Acupuncture and moxibustion in treatment of chronic obstructive pulmonary disease at stable stage: a network Meta-analysis / 中国针灸

The efficacy on chronic obstructive pulmonary disease (COPD) at stable stage treated with different methods of acupuncture and moxibustion was evaluated using network Meta-analysis method. The articles of the randomized controlled trial (RCT) on stable COPD treated with acupuncture and moxibustion were searched electronically in CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Web of Science and Cochrane library. The search was conducted from the inception of the databases to March 20th, 2022. Data analysis was performed using R4.1.1, Stata16.0 and RevMan5.3 softwares. A total of 48 RCTs were included, involving 15 kinds of acupuncture and moxibustion interventions and a sample size of 3 900 cases. The results of network Meta-analysis showed that: ① For the forced expiratory volume in one second predicted (FEV1%), both the governor vessel moxibustion combined with conventional treatment (G+C therapy) and the yang-supplementing moxibustion combined with conventional treatment (Y+C therapy) obtained the better effect than that of the conventional treatment (P<0.05), and the G+C therapy was more effective compared with the thread-embedding therapy combined with conventional treatment (E+C therapy) and warm needling (P<0.05). ② Concerning to COPD assessment test (CAT) score, the results indicated that the Y+C therapy, and the mild moxibustion combined with conventional treatment (M+C therapy) were more effective when compared with the conventional treatment (P<0.05), and the effect of the Y+C therapy was better than that of the E+C therapy (P<0.05). ③ Regarding six-minute walking distance (6MWD), the effect of acupuncture combined with conventional treatment (A+C therapy) was better than that of either the E+C therapy or the conventional treatment (P<0.05). The effect of the G+C therapy was optimal for improving FEV1%, the Y+C therapy obtained the best effect for improving CAT score, and A+C therapy was the most effective for improving 6MWD. Due to the limitation of the quality and quantity of included studies, this conclusion needs to be further verified through high-quality RCT.

The mediating effect of perceived social support in the relationship between maternal personality traits and pregnancy-related anxiety / 中华预防医学杂志

Objective: Exploring the mediating effect of perceived social support between the maternal personality traits and pregnancy-related anxiety. Methods: Singleton pregnant women who underwent antenatal checkups in the obstetrics department of general hospital affiliated to Ningxia Medical University from July to December 2021 were enrolled in this study to investigate perceived social support, pregnancy-related anxiety and conscious personality traits. Pearson correlation analysis was used to analyze the association between the maternal personality traits, perceived social support, and pregnancy-related anxiety, and the mediating effect of perceived social support was analyzed using Bootstrap method. Results: A total of 1 259 subjects were included in the study, of which 170 (13.50%) pregnant women felt introverted. The total score of perceived social support was (46.37±8.38), and 31.45% of pregnant women had high perceived social support. The total score of pregnancy-related anxiety was (21.48±5.53). The score of worry about fetal health was (10.09±3.24), and 368 (29.23%) of pregnant women had pregnancy-related anxiety. Maternal personality traits and pregnancy-related anxiety were negatively correlated (r=-0.076, P<0.05) and positively correlated with perceived social support during pregnancy (r= 0.127, P<0.05). Perceived social support during pregnancy and pregnancy-related anxiety were negatively correlated (r=-0.236, P<0.05). Perceived social support partially mediated the relationship between the maternal personality traits and pregnancy-related anxiety, with a relative effect value of 37.50%. Conclusion: The maternal personality traits, level of perceived social support and pregnancy-related anxiety are all related. Perceived social support could mediate the relationship between the maternal personality traits and pregnancy-related anxiety.

Clinical characteristics and serious complications of esophageal button battery ingestion in the pediatric on 83 cases / 中华耳鼻咽喉头颈外科杂志

Objective: To analyze the clinical characteristics and complications of esophageal foreign bodies of button battery ingestion in children. Methods: A retrospective descriptive study included 83 children who were hospitalized in our hospital on account of button battery ingestion from January 2011 to December 2021. There were 50 males (60.2%) and 33 females (39.8%). The age ranged from 7.6 months to one month off 10 years, with a median age of 18 months. The data of patient demographics and time from ingestion to admission, location, symptoms, management, complications, and follow-up outcome were recorded. SPSS17.0 software was used for statistical analysis. Results: Seventy-two children (86.7%) were younger than 3 years old. The time from ingestion to admission ranged from 1 h to 2 months, with a median time of 8 h. Among the 63 children who were first diagnosed in our hospital, the most common clinical symptoms were nausea and vomiting (32 cases, 50.8%), dysphagia (31 cases, 49.2%), salivation (11 cases, 17.5%) and fever (10 cases, 15.9%). Seventy-three of 83 cases had complete preoperative diagnostic tests, and 55 cases (75.3%) were diagnosed by X-ray. In 56 cases (76.7%), the foreign badies were impacted in the upper third of esophagus. In 72 cases (86.7%), the foreign badies were removed by rigid esophagoscopy. 23 (27.7%) had serious complications, including tracheoesophageal fistula in 15 cases(TEF;65.2%), vocal cord paralysis (VCP;34.8%) in 8 cases, esophageal perforation in 3 cases (EP;13.0%), hemorrhage in 3 cases(13.0%), mediastinitis in 3 cases (13%), and periesophageal abscess in 1 case (4.3%). There were significant differences in the exposure time of foreign bodies and unwitnessed ingestion by guardians in the complications group (P<0.05). 2 cases died (2.4%)respectively due to arterial esophageal fistula bleeding and respiratory failure caused by stent displacement during the treatment of tracheoesophageal fistula. Conclusion: Accidental button battery ingestion can be life-threatening. and it mostly happens in children under 3 years old. Serious complications may happen cause of non-specific clinical manifestations and unwitnessed ingestions. Anterior and lateral chest X-ray is the first examination choice. Tracheoesophageal fistula is the most common serious complication.

The role and treatment strategies of ferroptosis in liver diseases / 药学学报

The discovery of regulatory cell death has led to new breakthroughs in the field of disease treatment. As a novel discovered regulatory cell death in the past decade, ferroptosis is characterized by abnormal increase of intracellular iron ions and peroxidative damage of cell membrane lipids, morphological features of mitochondrial volume reduction, increased mitochondrial membrane density, as well as mitochondria decrease or disappear. The mechanism of ferroptosis is mainly associated with factors such as iron metabolism disorder, lipid metabolism abnormality, amino acid antioxidant system imbalance and oxidative stress. Since the liver is the main organ of human body for storing iron ions, it is necessary to deeply investigate the mechanism of ferroptosis in liver diseases. Relevant studies have shown that ferroptosis plays different roles in various liver diseases and is closely related to the process of liver diseases, including drug-induced liver injury, alcoholic fatty liver disease, non-alcoholic fatty liver diseases, viral hepatitis, liver fibrosis and hepatocellular carcinoma. The aim of this review is to link ferroptosis and liver diseases, concentrating on the iron metabolism disorder, accumulation of lipid peroxides in cell membranes, imbalance of amino acid antioxidant system, hyperpolarization of mitochondrial membrane potential and its accumulation of lipid peroxides, oxidative stress-related transcription factors and other aspects. This review summarizes the regulatory mechanism, current situation and the roles of ferroptosis in liver diseases, in order to provide a new theoretical basis and ideas for the in-depth study of ferroptosis and the treatment of liver diseases.

Clinical diagnosis and treatments of type Ⅱ-Ⅳ congenital laryngotracheoesophageal cleft in 8 children / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the clinical diagnosis and treatment of congenital laryngotracheoesophageal cleft (LTEC) in children. Methods: The clinical data of 8 children (including 7 males and 1 female)with congenital laryngotracheoesophageal cleft from January 2016 to June 2020 were retrospectively analyzed. The median diagnosing age was 3.75 months (5 days to 12 months). According to the modified Benjamin Inglis classification proposed by Sandu in 2006,there were 3 cases of type Ⅱ, 3 cases of type Ⅲa, 1 case of type Ⅲb and 1 case of type Ⅳa. All children were followed up regularly. Results: Six patients were treated for recurrent bronchopneumonia and aspiration during feeding. The patients were first treated in the pneumology departmentt or intensive care unit. Six patients combined with other malformations. Endoscopic repair operations were performed in 6 cases (3 cases of type Ⅱ, 3 cases of type Ⅲ a), 1 case of LTEC was operated through cervical approach, and 1 case of type IVa LTEC associated with VACTERL was repaired under thoracoscope combined with suspension laryngoscope. Seven patients underwent tracheotomy before or during the repair operations. Gastrostomy was performed in 2 children. The operations were successfully performed in all cases. Three children with type Ⅱ LTEC recovered well and decannulated. One case of type Ⅲa was followed up for 5 months with occasionally choking while feeding. Two cases of type Ⅲa, 1 case of type Ⅲb and 1 case of type Ⅳa died due to severe reflux, tracheomalacia or respiratory failure. Conclusions: Congenital LTEC is a rare congenital malformation which is difficult to diagnose for the poor specificity of clinical manifestations. LTEC needs to be classified by endoscopy examination under general anesthesia. Severe cases of LTEC have poorer outcomes than the mild cases, and the perioperative managements need multi-disciplinary cooperation to reduce the mortality.

Analysis of complications and outcomes of tracheotomy with different etiology in children / 中华耳鼻咽喉头颈外科杂志

Objective: To discuss the complications and postoperative outcomes of tracheotomy with different etiology in children. Methods: One hundred and eighty-six patients underwent tracheotomy were retrospectively analyzed from January 2016 to December 2018,including 117 males and 69 females. The children aged from 4 days to 14 years (median age 31.5months). One case was operated under local anesthesia in emergency room, 2 cases were operated under local anesthesia in pediatric intensive care unit, the rest 183 cases were operated under general anesthesia in operation room. The 186 children were divided into four groups according to their direct causes of tracheotomy. Group A(90 cases): Neuromuscular disease and severe infection,Group B(26 cases): Head and neck tumor,Group C(57 cases): Congenital malformation and upper airway obstruction,Group D(13 cases): Accidental injury. The basic information, surgical complications and postoperative outcomes were recorded and analyzed. All patients were followed up by clinic or by telephone. Spss 19.0 software was used for statistical analysis. Results: One hundred and eighty-six patients were followed up for one to four years. 33 children lost the follow-up and 46 died. Among the 186 patients, 23 cases had emergency tracheotomy (12.4%). The rate of emergency tracheotomy in group C(16 cases, 28.1%) was higher than that in the other three groups(χ2=28.08,P<0.05). The average age of patients and hospital stay in group C were significantly lower than those in the other three groups (F=33.76,P<0.05; F=14.95,P<0.05). Incision bleeding occurred in 11 cases, Subcutaneous emphysema occurred in 6 cases and accidental decannulation occurred in 10 cases (4 cases within 2 weeks and 6 after 2 weeks). Six patients underwent tracheocutaneous fistula closure operation after decannulation and the stoma healed spontaneously in other extubated children. Two patients underwent secondary tracheotomy due to accidental decannulation, and three patients underwent secondary tracheotomy for dyspnea after decannulation. In 107 cases of survival children, decannulation was successful in 65 patients and failed in 42 patients. The average duration of wearing tracheal tube was 8.8 months. The decannulation rates in the four groups were 55.6%, 45%, 69% and 77.8%, with no significant difference. Conclusions: The complications after tracheotomy in children are rare, and no severe complications occurred in long-term tracheotomy patients. The duration of wearing tracheal tube is related to the treatment of their primary disease.

Ancient Literatures of Classical Famous Prescription Dihuang Yinzi / 中国实验方剂学杂志

Classical famous prescription Dihuang Yinzi is widely used in modern clinical practice，and can treat many kinds of diseases，especially the diseases of nervous system in internal medicine. Its clinical effect is accurate，but it has not been converted into Chinese patent medicine preparations. Therefore，the authors have collected ancient traditional Chinese medicine（TCM） literatures of Dihuang Yinzi by the methods of bibliometrics，and selected and sorted out 254 pieces of effective data， involving 144 ancient books of TCM，and systematically summarized and analyzed the historical development origin，main treatment syndrome，formula making principle，dosage，preparation method，decoction method and medicine taking method of Dihuang Yinzi，in order to provide the ancient literary evidence support for the development and clinical application of classic famous prescriptions. It is found that Dihuang Yinzi was from Xuanming Lunfang written by LIU He-jian，a doctor of Jin dynasty. It was composed of 12 kinds of herbs，namely Rehmanniae Radix Praeparata，Morindae Officinalis Radix，Corni Fructus，Cistanches Herba，Dendrobii Caulis，Aconm Lateralis Radix Praeparaia，Schisandrae Chinensis Fructus，Cinnamomi Ramulus，Poria，maimendong，Acori Calami Rhizoma and Polygalae Radix, and mainly used for the treatment of Yinfei. The later records of Dihuang Yinzi mostly followed the prescription composition and main treatment set forth in Xuanming Lunfang，and its clinical application was expanded. In the 199 articles with the indications for disease treatment，Yinfei was the most commonest indication, and took up about half of the total，which was followed by stroke，taking up about two fifths of the total. It was also used for the treatment of sudden aphonia，flaccidity syndrome，vertigo，enuresis. Dihuang Yinzi has a wide range of treatment，but the pathogenes is always belongs to "the deficiency of water and fire in the kidney". The recipe of Dihuang Yinzi was unique，and can be used to treat both the upper and lower parts of the body，as well as both the outward symptoms and root causes of an illness at the same time， in particular，it mainly focuses on the treatment of the lower and the root. Among the 56 literatures with drug dosage records，about one third of them inherited the records of Xuanming Lunfang: "Equal division，the top is the end，3 qian for each dose." The dosage was generally light. The preparations are mostly decoction and boiled powder. In the decocting and taking methods，it was suggested that "turbid medicine shall be boiled for a short time，and taken after several boilings，with no limit to time."

Banxia Xiexin Decoction () Treats Diabetic Gastroparesis through PLC-IP / 中国结合医学杂志

OBJECTIVE@#To test the effect of Banxia Xiexin Decoction (, BXD) on the contraction and relaxation of gastric smooth muscle (SM) in diabetic gastroparesis (DGP) model rats, and to explore the mechanism of BXD in the prevention and treatment of DGP through experiments of signal pathway both in vivo and in vitro.@*METHODS@#Sixty Sprague-Dawley rats were divided into 6 groups according to a random number table: control group, model group, high-, medium- and low-dose BXD groups (9.2, 4.6 and 1.8 g/(kg·d), respectively), and domperidone group (10 mg/(kg·d)), 10 rats per group. DGP model was established initially by a single intraperitoneal injection of streptozotocin (STZ), and was confirmed by recording gastric emptying, intestinal transport velocity and gastric myoelectric activity of rats after 2 months. Each group was treated with a corresponding drug for 4 weeks. The mRNA and protein expressions of phospholipase C (PLC), inositol triphosphate (IP@*RESULTS@#Compared with the model group, high- and medium-dose BXD and domperidone significantly increased the expressions of PLC, IP@*CONCLUSIONS@#Treatment with high- and medium-dose BXD significantly attenuated STZ-induced experimental DGP in rats. The therapeutic effect of BXD on DGP rats might be associated with the PLC-IP

The epidemiological characteristics and the source of infection of reemerge human rabies from 2012 to 2017 in Qinghai / 中华疾病控制杂志

Objective To understand the epidemic situation and the source of infection of the reemerge human rabies in Qinghai. Methods We collected the data on human rabies and the data on the cases of multi- victims bitten by the identical dog, and also the laboratory data of the nucleoprotein ( N) gene of rabies virus from the samples which were detected by reverse transcription-polymerase chain reaction (RT-PCR) and direct immunofluorescence assay (DFA) from 2012 to 2017, to describe the epidemiological characteristics of human rabies and the prevalence of rabies virus in host animals, and to explore the source of infection of reemerge human rabies. Results A total of 7 human cases were reported in 2012-2017 in Qinghai province, among which 1 was bitted by wolf, 2 were bitted by stray dogs, 3 were bitted by domestic dogs which injured by stray dogs or wolfs. A total of 892 canine brain tissue samples were collected, from which 46 positive samples were detected with the positive rate of 5.16% (95% CI：3.70%-6.61%). The positive samples were collected from the nomadic region, which were consistent had the location of the human rabies. The samples collected from the cases of multi-victims bitten by the identical dog/animal had the positive rate of 73.08%, and 4 out of 7 human rabies were exposed to the cases of multi-victims bitten by the identical dog/animal. Genetic sequencing of the rabies virus detected from canine brain tissue samples were belong to China IV lineage, which was closely related to the Arctic clade. Conclusions The reemerging rabies happened in nomadic region of Qinghai province could be a consequence of spillover from wildlife especially from wolfs. The better surveillance system covering the human, livestock and wildlife should be set up to mitigate the rabies virus spread from the wildlife.

Visual-spatial neglect after right-hemisphere stroke: behavioral and electrophysiological evidence / 中华医学杂志(英文版)

Background:@#Visual-spatial neglect (VSN) is a neuropsychological syndrome, and right-hemisphere stroke is the most common cause. The pathogenetic mechanism of VSN remains unclear. This study aimed to investigate the behavioral and event-related potential (ERP) changes in patients with or without VSN after right-hemisphere stroke.@*Methods:@#Eleven patients with VSN with right-hemisphere stroke (VSN group) and 11 patients with non-VSN with righthemisphere stroke (non-VSN group) were recruited along with one control group of 11 age- and gender-matched healthy participants. The visual-spatial function was evaluated using behavioral tests, and ERP examinations were performed.@*Results:@#The response times in the VSN and non-VSN groups were both prolonged compared with those of normal controls (P < 0.001). In response to either valid or invalid cues in the left side, the accuracy in the VSN group was lower than that in the non-VSN group (P < 0.001), and the accuracy in the non-VSN group was lower than that in controls (P < 0.05). The P1 latency in the VSN group was significantly longer than that in the control group (F[2, 30] = 5.494, P = 0.009), and the N1 amplitude in the VSN group was significantly lower than that in the control group (F[2, 30] = 4.343, P = 0.022). When responding to right targets, the lefthemisphere P300 amplitude in the VSN group was significantly lower than that in the control group (F[2, 30] = 4.255, P = 0.025). With either left or right stimuli, the bilateral-hemisphere P300 latencies in the VSN and non-VSN groups were both significantly prolonged (all P < 0.05), while the P300 latency did not differ significantly between the VSN and non-VSN groups (all P > 0.05).@*Conclusions:@#Visual-spatial attention function is impaired after right-hemisphere stroke, and clinicians should be aware of the subclinical VSN. Our findings provide neuroelectrophysiological evidence for the lateralization of VSN.

Visual-spatial neglect after right-hemisphere stroke: behavioral and electrophysiological evidence / 中华医学杂志(英文版)

BACKGROUND@#Visual-spatial neglect (VSN) is a neuropsychological syndrome, and right-hemisphere stroke is the most common cause. The pathogenetic mechanism of VSN remains unclear. This study aimed to investigate the behavioral and event-related potential (ERP) changes in patients with or without VSN after right-hemisphere stroke.@*METHODS@#Eleven patients with VSN with right-hemisphere stroke (VSN group) and 11 patients with non-VSN with right-hemisphere stroke (non-VSN group) were recruited along with one control group of 11 age- and gender-matched healthy participants. The visual-spatial function was evaluated using behavioral tests, and ERP examinations were performed.@*RESULTS@#The response times in the VSN and non-VSN groups were both prolonged compared with those of normal controls (P  0.05).@*CONCLUSIONS@#Visual-spatial attention function is impaired after right-hemisphere stroke, and clinicians should be aware of the subclinical VSN. Our findings provide neuroelectrophysiological evidence for the lateralization of VSN.

Risk factors associated with the severity of diabetic retinopathy in Qingdao / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To investigate and analyse the prevalence and risk factors associated with diabetic retinopathy severity in Qingdao. ·METHODS: This survey consisted of the 2 following parts: 2859 community residents aged >60 years old and 4275 patients with T2DM who were older than 30 years old in Qingdao. Ophthalmic examinations were performed on all patients. A questionnaire was used to obtain the patient's age and gender, the duration of diabetes mellitus(DM), glycaemic control and their knowledge of diabetic retinopathy ( DR ). Blood pressure and haemoglobin levels were recorded. All included patients underwent a comprehensive ophthalmic examination that included a fundus examination and retinal photographs and that assigned a grade for the severity of retinopathy according to the Early Treatment Diabetic Retinopathy Study (ETDRS) severity scale. Patients with severe non-proliferative or proliferative diabetic retinopathy and clinically significant macular edema ( CSME ) required ophthalmic therapy were assigned to the need-treatment group, while the remaining patients with DR were assigned to the need-observation group. Correlation and regression analyses were performed to determine the required-treatment rate and risk factors for DR. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) after adjustment for age, gender and the duration of diabetes. ·RESULTS: DR was present in 334 (11. 68% ) of the 2859 community residents aged > 60 years old and 1097 (25. 66% ) of the 4275 hospital patients with T2DM, and 48 (14. 81% ) of the residents and 172 ( 15. 68% ) of the hospital patients required ophthalmic therapy. In univariate and multivariate logistic analyses, factors including the age of the patients (51-60 years old: OR, 1. 68; 95% CI, 1. 21-1. 72; 61-70 years old: OR, 1. 55;95% CI, 1. 38-1. 76), the duration of diabetes (11-15 years:OR, 2. 61; 95% CI, 1. 51-4. 72; >15 years: OR, 4. 15; 95% CI, 2. 32-5. 77), glycaemic control (medium: OR, 2. 51;95%CI,1.98-3.92;poor:OR,4.69;95%CI,3.39-6.95), and knowledge of DR ( did not understand: OR, 1. 45;95%CI, 1. 21-1. 95) were significantly associated with the required-treatment rate in DR, while gender, low and advanced age ( 31-50 years old and >70 years old ), duration of disease (<10y), hypertension, and insulin treatment did not. ·CONCLUSION: The prevalence rate and the required-treatment rate in DR in Qingdao are relatively high. Being aged 51-70 years old and having a duration of diabetes>10y, poor glycaemic control and a lack of knowledge of DR were found to be potential risk factors that increased the rate of required ophthalmic therapy in patients with DR. In patients with T2DM who were aged 51-70 years old, we found that focusing on using science and education to strengthen the patients' knowledge of DR, establishing specifications for a community DR screening system, and effectively implementing early intervention in the community of DR - affected individuals were particularly important for preventing and controlling the high DR prevalence and the high rate of DR-associated blindness

Identification and Quantification of Chlorpyrifos Metabolites in Urine Samples by Ultra Performance Liquid Chromatography-Triple Quadrupole-Linear Ion Trap Mass Spectrometry / 分析化学

A method was established for the determination of chlorpyrifos metabolites employing QuEChERS method and ultra performance liquid chromatography-triple quadrupole-linear ion trap mass spectrometry (UPLC-QTRAP). The urine samples were extracted by acetonitrile and then cleaned up with PSA and GCB. The samples were separated with the gradient elution of acetonitrile-0.2% ammonia water on ZORBAX Eclipse Plus C18column. The analytes were detected by tandem mass spectrometry under negative ion mode with electrospray ionization (ESI) source and MRM-IDA-EPI mode. Under the optimized conditions, the calibration curve was linear in range of 1.0-100.0 μg/L,and the limits of detection were 0.10-0.73 μg/L. The average recoveries were 80.3%-90.1%, and RSDs were all within 10%. The developed method was simple,sensitive,accurate,and repeatable,and could avoid false positive result of samples effectively. The established method was successfully applied to determine the exposure level of chlorpyrifos metabolites in real samples of human health risk analysis. The results showed that the maximum concentration of chlorpyrifos metabolites was 54.6 μg/L. This method provided technic support for simultaneous identification and quantification of chemicals in complex matrix.

Differential diagnosis of hepatocellular carcinoma and hepatic hemangiomas based on radiomic features of gadoxetate disodium-enhanced magnetic resonance imaging / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the feasibility of using radiomic features for differential diagnosis of hepatocellular carcinoma (HCC) and hepatic cavernous hemangioma (HHE).</p><p><b>METHODS</b>Gadoxetate disodium-enhanced magnetic resonance imaging data were collected from a total of 135 HCC and HHE lesions. The radiomic texture features of each lesion were extracted on the hepatobiliary phase images, and the performance of each feature was assessed in differentiation and classification of HCC and HHE. In multivariate analysis, the performance of 3 feature selection algorithms (namely minimum redundancy-maximum relevance, mRmR; neighborhood component analysis, NCA; and sequence forward selection, SFS) was compared. The optimal feature subset was determined according to the optimal feature selection algorithm and used for testing the 3 classifier algorithms (namely the support vector machine, RBF-SVM; linear discriminant analysis, LDA; and logistic regression). All the tests were repeated 5 times with 10-fold cross validation experiments.</p><p><b>RESULTS</b>More than 50% of the radiomic features exhibited strong distinguishing ability, among which gray level co-occurrence matrix feature S (3, -3) SumEntrp showed a good classification performance with an AUC of 0.72 (P<0.01), a sensitivity of 0.83 and a specificity of 0.57. For the multivariate analysis, 15 features were selected based on the SFS algorithm, which produced better results than the other two algorithms. Testing of these 15 selected features for their average cross-validation performance with RBF-SVM classifier yielded a test accuracy of 0.82∓0.09, an AUC of 0.86∓0.12, a sensitivity of 0.88∓0.11, and a specificity of 0.76∓0.18.</p><p><b>CONCLUSION</b>The radiomic features based on gadoxetate disodium-enhanced magnetic resonance images allow efficient differential diagnosis of HCC and HHE, and can potentially provide important assistance in clinical diagnosis of the two diseases.</p>

Sleep Duration and Factors Related to Sleep Loss in 3-14-Year-Old Children in Beijing: A Cross-Sectional Survey / 中华医学杂志(英文版)

Background@#It is known that short sleep duration adversely affects children's behavior and physical development. This study aimed to investigate the status of sleep duration in 3-14-year-old children in Beijing and explore the related factors of sleep loss with them.@*Methods@#In this study, a cross-sectional study of random stratified cluster sampling was conducted on 3-14-year-old children and adolescents in Beijing. According to the proportion of children in each district and school, the final cohort included a total of 11 kindergartens, 7 primary schools, and 8 junior high schools from 7 districts of Beijing. Children of sampled classes were included, and their parents were invited to fill a series of questionnaires including the simplified Chinese version of Pediatric Sleep Questionnaire, Sleep Questionnaire Scale, and Hong Kong-Children Sleep Questionnaire about the performance of the last 6 months.@*Results@#Out of the total 11,420 questionnaires, 9198 questionnaires were valid and effective with the response rate of 80.54%. The age of the investigated children was 8.8 ± 3.8 years, including 4736 males and 4462 females. The daily sleep duration of children in Beijing was 9.7 ± 0.7 h. The prevalence of sleep loss (<9 h/day) of children in Beijing was 11.8%. The daily sleep duration of children aged <6, 6 ≤ age <11, and ≥11 years was 9.7 ± 0.6 h, 9.6 ± 0.6 h, and 9.5 ± 0.8 h, respectively. The sleep duration reduced significantly in children aged ≥11 years as compared to younger children in Beijing which was mainly contributed by the variation tendency of sleep duration on weekdays. The multivariate logistic regression analysis identified factors associated with sleep loss (P < 0.05): male (odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.15-1.51), age ≥11 years (OR = 2.37, 95% CI: 1.92-2.93), overweight (OR = 1.34, 95% CI: 1.17-1.54), family history of snoring (OR = 1.35, 95% CI: 1.13-1.61) and activities before bedtime with watching TV (OR = 1.24, 95% CI: 1.08-1.43), sports (OR = 1.22, 95% CI: 1.01-1.48), playing cellphone (OR = 1.91, 95% CI: 1.31-2.73) and surfing the Internet (OR = 1.27, 95% CI: 1.06-1.52) and among them age ≥11 years and playing cellphone before bedtime had greater impact on children's short sleep duration than that of other factors.@*Conclusions@#Sleep loss was common among 3-14-year-old children in Beijing. Sleep duration decreased with age, especially among children over 11 years old. Factors associated with sleep loss covered sociodemographic characteristics, family sleep habits and routine activities before bedtime, and among those variables, age ≥11 years and playing with cellphones before bedtime had a greater impact on sleep duration, indicating that existing sleep loss in 3-14-year-old children could be, at least partly, improved by paying more attention to children aged of 11 years or entering Grade 5 and Grade 6 and to children with a family history of snoring; by reducing the use of electronic products before bedtime, especially cellphones; by managing weight and keeping fit; and by improving the bedtime routine.

Expression of endoplasmic reticulum-associated apoptosis protein CHOP in lung tissues of COPD model rats / 中国病理生理杂志

AIM:To investigate whether cigarette smoke(CS)promotes the expression of endoplasmic reticu-lum-associated apoptosis protein CCAAT/enhancer-binding protein homologous protein(CHOP)in rat lung tissues. METHODS:Adult male Wistar rats(n=40)were randomly divided into 4 groups with 10 rats in each group: control group,CS-2 group(exposed to CS for 2 months),CS-4 group(exposed to CS for 4 months)and ex-smoking(Ex-S)group (exposed to CS for 4 months and then quit smoking for 1 month).The percentage of forced expiratory volume in 0.3 second to forced vital capacity(FEV0.3/FVC)and peak expiratory flow(PEF)were measured.TUNEL assay was used to detect the apoptotic cells.In situ hybridization and RT-PCR were used to determine the mRNA expression of CHOP.The methods of immunohistochemistry and Western blot were used to determine the protein expression of CHOP.Western blot was also used to determine the protein levels of protein kinase R-like endoplasmic reticulum kinase(PERK),p-PERK,eukaryotic initiation factor(eIF)2αand p-eIF2α.RESULTS:The pulmonary function greatly decreased in the rats exposed to CS for 2 months in comparison with control group(P<0.05),markedly decreased in the rats exposed to CS for 4 months as com-pared with the rats after exposure to CS for 2 months(P<0.05),and was improved little in ex-smoking rats(P>0.05). The structural destruction of the lung was observed in the rats exposed to CS for 2 months,and more obvious changes were found in the rats exposed to CS for 4 months.However,the structural destruction of the lung remained obvious in ex-smok-ing rats.The apoptotic cells were markedly increased in the rats exposed to CS for 2 months and were even more in the rats exposed to CS for 4 months.The apoptotic cells were alveolar epithelial cell I(ACE I),ACE II,vascular endothelial cells and bronchial epithelial cells.The protein levels of p-PERK,p-eIF2αand CHOP were remarkably increased in the rats af-ter exposure to CS for 2 months compared with the control rats(P<0.05),significantly elevated in the rats exposed to CS for 4 months compared with the rats exposed to CS for 2 months(P<0.05),and slightly decreased in ex-smoking rats in comparison with the rats after exposure to CS for 4 months(P>0.05).The total protein levels of PERK and eIF2αdid not change between the control rats and those exposed to CS.CONCLUSION: CS promotes the development of chronic ob-structive pulmonary disease(COPD)by inducing the expression of endoplasmic reticulum-associated apoptosis protein CHOP via PERK/eIF2α/CHOP signaling pathway.

Effects of short-chain acyl-CoA dehydrogenase on hypertensive vascular remodeling / 中国病理生理杂志

AIM:To investigate the changes of short-chain acyl-CoA dehydrogenase(SCAD)in hypertensive vascular remodeling and to explore the relationship between SCAD and vascular remodeling in hypertension.METHODS:The spontaneously hypertensive rats(SHR;24 weeks old)and Wistar rats(24 weeks old)were used as experimental con-trol groups.The SHR and Wistar rats of 16 weeks old were trained by swimming as experimental groups.The systolic pres-sure was measured periodically.The thickness of vascular wall and the diameter of the vascular lumen were measured.The contents of ROS and ATP,the enzyme activity of SCAD, and the expression of SCAD at mRNA and protein levels in the aorta were determined.The free fatty acid in the serum and aorta was also measured.RESULTS:Compared with Wistar group,the diameter of vascular lumen decreased in SHR group.The thickness of vascular wall,the ratio of vascular wall and the diameter of vascular lumen,and the blood pressure in SHR group were increased significantly(P<0.05).Com-pared with SHR group,the diameter of vascular lumen increased in SHR +swim group.The thickness of vascular wall,the ratio of vascular wall and the diameter of vascular lumen,and the blood pressure in SHR +swim group were decreased sig-nificantly.Compared with control group, the expression of SCAD at mRNA and protein levels, the enzyme activity of SCAD,and the content of ATP were decreased in SHR group.However,the free fatty acid in the serum and aorta,and the content of ROS in the aorta were increased in SHR group.The expression of SCAD at mRNA and protein levels,the en-zyme activity of SCAD,the content of ATP were increased in Wistar +swim group and SHR +swim group.However, the free fatty acid in serum and aorta,and the content of ROS in the aorta were decreased in Wistar +swim group and SHR+swim group.CONCLUSION: Decrease in SCAD expression may be associated with hypertensive vascular remodeling. Swimming training can reverse hypertensive vascular remodeling by increasing the expression of SCAD in the aorta.

Association between Plasma Metal Levels and Diabetes Risk: a Case-control Study in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Many metals, some of which have been classified as environmental endocrine disruptors, are used extensively in everyday consumer products and are ubiquitous in our living environment. In the present study, we aimed to explore the associations between the prevalence risk of type 2 diabetes and plasma levels of 20 trace elements as well as those of heavy metals in a Han Chinese population.</p><p><b>METHODS</b>We conducted a case-control study to investigate the associations between plasma concentrations of 20 metals and diabetes in Jiangsu province. A total of 122 newly diagnosed cases of type 2 diabetes and 429 matched controls were recruited from community physical examinations in Suzhou City of Jiangsu Province. Plasma metal levels were measured by inductively-coupled plasma mass spectrometry.</p><p><b>RESULTS</b>After adjusting for confounders, plasma vanadium, chromium, manganese, copper, zinc, arsenic, selenium, strontium, palladium, cadmium, cesium, and barium were associated with diabetes risk (P < 0.05). The adjusted OR increased with increasing concentration of vanadium, manganese, copper, zinc, and cesium.</p><p><b>CONCLUSION</b>Many metals, including manganese, copper, zinc, arsenic, selenium, and cadmium in plasma, are associated with the morbidity of diabetes. Monitoring of environmental metal levels and further studies are urgently needed.</p>

A Meta analysis of family risk factors for attention deficit hyperactivity disorder / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the risk factors for attention deficit hyperactivity disorder (ADHD) and to provide a basis for future prevention and treatment of this disease.</p><p><b>METHODS</b>Following a systematic search for case-control studies on the risk factors for ADHD in China between 2000 and 2014, relevant family risk factors were extracted accordingly. The quality of selected studies was evaluated according to the NOS scale. A Meta analysis on the selected studies was conducted using Stata 12.0 software.</p><p><b>RESULTS</b>A total of 16 studies were selected, involving 2 167 children with ADHD and 2 148 normal controls. Results of Meta analysis showed that good parenting (OR=0.32, 95% CI: 0.26-0.40), nuclear family (OR=0.56, 95% CI: 0.41-0.76), high education level of father (OR=0.56, 95% CI: 0.41-0.76), high education level of mother (OR=0.65, 95% CI: 0.47-0.89), and extroversion of mother (OR=0.33, 95% CI: 0.18-0.61) are favorable factors for ADHD. Poor parental relationship (OR=1.90, 95% CI: 1.17-3.06) and family history of ADHD (OR=5.86, 95% CI: 3.67-9.35) are risk factors for ADHD.</p><p><b>CONCLUSIONS</b>Good parenting, nuclear family, high education level of parents, and mother with extroversion are protective factors for ADHD, whereas poor parental relationship and family history of ADHD are associated with an increased risk for ADHD.</p>

Relationship between serum zinc levels and attention deficit hyperactivity disorder in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the possible relationship between serum zinc levels and attention deficit hyperactivity disorder (ADHD) in Chinese children.</p><p><b>METHODS</b>Following a systematic search for case-control studies on the serum zinc levels in Chinese children with ADHD published between 2000 and 2015, a Meta analysis was conducted using Stata 12.0 software.</p><p><b>RESULTS</b>A total of 17 studies, including 2 177 children with ADHD and 2 900 normal children, were enrolled. The Meta analysis showed that serum zinc levels in children with ADHD were lower than normal children (SMD= -1.33; 95%CI: -2.22, -0.44; P=0.003). The sensitivity analysis indicated that the results were reliable. Eggerγs test did not find the existence of publication bias.</p><p><b>CONCLUSIONS</b>Serum zinc levels may be associated with susceptibility to ADHD in children.</p>