Analysis of birth surveillance results in Baoshan Districtfrom 2013 to 2022 / 预防医学

Objective @#To investigate the fertility level of registered population in Baoshan District, Shanghai Municipality and the incidence of adverse birth outcomes of live births from 2013 to 2022, so as to provide the evidence for improving maternal and child health care strategies. @*Methods@#The data pertaining to live births registered in Baoshan District from 2013 to 2022 were collected through the Shanghai Birth Medical Information System, including the basic information of live births and maternal fertility. The indicators such as fertility level, parity, birth age and incidence of adverse birth outcomes of live births were descriptively analyzed. The trend of crude birth rate and total fertility rate was analyzed by annual percent change (APC). @*Results@#A total of 56 719 live births were registered in Baoshan District from 2013 to 2022. The crude birth rate was 6.54‰, the total fertility rate was 31.78‰, and the sex ratio at birth was 105.61. The crude birth rate showed a downward trend from 2016 to 2022 (APC=-11.054%, P<0.05), and the total fertility rate showed a downward trend from 2017 to 2022 (APC=-10.377%, P<0.05). The proportion of second parity and above showed an increasing trend from 2013 to 2017 (P<0.05) and a decreasing trend from 2017 to 2022 (P<0.05). The maternal childbearing age showed an increasing trend from 2013 to 2022 (P<0.05), the incidence of premature infants and low birth weight infants showed an increasing trend (both P<0.05). The incidence of premature infants and low birth weight infants increased with the rising childbearing age (both P<0.05). @*Conclusions@#The fertility level in Baoshan District was relatively low from 2013 to 2022. The proportion of second parity and above showed an upward trend followed by a downward trend. The incidence of premature infants and low birth weight infants increased with the rising childbearing age.

Influences of balance training on motor coordination in aerobics students / Influências do treinamento do equilíbrio na coordenação motora dos estudantes de aeróbica / Influencia del entrenamiento del equilibrio en la coordinación motora de estudiantes de aeróbic

ABSTRACT Introduction: The standardization of body movements is essential for aerobics gymnastic practitioners and motor coordination for the execution of consecutive movements of large amplitudes is strongly related to balance ability. Therefore, it is believed that balance training can positively impact motor coordination in aerobics students Objective: Explore the influences of balance training on motor coordination in aerobics students. Methods: 100 volunteers were selected as aerobics students, divided into an experimental and a control group for a 6-week experiment. The experimental group was given a balance training protocol, while the control group maintained the traditional teaching protocol. Data on functional exercises and fitness indices were collected before and after the experiment for comparison and analysis. Results: The difference in the exercise in the unipodal orthostatic position with eyes closed was 6.45, the difference in the balance test in the swallow position was 4.04, the difference in the later-forward Y balance exercise was 1.88, the later-posterior was 2.09, and posterior Y balance was 2.53. The difference between all items in the control group was small, especially the three items of frontal, lateral, posterior, and mid-posterior Y balance. Conclusion: Balance training positively affected the motor coordination of aerobics students, resulting in a statistically significant increase in all analyzed postural balance indexes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A padronização dos movimentos corporais é essencial para os praticantes de ginástica aeróbica e a coordenação motora para a execução de movimentos consecutivos de grandes amplitudes está fortemente relacionada à capacidade de equilíbrio. Acredita-se, por isso, que o treino de equilíbrio possa impactar positivamente a coordenação motora dos estudantes de aeróbica Objetivo: Explorar as influências do treinamento de equilíbrio na coordenação motora dos estudantes de aeróbica. Métodos: Foram selecionados 100 voluntários estudantes de aeróbica, divididos em grupo experimental e controle para um experimento de 6 semanas. Ao grupo experimental foi incrementado um protocolo de treinamento de equilíbrio, enquanto o grupo de controle manteve o protocolo de ensino tradicional. Os dados pertinentes aos exercícios funcionais e índices de aptidão física foram coletados antes e após o experimento para comparação e análise. Resultados: A diferença do exercício em posição ortostática unipodal de olhos fechados foi 6,45, a diferença no teste de equilíbrio em posição de andorinha foi 4,04, a diferença do exercício de equilíbrio latero-dianteiro em Y foi 1,88, latero-posterior foi 2,09, e posterior em Y foi 2,53. A diferença de todos os itens do grupo de controle foi pequena, especialmente os três itens de equilíbrio frontal, lateral, posterior e médio-posterior em Y. Conclusão: O treinamento de equilíbrio afetou positivamente a coordenação motora dos estudantes de aeróbica, resultando num incremento estatisticamente expressivo em todos os índices de balanço postural analisados. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La estandarización de los movimientos corporales es esencial para los practicantes de gimnastica aeróbic y la coordinación motora para la ejecución de movimientos consecutivos de gran amplitud está fuertemente relacionada con la capacidad de equilibrio. Por lo tanto, se cree que el entrenamiento del equilibrio puede influir positivamente en la coordinación motora de los estudiantes de aeróbic Objetivo: Explorar las influencias del entrenamiento del equilibrio en la coordinación motora de los estudiantes de aeróbic. Métodos: Se seleccionaron 100 voluntarios estudiantes de aeróbic, divididos en un grupo experimental y un grupo de control para un experimento de 6 semanas. Al grupo experimental se le incrementó un protocolo de entrenamiento del equilibrio, mientras que el grupo de control mantuvo el protocolo de enseñanza tradicional. Se recogieron datos relativos a ejercicios funcionales e índices de aptitud física antes y después del experimento para su comparación y análisis. Resultados: La diferencia en el ejercicio en posición ortostática unipodal con ojos cerrados fue de 6,45, la diferencia en la prueba de equilibrio en posición de deglución fue de 4,04, la diferencia en el ejercicio de equilibrio latero-direccional en Y fue de 1,88, latero-posterior fue de 2,09, y posterior en Y fue de 2,53. La diferencia de todos los ítems en el grupo de control fue pequeña, especialmente los tres ítems de equilibrio frontal, lateral, posterior y medio-posterior en Y. Conclusión: El entrenamiento en equilibrio afectó positivamente a la coordinación motora de los estudiantes de aeróbic, resultando en un incremento estadísticamente expresivo en todos los índices de equilibrio postural analizados. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Influences of pnf stretching on physical fitness in aerobic athletes / Influências do alongamento pnf na aptidão física em atletas de aeróbica / Influencias del estiramiento pnf sobre la aptitud física en atletas aeróbicos

ABSTRACT Introduction: The quality of flexibility greatly impacts the performance of aerobics athletes. It is believed that stretching by proprioceptive neuromuscular facilitation (PNF) can contribute to this aspect by maximizing active joint range motion. Objective: Explore the influences of PNF stretching on the physical fitness of aerobics athletes. Methods: 24 professional aerobics athletes were selected, and randomly distributed into two groups with no statistical discrepancies in physical indices. PNF stretching exercise was performed on aerobics athletes in the experimental group, while no training intervention was performed in the control group. Physical fitness was assessed before and after the nine weeks of the intervention. Results: After PNF stretching training, the lower limb vertical score in the experimental group was from 6.58±0.19 to 8.20±0.47, and the transverse pronation score changed from 5.95±0.35 to 7.09±0.61. The vertical score in the control group was from 6.44±59.89 to 6.83±0.37 after the experiment; the transverse pronation penetration score was from 5.78±0.37 to 6.58±0.33. Conclusion: PNF stretching can effectively improve athletes' physical fitness, both statically and dynamically, generating gains in range of motion and providing favorable conditioning for overall competitive performance. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A qualidade da flexibilidade tem um grande impacto sobre o desempenho dos atletas de aeróbica, e acredita-se que o alongamento por facilitação neuromuscular proprioceptiva (PNF) possa contribuir neste quesito com a maximização da amplitude de movimento articular ativa. Objetivo: Explorar as influências do alongamento PNF sobre a aptidão física dos atletas de aeróbica. Métodos: Foram selecionadas 24 atletas profissionais de aeróbica, aleatoriamente distribuídas em dois grupos sem discrepâncias estatísticas nos índices físicos. Foi realizado o exercício de alongamento PNF em atletas de aeróbica no grupo experimental, enquanto nenhuma intervenção de treinamento foi realizada no grupo de controle. A aptidão física foi avaliada antes e após as nove semanas da intervenção. Resultados: Após o treinamento de alongamento PNF, a pontuação de membros inferiores vertical no grupo experimental foi de 6,58±0,19 para 8,20±0,47, e a pontuação da pronação transversal mudou de 5,95±0,35 para 7,09±0,61. A pontuação vertical no grupo de controle foi de 6,44±59,89 para 6,83±0,37 depois do experimento; a pontuação da penetração transversal de pronação foi de 5,78±0,37 para 6,58±0,33. Conclusão: O alongamento PNF pode efetivamente melhorar a aptidão física das atletas, tanto estática quanto dinâmica, gerando ganhos à amplitude de movimento proporcionando um condicionamento favorável ao desempenho competitivo geral. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La calidad de la flexibilidad tiene un gran impacto en el rendimiento de los atletas de aeróbic, y se cree que el estiramiento por facilitación neuromuscular propioceptiva (PNF) puede contribuir en esta cuestión con la maximización de la amplitud articular activa de movimiento. Objetivo: Explorar las influencias del estiramiento PNF en la condición física de atletas de aeróbic. Métodos: Fueron seleccionados 24 atletas profesionales de aeróbic, distribuidos aleatoriamente en dos grupos sin discrepancias estadísticas en los índices físicos. Se realizaron ejercicios de estiramiento PNF en los atletas de aeróbic del grupo experimental, mientras que en el grupo de control no se realizó ninguna intervención de entrenamiento. Se evaluó la aptitud física antes y después de las nueve semanas de intervención. Resultados: Tras el entrenamiento de estiramiento PNF, la puntuación vertical de las extremidades inferiores en el grupo experimental fue de 6,58±0,19 a 8,20±0,47, y la puntuación de pronación transversal cambió de 5,95±0,35 a 7,09±0,61. La puntuación vertical en el grupo de control fue de 6,44±59,89 a 6,83±0,37 después del experimento; la puntuación de penetración de pronación transversal fue de 5,78±0,37 a 6,58±0,33. Conclusión: El estiramiento PNF puede mejorar eficazmente la condición física de los atletas, tanto estática como dinámica, generando ganancias en el rango de movimiento y proporcionando un acondicionamiento favorable para el rendimiento competitivo general. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Medication rule and mechanism of traditional Chinese medicine in treating metabolism-associated fatty liver disease based on bioinformatics technology / 数字中医药（英文）

@#[Objective[ To analyze the main syndrome types, medication rules, and core prescription characteristics of traditional Chinese medicine (TCM) in the treatment of metabolism-associated fatty liver disease (MAFLD), and to predict the anti-MAFLD mechanism of core formula, so as to provide references for the clinical application of TCM and the development of new drugs. [Methods] Literature research on TCM in treating MAFLD was retrieved from China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang Database since the establishment of the database to July 2022. Excel 2019 and Chinese Medicine Inheritance Computing Platform (V3.0) were used for frequency analysis, association rule analysis, and cluster analysis of effective prescriptions. The key components, targets, and action pathways of anti-MAFLD core formulas were predicted by network pharmacology. Finally, the interactions between the obtained core components and their core targets were verified reversely by molecular docking technology. [Results] A total of 218 articles were screened and selected, including 352 prescriptions, involving 270 traditional Chinese herbs. The drugs were used a total of 3 901 times, and a total of 10 915 cases were collected, among which the prevalence rate was higher in males. The main types of TCM syndrome included intermingled phlegm and blood stasis syndrome, liver depression and spleen deficiency syndrome, and damp-heat in liver and gallbladder syndrome, among which Shanzha (Crataegi Fructus), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Fuling (Poria), Zexie (Alismatis Rhizoma), Chaihu (Bupleuri Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma) were the most frequently used. The properties of Chinese medicine primarily encompassed thermal characteristics, with a predominant emphasis on cold and warm; the flavors of herbs were predominantly characterized by bitterness and sweetness, while the majority exhibited tropism towards the spleen and liver meridians. The drugs were primarily classified based on their efficacy in tonifying deficiencies, promoting diuresis and moistening, enhancing blood circulation and removing blood stasisheat-clearing, etc. The association rules were employed to derive a set of 20 core drug pairs, while cluster analysis was utilized to identify three distinct groups of core drug combinations. Network pharmacological showed that the main components of the core formula “Shanzha (Crataegi Fructus) - Danshen (Salviae Miltiorrhizae Radix et Rhizoma) - Zexie (Alismatis Rhizoma) - Chaihu (Bupleuri Radix) - Fuling (Poria)” in the treatment of MAFLD were quercetin, apigenin, puerarin, luteolin, ursolic acid, kaempferol, tanshinone IIA, emodin, paeonol, etc., which involved RAC-alpha serine/threonine-protein kinase 1 (AKT1), cellular tumor antigen p53 (TP53), interleukin (IL)-6, IL-1β, signal transducer and activator of transcription 3 (STAT3), epidermal growth factor receptor (EGFR), peroxisome proliferative activated receptor gamma (PPARG), and other key targets. The molecular docking results showed that the core components had good binding to lipid and atherosclerosis, and phosphatidylinositol 3 kinase (PI3K)/AKT signaling pathway-associated proteins. [Conclusion] The main principles of TCM for the treatment of MAFLD involve soothing the liver and strengthening the spleen, eliminating phlegm and dampness, clearing heat and dampness, as well as promoting blood circulation and removing blood stasis. The core formula may exert anti-MAFLD effects mediated through multiple components, targets, and signaling pathways. This study establishes a theoretical foundation for the clinical application of TCM in the treatment of MAFLD, and serves as a reference for further exploration of new drugs against MAFLD.

Analyzing the distribution characteristics of occupational pneumoconiosis in Sichuan Province, 2012-2021 / 中国职业医学

Objective: To analyze the distribution feature of occupational pneumoconiosis in Sichuan Province. Methods: The cases of newly diagnosed occupational pneumoconiosis from 2012 to 2021 in Sichuan Province were collected from the Occupational Diseases and Hazards Monitoring Information System under China Disease Prevention and Control Information System, and were analyzed retrospectively. Results: From 2012 to 2021, there were 30 136 newly diagnosed occupational pneumoconiosis cases in Sichuan Province. The average age of patients was 55.2 years and the median work age was 12.1 years. There were 6 471 cases (accounting for 21.5%) exposed to dust for less than 5.0 years. The number of the cases declined in newly diagnosed occupational pneumoconiosis and occupational pneumoconiosis with less than 5.0 years of dust exposure. The numbers of coal workers' pneumoconiosis and silicosis were 16 210 and 13 577, respectively (accounting for 98.9% of the total cases). The majority of pneumoconiosis cases were classified as stage Ⅰ(accounting for 67.1%). The cases from Leshan City, Bazhong City, Dazhou City, Yibin City, Guangyuan City and Luzhou City accounted for 68.8% of the total cases. The main types of work were coal miner and excavation worker, which accounted for 31.7% and 18.8%, respectively. The scale of enterprises was mostly small and micro, accounting for 35.1% of the cases, and the industry distribution was mostly coal mining and washing, accounting for 53.4% of the cases. Conclusion: In Sichuan Province, the number of cases shows an overall decline in both newly diagnosed occupational pneumoconiosis and occupational pneumoconiosis with less than 5.0 years of dust exposure, with a relatively short duration of occupational exposure. The key cities for pneumoconiosis prevention and control are Leshan City, Bazhong City, and Dazhou City, while the key industry is coal mining and washing.

Mechanism for regulation of trophoblast invasion through piR-3127964 via PIWIL-3/sialophorin pathway / 中华围产医学杂志

Objective:To investigate the molecular mechanism for regulation of trophoblast invasion by piR-3127964, which is differentially expressed in placental tissues of preeclamptic and healthy pregnant women.Methods:Placenta samples of healthy (control group, n=12) and preeclamptic pregnant (PE group, n=10) women who delivered by caesarean section and chorionic villi specimens of patients undergoing artificial abortion were collected in the Department of Obstetrics of the First Affiliated Hospital of Chongqing Medical University during November 2020 to August 2021. Total RNA was extracted from placenta samples and sequenced and the expression of piR-3127964 in different tissues was determined by real-time quantitative-polymerase chain reaction (qRT-PCR). The expressions of PIWI proteins including PIWIL-1, PIWIL-2 and PIWIL-3 in different tissues were detected by Western blot. The expressions of two candidate targets, guanine nucleotide-binding protein-like 3-like (GNL3L) mRNA and sialophorin (SPN) mRNA were evaluated by qRT-PCR after exogenous treating HTR-8/SVneo cells with mimics, inhibitor or negative control of piR-3127964, respectively. qRT-PCR was also used to detect the relative expression of GNL3L and SPN at mRNA level in placentas of all women. The interactions between GNL3L/SPN and piR-3127964 were analyzed by double luciferase reporter gene detection. The localization of piR-3127964 and SPN in chorionic villi was detected by fluorescence in situ hybridization and immunofluorescence. Transwell assay was performed to analyze the influence of piR-3127964 on the invasion of HTR-8/SVneo cells and the possible mechanism. Independent sample t-test, analysis of variance, and LSD post test were used for analysis Results:(1) Enrichment pathways of candidate targets predicted by differentially expressed piR-3127964 were associated with cell motility. There were statistically significant differences in piR-3127964 expression in villi, healthy and preeclamptic placentas (2.950±0.853 vs 1.036±0.303 vs 0.254±0.155, F=27.35, P<0.05), and piR-3127964 was predominantly expressed in extravillous cytotrophoblasts (EVTs). (2) The expression of PIWIL-3 protein in placentas of preeclamptic patients was significantly lower than that in healthy placentas and villi (0.810±0.400 vs 3.175±0.429 and 6.843±1.379, F=49.36, P<0.05). (3) Compared with the control group, exogenous piR-3127964 mimics (piR-mimics) and inhibitors (piR-inhibitor) significantly affected the expression of SPN mRNA (0.971±0.045 vs 0.732±0.010, F=6.50; 1.076±0.073 vs 1.293±0.092, F=7.58; both P<0.05), while the expression of GNL3L mRNA had no significant correlation with piR-3127964 level. (4) The luciferase activity of wild-type SPN (SPN-WT) plasmids was significantly affected by piR-mimics (1.010±0.049 vs 0.645±0.047, t=9.34, P<0.05) and piR-inhibitor (1.035±0.058 vs 1.397±0.015, t=－10.60, P<0.05). (5) SPN mRNA was significantly upregulated in placentas of preeclamptic patients than in healthy placentas (2.097±0.239 vs 1.305±0.290, t=－4.22, P<0.05), but no significant difference in the expression of GNL3L mRNA was observed. Immunofluorescence experiment showed that SPN was expressed in EVTs. (6) The invasive potential of HTR8/SVneo cells treated with piR-inhibitor was significantly inhibited, but this effect could be reversed by SPN knockdown (160.714±53.860 vs 371.667±103.061 and 344.333±120.267, F=9.76, both P<0.05). Conclusions:piR-3127964 expression is abnormally downregulated in placentas of preeclamptic patients, resulting in inhibition of trophoblasts invasion through upregulation of SPN expression, which may be related to the pathogenesis of preeclampsia.

Influence of high myopia during pregnancy on obstetric management and its research progress / 中华围产医学杂志

Structure of maternal retina and choroid would change reversibly with the changes in metabolism, hormone levels, and the hemodynamic state during pregnancy. However, high myopia could further aggravate the impact on the ocular lesions of pregnant women. This article describes the clinical characteristics of pregnant women with high myopia, summarizes the potential risk factors affecting adverse outcomes of high myopia during pregnancy, and reviews the current comprehensive obstetric and ophthalmic management strategies to guide the clinical practice.

Hematological phenotype analysis of fetuses and patients with hemoglobin H disease / 中华地方病学杂志

Objective:To analyze the relationship between hematological and genotype characteristics of fetuses and patients with hemoglobin (Hb) H disease and their natural disease progression.Methods:From 2010 to 2022, a total of 1 252 blood samples from fetuses and patients with Hb H disease who visited the Guangxi Zhuang Autonomous Regional Maternal and Child Health Hospital were collected (including 174 umbilical cord blood samples, 1 062 peripheral blood samples from patients over 2 years old, and 16 peripheral blood samples from patients with rare cases of genotype Hb H). Additionally, 278 peripheral blood samples were collected from patients aged 0 - 2 years old with Hb H 3.7, Hb H 4.2, Hb H CS, and Hb H WS disease for the study of trends in red blood cell development. Multiple probe hybridization and microarray comparative genomic hybridization technology combined with first-generation Sanger sequencing were used for rare mutation detection.Results:Among the 1 062 Hb H disease patients over 2 years old, 62.34% (662/1 062) had gene deletion (--/-α), of which Hb H 3.7 (-- SEA/-α 3.7) and Hb H 4.2 (-- SEA/-α 4.2) were the most common, accounting for 42.28% (449/1 062) and 19.11% (203/1 062) of the total, respectively. Among the non-deletion genotypes (--/αα T or α Tα/αα T), Hb H CS (-- SEA/α CS), Hb H WS (-- SEA/α WS) and α CSα/α CSα accounted for 16.85% (179/1 062), 16.48% (175/1 062) and 1.98% (21/1 062), respectively. The 81.12% (537/662) of patients with deletional Hb H disease showed mild to moderate anemia, with Hb H detection rates ranging from 75% to 80%. Among non-deletional Hb H disease, Hb H WS disease showed the mild (blood Hb concentration > 95 g/L in 90% of patients) phenotype while Hb H CS and Hb H QS (-- SEA/αα QS) patients had moderate to severe anemia, with Hb H detected in peripheral blood at higher levels than in other types of Hb H disease patients. Except for Hb H CS and Hb H QS, which did not show a significant increase in Hb A2 levels when complicated with β-thalassemia, Hb A2 levels were increased (> 3.5%) in all other types of Hb H disease patients. When Hb H disease was complicated with β-thalassemia, Hb H peaks were not detected in either type of Hb H disease. The results of red blood cell development trend detection showed that erythrocyte counts were elevated in patients with Hb H disease compared to their normal counterparts; whereas, blood Hb, mean erythrocyte volume (MCV) and mean erythrocyte hemoglobin content (MCH) were lower than in their normal counterparts ( P < 0.05) and decreased to the minimum at 6 months to 1 year of age. Patients with Hb H CS disease, as the most severe form of anemia, had the highest MCV values ( P < 0.001). The results of fetal cord blood with Hb H disease showed that α CSα/α CSα caused severe intrauterine anemia, followed by Hb H QS and Hb H CS. The content of Hb Bart's in umbilical cord blood was negatively correlated with the severity of anemia ( rs = - 0.58, P < 0.001). When Hb H disease was complicated with β-thalassemia, there was no significant improvement in fetal anemia, and the Hb Bart's content did not change significantly ( P > 0.05). In addition, Hb H 21.9 (-α 21.9kb/-- SEA) and Hb H 2.4 (-α 2.4/-- SEA) were common in patients with deletion rare Hb H. In patients with non-deletion rare Hb H, αα Amsterdam-A1/-- SEA and αα Hb G-Georgia/-- SEA were both first reported. Conclusions:There is heterogeneity in clinical manifestations of patients with different types of Hb H disease or same type of Hb H disease at different developmental stages. When patients with Hb H are complicated with β-thalassemia, the phenotype of patients with the deletion type is improved, while that of patients with the non-deletion type is not. Compared to normal individuals, patients with Hb H disease have lower blood Hb concentration, MCV and MCH, and more rapid physiological changes in red blood cells.

Analysis of practice effect of teaching reform in the course of nursing education based on Rain Classroom / 中华医学教育探索杂志

Objective:To investigate the application effect of blended teaching mode based on Rain Classroom in the course of nursing education.Methods:The nursing teaching class in 2019 was set as the observation group ( n=20), which adopted blended teaching mode combining classroom teaching and online learning of Rain Classroom platform. The teaching class with the same number of students in the same period in 2018 was set as the control group ( n=20), which implemented the traditional classroom teaching mode. SPSS 22.0 was used for statistical processing, and independent-samples t-test was used to analyze the results of seminar, simulated teaching and final theoretical examination of the two classes of students and the evaluation of the teaching effect of the course. Results:There was no significant difference between the two groups in the results of simulated teaching ( t=0.21, P = 0.834). The scores of seminar [(91.18±1.20), t=3.09, P<0.05] and final theoretical examination [(78.63±6.28), t=3.33, P<0.05] in the observation group were significantly higher than those in the control group. The scores of information retrieval and processing ability ( t=-3.33, P < 0.05), problem finding ability ( t=-2.17, P < 0.05), independent thinking ability ( t=-2.53, P < 0.05), knowledge integration ability ( t=-3.86, P < 0.001), self-learning ability ( t=-3.12, P<0.05), the sense of identity to the role of nursing teachers ( t=-2.53, P < 0.05), the awareness of active learning ( t=-3.13, P < 0.05) and the attitude of lifelong learning ( t=-4.46, P < 0.001) in the experimental group were higher than those in the control group. Conclusion:The blended teaching based on Rain Classroom is conducive to the cultivation of students' inquiry learning ability and deep learning of theoretical knowledge, and promotes the effective achievement of curriculum teaching objectives.

Radiofrequency ablation for infants with incessant ventricular tachycardia and heart failure / 中国小儿急救医学

Objective:To investigate the effect of radiofrequency ablation on infants with incessant ventricular tachycardia(IIVT) and heart failure.Methods:Twenty-eight infants with IIVT combined with heart failure admitted to Beijing Children′s Hospital of Capital Medical University from January 2006 to December 2021 were selected, including 16 boys and 12 girls; 26 cases were treated with radiofrequency ablation.The characteristics of IIVT and heart failure and the results of radiofrequency ablation were analyzed.Results:The average age of the first diagnosis of 28 infants was 13.9 months old, and all of them had heart failure.Eleven infants had cardiogenic shock, three infants had cardiogenic syncope, two infants had respiratory failure for respiratory support, and one infant died.Color Doppler echocardiography showed that the left ventricular diameter increased and/or left ventricular systolic function decreased.Anti-heart failure treatment was effective in 27 cases(96.4%), electrical cardioversion in five cases, effective in three cases, and anti-arrhythmic drugs were effective in 17 cases(60.7%). Twenty-six cases(92.9%, 26/28) were treated with radiofrequency ablation, with immediate success in 23 cases(88.5%, 23/26) and effective in three cases(11.5%, 3/26). During the follow-up period for 3 to 36 months, cardiac function returned to normal in 25 cases(96.2%, 25/26) and recurred in three cases(11.5%, 3/26 cases), which were cured after radiofrequency ablation again.Temporary complications of atrioventricular block occurred in one case(3.8%, 1/26). In 26 cases of surgical children, 15 cases were measured by X-ray two-dimensional mapping and 11 cases were measured by three-dimensional mapping.The cumulative X-ray exposure was 87.0(51.5, 151.5) mGy and 1.2(0, 15.9) mGy, respectively, and the dose area product was 39.8(19.2, 427.8) μGy/m 2 and 2.8(0, 44.3) μGy/m 2.The cumulative X ray exposure and the dose area product were significantly reduced under the three-dimensional mapping method( P<0.001). Conclusion:The infants with IIVT combined with heart failure are prone to serious complications, and the effects of cardioversion and anti-arrhythmic drugs are limited.Radiofrequency ablation should be performed as soon as possible after heart failure is controlled.The application of three-dimensional mapping technology in surgery can significantly reduce ionizing radiation.

Advance in the immunodeficiency-centromeric instability-facial anomalies syndrome / 中华实用儿科临床杂志

The immunodeficiency-centromeric instability-facial anomalies (ICF) syndrome is the only known human genetic disease involving DNA methylation defects.About 50% of the cases are caused by the compound heterozygous mutation of DNMT3B gene.About a hundred cases were reported in the world, but only a few cases came from China.There may be a misdiagnosis and missed diagnosis.To the best of our knowledge, no Chinese article systematically discusses the ICF syndrome.This paper aims to review the possible mechanisms, clinical manifestations, genetic characteristics, treatment, and prognosis of the ICF syndrome, and to improve Chinese doctors′ knowledge about this disease.

Analysis of high risk factors for chromosomal aberrations in peripheral blood lymphocytes of 200 radiation workers in Hainan Province / 上海预防医学

ObjectiveTo investigate the current status and high-risk factors of chromosomal aberrations in peripheral blood lymphocytes （PBL） of radiation workers in Hainan Province. MethodsA total of 200 radiological workers who underwent occupational health examination in Hainan Provincial Hospital of Traditional Chinese Medicine from January 2021 to December 2021 were selected to collect the occupational health examination data and the rate of PBL chromosomal aberrations. The influencing factors of PBL chromosomal aberrations were analyzed by logistic regression model. The predictive value of logistic regression prediction model on PBL chromosomal aberrations were determined by using the reciver operator characteristic （ROC） curve. ResultsA total of 20 000 cells （100 cells/person） were tested. The chromosomal aberration rate was 0.37% （74/20 000） and the PBL chromosomal aberration rate in the subjects was 6.00% （12/200）. Univariate analysis showed that PBL chromosomal aberrations in radiological workers were related to age， length of service， type of work and education （all P<0.05）， but not to gender （P>0.05）. The logistic regression prediction model was constructed based on the influencing factors， with χ2=9.413， df=9， P=0.852， suggesting a good model fit. The logistic regression prediction model predicted the area under the curve （AUC） for the occurrence of PBL chromosomal aberrations in radiation workers was 0.914 （95%CI： 0.866‒0.949）， with a cut-off value of 3.05， corresponding to a prediction sensitivity and specificity of 100.00% and 75.98%， respectively. ConclusionThe incidence of PBL chromosomal aberrations in radiological workers in Hainan Province was 6.00%， with age， working age and job type as high-risk factors and education level as a protective factor. The prediction model constructed by the above factors can provide a reliable basis for clinical prediction of PBL chromosomal aberrations in radiological workers.

Treatment strategies for periodontitis patients with systemic disease / 华西口腔医学杂志

Periodontitis is a chronic inflammatory disease that destroys the integrity of tooth-supporting tissue. Periodontitis is listed as a major oral disease by the World Health Organization and is a public-health problem affecting global oral and systemic health. The fourth national oral health epidemiological survey has revealed that periodontitis is one of the most common oral problems in China. With the development of science and medicine, increased attention is being paid to the importance of oral health and its influence on general health. Accordingly, stomatologists are required to master more relevant information on clinical diagnosis and treatment, as well as to pay more attention to the diagnosis and treatment methods of patients with different systemic diseases. This article expounds the diagnosis and treatment strategy of patients with systemic disease periodontitis. We aimed to help stomatologists make more reasonable diagnosis and treatment decisions.

Peptide P3 ameliorates foam cell formation in RAW264.7 cells and its molecular mechanisms / 中国药理学通报

Aim To examine the effect of peptide P3 on lipid accumulation in RAW264.7 cells and the underlying molecular mechanism. Methods MTT method was used to screen the concentration of peptide P3 and oxidized low density lipoprotein(ox-LDL),and RAW.264.7 cells were induced to form foam cells by ox-LDL with 80 mg·L

Clinical and imaging features of acute encephalopathy with biphasic seizures and late reduced diffusion in children / 中华儿科杂志

Objective: To explore the clinical and imaging features of acute encephalopathy with biphasic seizures and late reduced diffusion(AESD) in children. Methods: For the case series study, 21 children with AESD from Peking University First Hospital, Provincial Children's Hospital Affiliated to Anhui Medical University, Children's Hospital of Fudan University, and Shanxi Children's Hospital who were diagnosed and treated from October 2021 to July 2023 were selected. Clinical data were collected to summarize their clinical information, imaging, and laboratory tests, as well as treatment and prognostic characteristics. Descriptive statistical analysis was applicated. Results: Of the 21 cases with AESD, 11 were males and 10 were females, with the age of onset of 2 years and 6 months (1 year and 7 months, 3 years and 6 months). Of the 21 cases, 18 were typical cases with biphasic seizures. All typical cases had early seizures within 24 hours before or after fever onset. Among them, 16 cases had generalized seizures, 2 cases had focal seizures, and 7 cases reached the status epilepticus. Of the 21 cases, 3 atypical cases had late seizures in biphasic only. The late seizures in the 21 cases occurred on days 3 to 9. The types of late seizures included focal seizures in 12 cases, generalized seizures in 6 cases, and both focal and generalized seizures in 3 cases. Diffusion-weighted imaging (DWI) test on days 3 to 11 showed reduced diffusion of subcortical white matter which was named "bright tree sign" in all cases. The diffuse cerebral atrophy predominantly presented in the front-parietal-temporal lobes was found in 19 cases between day 12 and 3 months after the onset of the disease. Among 21 cases, 20 had been misdiagnosed as autoimmune encephalitis, central nervous system infection, febrile convulsions, posterior reversible encephalopathy syndrome, acute disseminated encephalomyelitis, and hemiconvulsion-hemiplegia-epilepsy syndrome. All the cases received high-dose gammaglobulin and methylprednisolone pulse therapy with poor therapeutic effect. By July 2023, 18 cases were under follow-up. Among them, 17 cases were left with varying degrees of neurologic sequelae, including 11 cases with post-encephalopathic epilepsy; 1 recovered completely. Conclusions: AESD is characterized by biphasic seizures clinically and "bright tree sign" on DWI images. Symptomatic and supportive treatments are recommended. The immunotherapy is ineffective. The prognosis of AESD is poor, with a high incidence of neurological sequelae and a low mortality.

Analysis of the clinical features and the risk factors of severe human metapneu movirus-associated community acquired pneumonia in children / 中华儿科杂志

Objective: To investigate the clinical characteristics and the risk factors of severe human metapneumovirus (hMPV)-associated community acquired pneumonia (CAP) in children. Methods: A retrospective case summary was conducted. From December 2020 to March 2022, 721 children who were diagnosed with CAP and tested positive for hMPV nucleic acid by PCR-capillary electrophoresis fragment analysis of nasopharyngeal secretions at the Yuying Children's Hospital, the Second Affiliated Hospital of Wenzhou Medical University were selected as the research objects. The clinical characteristics, epidemiological characteristics and mixed pathogens of the two groups were analyzed. According to CAP diagnostic criteria, the children were divided into the severe group and the mild group. Chi-square test or Mann-Whitney rank and contrast analysis was used for comparison between groups, while multivariate Logistic regression was applied to analyze the risk factors of the severe hMPV-associated CAP. Results: A total of 721 children who were diagnosed with hMPV-associated CAP were included in this study, with 397 males and 324 females. There were 154 cases in the severe group. The age of onset was 1.0 (0.9, 3.0) years, <3 years old 104 cases (67.5%), and the length of hospital stay was 7 (6, 9) days. In the severe group, 67 children (43.5%) were complicated with underlying diseases. In the severe group, 154 cases (100.0%) had cough, 148 cases (96.1%) had shortness of breath and pulmonary moist rales, and 132 cases (85.7%) had fever, 23 cases (14.9%) were complicated with respiratory failure. C-reactive protein (CRP) was elevated in 86 children (55.8%), including CRP≥50 mg/L in 33 children (21.4%). Co-infection was detected in 77 cases (50.0%) and 102 strains of pathogen were detected, 25 strains of rhinovirus, 17 strains of Mycoplasma pneumoniae, 15 strains of Streptococcus pneumoniae, 12 strains of Haemophilus influenzae and 10 strains of respiratory syncytial virus were detected. Six cases (3.9%) received heated and humidified high flow nasal cannula oxygen therapy, 15 cases (9.7%) were admitted to intensive care unit, and 2 cases (1.3%) received mechanical ventilation. In the severe group, 108 children were cured, 42 children were improved, 4 chlidren were discharged automatically without recovery and no death occurred. There were 567 cases in the mild group. The age of onset was 2.7 (1.0, 4.0) years, and the length of hospital stay was 4 (4, 6) days.Compared with the mild group, the proportion of children who age of disease onset <6 months, CRP≥50 mg/L, the proportions of preterm birth, congenital heart disease, malnutrition, congenital airway malformation, neuromuscular disease, mixed respiratory syncytial viruses infection were higher (20 cases (13.0%) vs. 31 cases (5.5%), 32 cases (20.8%) vs. 64 cases (11.3%), 23 cases (14.9%) vs. 44 cases (7.8%), 11 cases (7.1%) vs. 18 cases (3.2%), 9 cases (5.8%) vs. 6 cases (1.1%), 11 cases (7.1%) vs. 12 cases (2.1%), 8 cases (5.2%) vs. 4 cases (0.7%), 10 cases (6.5%) vs. 13 cases (2.3%), χ2=0.42, 9.45, 7.40, 4.94, 11.40, 8.35, 3.52, 6.92, all P<0.05). Multivariate Logistic regression analysis showed that age<6 months (OR=2.51, 95%CI 1.29-4.89), CRP≥50 mg/L (OR=2.20, 95%CI 1.36-3.57), prematurity (OR=2.19, 95%CI 1.26-3.81), malnutrition (OR=6.05, 95%CI 1.89-19.39) were the independent risk factors for severe hMPV-associated CAP. Conclusions: Severe hMPV-associated CAP is most likely to occur in infants under 3 years old and has a higher proportion of underlying diseases and co-infection. The main clinical manifestations are cough, shortness of breath and pulmonary moist rales, fever. The overall prognosis is good. Age<6 months, CRP≥50 mg/L, preterm birth, malnutrition are the independent risk factors for severe hMPV-associated CAP.

Monte Carlo design and preliminary test of X-ray protective rubber / 中国辐射卫生

@#<b>Objective</b> To complete the Monte Carlo design and preliminary test of X-ray protective rubber. <b>Methods</b> According to the characteristics of X-ray energy spectrum for interventional therapy, the shielding effects of lead rubber, tungsten and bismuth composite rubber, and gadolinium and bismuth composite rubber samples were calculated by Monte Carlo simulation. The variation law of lead equivalent of lead-free rubber and lead rubber with X-ray peak tube voltage was obtained through actual measurement. <b>Results</b> Within the peak tube voltage range of 60-110 kV, lead-free rubber effectively replaced lead rubber. <b>Conclusion</b> The shielding and attenuation effect of the existing lead-free protective rubber on low-energy stray X-rays is better than that of lead rubber. Considering the inherent defects of lead rubber, flexible X-ray protective materials with thermoplastic elastomer as filler will have broad development prospects.

Flavonoid-Rich Extract of Oldenlandia diffusa (Willd.) Roxb. Inhibits Gastric Cancer by Activation of Caspase-Dependent Mitochondrial Apoptosis / 中国结合医学杂志

OBJECTIVE@#To evaluate the apoptosis and cycle arrest effects of Oldenlandia diffusa flavonoids on human gastric cancer cells, determine the action mechanisms in association with the mitochondrial dependent signal transduction pathway that controls production of reactive oxygen species (ROS), and evaluate the pharmacodynamics of a mouse xenotransplantation model to provide a reference for the use of flavonoids in prevention and treatment of gastric cancer.@*METHODS@#Flavonoids were extracted by an enzymatic-ultrasonic assisted method and purified with D-101 resin. Bioactive components were characterized by high-performance liquid chromatography. Cell lines MKN-45, AGS, and GES-1 were treated with different concentrations of flavonoids (64, 96, 128, 160 µg/mL). The effect of flavonoids on cell viability was evaluated by MTT method, and cell nuclear morphology was observed by Hoechst staining. The apoptosis rate and cell cycle phases were measured by flow cytometry, the production of ROS was detected by laser confocal microscope, the mitochondrial membrane potential (MMP) were observed by fluorescence microscope, and the expression of apoptotic proteins related to activation of mitochondrial pathway were measured by immunoblotting. MKN-45 cells were transplanted into BALB/c nude mice to establish a xenograft tumor model. Hematoxylin and eosin staining was used to reveal the subcutaneous tumor tissue. The tumor volume and tumor weight were measured, the expression levels of proliferation markers proliferating cell nuclear antigen (PCNA) and Ki-67 were detected by immunohistochemistry, and the expression levels of CA72-4 were measured by enzyme linked immunosorbent assay.@*RESULTS@#Oldenlandia diffusa flavonoids inhibited proliferation of MKN-45 and AGS human gastric cancer cells, arrested the cell cycle in G1/S phase, induced accumulation of ROS in the process of apoptosis, and altered MMP. In addition, flavonoids increased Apaf-1, Cleaved-Caspase-3, and Bax, and decreased Cyclin A, Cdk2, Bcl-2, Pro-Caspase-9, and Mitochondrial Cytochrome C (P<0.05). The MKN-45 cell mouse xenotransplantation model further clarified the growth inhibitory effect of flavonoids towards tumors. The expression levels of PCNA and Ki-67 decreased in each flavonoid dose group, the expression level of CA72-4 decreased (P<0.05).@*CONCLUSION@#Flavonoids derived from Oldenlandia diffusa can inhibit proliferation and induce apoptosis of human gastric cancer cells by activating the mitochondrial controlled signal transduction pathway.

Research on the Application of Electromagnetic Navigation Technology in Surgical Robots / 中国医疗器械杂志

Due to the need to achieve precise operations during surgery, in order to prevent hand tremors and poor surgical field of view, more and more surgical robots are used in surgical operations combined with navigation technology to meet the requirements for surgical accuracy. Open surgery such as orthopaedics, joint replacement and neurosurgery on the market generally use optical navigation systems to guide robots to achieve precise positioning, but optical navigation systems cannot be used for operations in areas with small surgical space. Therefore, a robotic surgical system based on electromagnetic navigation technology that can be applied to the craniofacial area was proposed. By using this robot, the problems of difficult operation and low precision caused by the narrow craniofacial space can be solved. Key techniques and considerations are studied. The function of the developed prototype is verified through model tests. The test results show that the surgical robot under the electromagnetic navigation technology can achieve precise surgical operations improve the success rate of the doctor's surgery and reduce postoperative complications.