Clinical study of electroacupuncture combined with exercise therapy in improving the balance function of patients with knee osteoarthritis / 针灸推拿医学（英文版）

Objective:To observe the clinical effect of electroacupuncture(EA)combined with exercise therapy on balance function in patients with knee osteoarthritis(KOA). Methods:Seventy patients with KOA were randomly divided into a treatment group and a control group,with 35 cases in each group.The treatment group was treated with EA combined with exercise therapy.EA was applied to Dubi(ST35),Neixiyan(EX-LE4),Xuehai(SP10),Liangqiu(ST34),Yanglingquan(GB34),and Zusanli(ST 36).Exercise therapy(muscle strength training and knee mobility training)was applied after EA.The control group only received the same exercise therapy as the treatment group.The two groups were treated with the same course of treatment,3 times a week for 4 consecutive weeks,12 times in total,and followed up for 1 month.The Pro-Kin254P balance test system was used to measure the balance function parameters at 4 time points,including before treatment,after 1 session of treatment,after 12 sessions of treatment,and at 1-month follow-up after treatment.The visual analog scale(VAS)and the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)scores were recorded. Results:The markedly effective rate and total effective rate in the treatment group were higher than those in the control group(P<0.01).The Romberg area,Romberg length,and VAS scores of the two groups decreased significantly after 1 session of treatment,12 sessions of treatment,and 1 month after treatment,and the differences between different time points in the same group were statistically significant(P<0.01).There were significant differences between the two groups at the same time point(P<0.05).The total WOMAC scores of the two groups after 1 session of treatment,12 sessions of treatment,and 1 month after treatment decreased significantly,and there were significant differences between different time points in the same group(P<0.05),but there was no significant difference between the two groups at the same time point(P>0.05). Conclusion:EA combined with exercise therapy or exercise therapy alone can enhance the balance function,relieve joint pain,and improve joint function in patients with KOA.EA combined with exercise therapy is superior to exercise therapy alone in improving balance function and pain,but the two treatment protocols have similar effects in improving joint function.

Anti-tumor Activity of Chinese Medicine Based on EGFR Signaling Pathway： A Review / 中国实验方剂学杂志

In China， malignant tumors have become the main cause of death. In the past half century， the incidence and mortality of malignant tumors have been on the rise， posing a threat to health of patients， and the burden of cancer has been increasing. At the moment， malignant tumors are mainly treated by surgery， radiotherapy， and cytotoxic drugs， which， however， have limitations and induce great adverse reactions. As biological technology and the research on tumor microenvironment， immunology， cell biology， and molecular biology advance， high-efficiency low-toxicity targeted therapy has attracted wide attention in the treatment of tumors. Epidermal growth factor receptor （EGFR） plays an important role in many cellular processes such as cell proliferation， survival， differentiation， migration， inflammation， and stromal homeostasis. EGFR promotes tumor growth， proliferation， and metastasis in a variety of ways. Chinese medicine has unique efficacy in the comprehensive treatment of malignant tumors. Through multiple components， multiple targets， and multiple pathways， it enhances the efficacy， reduces toxicity， prolongs life， and improves life quality in the treatment of tumors. Many Chinese medicines and their active components exert anti-tumor effect by inhibiting the EGFR signal transduction pathway. Through targeted inhibition of EGFR， Chinese medicine can promote the apoptosis and autophagy of tumor cells， suppress the proliferation and metastasis of tumor cells， and delay the progression of tumors. Thus， EGFR is a potential target for suppressing tumor. This paper summarizes the relationship between EGFR signal transduction pathway and tumor occurrence and development and analyzes the anti-tumor action mode and possible mechanisms of Chinese medicine and the active components by regulating EGFR signaling pathway， which is expected to provide a reference for clinical practice.

Application of entropy weight TOPSIS comprehensive method in the evaluation of students' physical health level / 中华预防医学杂志

Objective: To comprehensively evaluate the physical health level of students of different school-age segments in four regions of Anhui province using the entropy weight approximation ideal solution ranking method (TOPSIS), and to provide a scientific method and basis for conducting school health work evaluation. Methods: Using the physical fitness survey data of four regions in Anhui province, the entropy weight method was used to draw the weights of various indicators for different school-age segments of men and women. Then, the TOPSIS method was used to evaluate the school-age segments of men and women in the four regions. Finally, the physical health level of students in four regions was classified according to the results of entropy weight TOPSIS and the rank sum ratio method. Results: A total of 10 127 students were included in this study, with an average age of (11.85±3.82) years, including 5 050 males (49.8%) and 5 072 urban students (50.1%). The results of the entropy weight method showed that the weight of body mass index of boys was similar to that of girls in each school-age segment. According to the TOPSIS and rank sum ratio analysis, the physical health level of students in the four regions of Anhui province was different. The physical health score of Suzhou was 0.617 4 points, which was classified as the best grade. The scores of Hefei and Wuhu were 0.556 3 and 0.411 2, which were classified as middle. Jiju City scored 0.381 9 points, which was classified as poor. Conclusion: TOPSIS combined with rank sum ratio can reflect the level of students' physical health, which can be applied to the evaluation of students' physical health and provide a basis for monitoring students' physical health .

Establishment of a Patient-Derived T-Cell Acute Lymphoblastic Leukemia Xenograft Model in Novel Immunodeficient NCG Mice / 中国实验血液学杂志

OBJECTIVE@#The leukemia cells from patients with T-cell acute lymphoblastic leukemia (T-ALL) were inoculated into NCG mice to establish a stable human T-ALL leukemia animal model.@*METHODS@#Leukemia cells from bone marrow of newly diagnosed T-ALL patients were isolated, and the leukemia cells were inoculated into NCG mice via tail vein. The proportion of hCD45 positive cells in peripheral blood of the mice was detected regularly by flow cytometry, and the infiltration of leukemia cells in bone marrow, liver, spleen and other organs of the mice was detected by pathology and immunohistochemistry. After the first generation mice model was successfully established, the spleen cells from the first generation mice were inoculated into the second generation mice, and after the second generation mice model was successfully established, the spleen cells from the second generation mice were further inoculated into the third generation mice, and the growth of leukemia cells in peripheral blood of the mice in each group was monitored by regular flow cytometry to evaluate the stability of this T-ALL leukemia animal model.@*RESULTS@#On the 10th day after inoculation, hCD45+ leukemia cells could be successfully detected in the peripheral blood of the first generation mice, and the proportion of these cells was gradually increased. On average, the mice appeared listless 6 or 7 weeks after inoculation, and a large number of T lymphocyte leukemia cells were found in the peripheral blood and bone marrow smear of the mice. The spleen of the mice was obviously enlarged, and immunohistochemical examination showed that hCD3+ leukemia cells infiltrated into bone marrow, liver and spleen extensively. The second and third generation mice could stably develop leukemia, and the average survival time was 4-5 weeks.@*CONCLUSION@#Inoculating leukemia cells from bone marrow of patients with T-ALL into NCG mice via tail vein can successfully construct a patient-derived tumor xenografts (PDTX) model.

Inhibitory Effect of Cinobufotalin on Macrophage Inflammatory Factor Storm and Its Mechanism / 中国实验血液学杂志

OBJECTIVE@#To investigate the inflammatory effects of Cinobufotalin on monocytes in resting state and macrophages in activated state and its molecular mechanism.@*METHODS@#THP-1 cells were stimulated with Phorbol 12-myristate 13-acetate to induce differentiation into macrophages. Lipopolysaccharides was added to activate macrophages in order to establish macrophage activation model. Cinobufotalin was added to the inflammatory cell model for 24 h as a treatment. CCK-8 was used to detect cell proliferation, Annexin V /PI double staining flow cytometry was used to detect cell apoptosis, flow cytometry was used to detect macrophage activation, and cytometric bead array was used to detect cytokines. Transcriptome sequencing was used to explore the gene expression profile regulated by Cinobufotalin. Changes in the significantly regulated molecules were verified by real-time quantitative polymerase chain reaction and Western blot.@*RESULTS@#1∶25 concentration of Cinobufotalin significantly inhibited the proliferation of resting monocytes(P<0.01), and induced apoptosis(P<0.01), especially the activated macrophages(P<0.001, P<0.001). Cinobufotalin significantly inhibited the activation of macrophages, and significantly down-regulated the inflammatory cytokines(IL-6, TNF-α, IL-1β, IL-8) released by activated macrophages(P＜0.001). Its mechanism was achieved by inhibiting TLR4/MYD88/P-IκBa signaling pathway.@*CONCLUSION@#Cinobufotalin can inhibit the inflammatory factors produced by the over-activation of macrophages through TLR4/MYD88/P-IκBa pathway, which is expected to be applied to the treatment and research of diseases related to the over-release of inflammatory factors.

ZHUANG Li-xing's experience in treatment of dyskinesia of Parkinson's disease with acupuncture at triple-acupoint prescription / 中国针灸

The paper introduces professor ZHUANG Li-xing's clinical experience in treatment of dyskinesia of Parkinson's disease with acupuncture at triple-acupoint prescription. In pathogenesis, dyskinesia of Parkinson's disease refers to yang deficiency and disturbing wind. In treatment, acupuncture focuses on warming yang, promoting the circulation of the governor vessel, regulating the spirit and stopping trembling; and Baihui (GV 20), Suliao (GV 25) and Dingchanxue (Extra) are selected to be "trembling relief needling". In combination with Jin's three needling, named "three-trembling needling" "three-governor-vessel needling" and "three-spasm needling", the triple-acupoint prescription is composed. To ensure the favorable therapeutic effect, this prescription is modified according to the symptoms and the specific techniques of acupuncture are combined such as conducting qi, harmonizing yin and yang, and manipulating gently for reinforcing and reducing.

Impact of Xingnao Kaiqiao Acupuncture Method on Synaptic Plasticity in Stroke Rats Based on Intestinal Flora / 世界科学技术-中医药现代化

Objective To observe the impacts of Xingnao Kaiqiao acupuncture(AC)method on synaptic plasticity and intestinal flora in stroke rats.Methods The middle cerebral artery occlusion method was applied to establish a rat model of ischemic stroke,and the rats with Zea Longa score of 1-3 were randomly grouped into model(M)group and AC group,and rats without middle cerebral artery occlusion were regarded as the sham(S)group,with 15 animals per group.After modeling,groups S and M were not intervened,and group AC was intervened with AC,once a day,for 7 consecutive days.The Zea Longa method was applied to assess neurological function;transmission electron microscopy(TEM)and Golgi staining were applied to visualize synaptic structures in the ischemic penumbra(IP);Western blot was applied to detect the protein expression of BDNF,SYN and GAP-43 in the IP cortex tissue;ELISA was applied to detect the content of IL-1β,TNF-α,IL-17 in the IP cortex tissue;16S rDNA amplification and sequencing method was applied to analyze the structure of rat intestinal flora.Results Compared with the S group,the M group had irregular synaptic morphology,blurred boundaries,thinned postsynaptic zona densities,higher neurological function scores,protein levels of BDNF,SYN,GAP-43 and content of IL-1β,TNF-α,IL-17(P<0.05),and lower density of spines(P<0.05).Compared with the M group,AC intervention could improve the synaptic morphology,reduce the neurological function score and content of IL-1β,TNF-α,IL-17(P<0.05),and increase the density of dendritic spines,BDNF,SYN,and GAP-43 protein levels(P<0.05).The intestinal flora analysis showed that compared with the S group,the M group had a reduced diversity and number of bacterial flora,at the phylum level,the M group had a lower relative abundance of Bacteroidetes,and higher F/B ratio(P<0.05);at the genus level,the group M had a higher relative abundances of Bacteroides and Rikenbacteria(P<0.05),and lower relative abundances of Lactobacillus and Lachnospiraceae_UCG-006(P<0.05).Compared with the M group,AC intervention could increase the diversity and quantity of the flora,increase the relative abundance of Bacteroidetes and reduce the F/B ratio at the phylum level(P<0.05),increase the relative abundances of Faecalibacterium and Lactobacillus and reduce the relative abundances of Riken,Escherichia-Shigella,etc.at the genus level(P<0.05).Conclusion Xingnao Kaiqiao acupuncture can restore the relative abundance of beneficial bacteria,reduce the relative abundance of harmful bacteria,attenuate brain inflammation,improve synaptic plasticity,and reduce neurological damage in stroke rats.

New understanding and research opportunities of metabolically healthy obesity / 中华预防医学杂志

The paradox of obesity and metabolically healthy obesity are being challenged. More and more studies have disputed the potential mechanism and prognostic value of metabolically healthy obesity. The study of metabolically healthy obesity is helpful to clarify the potential causes of obesity paradox and the potential mechanism of different degrees of obesity harm to the population. From the perspective of evidence-based medicine, combined with the relevant literature at home and abroad, this study reviewed the new understanding of metabolically healthy obesity, lifestyle factors, the impact of fat factors on metabolically healthy obesity, and the new opportunities of metabolically healthy obesity research, in order to explore whether metabolically healthy obesity can maintain and gradually reduce weight for a long time, so as to improve cardiovascular disease In order to achieve the purpose of primary prevention of related diseases.

Quality Regionalization of Angelica sinensis in Genuine Producing Area / 中国实验方剂学杂志

Objective:To study on the quality regionalization of <italic>Angelica sinensis</italic>，in order to guide the rational cultivation of <italic>A. sinensis</italic>. Method:Through visits and field surveys，a total of 857 batches of <italic>A. sinensis</italic> were collected from different counties of Dingxi，relevant geographic information such as longitude，latitude，altitude of each sampling point were obtained by using the global positioning system（GPS），the content of 8 indexes in <italic>A. sinensis </italic>was detected by UPLC， and based on national ecological environment factor data，the suitability analysis of the quality of <italic>A. sinensis</italic> was performed by using MaxEnt，ArcGIS，SPSS. Result:The suitable areas of <italic>A. sinens </italic>were concentrated in central and southern Dingxi. In the suitable areas，the content of ferulic acid，coniferyl ferulate，senkyunolide H decreased from south to north，the content of chlorogenic acid decreased from north to south，the content of senkyunolide A，senkyunolide I decreased from east to west，the distribution regularity of butenyl phthalide was not strong，the highest-content areas were in western Min county，Qingyuan town of Qingyuan county，Shangwan Township and Huichuan town. The content of ligustilide was consistent in the suitable area，and the highest content were in the middle of Weiyuan county and the northern Tongwei county. The results showed that it had a higher index components and comprehensive quality in Min county，Zhang county，southern Weiyuan county and northern Tongwei county. Conclusion:In this study，the quality suitability areas of <italic>A. sinensis</italic> in Dingxi were graded. The chemical components and the quality suitability zoning maps were generated. The findings could provide references for the comprehensive utilization of <italic>A. sinensis</italic>，the selection and construction of high-quality <italic>A. sinensis</italic> raw material base，and the scientific guidance for the production and regional development of <italic>A. sinensis</italic> in Dingxi.

Interpretation of IMI-Industry Guidelines and Ethical Considerations for Myopia Control Report / 中华实验眼科杂志

Along with the increasing global prevalence of myopia, severer myopia brings concerns about a higher risk of potentially blinding complications.Myopia is becoming one of the major causes of vision impairment and blindness in the world, and the myopia prevention and control has been a focus of the whole society.Management of myopia includes more outdoor activities, medications, orthokeratology, peripheral defocus soft contact lens, progressive addition lenses and bifocal lenses, etc.These methods have raised ethical disputes among regulatory bodies, manufacturers, academics and clinicians, who share an ethical responsibility to ensure that the products used for myopia control are safe and efficacious and that patients understand the benefits and potential risks of such products.The IMI- Industry Guidelines and Ethical Considerations for Myopia Control Report published in 2019 highlights the ethical challenges and provides stakeholders with recommendations and guidelines in decision-making, production development, spreading of research progress, prescribing, financial support and advertising of such treatments.Some common problems in combination with the latest clinical studies and relevant evidence-based guidelines were reviewed and reasonable solutions were recommended in this article.

Effect of Transplanting Densities on Growth, Development, Yield and Quality of Astragalus membranaceus var. mongholicus / 中国实验方剂学杂志

Objective::Astragali Radix is an important medicinal and edible herb. To achieve standardized cultivation of Astragali Radix and improve cultivation results, Astragalus membranaceus var. mongholicus was cultivated with a row spacing of 30 cm and different plant spacing (8, 10, 12, 14, 16 cm) in a test base of Longxi County, Gansu Province. Method::The growth and development dynamics of green strains and the yield and quality of medicinal materials were measured, and the comprehensive evaluation of membership function was used to determine the rational transplanting density and explore the standard production technology of A. membranaceus var. mongholicus. Result::The transplanting topping had a significant effect on the growth and development of A. membranaceus var. mongholicus under the condition of the row spacing of 30 cm. With the increase of topping, the biomass of astragalus on the ground decreased, and the ratio of root to shoot increased, but the yield of medicinal material per unit area decreased. The appearance traits were improved as the transplant density decreased. Under the row spacing of 14 cm, the content of astragaloside and calycosin-7-glucoside were the highest. Under the row spacing of 8-16 cm, the content of root extract of Astragali Radix was better than the Chinese Pharmacopoeia standard. The comprehensive evaluation index of each plant spacing treatment was 14 cm>16 cm>10 cm>8 cm>12 cm in turn. Conclusion::Combined with the comprehensive evaluation of yield and economic benefit, the optimal transplanting plant spacing and row spacing were 30 cm×14 cm (with the density of 238 100 strains/hm2). Under this density, A. membranaceus var. mongholicus grows vigorously, with thick stems, big root crowns, a high yield and high quality.

Predicting value of forearm bone density on osteoporosis in patients with postmenopausal rheumatoid arthritis and its influencing factors / 中国医师进修杂志

Objective@#To explore the predictive value of forearm bone density on osteoporosis in patients with postmenopausal rheumatoid arthritis (RA) and its influencing factors.@*Methods@#The clinical data of 98 postmenopausal RA patients in Department of Endocrinology and Hematology, the Third People′s Hospital of Hangzhou from January 1, 2016 to December 31, 2018 were retrospectively analyzed. The bone density of the forearm (left) and central axis (lumbar spine and left hip) were measured using dual-energy X-ray absorptiometry (DXA), and the score of health assessment questionnaires (HAQ) was evaluated. The relationship between central axis bone density and forearm bone density, the optimal T value of forearm bone density for the diagnosis of lumbar spine and left hip osteoporosis, and the influencing factors of forearm bone density were analyzed.@*Results@#In 98 patients with postmenopausal RA, lumbar vertebrae bone density was (0.92 ± 0.17) g/cm2, and T value was -0.7 ± 0.4; left hip bone density was (0.80 ± 0.15) g/cm2, and T value was -1.2 ± 1.1; forearm bone density was (0.36 ± 0.13) g/cm2, bone mineral content was (0.72 ± 0.23) g/cm, and T value was -2.3 ± 1.8. The central axial bone density measurement result showed that normal bone density was in 15 cases (15.31%), and abnormal bone density was in 83 cases (84.69%). The lumbar spine bone density measurement result showed that normal bone density was in 36 cases (36.73%), and abnormal bone density was in 62 cases (63.27%). The left hip bone density measurement result showed that normal bone density was in 19 cases (19.39%), and abnormal bone density was in 79 cases (80.61%). The forearm bone density measurement result showed that normal bone density was in 24 cases (24.49%), and abnormal bone density was in 74 cases (75.51%). The age was significantly younger, the forearm bone density, bone mineral content and T value were significantly higher in patients with normal central axial bone, lumbar spine and left hip bone density, compared with those in patients with abnormal central axial bone, lumbar spine and left hip bone density respectively, and there were statistical differences (P<0.01 or <0.05); there was no statistical difference in body mass index (P>0.05). The receiver operating characteristic curve analysis result showed that the area under curve (AUC) of forearm bone density for the diagnosis of lumbar osteoporosis was 0.842 (95% CI 0.795 to 0.913), and the optimal T value was -2.46, with a sensitivity of 75.00%, and a specificity of 85.48%; the AUC of forearm bone density for diagnosis of left hip osteoporosis was 0.849 (95% CI 0.802 to 0.908), and the optimal T value was -2.32, with a sensitivity of 73.68%, and a specificity of 83.54%. The age, duration of disease and HAQ score in patients with normal forearm bone density were significantly lower than those in patients with abnormal forearm bone density: (50.21 ± 11.92) years vs. (58.45 ± 14.13) years, (6.95 ± 2.41) years vs. (9.73 ± 3.17) years and (1.14 ± 0.36) scores vs. (1.63 ± 0.51) scores, and there were statistical differences (P<0.05 or <0.01); there was no statistical difference in body mass index (P>0.05). Multivariate Logistic regression analysis result showed that age, duration of disease and HAQ score were independent risk factors for forearm bone density in patients with postmenopausal RA (OR = 1.829, 2.347 and 3.732; 95% CI 1.123 to 2.980, 1.244 to 4.428 and 1.160 to 12.003; P < 0.05 or <0.01).@*Conclusions@#Forearm bone density can be used as an auxiliary tool for screening central axial osteoporosis in patients with postmenopausal RA.

A study of the predictive effects of machine learning for the relationship between axial length elongation and the progression of myopia in school-aged children / 中华实验眼科杂志

Objective@#To investigate the relationship between axial length (AL)elongation and the progression of spherical equivalent refraction (SER) and its influential factors in school-aged children with myopia based on machine learning (ML).@*Methods@#A cross-sectional study evaluated 1 011 eyes of school-aged myopic children admitted to the optometry center of Peking University People's Hospital from January 2017 to December 2018, and data from the right eyes were used for analysis.All the collected data were used to train ML algorithms.When building predictive models, the input features included age, gender, central corneal thickness (CCT), mean K readings (K-mean), horizontal visible iris diameter (HIVD), lens power, and axial length (AL), and the output parameter was SER.A five-fold cross validation scheme randomly divided all the data into five groups, of which four were used as training data, and one group was used as validation data.This process was repeated five times so that all the data were validated by this model, which allowed a better prediction of the overall sample.The prediction accuracy of different models was evaluated by the R-value and R2.The best-performing algorithm was applied to investigate the relationship between AL elongation and the progression of SER and its influencing factors.Written informed consent was obtained from each guardian of each patient prior to entering the study cohort.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Peking University People's Hospital (No.2019PHB280-01).@*Results@#In the comparison of the R-value and R2 of six ML algorithms based on five-fold cross validation, among all models, the best was the quadratic SVM regression model, with an R-value and R2 of 0.99 and 0.98, respectively.The results of Pearson correlation analysis showed that lens power was negatively correlated with age (r=-0.301, P<0.01). According to the results calculated by the Bennett-Rabbetts formula, the average lens power of the 6-year-old myopic group was higher than that of the 18-year-old myopic group.According to this model, the SER change caused by AL elongation was not a constant value, which was estimated from plano to nearly -3.00 D, depending mainly on the time needed for 1-mm AL elongation.According to the results calculated by this model, the longer it took for the AL to grow by 1 mm, the smaller the corresponding SER change.In myopic children over an age span of one year, for example, from 6-7 years or 12-13 years, 1-mm elongation of the AL corresponded to -2.50 D and -2.33 D of SER change, respectively.Over a three years span, for example, from 6-9 years, a 1-mm elongation of the AL corresponded to -1.77 D of SER change.@*Conclusions@#For myopic children, the longer the age span required for 1-mm elongation of the AL, the smaller the SER change.An ML algorithm can provide clinical practitioners with a relatively precise estimation for the relationship between AL elongation and myopia progression.

Study on ecological suitability of Angelica sinensis in Gansu Province / 中草药

Objective: To study the ecological suitability of Angelica sinensis growing in Gansu Province and guide the rational cultivation. Methods: Through visiting and field investigation, 1 545 batches of Chinese angelica samples were collected from the county areas in Gansu Province. The information about the longitude, latitude, altitude of each sampling point was collected by using the GPS, combining with national environmental factor data, and using Maxent model and spatial analysis function of ArcGIS software. Results: The areas with high suitability of A. sinensis distribution are in the southeast of Gansu Province. The main ecological factors affecting the suitability distribution of A. sinensis were altitude, rainfall in March, May and December, wettest month precipitation, soil pH and other ecological factors. Conclusion: The research findings are basically consistent with the living habits of A. sinensis that cultivated in high-cold mountain areas and plateau flat pasture areas with a cool climate, moderate soil, moisture, slightly acidic to neutral fertile and loose brown sandy loam soil. This result can provide scientific basis for the reasonable distribution of A. sinensis cultivation area in Gansu Province.

A study of the predictive effects of machine learning for the relationship between axial length elongation and the progression of myopia in school-aged children / 中华实验眼科杂志

Objective To investigate the relationship between axial length (AL)elongation and the progression of spherical equivalent refraction (SER) and its influential factors in school-aged children with myopia based on machine learning (ML).Methods A cross-sectional study evaluated 1 011 eyes of school-aged myopic children admitted to the optometry center of Peking University People's Hospital from January 2017 to December 2018,and data from the right eyes were used for analysis.All the collected data were used to train ML algorithms.When building predictive models,the input features included age,gender,central corneal thickness (CCT),mean K readings (K-mean),horizontal visible iris diameter (HIVD),lens power,and axial length (AL),and the output parameter was SER.A five-fold cross validation scheme randomly divided all the data into five groups,of which four were used as training data,and one group was used as validation data.This process was repeated five times so that all the data were validated by this model,which allowed a better prediction of the overall sample.The prediction accuracy of different models was evaluated by the R-value and R2.The best-performing algorithm was applied to investigate the relationship between AL elongation and the progression of SER and its influencing factors.Written informed consent was obtained from each guardian of each patient prior to entering the study cohort.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Peking University People's Hospital (No.2019PHB280-01).Results In the comparison of the R-value and R2 of six ML algorithms based on five-fold cross validation,among all models,the best was the quadratic SVM regression model,with an R-value and R2 of 0.99 and 0.98,respectively.The results of Pearson correlation analysis showed that lens power was negatively correlated with age (r =-0.301,P＜0.01).According to the results calculated by the Bennett-Rabbetts formula,the average lens power of the 6-year-old myopic group was higher than that of the 18-year-old myopic group.According to this model,the SER change caused by AL elongation was not a constant value,which was estimated from plano to nearly-3.00 D,depending mainly on the time needed for 1-mm AL elongation.According to the results calculated by this model,the longer it took for the AL to grow by 1 mm,the smaller the corresponding SER change.In myopic children over an age span of one year,for example,from 6-7 years or 12-13 years,1-mm elongation of the AL corresponded to-2.50 D and-2.33 D of SER change,respectively.Over a three years span,for example,from 6-9 years,a 1-mm elongation of the AL corresponded to-1.77 D of SER change.Conclusions For myopic children,the longer the age span required for 1-mm elongation of the AL,the smaller the SER change.An ML algorithm can provide clinical practitioners with a relatively precise estimation for the relationship between AL elongation and myopia progression.

Predicting value of forearm bone density on osteoporosis in patients with postmenopausal rheumatoid arthritis and its influencing factors / 中国医师进修杂志

Objective To explore the predictive value of forearm bone density on osteoporosis in patients with postmenopausal rheumatoid arthritis (RA) and its influencing factors.Methods The clinical data of 98 postmenopausal RA patients in Department of Endocrinology and Hematology,the Third People's Hospital of Hangzhou from January 1,2016 to December 31,2018 were retrospectively analyzed.The bone density of the forearm (left) and central axis (lumbar spine and left hip) were measured using dual-energy X-ray absorptiometry (DXA),and the score of health assessment questionnaires (HAQ) was evaluated.The relationship between central axis bone density and forearm bone density,the optimal T value of forearm bone density for the diagnosis of lumbar spine and left hip osteoporosis,and the influencing factors of forearm bone density were analyzed.Results In 98 patients with postmenopausal RA,lumbar vertebrae bone density was (0.92 ± 0.17) g/cm2,and T value was -0.7 ± 0.4;left hip bone density was (0.80 ± 0.15) g/cm2,and T value was-1.2 ± 1.1;forearm bone density was (0.36 ± 0.13) g/cm2,bone mineral content was (0.72 ± 0.23) g/cm,and T value was -2.3 ± 1.8.The central axial bone density measurement result showed that normal bone density was in 15 cases (15.31％),and abnormal bone density was in 83 cases (84.69％).The lumbar spine bone density measurement result showed that normal bone density was in 36 cases (36.73％),and abnormal bone density was in 62 cases (63.27％).The left hip bone density measurement result showed that normal bone density was in 19 cases (19.39％),and abnormal bone density was in 79 cases (80.61％).The forearm bone density measurement result showed that normal bone density was in 24 cases (24.49％),and abnormal bone density was in 74 cases (75.51％).The age was significantly younger,the forearm bone density,bone mineral content and T value were significantly higher in patients with normal central axial bone,lumbar spine and left hip bone density,compared with those in patients with abnormal central axial bone,lumbar spine and left hip bone density respectively,and there were statistical differences (P ＜ 0.01 or ＜ 0.05);there was no statistical difference in body mass index (P ＞ 0.05).The receiver operating characteristic curve analysis result showed that the area under curve (AUC) of forearm bone density for the diagnosis of lumbar osteoporosis was 0.842 (95％ CI 0.795 to 0.913),and the optimal T value was -2.46,with a sensitivity of 75.00％,and a specificity of 85.48％;the AUC of forearm bone density for diagnosis of left hip osteoporosis was 0.849 (95％ CI 0.802 to 0.908),and the optimal T value was-2.32,with a sensitivity of 73.68％,and a specificity of 83.54％.The age,duration of disease and HAQ score in patients with normal forearm bone density were significantly lower than those in patients with abnormal forearm bone density:(50.21 ± 11.92) years vs.(58.45 ± 14.13) years,(6.95 ± 2.41) years vs.(9.73 ± 3.17) years and (1.14 ± 0.36) scores vs.(1.63 ± 0.51) scores,and there were statistical differences (P＜ 0.05 or ＜ 0.01);there was no statistical difference in body mass index (P＞ 0.05).Multivariate Logistic regression analysis result showed that age,duration of disease and HAQ score were independent risk factors for forearm bone density in patients with postmenopausal RA (OR =1.829,2.347 and 3.732;95％ CI 1.123 to 2.980,1.244 to 4.428 and 1.160 to 12.003;P ＜ 0.05 or ＜ 0.01).Conclusions Forearm bone density can be used as an auxiliary tool for screening central axial osteoporosis in patients with postmenopausal RA.

Therapeutic effect of nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate on patients with systemic lupus erythematosus and its effect on efficacy and immune function / 中国医师进修杂志

Objective:To investigate the therapeutic effect of nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate on systemic lupus erythematosus (SLE) patients and its immune function.Methods:Sixty-two patients with systemic lupus erythematosus admitted to Third People′s Hospital of Hangzhou from March 2017 to March 2019 were randomly divided into observation group (31 cases) and control group (31 cases) by random number table. The patients in the control group were treated with prednisone and methotrexate, while the patients in the observation group were treated with nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate on the basis of the control group. Both groups were treated for 3 months. The therapeutic effects of the two groups were compared, and the changes of complement C3 and C4, immune function before and after treatment were compared.Results:The total effective rate of the observation group was higher than that of the control group [96.77%(30/31) vs.74.19%(23/31)], and there was significant difference ( χ2=6.369, P<0.05). The levels of complement C3 and C4 in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of complement C3 and C4 in two groups were significantly increased ( P<0.05), and the levels of complement C3 and C4 in observation group were significantly higher than those in control group [(1.08 ± 0.15) g/L vs. (0.81 ± 0.13) g/L, (0.24 ± 0.05)g/L vs. (0.18 ± 0.03) g/L], and there were significant differences ( t=7.574, 5.729, P<0.05). The levels of CD 3+, CD 4+ and CD 4+/CD 8+ in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of CD 3+, CD 4+ and CD 4+/CD 8+ in two groups were significantly increased ( P<0.05), and the levels of CD 3+, CD 4+ and CD 4+/CD 8+ in observation group were significantly higher than those in control group [(65.72 ± 5.62)% vs. (58.93 ± 4.25)%, (41.03 ± 1.75)% vs.(38.21 ± 1.43)%, 1.65 ± 0.09 vs.1.41 ± 0.12], and there were significant differences ( t=5.365, 6.948, 8.908, P<0.05). The levels of IgA, IgG and IgM in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of IgA, IgG in two groups were increased, the level of IgM in two groups was decreased, and there were significant differences ( P<0.05). The levels of IgA, IgG in observation group were significantly higher than those in control group [(1.85 ± 0.38) g/L vs. (2.54 ± 0.42) g/L, (12.19 ± 1.63) g/L vs. (14.53 ± 1.37) g/L], and there were significant differences ( t=6.783, 6.119, P<0.05). Conclusions:Nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate in treating SLE is effective, which can effectively improve the levels of complement C3 and C4 and immune function.

Fetal growth, fetal development, and placental features in women with polycystic ovary syndrome: analysis based on fetal and placental magnetic resonance imaging / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#Polycystic ovary syndrome (PCOS), a common endocrine-metabolic dysfunction in reproductive-aged women, may be involved in compromised pregnancy and offspring outcomes. This study aimed to investigate whether maternal PCOS affects fetal growth, fetal development, and placental features.@*METHODS@#This retrospective case-control study included 60 pregnant women with PCOS (PCOS group) and 120 healthy pregnant women without PCOS (control group). Fetal magnetic resonance imaging (MRI) was performed followed by an ultrasound examination and indications for imaging, including known or suspected fetal pathology, history of fetal abnormality in previous pregnancy or in a family member, and concern for placenta accreta. Fetal MRI images were analyzed for head circumference (HC), abdomen circumference (AC), lung-to-liver signal intensity ratio (LLSIR, a prenatal marker of fetal lung maturity), lengths of liver and kidney diameters in fetuses, and placental relative signal intensity on T2-weighted single-shot fast spin echo (SSFSE) imaging (rSI@*RESULTS@#Compared to the control group, the PCOS group showed the following characteristics: (1) smaller biparietal diameter and femur length in fetuses (P=0.026 and P=0.005, respectively), (2) smaller HC in fetuses (evident after 32 weeks; P=0.044), (3) lower LLSIR and smaller dorsoventral length of liver in fetuses (evident before 32 weeks; P=0.005 and P=0.019, respectively), and (4) smaller placental thickness (evident before 32 weeks; P=0.017). No significant differences in placental rSI@*CONCLUSIONS@#There exist alterations of fetal growth, fetal development, and placental features from women with PCOS.

Interaction of health literacy and second-hand smoke exposure on psychopathological symptoms of middle school students / 中华预防医学杂志

To explore the interaction of health literacy and second-hand smoke exposure on psychopathological symptoms of middle school students. From November 2015 to January 2016, 22 628 middle school students from Shenyang of Liaoning Province, Bengbu of Anhui Province, Xinxiang of Henan Province, Ulanqab of Inner Mongolia Autonomous Region, Chongqing Municipality, and Yangjiang of Guangdong Province were enrolled by using the multi-stage cluster convenience sampling method. A questionnaire was used to collect the data including demographic information, health literacy, second-hand smoke exposure, and psychopathological symptoms. A multivariate logistic regression model was used to analyze the interaction of health literacy and second-hand smoke exposure on psychopathological symptoms of middle school students. The age of students was (15.36±1.79) years old, of which 10 990 were boys, accounting for 48.6% of total students. The detection rate of psychopathological symptoms was 29.1% (6 581/22 628). The detection rate of psychopathological symptoms in those who were exposed to second-hand smoke was 38.1% (2 401/6 304), which was higher than that in the non-second-hand smoke exposure group [25.6% (4 180/16 324)] (0.001). The (95) of the interaction between medium and low levels of overall health literacy, low level of interpersonal dimension of health literacy and second-hand smoke exposure was 1.19 (1.15-1.24), 2.00 (1.92-2.10) and 1.59 (1.52-1.66), respectively. There was a positive interaction between middle and low levels of overall health literacy, low level of interpersonal dimension of health literacy and second-hand smoke exposure on psychopathological symptoms of middle school students.

The function of αA-crytstallin and effects in ocular diseases / 中华实验眼科杂志

αA-crystallin is an important protein in lens,with molecular chaperone founction,apoptosis regulation effect,neovascularization regulation,oxidation-reduction reaction process regulation and inflammation reaction regulation.Now,more and more studies have verified that αA-crystallin exists not only in lens,but also in other intraocular structures,such as retina.αA-crystallin can not only maintain the internal environment homeostasis,but also participate in many other eye diseases,such as optic nerve injury diseases,retinal degeneration,ocular neoplasmas,inflammatory diseases and retinal choroidal vascular diseases.This article reviewed the distribution,structure and founction of αA-crystallin and its effects in ocular diseases.