53% (4/17) and 17.65% (3/17) for detection of echinococcosis (χ2 = 8.24, P > 0.05). In addition, the anti-cysticercus IgM anti-body test kit (brand A) showed false positive rates of 76.67% (23/30), 23.53% (4/17) and 73.68% (14/19) for detection of paragonimiasis, echinococcosis and sparganosis (χ2 = 14.537, P < 0.05), with the lowest false positive rate seen for detection of echinococcosis (χ2 = 14.537, P’ < 0.014), while no significant differences were seen in the false positive rate for detection of paragonimiasis, echinococcosis and sparganosis by other three ELISA kits (all P > 0.05). Conclusions The four anti-cysticercus IgG, IgG4 or IgM antibody test kits exhibit various efficiencies for serodiagnosis of cysticercosis. The anti-cysticercus IgG antibody test kit (brand A) has a high sensitivity for serodiagnosis of cysticercosis; however, it still needs to solve the problems of cross-reaction with other parasitic diseases and stability.

Comparison of clavicular hook plate with extra suture hole and traditional hook plate in the treatment of acute acromioclavicular dislocation / 中华骨科杂志

Objective:To compare the clinical effective of clavicular hook plate with extra suture hole and traditional hook plate in the treatment of acute acromioclavicular dislocation.Methods:This study retrospectively analyzed the clinical data of traumatic acromioclavicular dislocation patients who were treated by operation from March 2017 to September 2020. The patients were included in traditional hook plate (THP) group and triangle stabilization technique hook plate (TSTHP) group according fracture fixations. TSTHP group adopted clavicular hook plate with extra suture hole. There were 27 patients in THP group with 18 male patients and 9 female patients; average age with 37.56±8.94 years old; 16 patients injured left side and 11 patients injured right side; crush injuries of 10 patients, traffic injuries of 9 patients and sports injuries of 8 patients; Rockwood classification of type III (9 patients), type IV (10 patients) and type V (8 patients). There were 20 patients in TSTHP group with 15 male patients and 5 female patients; average age with 38.95±9.91 years old; 13 patients injured left side and 7 patients injured right side; crush injuries of 9 patients, traffic injuries of 8 patients and sports injuries of 3 patients; Rockwood classification of type III (5 patients), type IV (9 patients) and type V (6 patients). The operation time, intraoperative bleeding, postoperative coracoclavicular space, visual analogue scale (VAS) and shoulder joint Constant-Murley score were compared between the two groups.Results:The operation time and blood loss of THP group and TSTHP group were 51.07±11.27 min, 87.41±15.34 ml and 55.65±8.59 min, 90.50±14.32 ml, respectively. The difference was not statistically significant ( t=1.52, 0.70, all P>0.05). Patients in both groups were followed up for 12 to 14 months after operations, with an average of 12.28 months. Six months after surgery, the coracoclavicular spaces of THP group and TSTHP group were 12.16±0.90 mm and 11.26±0.70 mm, respectively. The difference was statistically significant ( t=3.70, P<0.001). Postoperative VAS scores (2 days, 3 months, 6 months and 12 months) of TSTHP group [1.8±0.77, 0.00(0.00, 1.00), 0.00 (0.00, 0.00), 0.00(0.00, 0.00)] were significantly better than THP group [4.22±1.25, 2.00 (1.00, 3.00), 1.00 (0.00, 1.00), 0.00 (0.00, 1.00)]. The difference was statistically significant ( t=7.65, P<0.001; Z=4.85, P<0.001; Z=3.44, P=0.001; Z=2.96, P=0.003). Postoperative Constant-Murley scores (3 months, 6 months and 12 months) of TSTHP group (87.00±5.18, 91.25±2.75, 92.30±2.74) were significantly better than THP group (76.96±5.21, 83.22±3.86, 85.22±3.49). The difference was statistically significant ( t=6.54, 7.93, 7.51; P<0.001). The postoperative complication rates of THP group were higher than TSTHP group [70.4% (19/27) vs. 5.0% (1/20)]. Conclusion:In the treatment of acute acromioclavicular dislocation, the clavicular hook plate with extra suture hole can obtain satisfactory clinical effect compared with the THP, and clavicular hook plate with extra suture hole is more conducive to early recovery of shoulder function and reduce postoperative complications.

Effectiveness of health education interventions targeting taeniasis and cysticercosis among primary school students in disease-elimination pilot areas of Henan Province / 中国血吸虫病防治杂志

Objective To compare the changes of knowledge, attitude and practice (KAP) related to taeniasis and cysticercosis among primary school students before and after health education interventions in disease-elimination pilot areas of Henan Province, so as to evaluate the effectiveness of health education interventions. Methods A primary school was selected from each of Dushu, Bowang and Yangji townships, Fangcheng County, Henan Province from 2017 to 2019; then, 2 to 3 classes were randomly selected from grade 4 to 6 in each primary school, and finally, all students in these classes were enrolled as study subjects. A thematic health education lecture pertaining to taeniasis and cysticercosis was given once each year by means of “health education in class”. The KAP towards taeniasis and cysticercosis was investigated among primary school students using selffilled structured questionnaires, and the changes of awareness of taeniasis and cysticercosis control knowledge and percentage of healthy behaviors formation were compared in primary school students among years and following various frequencies of health education interventions. Results More than 10 thousand person-time primary school students received health education interventions during the period from 2017 to 2019, and a total of 1 223 person-time primary school students were investigated during the 3-year study period, including 633 person-time men and 590 person-time women and 88.55% of primary school students at ages of 10 to 12 years. The proportion of households raising pigs and using dry toiliets decreased from 5.30% (24/453) and 18.10% (82/453) in 2017 to 3.60% (13/361) and 11.08% (40/361) in 2019, respectively. The awareness rate of taeniasis and cysticercosis control knowledge increased significantly from 0.22% (1/453) in 2017 to 62.59% (256/409) in 2018 and 76.73% (277/361) in 2019 (χ2 = 567.60, P < 0.001), and the awareness rate was 85.25% (104/122) among primary school students attending the thematic special health education courses for successive three times. The awareness rates of taeniasis and cysticercosis control knowledge were 0.44% (1/225), 58.00% (116/200) and 71.63% (149/208) among male students and 0 (0/338), 66.99% (140/209) and 83.66% (128/153) among female students from 2017 to 2019, and there was a significant difference in the awareness of taeniasis and cysticercosis control knowledge between male and female students in 2019 (χ2 = 7.14, P = 0.01). On-site teaching by doctors was the students’ favorite way to receive health education interventions (70.07%, 857/1 223), followed by watching health education videos (58.63%, 717/1 223) and seeing parasite specimens (48.9%, 598/1 223). The proportion of students’ families who used cutting boards for raw and cooked food separately increased from 7.28% (33/453) in 2017 to 47.37% (171/361) in 2019, was 67.21% (82/122) among students attending the health education courses for successive three times. The proportion of students who frequently washed their hands before meals and after using toilet increased from 71.96% (324/453) in 2017 to 89.47% (319/361) in 2019 and was 95.90% (117/122) among students attending the health education courses for successive three times. In addition, the percentage of students washing hands frequently in families using dry toilets was significantly lower in those who did not use dry toilets (χ2 = 9.21, P = 0.002), and the proportion of students with a habit of eating raw or undercooked meat decreased significantly from 35.76% (162/453) in 2017 to 6.65% (24/361) in 2019 (χ2 = 69.11, P < 0.01). Conclusion The thematic health education activity of “health education in class” contributes greatly to the increase in the awareness of taeniasis and cysticercosis control knowledge and the rate of healthy behaviors formation among primary school students in diseaseelimination pilot areas of Henan Province.

Association of drinking behavior and self injury behavior in adolescents / 中国学校卫生

Objective@#To explore the association between drinking behavior and self injury behavior in adolescents.@*Methods@#A total of 9 247 students from 4 middle schools were investigated. Drinking behavior and self injury behavior were collected from questionnaire survey. Univariate and multivariate Logistic regression analysis were used to analyze the relationship between drinking behavior and self injury behavior.@*Results@#Among the 9 247 middle school students, 52.8% reported ever drinking, 24.9% reported drinking behavior in the past 30 days, and 14.6% reported been drunk in the past year. The average age of drinking for the first time was 12.47±3.05. About 47.2% of the participants had self injury behavior. Male with younger drinking age ( OR =1.52), had been drunken ( OR =1.35) and frequent drinking ( OR =1.54) increased the incidence of self injury. Female reported drinking at younger age ( OR =1.69), had been drunk ( OR =1.82) and lived in cities and towns ( OR =1.20) had a higher risk of self injury.@*Conclusion@#Drinking at younger age, heavy and frequent drinking are associated with higher risk of self injury in adolescents in sex specific fashion.

Defining Treatment Response, Remission, Relapse, and Recovery in First-Episode Psychosis: A Survey among Korean Experts

Objective@#For the proper treatment of first-episode psychosis, assessment of treatment response, remission, relapse, and recovery is important. Therefore, the present study aimed to develop operational definitions of clinical outcomes in first-episode psychosis. @*Methods@#A questionnaire was developed by a panel of experts and underwent three revisions. The final survey was presented to 150 psychiatrists who were members of the Korean Society for Schizophrenia Research. Respondents selected factors that they believed were important to consider while defining treatment response, remission, relapse, and recovery using a 6-point Likert scale. Selected factors that constituted each definition were statistically extracted, and operational definitions were developed. @*Results@#A total of 91 experts responded to the survey. The extent of reduction in psychopathology, socio-occupational functioning, and duration of each state were the core factors of each definition. Outcomes obtained from discussions and consultations by experts have been summarized and proposed. @*Conclusion@#The criteria developed in this survey tended to be somewhat stricter than those used by other studies. The fundamental reason for this is that this survey focused on first-episode psychosis. A better understanding of each definition in first-episode psychosis is necessary to improve effective treatment outcomes.

Determination of Main Components in Baihutang with Separation of Different Phase States and Different Phase States / 中国实验方剂学杂志

Objective:The phase separation of Baihutang was carried out. The content of mangiferin，new mangiferin，calciumion，glycyrrhizin and ammonium glycyrrhizinate in the solution phase，the nano phase and the precipitated phase of Baihutang were measured，so as to define the effect of nanometer particles of Baihutang on the growth of active components，and explain the mechanisms of Baihutang in potent detoxification and heat removal. Method:The phase separation of Baihutang was performed by high-speed centrifugation and dialysis. The contents of mangiferin，new mangiferin，glycyrrhizin and ammonium glycyrrhizinate in Baihutang were determined by HPLC. Chromatographic column Diamonsil C18 (4.6 mm×250 mm，5 μm) was adopted, with acetonitrile-25 mmol·L-1 potassium dihydrogen phosphate solution as the mobile phase, and eluted in a gradient mode. The detection wavelength was 257 nm，the column temperature was 30 ℃，and the flow rate was 1.0 mL·min-1. EDTA-2Na solution was used to calibrate the calcium concentration in different phase states of Baihutang. Result:1 mL Baihutang nanoparticles contained 483.00 μg new mangiferin，1 068.88 μg mangiferin，219.93 μg glycyrrhizin and 187.10 μg ammonium glycyrrhizin，and the content of new mangiferin and mangiferin accounted for 89.4% and 89.9% respectively in 1 mL Baihutang. The new mangiferin and mangiferin in the nano phase were 230.0 and 23.3 times the true solution，and 8.5 and 14.4 times of the precipitation，respectively. The content of calcium ions in Baihutang in the nano phase was higher，accounting for 86.9% of Baihutang，and the content of calcium ions in Baihutang and Baihutang in the nano phase was higher than that in gypsum group. Conclusion:The content of main components in Baihutang in nanometer phase is significantly higher than that in other phases. The nanoparticles of Baihutang have a solubilizing effect on the main antipyretic components, such as mangiferin，mangiferin and calcium ions as well as the antitoxic components glycyrrhizic acid and glycyrrhizic acid. The mechanism of action of Baihutang is related to the formation of nanoparticles.

Association of bone mineral density with chronic obstructive pulmonary disease in postmenopausal women

Abstract Background Osteoporosis (OP) is common in patients with chronic obstructive pulmonary disease (COPD). The relationship between OP and COPD has been primarily studied in male patients, and few reports are available in postmenopausal women. Objective The purpose of this study was to investigate the association between bone mineral density (BMD) and COPD in postmenopausal women. Methods This cross-sectional study included 133 clinically stable female ex-smokers with confirmed COPD, and 31 age-matched “ex-smoker” female controls. We analyzed groups according to their airway obstruction category. BMD was measured on dual-energy X-ray absorptiometry images of the left femoral neck. Results Patients with COPD had lower T-scores and higher prevalence of osteopenia/OP than the control group. In the COPD group, the airway obstruction category was significantly associated with the T-score after adjustment for confounders. Multivariate logistic regression analysis showed COPD was an independent marker for increased risk of osteopenia/OP in postmenopausal women. Conclusions COPD and airway obstruction category were strongly related to BMD. Postmenopausal women with COPD, especially those with severe airway obstruction, had a higher prevalence rate and a higher risk of osteopenia and OP than female controls without COPD.

An investigation of recognition and needs of policies of science and technology achievement transformation a-mong the medical personnel in 21 tertiary hospitals in Shanghai / 中华医学科研管理杂志

Objective To understand the cognition ,attitudes and needs of the science and technology achievement trans-formation policies among the medical personnel of 21 tertiary hospitals in Shanghai .Methods Convenient sampling method was used .The self-designed questionnaires were used to survey 420 personals in 21 tertiary hospitals in Shanghai ,and 411 valid questionnaires were responded with a valid rate of 97 .86％ .Results The cognition of science and technology achievement transformation policies of the respondents was low ,and the degree of cognition was related to the professional titles ( P<0 .05) .While the recognition degree of some policies was high ;40 .47％ agreed that enterprises could be the decision-maker during the transformation process ;85 .99％ agreed that it is OK to hire the Technology intermediary service agencies to evalu-ate the achievements value ,confirmed that need such agencies to provide the services of information collection and screening . Conclusions More Policy publicity should be enhanced among the medical personnel ,communications about their needs and suggestions on the science and technology achievement transformation should be carried out to further update related policies , as well as improve the transformation of science and technology achievements in health system .

Study on the AIDS knowledge level and its influencing factors of middle school students in the high prevalence area of AIDS in Liangshan Yi autonomous prefecture / 中国学校卫生

Objective@#To understand the awareness level of AIDS knowledge and its influencing factors among middle school students from AIDS high prevalence areas of Yi Autonomous Prefecture (Liangshan Prefecture), and to provide a reference for making propaganda strategies of AIDS knowledge and intervention measures in the relevant departments.@*Methods@#Totally 10 749 students in 4 middle schools were selected from AIDS high prevalence areas of Yi Autonomous Prefecture in Liangshan by the method of cluster sampling. A self-made questionnaire was used to investigate the ways of getting AIDS knowledge and the condition of conducting AIDS life training skills in school.@*Results@#The awareness rate of AIDS-related knowledge among middle school students in Liangshan Prefecture was 44.4%. According to the results of multivariate Logistic regression analysis, female students, junior grade, Yi nationality, poor self-evaluation, lack of parents, living in rural areas, good family economic condition (student self-assessment), living in a community of Yi nationality were all the dangerous factors to the awareness rate of AIDS. School education, radio and television, and health promotion were the main ways for students to acquire AIDS knowledge(88.82%, 80.83%, 73.54%). Minority students, students in severely affected areas received less AIDS life skills training in schools, the time was later, and student needs were not strong.@*Conclusion@#The AIDS awareness level of middle school students in Liangshan AIDS high-incidence area is too low, so it is necessary to pay attention to develop targeted programs to strengthen AIDS health education for middle school students.

Association of Severity of Coronary Lesions with Bone Mineral Density in Postmenopausal Women / Associação entre Gravidade das Lesões Coronarianas e Densidade Mineral Óssea em Mulheres Pós-Menopausa

Abstract Background: Coronary artery disease (CAD) and osteoporosis (OP) are common diseases in postmenopausal women. In both cross-sectional and longitudinal epidemiologic studies, low bone mass has been related to increased frequency of CAD. However, available data on the relationship between bone mineral density (BMD) and severity of coronary lesions is limited. Objective: To investigate association between the BMD and severity of coronary lesions assessed by Gensini score in postmenopausal women. Methods: This study included 122 postmenopausal women who were diagnosed with CAD. These patients were divided into two groups according to the severity of coronary lesions assessed by the Gensini score - patients with mild coronary lesions (Gensini score < 25) and patients with severe coronary lesions (Gensini score ≥ 25). Femoral neck mineral density was measured with dual energy X-ray absorptiometry (DXA). Results: The study included postmenopausal women aged 64.31 ± 4.71 years, 85 of whom (69.7%) exhibited severe coronary lesions. Participants with severe coronary lesions had a significantly higher T score than did those with mild coronary lesions at the femoral neck (p < 0.05). The mean T-score was −0.84 ± 1.01 in mild coronary lesions group, −1.42 ± 1.39 in severe coronary lesions group (p < 0.05). Multivariable logistic regression analysis showed that osteopenia-osteoporosis at the Femoral neck (odds ratio 2.73; 95% confidence interval 1.06 to 6.13) was associated with an increased risk of developing severe coronary lesions. The multiple regression model showed that T-scores (b = −0.407, SE = 0.151, p=0.007) were the independent predictors of Gensini score. Conclusion: The relationship between severity of coronary lesions and BMD was significant in postmenopausal women. BMD, a low-cost technique involving minimal radiation exposure, widely used for osteoporosis screening, is a promising marker of severity of coronary lesions.

Resumo Fundamento: A doença arterial coronariana (DAC) e a osteoporose são doenças comuns em mulheres pós-menopausa. Tanto em estudos transversais como em estudos epidemiológicos longitudinais, a massa óssea diminuída foi relacionada à frequência aumentada de DAC. No entanto, dados disponíveis sobre a relação entre densidade mineral óssea (DMO) e gravidade das lesões coronarianas são limitados. Objetivo: Investigar a associação entre DMO e gravidade das lesões coronarianas avaliadas pelo escore de Gensini em mulheres pós-menopausa. Métodos: Este estudo incluiu 122 mulheres pós-menopausa diagnosticadas com DAC. As pacientes foram divididas em dois grupos de acordo com a gravidade das lesões coronarianas avaliada pelo escore de Gensini - pacientes com lesões coronarianas leves (escore de Gensini < 25) e pacientes com lesões coronarianas graves (escore de Gensini ≥ 25). A densidade mineral do colo femoral foi medida por absorção de raios-X de dupla energia (DXA). Resultados: O estudo incluiu mulheres pós-menopausa com idade de 64,31 ± 4,71 anos, 85 delas (69,7%) com lesões coronarianas graves. Pacientes com lesões coronarianas graves apresentaram um escore T mais elevado que aquelas com lesões coronarianas leves no colo femoral (p < 0,05). O escore T médio foi -0,84 ± 1,01 no grupo com lesões leves, e -1,42 ± 1,39 no grupo com lesões graves (p < 0,05). A análise de regressão logística multivariada mostrou que a osteopenia-osteoporose no colo femoral (odds ratio 2,73; intervalo de confiança de 95% 1,06 - 6,13) esteve associada com um risco aumentado de se desenvolver lesões coronarianas graves. O modelo de regressão múltipla mostrou que os escores T (b = -0,407; EP= 0,151; p = 0,007) foram preditores independentes do escore de Gensini. Conclusão: Encontrou-se uma relação significativa entre a gravidade das lesões coronarianas e a DMO em mulheres pós-menopausa. DMO, uma técnica de baixo custo que envolve mínima exposição à radiação, e amplamente utilizada no rastreamento de osteoporose, é um marcador promissor da gravidade de lesões coronarianas graves.

Experiment design and feasibility of BOLD and MRS multimodal fMRI in analysis of brain effect induced by acupuncture / 中国医学影像技术

Objective To establish the methodology of combining BOLD and 1H-MRS for investigating correlation between the deactivation in medial prefrontal cortex (MPFC) and gamma-aminobutyric acid (GABA) concentration by acupuncture at LI4 (Point Hegu),and to optimize the experimental technique and procedure.Methods Twenty healthy adult volunteers were enrolled.During fMRI-BOLD scanning,each subject received acupuncture at right LI4 (Point Hegu).MRS scanning was based on MEGA-PRESS sequence,and ROIs were located at bilateral MPFC.The task BOLD fMRI was block design,including 3 stimulations (30 s) with 2 intervals (2 min).Then MRS scanning was performed before and after BOLD.The quantitative values of the BOLD positive and negative activations (Pm) and GABA concentrations were calculated.Results All 20 subjects completed BOLD fMRI scanning,and met the postprocessing requirements.MRS images of 9 subjects with good image quality were included in analysis.Among all 20 subjects,positive activation (Pm=1.17± 0.16) was observed in 9,while negative activation (Pm =-1.31 ± 0.17) was observed in 11 subjects.The GABA average values before and after the acupuncture were (19.93 ±1.04) nmol/L and (20.04±0.81)nmol/L,respectively,and the average amplitude between post-and pre-acupuncture was (0.11 ± 1.60)nmol/L.Conclusion The success rate of this method for quantitative study of brain function established multimodal-functional (BOLD-fMRI and MRS) was acceptable,and the multimodal brain function changes as well as the quantitative values were observed in the brain region during acupuncture.Combined BOLD and MRS quantitative method is feasible for testing acupuncture response in the brain.

Application of electromyographic in monitoring nerve root at fracture fixation process / 局解手术学杂志

Objective To evaluate the noninferiority of domestic electomyographic (EMG) evoked potential instrument utility on avoiding iatrogenic injury of nerve roots compare to the imported ones,and understand the methods,accuracy and practicability of domestic machine on monitoring nerve root at the fracture fixation process.Methods Domestic of Neurocare-C machine and Nicolet Viking select8 concurrent monitoring 30 cases of bone fracture fixation,including 20 cases of spinal fixation and 10 cases of fractures fixation of limbs and pelvic.The trend of positive change,the rate and amplitude variation of electromyographic response between two instruments were compared.Results The nerve root function could be accurately judged by EMG monitoring during operation.Intraoperative EMG could be detected by both domestic and imported instruments occurred in 5 patients,3 cases were internal fixation of vertebral fracture,1 case was humeral fractures fixation,1 case was pelvic fracture.The rate of electromyographic response of both domestic and imported instruments were 16.67％.There was no significant difference in amplitude variation of electromyographic response of quadriceps femoris,biceps femoris,rectus femoris and tibialis anterior between two instruments (P ＞ 0.05).Conclusion Both domestic and imported EMG evoked potentials can accurately and timely respond to nerve root function,avoid nerve root injury,and ensure the safety of fracture fixation surgery.

Effect of Acupuncture at Baihui and Renzhong on Glucose Transporter 1,3 in Acute Cerebral Ischemia Rat Model / 广州中医药大学学报

Objective To investigate the effect of early-stage acupuncture therapy on local glucose metabolism in model rats with cerebral ischemia. Methods Eighty three-month-old SD rats were randomly divided into 4 groups,namely normal group,model group,2-h acupuncture group and 24-h acupuncture group,20 rats in each group. Craniotomy was used to establish the rat model of acute cerebral ischemia. Acupuncture treatment was carried out on acupoint of Baihui(GV20)and Renzhong(DU26)with reducing method,needle twirling and rotating frequency being 120 times per minute,once every other 4 min and for one min,and the total needling time for 30 min. Rats in 2-h acupuncture group were given acupuncture 2 h after the successful modeling,and once again after 24 h,two times in total;rats in 24-h acupuncture group were given acupuncture only for one time 24 h after successful modeling. At the end of treatment,the rat neurological function was scored,and the infarction area was measured by 2,3,5-triphenyltetrazole chloride (TTC)staining. The protein expression levels of glucose transporter(GLUT)1 and 3 in ischemic brain tissue were detected by immunohistochemistry. Results Compared with the normal group, the scores of neurological function in the model group were increased;TTC staining results showed that the left hemisphere was swollen,and the infarct volume was significantly larger than that of the contralateral side;immunohistochemical results showed that the GLUT1 and GLUT3 expression levels in the ischemic brain tissue were increased(P < 0.01). Compared with the model group,2-h acupuncture group and 24-h acupuncture group could effectively improve the cerebral ischemia, reduce the neurological function indexes and infarction area showed by TTC staining,and increase the expression levels of GLUT1 and GLUT3 in ischemic brain tissue significantly (P<0.05). And the therapeutic effect of 2-h acupuncture group was superior to that of 24-h acupuncture group(P<0.05). Conclusion Acupuncture can effectively improve cerebral ischemia in rats with acute cerebral ischemia. Acupuncture can improve the energy metabolism of ischemic brain tissue by up-regulating the protein expression of cerebral GLUT1 and GLUT3 and by increasing the blood-brain barrier transport efficiency for glucose,thus to promote glucose metabolism and provide energy for ischemic brain tissue to relieve relatively inadequate energy, and to protect against cerebral ischemic injury. Early acupuncture intervention exerts a positive effect on regulating energy metabolism of rats with cerebral ischemia.

Effects of Adipose-derived Mesenchymal Stem Cell Exosomes on Corneal Stromal Fibroblast Viability and Extracellular Matrix Synthesis / 中华医学杂志(英文版)

<p><b>Background</b>Corneal stromal cells (CSCs) are components of the corneal endothelial microenvironment that can be induced to form a functional tissue-engineered corneal endothelium. Adipose-derived mesenchymal stem cells (ADSCs) have been reported as an important component of regenerative medicine and cell therapy for corneal stromal damage. We have demonstrated that the treatment with ADSCs leads to phenotypic changes in CSCs in vitro. However, the underlying mechanisms of such ADSC-induced changes in CSCs remain unclear.</p><p><b>Methods</b>ADSCs and CSCs were isolated from New Zealand white rabbits and cultured in vitro. An Exosome Isolation Kit, Western blotting, and nanoparticle tracking analysis (NTA) were used to isolate and confirm the exosomes from ADSC culture medium. Meanwhile, the optimal exosome concentration and treatment time were selected. Cell Counting Kit-8 and annexin V-fluorescein isothiocyanate/propidium iodide assays were used to assess the effect of ADSC- derived exosomes on the proliferation and apoptosis of CSCs. To evaluate the effects of ADSC- derived exosomes on CSC invasion activity, Western blotting was used to detect the expression of matrix metalloproteinases (MMPs) and collagens.</p><p><b>Results:</b>ADSCs and CSCs were successfully isolated from New Zealand rabbits. The optimal concentration and treatment time of exosomes for the following study were 100 μg/ml and 96 h, respectively. NTA revealed that the ADSC-derived exosomes appeared as nanoparticles (40-200 nm), and Western blotting confirmed positive expression of CD9, CD81, flotillin-1, and HSP70 versus ADSC cytoplasmic proteins (all P < 0.01). ADSC-derived exosomes (50 μg/ml and 100 μg/ml) significantly promoted proliferation and inhibited apoptosis (mainly early apoptosis) of CSCs versus non-exosome-treated CSCs (all P < 0.05). Interestingly, MMPs were downregulated and extracellular matrix (ECM)-related proteins including collagens and fibronectin were upregulated in the exosome-treated CSCs versus non-exosome-treated CSCs (MMP1: t = 80.103, P < 0.01; MMP2: t = 114.778, P < 0.01; MMP3: t = 56.208, P < 0.01; and MMP9: t = 60.617, P < 0.01; collagen I: t = -82.742, P < 0.01; collagen II: t = -72.818, P < 0.01; collagen III: t = -104.452, P < 0.01; collagen IV: t = -133.426, P < 0.01, and collagen V: t = -294.019, P < 0.01; and fibronectin: t = -92.491, P < 0.01, respectively).</p><p><b>Conclusion:</b>The findings indicate that ADSCs might play an important role in CSC viability regulation and ECM remodeling, partially through the secretion of exosomes.</p>

Analysis on the causes and countermeasures of the dilemma in medical patents transfer / 中华医学科研管理杂志

Objective To investigate the causes of the dilemma in the medical patents transfer,analyze the corresponding countermeasures.Methods The research clarify the causes of the dilemma in the medical patents transfer and put forward countermeasures to promote the medical patents trans fer according to depth interviews to relevant personnel involved in medical patents transfer and literature analysis.Results A lot of factors,including the professionalism and technical of the medical patents,the special status of the inventor,the imperfect institutions,attitude of hospital administration to the medical patents transfer and environment which ignore the medical patents transfer,lead to the dilemma of the medical patents transfer.Countermeasures like the establishment of a special transfor mation entity,the incentives for transformation personnel,improve the transformation system and processes can promote the medical patents transfer.Conclusions Comprehensive consideration of the objective environment,the effective using of available resources,encouraging collaborations between hospitals and enterprises to making good use of their own advantages,as well as ask for related regulatory support,can help the smooth transfer of medical patents.