Germplasm resources and secondary metabolism regulation in Reishi mushroom (Ganoderma lucidum) / 中草药·英文版

Ganoderma lucidum is a valuable medical macrofungus with a myriad of diverse secondary metabolites, in which triterpenoids are the major constituents. This paper introduced the germplasm resources of genus Ganoderma from textual research, its distribution and identification at the molecular level. Also we overviewed G. lucidum in the components, the biological activities and biosynthetic pathways of ganoderic acid, aiming to provide scientific evidence for the development and utilization of G. lucidum germplasm resources and the biosynthesis of ganoderic acid.

Effect of polypharmacy on anticoagulant therapy in elderly patients with atrial fibrillation / 中华老年医学杂志

Atrial fibrillation(AF)is a prevalent arrhythmia in elderly patients.Such patients often have comorbidities and are subjected to polypharmacy, which may lower medication compliance and increase the risk of bleeding and cardiovascular events.These factors may also affect the efficacy of anticoagulant therapy.According to research, non-vitamin K antagonistic oral anticoagulants like Rivaroxaban, Apixaban, and Dabigatran are a safer and more effective option for anticoagulant therapy in elderly patients with atrial fibrillation compared to warfarin.Studying the impact of polypharmacy on anticoagulant therapy in elderly patients with atrial fibrillation can aid in the development of personalized treatment strategies and improve the prognosis of aged patients.

Value of machine learning model based on 18F-FDG PET/CT radiomics features in differential diagnosis between gastric cancer and primary gastric lymphoma / 中华核医学与分子影像杂志

Objective:To investigate the value of machine learning model based on 18F-FDG PET/CT radiomics features in preoperative differential diagnosis of gastric cancer (GC) and primary gastric lymphoma (PGL). Methods:A total of 155 patients with GC (104 males, 51 females; age (59.3±12.8) years) and 82 patients with PGL (40 males, 42 females; age (56.8±14.6) years) who underwent 18F-FDG PET/CT imaging before treatment from January 2012 to December 2020 in Tianjin Medical University Cancer Institute and Hospital were included in this retrospective study. Patients were randomly divided into training set and test set by using Python3.7.1 software. Volumes of interest (VOIs) in PET and CT images were drawn and two-dimensional and three-dimensional radiomics features were extracted. Two machine learning models, including multi-layer perceptron (MLP) and support vector machine (SVM), were established based on CT radiomics features alone, PET radiomics features alone and PET/CT radiomics features to differentiate GC and PGL, respectively. The predictive performance of each model was evaluated by ROC curve analysis. Results:There were 166 patients in training set and 71 patients in test set. Generally, SVM machine learning model based on PET/CT radiomics features showed a trend to be superior to MLP machine learning model in the differential diagnosis of GC and PGL (PET-SVM: AUC=0.88, 95% CI: 0.83-0.94); PET/CT-MLP: AUC=0.80, 95% CI: 0.73-0.87; z=1.15, P=0.337). The AUC of PET/CT-SVM machine learning model was significantly higher than that of CT-SVM machine learning model (CT-SVM: AUC=0.74, 95% CI: 0.67-0.81; z=2.28, P=0.022). Conclusion:Machine learning model based on 18F-FDG PET/CT radiomics features is expected to be a non-invasive, effective tool for preoperative differential diagnosis of GC and PGL.

Predictive value of 18F-FDG PET/CT radiomic fusion features combined with XGBoost model for HER2 expression status in breast cancer / 中华核医学与分子影像杂志

Objective:To evaluate the value of radiomic fusion features combined with extreme gradient boosting (XGBoost) machine learning models based on 18F-FDG PET/CT images in the prediction of human epidermal growth factor receptor 2 (HER2) expression status in breast cancer. Methods:18F-FDG PET/CT images of 210 patients with primary breast cancer (all females; age 52(46, 60) years; 95 HER2-positive and 115 HER2-negative) in Tianjin Medical University Cancer Institute and Hospital between January 2012 and December 2019 were retrospectively analyzed. About 70% of the HER2-positive and HER2-negative groups were randomly selected using Python 3.7.1 software as a training set ( n=147; 67 HER2-positive and 80 HER2-negative, age: 52(46, 60) years vs 55(45, 62) years) and 30% as a test set ( n=63; 28 HER2-positive and 35 HER2-negative, age: 54(43, 65) years vs 52(45, 61) years). After tumor segmentation on CT and PET images being finished, CT and PET radiomic features were extracted respectively. PET/CT fusion features (including PET/CT splicing features and PET/CT mean features) were obtained through post-processing. The support vector machine (SVM) model and XGBoost model were established. The selected features were input to predict the expression status of HER2 in primary breast cancer lesions, and the prediction efficiency of the model was evaluated by ROC curve. The Delong test was used to compare the predictive effectiveness of different models and radiomic features, and the calibration curve of the machine learning model with the highest prediction efficiency was plotted. Results:Compared with SVM model, XGBoost model had better prediction performance ( z values: 2.26-3.54, P values: 0.016-0.040) when four kinds of radiomic features (CT features, PET features, PET/CT splicing features and PET/CT mean features) were input. ROC curve analysis showed that PET/CT mean features with XGBoost machine learning model had the best performance in predicting the expression status of HER2, and the maximum AUC was 0.83 (95% CI: 0.73-0.93), which was superior to CT features (0.75(95% CI: 0.63-0.88); z=3.57, P=0.027), PET features (0.73(95% CI: 0.60-0.86); z=2.64, P=0.034) and PET/CT splicing features (0.74(95% CI: 0.60-0.87); z=2.49, P=0.037). Conclusion:XGBoost machine learning model based on PET/CT radiomics fusion features is expected to predict HER2 expression status in patients with breast cancer.

Family function and fear of missing out among college students: the chain mediating effect of relatedness need-frustration and self-control / 中华行为医学与脑科学杂志

Objective:To explore the chain mediating effect of relatedness need-frustration and self-control between family function and fear of missing out (FoMO) in college students.Methods:A sample of 409 college students from five universities in Guangdong province was surveyed with family assessment device (FAD), relatedness need-satisfaction and frustration scale, self-control scale (SCS), and fear of missing out scale.Common method bias test, Pearson correlation analysis and Hierarchical regression analysis were conducted to analyze the data using SPSS 26.0 software, and PROCESS V3.5 macro program was used to test the mediating effect.Results:(1) The total scores of family function, relatedness need-frustration, self-control and FoMO were(166.01±16.08), (9.39±2.51), (37.88±6.27)and(56.38±6.59), respectively. (2) Family function was negatively correlated with relatedness need-frustration ( r =-0.43, P<0.01), positively correlated with self-control( r =0.43, P<0.01), and negatively correlated with FoMO ( r =-0.39, P<0.01). Relatedness need-frustration was negatively correlated with self-control ( r =-0.37, P<0.01), and positively correlated with FoMO( r =0.38, P<0.01). Self-control was negatively correlated with FoMO( r =-0.42, P<0.01). (3)The direct effect of family function on FoMO was -0.17(95% CI =-0.27--0.07). Family function affected FoMO through three paths. The separate mediation effect of relatedness need-frustration was -0.09(95% CI =-0.14--0.05), the separate mediation effect of self-control was -0.09(95% CI =-0.14--0.05), and the chain mediation effect of relatedness need-frustration and self-control was -0.03(95% CI =-0.04--0.01). Conclusion:Family function not only directly affects FoMO, but also indirectly affects FoMO through relatedness need-frustration and self-control.

Internal exposure levels of polycyclic aromatic hydrocarbons in children and adolescents: a systematic review and meta-analysis

Polycyclic aromatic hydrocarbons (PAHs) are widely found in the environment, and comparing to adults, children are more vulnerable to PAHs exposure. Urinary metabolites of PAHs are used as preferred biomarkers to estimate the PAHs exposure. Systematic review on the internal exposure level of children and adolescents is rare. We aimed to calculate the internal exposure levels of PAHs in children and adolescents and compare the levels of PAHs internal exposure in various children groups. We searched PubMed, OVID, Web of Science, EBSCO, ACS, and four Chinese databases, and all studies examining the urinary concentrations of PAHs in children and adolescent were identified. The total exposure level of 11 PAHs metabolites were pooled. Standard mean difference (SMD) and 95% confidence intervals (CIs) of PAHs urinary concentration were calculated and pooled by RevMan5.3 to compare the exposure levels of different children groups. We found that 1-OHPyr, 2-OHNap, 2-OHFlu, 3-OHPhe, and 4-OHPhe were five PAHs metabolites most commonly studied in existing studies in children, and their total exposure levels were 0.38 ± 0.98, 2.32 ± 4.83, 0.81 ± 1.54, 0.09 ± 0.14, 0.03 ± 0.10 μmol/mol creatinine, respectively. The meta-analysis showed that the levels of 1-OHPyr were higher in higher environmental exposure group (SMD = 0.21, 95% CI = 0.03~0.40), ETS exposure group (SMD = 0.31, 95% CI = 0.08~0.54), and 6~11 years group (SMD = 0.16, 95% CI = 0.09~0.24); the level of 2-OHNap (SMD = 0.27, 95% CI = 0.01~0.53) was higher in higher environmental exposure group; however, the levels of 3-OHPhe (SMD = - 0.34, 95% CI = - 0.57~- 0.12) and 4-OHPhe (SMD = - 0.48, 95% CI = - 0.69~- 0.28) were higher in lower environmental exposure group. The levels of 1-OHPyr (SMD = - 0.01, 95% CI = - 0.11~0.10) and 2-OHNap (SMD = 0.01, 95% CI = - 0.20~0.22) were not statistically different between boys and girls. In conclusions, we found that the internal diversity of PAHs existed in children and adolescents, and the level of 1-OHPyr in children and adolescents was in higher status compared with non-occupational people who do not smoke.

Cytomegalovirus infection with skin lesions as the primary manifestation: a case report / 中华皮肤科杂志

A case of cytomegalovirus infection with skin lesions as the primary manifestation is reported.A 46-year-old female patient presented with a 3-month history of painful perioral blisters and erosions,and a 6-week history of erythema,blisters and erosions on the left ann.The patient was ever diagnosed with systemic lupus erythematosus and lupus nephritis 12 years prior to the presentation.Systemic lupus erythematosus was exacerbated 5 months prior to this presentation,and glucocorticoids and mycophenolate mofetil were administered.Skin examination revealed irregularly shaped perioral blisters with erosions and crusts,localized patchy erythema with erosion in the center on the flexor aspect of the left forearm,erythema and blisters on the left upper arm,and multiple petechiae and ecchymoses on the abdomen.Histopathological examination of the skin lesion on the left upper limb showed epidermal necrolysis with scattered viral inclusion bodies.Immunohistochemical examination revealed positive staining for cytomegalovirus antigen in giant cells in the necrolytic epidermis.Cytomegalovirus DNA was detected in exudates from lesions.However,cytomegalovirus DNA was not detected in the serum in the initial test,but became positive (8.04 × 103 copies/ml) 1 week later.In addition,anti-cytomegalovirus IgG antibodies were detected in the serum.The patient was diagnosed with cutaneous cytomegalovirus infection.Affter the treatment with both oral and topical ganciclovir,the lesions were improved gradually,followed by severe pulmonary infection,and the patient was finally died of multiple organ failure.

Association between psoriasis and STAT3 / 中华皮肤科杂志

Psoriasis is a chronic inflammatory skin disease.Its pathogenesis remains unclear,and is currently considered to be co-mediated by heredity,environment and immunity.Signal transducer and activator of transcription 3 (STAT3) is an important transcription factor,which is associated with cancer and autoimmune diseases.STAT3 plays a crucial role in the occurrence of psoriasis by participating in the differentiation of T helper 17 cells,hyperproliferation and abnormal differentiation of keratinocytes,interaction with inflammatory cells,hyperplasia of dermal vessels and other important pathological processes.In recent studies,therapies targeting STAT3 and its upstream Janus kinases (JAK) have shown good efficacy and safety in the management of psoriasis.This review summarizes the association between psoriasis and STAT3,so as to provide evidence for the feasibility of the treatment of psoriasis with targeted inhibition of STAT3.

Association of prenatal and childhood environment smoking exposure with puberty timing: a systematic review and meta-analysis

OBJECTIVES@#Mothers who smoke during pregnancy or while their children are small were common in some populations. Epidemiological studies have tried to detect the effect of prenatal tobacco smoke (PTS), and childhood environmental tobacco smoke (ETS) on puberty timing have not shown a consensus results. We aimed to examine current evidence and estimate the associations between PTS or/and ETS and puberty timing.@*METHODS@#Seven databases were searched from inception to May 2017. All the cohort studies examining the associations between PTS and/or ETS and puberty timing were identified. Two reviewers independently screened all studies, evaluated the quality of eligible studies, and extracted the data. The quality assessment of the eligible cohort studies was based on the Newcastle-Ottawa Scale. Risk ratio (RR), standard mean difference (SMD), and 95% confidence intervals (CIs) were calculated and pooled by CMA (Version 2.0, Biostat, Inc., USA).@*RESULTS@#Compared with controls, girls with PTS and ETS exposure have an earlier age at menarche (SMD - 0.087, 95% CI 0.174 to - 0.000), and similar results were found in both PTS subgroup (SMD - 0.097, 95% CI - 0.192 to - 0.002) and prospective cohort subgroup (SMD - 0.171, 95% CI - 0.253 to - 0.090). And number of boys with early voice break in PTS group was significantly increasing than non-exposed boys (RR 1.34, 95% CI 1.29 to 1.40).@*CONCLUSIONS@#PTS exposure possibly decrease age of menarche of girls, and studies on boys were urgent needed. Appropriate and comprehensive outcome measures using unified criteria to classify puberty should be reported in future studies.

Research Progress on Patient Education Materials Assessment Tool / 中国基层医药

With the transformation of the ＂patient－centered＂medical model,patient education has become an important part of the holistic nursing care .As an implementation medium of patient education , patient education materials are the premise for the development of patient education .The quality of patient education materials plays a positive role in improving the quality of care .This article summarizes the domestic and international research progress of patient education materials assessment tools ;it also summarizes the currently used international patient education materials assessment tool ;it explores the existing problems in the domestic research .In addition,this article discusses the different characteristics of commonly used international assessment tools , and identifies an applicable patient education materials assessment tool that can be introduced into China so as to guide the domestic research direction in the future.

Advances in hepatopancreatobiliary surgery of the 13th World Congress of the International Hepato-Pancreato-Biliary Association / 中华消化外科杂志

The 13th World Congress of the International Hepato-Pancreato-Biliary Association was held from 4th to 7th September 2018 in Geneva,Switzerland.Thousands of wellknown specialists and scholars from 96 countries around the world were invited for the great event.The congress aimed to explore the latest achievements of diagnosis and treatment of hepatobiliary and pancreatic diseases from both the clinical and basic perspective.In this article,authors reviewed and analyzed the up-to-date research information and combined clinical researches of the author team,in order to share the experience and achievements in the field of hepato-pancreato-biliary surgery with colleagues and provide new information and inference for optimization of diagnosis and treatment in this field.

Clinical and pathological analysis of three cases of lichen planopilaris / 中华皮肤科杂志

Objective To investigate clinical and histopathological features of lichen planopilaris (LPP).Methods The clinical and histopathological findings in 3 cases of LPP were analyzed.Results All the 3 patients were female,and their average age was 49 years.One patient presented with large-area patchy hair loss on the frontal,parietal and occipital region,and 2 patients presented with irregular patchy hair loss on the scalp and skin atrophy.Besides the hair loss,the eyebrows and axillary hairs also lost in 1 patient.Histopathological examination showed liquefaction degeneration of basal cells in the walls of hair follicles and infiltration of lymphocytes.Infiltration of a small number of lymphocytes was also observed around blood vessels and appendages.Conclusions LPP may only affect the scalp,or involve the other sites all over the body.LPP commonly manifests as patchy hair loss on the scalp and skin atrophy,and is pathologically characterized by liquefaction degeneration of basal cells in hair follicles and infiltration of lymphocytes.

Analysis of causative genes of tyrosinemia type Ⅱ in a pedigree / 中华皮肤科杂志

Objective To report a pedigree with tyrosinemia type Ⅱ,and to analyze its causative mutations.Methods Clinical data were obtained from a 10-year-old male proband with tyrosinemia type Ⅱ,and analyzed retrospectively.Blood and urine samples were collected from 19 persons in 3 generations of the pedigree,and the amino acid level was detected in these samples.Genomic DNA was extracted from all of the 19 family members,and mutations in the tyrosine aminotransferase (TAT) gene were detected.Results The patient developed photophobia at 2 months after birth,and the symptom was gradually aggravated after that.At the age of 6 years,ocular pain and photophobia occurred.At the age of 8 years,linear keratotic plaques occurred on his fingertips and soles of both feet,with obvious tenderness.Ophthalmic examination showed no obvious abnormalities in corneal staining or ocular fundus.Skin examination showed multiple linear keratotic plaques on the fingers and soles of both feet.The serum tyrosine level was 825.64 μmol/L,and the level of p-hydroxyphenyllactic acid in urine was 161.4 μmol/L.Genetic testing showed 2 novel mutations,including c.236G ＞ A at position 236 in exon 2 of the TAT gene causing the substitution of glycine by glutamic acid (p.Gly79Glu),and c.1141G ＞ T at position 1141 in exon 10 of the TAT gene leading to the formation of a premature termination codon instead of glutamic acid (p.Glu381*).The proband was the only patient in the family.Some members in the patrilineal family carried the mutation c.1141G ＞ T (p.Glu381*),and some in the maternal family carried the mutation c.236G ＞ A (p.Gly79Glu).Conclusion This is the first case of tyrosinemia type Ⅱ reported in the domestic population,and 2 novel heterozygous mutations were identified in the TAT gene,which may lead to the occurrence of tyrosinemia type Ⅱ in the patient.

The efficacy of cognitive behavioral therapy in insomnic patients with or without comorbidities:a pilot study / 中华内科杂志

Objectives To evaluate the effectiveness of cognitive behavior therapy for insomnia (CBT-i) in chronic insomnia patients in terms of the improvements of psychological and sleep diary parameters. Methods Patients who met the diagnostic criteria of chronic insomnia, were divided into primary group or comorbid group. Both groups received standard CBT-i interventions. Psychological scales and sleep diaries were used to evaluate participants' severity of insomnia and psychological conditions related to insomnia at four time points:before intervention (baseline), immediate after intervention, 4 weeks and 16 weeks after intervention. Results Both groups achieved significant improvements after intervention on psychological measurements and sleep diary parameters. Such improvements were maintained at 4-week and 16-week follow-ups. The sleep diary data indicated that by the end of the intervention, there were significant differences on sleep onset latency(51.72 min to 10.53 min in primary group, P<0.01;59.26 min to 15.67min in comorbid group, P<0.01)and sleep efficiency (71％to 95％in primary group, P<0.01;68％to 90％in comorbid group, P<0.01). There were differences on sleep onset latency (10.00 min vs. 13.93 min,P<0.05), total sleep time (355.71 min vs. 327.85 min, P<0.05) and sleep efficiency (95％vs. 91％, P<0.01) in primary group and comorbid group respectively. No differences were found on wake after sleep onset in the two groups. Conclusions Chronic insomnia patients with or without comorbidities both have improvements after CBT-i. Sleep diary parameters rather than psychological measurements are different in two groups. Thus, CBT-i is an effective non-pharmaceutical therapy inpatients with chronic insomnia.

Advances in pancreatic cancer research from 2017 annual meeting of the American Society of Clinical Oncology / 中华消化外科杂志

Pancreatic cancer is one of the most aggres sive malignant tumors with dismal prognosis.The 2017 annualmeeting of the American Society of Clinical Oncology (ASCO)brings together thousands of oncology professionals from around the world to discuss state-of-the-art treatment modalities,new therapies,and ongoing controversies in the field.In this paper,authors selected and reviewed pancreatic cancer research from 2017 annual meeting of the ASCO,especially the latest research progress in genetic diagnosis,chemotherapy,immunotherapy,targeted therapy and neoadjuvant treatments.

Advances in immunotherapy of pancreatic ductal adenocarcinoma / 中华外科杂志

The morbidity of pancreatic ductal adenocarcinoma (PDAC) has been increasing over years, while the treatment efficacy and prognosis of PDAC remain far from satisfying. The newly-ermerged tumor immunotherapy has not only made lots of breakthroughs in various malignancies, but also brought an opportunity to the treatment of pancreatic cancer.PDAC immunotherapies, mainly including vaccine therapy, adoptive T cell thanfer therapy, checkpoint blockade therapy, have achieved a certain effect, however, the clinical outcomes have not been satisfactory. Therefore, the combination of immunotherapies based on different theoretical views is important and is likely to be the trend in the future. Carcinoma associated fibroblast (CAF) is the most common cell in pancreatic cancer stromal component. It will be helpful to develop more potential therapeutic targets by further exploring CAF and the mechanism of fibrosis mediated immunosuppression.

Challenges and considerations in the diagnosis and treatment for pancreatic cystic neoplasms / 中华消化外科杂志

With the development of abdominal imaging examination,detection rate of pancreatic cystic neoplasms is increasing in recent years.Misdiagnosis and unreasonable treatment sometimes are unavoidable since the variable subtype,pathology and natural history.Multidisciplinary team (MDT)including surgeons,radiologists,gastro-enterologists and pathologists is very helpful to make an exact diagnosis and appropriate treatment for pancreatic cystic neoplasms.However,because of the complexities of pancreatic cystic neoplasms,challenges and difficulties of MDT always exist.In this article,authors summarized the newest advancement of pancreatic cystic neoplasms and highlighted the experiences in the management of pancreatic cystic neoplasms from MDT,aiming to seek the optimal strategy.

Challenges and considerations in the diagnosis and treatment for pancreatic cystic neoplasms / 中华消化外科杂志

With the development of abdominal imaging examination,detection rate of pancreatic cystic neoplasms is increasing in recent years.Misdiagnosis and unreasonable treatment sometimes are unavoidable since the variable subtype,pathology and natural history.Multidisciplinary team (MDT)including surgeons,radiologists,gastro-enterologists and pathologists is very helpful to make an exact diagnosis and appropriate treatment for pancreatic cystic neoplasms.However,because of the complexities of pancreatic cystic neoplasms,challenges and difficulties of MDT always exist.In this article,authors summarized the newest advancement of pancreatic cystic neoplasms and highlighted the experiences in the management of pancreatic cystic neoplasms from MDT,aiming to seek the optimal strategy.

Relationship between father parenting stress, marital satisfaction and father involvement / 中华行为医学与脑科学杂志

Objective To examine the effect of father parenting stress and paternal marital satisfaction on father involvement,and to explore the mediating role of maternal perceptions of father involvement in father involvement and maternal marital satisfaction.Methods 300 children's fathers and mothers from 5 kindergartens in Beijing city,Dezhou city,Wuhu city were surveyed with the Chinese version of the PSI/SF,the father involvement questionnaire and the marital satisfaction questionnaire.Results The score of paternal marital satisfaction was (3.98±0.75),(3.84±0.76) for maternal marital satisfaction,(2.26±0.50) for father parenting stress,(2.60±0.49) for father involvement,(2.50±0.50) for maternal perceptions of father involvement.Correlation analysis showed that father parenting stress was negatively correlated with father involvement(r=-0.36,P＜0.01),paternal marital satisfaction was positively correlated with father involvement (r=0.33,P＜0.01),father involvement was positively correlated with maternal marital satisfaction(r=0.36,P ＜0.01),father involvement was positively correlated with maternal perceptions of father involvement (r=0.48,P＜0.01).A structure equation model consisting of father parenting stress,father involvement and marital satisfaction had a better degree of fitting:GFI =0.99,NFI =0.99,CFI =0.99,RMSEA＜0.001.Maternal perceptions of father involvement mediated the effect of father involvement on maternal marital satisfaction (effect value:0.41,P＜0.05).Conclusion Father parenting stress and paternal marital satisfaction could significantly predict father involvement,father involvement could significantly predict maternal marital satisfaction.These studies verified the spillover effect and the crossover effect between spousal subsystem and parental subsystem.

Association of serum levels of matrix metalloproteinases and their tissue inhibitors with mortality in patients with malignant middle cerebral artery infarction / 中国医师杂志

Objective To investigate the relationship between serum levels of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMP) and the mortality in patients with malignant middle cerebral artery infarction.Methods A total of 74 patients with malignant middle cerebral artery infarction (MMCAI) was assigned to research group,74 healthy volunteers were recruited to serve as healthy controls,and 242 patients with other cerebral infarction were recruited to serve as case controls.Quality-of-life questionnaire and clinical examination were used to collect the information of participants.Endpoint was 30-day mortality.Results The research group showed higher serum levels of MMP-9,MMP-10,and TIMP-1 relative to the case control group,and the case control group showed higher serum levels of MMP-9,MMP-10,and TIMP-1 relative to the healthy control group (P ＜ 0.05).Compared to survivor ones,non-surviving MMCAI patients showed lower Glasgow Coma Scale score (P ＜ 0.05),higher serum levels of tumor necrosis factorα (TNF-α),MMP-9,MMP-10,and TIMP-1 (P ＜ 0.05).Multiple logistic regression analysis showed that serum levels of TNF-α,MMP-9,MMP-10,and TIMP-1 were associated with 30-day mortality,and the OR were 1.09,1.18,1.13,and 1.32,respectively.Conclusions Serum levels of MMP-9,MMP-10,and TIMP-1 levels in MMCAI patients were associated with mortality,and could be used as an auxiliary index of mortality in MMCAI patients.