Current status and multidimensional influences on the comorbidity of obesity and high blood pressure among children in Xiamen City / 中国学校卫生

Objective@#To understand the current status of obesity and high blood pressure (HBP) comorbidity and their multidimensional influencing factors in children aged 7-12 years in Xiamen, so as to provide reference basis for subsequent preventive measures.@*Methods@#Based on the baseline survey of the Xiamen pubertal development cohort in 2017, a total of 4 798 primary school students from second to sixth grade were selected in the study by cluster random sampling method. And physical examination and questionnaires were conducted. The Logistic regression was used to screen potential variables for obesity combined with HBP. A multivariate Logistic regression model was used to analyse the factors influencing obesity combined with HBP.@*Results@#About 9.15 % children were found with obesity and 11.65% with HBP. The rate of obesity combined with HBP was 3.00% in boys and 1.80 % in girls. The rate of HBP was 8.28% in normal weight children and 26.88% in obese children. Multivariate Logistic regression models showed that consumption of sugary drinks at least once a week ( OR =2.50), daily consumption of salted or pickled vegetables ( OR =4.52), family history of obesity ( OR =3.09) were positively associated with obesity combined with HBP ( P <0.05). Girls ( OR =0.53), consumption of highenergy snacks at least once a week ( OR =0.40) and adequate physical activity ( OR =0.58) were negatively associated with comorbidity of obesity and HBP ( P <0.05).@*Conclusion@#Gender differences in comorbidity burden of obesity and HBP exist among children aged 7-12 years in Xiamen. Dietary behaviour and exercise behaviour are the main dimensions influencing the comorbidity of obesity and HBP. Prevention and control of obesity and HBP in children should be based on multiple dimensions, including diet and exercise behavioural environment, to prevent early the occurrence for comorbidity of obesity and HBP in children.

Association between early life factors and cardiometabolic risk factors in children and adolescents / 中国学校卫生

Objective@#To understand the early life factors that influence cardiometabolic risk factors in children and adolescents, so as to provide effective measures to curb cardiometabolic risk factors such as hypertension and diabetes in children and adolescents.@*Methods@#Data were sourced from the 2020 follow up survey of the Xiamen Adolescent Development Cohort. The study involved 1 197 subjects for whom completed anthropometric examination and blood biochemistry testing data, as well as early life data. Early life and sociodemographic data were obtained through questionnaire surveys, while cardiometabolic indicator data were sourced through physical examinations and blood testing. Logistic regression analysis was performed to analyze the impact of early life factors on the cardiometabolic risk factors after adjusting for gender, age, and family history.@*Results@#The prevalence rate of cardiometabolic risk factors clustering in children and adolescents in Xiamen was 17.96%, with boys (26.67%) reporting higher rates than girls (9.64%), and the difference was statistically significant ( χ 2=57.69, P <0.01). For every additional early life risk factor, the risk factors of obesity increased 0.35 times ( OR=1.35, 95%CI=1.03-1.78, P <0.05). Post term pregnancy may be a primary early life risk factors for cardiometabolic risk factors, and it was associated with an increased risk of cardiometabolic risk factors clustering (OR=2.45, 95% CI =1.11-5.41) and high triglycerides ( OR=3.25, 95%CI =1.39-7.61)( P <0.05).@*Conclusion@#Increased cardiometabolic risk factors in youth is associated with early life adverse factors. It is crucial to pay greater attention to post term pregnancy as an early life factor and to consider obesity as a cardiometabolic risk factors. Controlling early life adverse factors is important for the prevention of cardiovascular disease.

Clinical study of Tiaogan Lifei Decoction on improving the level of symptom control in asthmatic patients with moderate and high dose glucocorticoid inhalation / 国际中医中药杂志

Objective:To investigate the effects of Tiaogan Lifei Decoction on the level of symptom control in patients with bronchial asthma (asthma) treated with moderate and high dosage inhaled glucocorticoids (ICS).Methods:Randomized double-blind placebo controlled prospective study was used. Totally 90 patients with asthma (liver lung disharmony, wind phlegm blocking collateral syndrome) using moderate and high dosage ICS who met the inclusion criteria from January 2020 to December 2021 in Chaoyang District Hospital of Traditional Chinese Medicine in Beijing were divided into two groups according to random number table method, with 45 cases in each group. On the basis of using the original dosage of ICS, the treatment group used Tiaogan Lifei Decoction, while the control group used Tiaogan Lifei Decoction simulant. The course of treatment was 12 weeks. TCM symptom score of both group before and after the treatment was detected; asthma control test (ACT) was used to assess the effects of asthma on the patients; St George's Hospital Respiratory Questionnaire (SGRQ) was used to assess patients' quality of life; the peak expiratory flow rate (PEF) was measured with a peak expiratory flow meter. 2 ml of venous blood was collected for eosinophil (EOS) detection, and the serum allergen specific IgE level was determined by ELISA. The adverse reactions were observed during the treatment and the clinical efficacy was evaluated.Results:During the test, 3 cases and 2 cases in the treatment group and control group lost prevention respectively. 3 cases in the treatment group and 6 cases in the control group withdrew from the trial because of the aggravation of symptoms and the need to increase the dosage of ICS. The total effective rate in the treatment group was 78.6% (33/42), and that in the control group was 55.8% (24/43), with statistical significance ( χ2=4.98, P=0.026). After treatment, the scores of daily activities, early awakening, control and total scores in the treatment group were higher than those in the control group ( t values were 1.76, 1.99, 2.00, 2.69, respectively, P<0.01 or P<0.05); after treatment, the scores of cough, chest tightness, active wheezing, upset, pharyngeal itch and total score in the treatment group were lower than those in the control group ( t values were -5.89, -6.01, -5.66, -4.27, -6.67, -9.05, respectively, P<0.01); SGRQ score in the treatment group was lower than that of the control group ( t=-7.19, P<0.01). No serious adverse reactions occurred during treatment in the two groups. Conclusion:Tiaogan Lifei Decoction is helpful to improve the symptom control level of asthma patients who are using ICS, and effectively improve the quality of life of patients with asthma of liver lung disharmony and wind phlegm obstructing collaterals syndrome.

A preliminary analysis of individual neutron dose monitoring with 6LiF-7LiF and CR39 / 中国辐射卫生

Objective To preliminarily compare 6LiF-7LiF and CR39 in individual neutron dose monitoring, and to provide a reference for improving individual neutron dose monitoring. Methods According to the GBZ 128-2019, 26 radiation workers from 7 institutions received individual neutron dose monitoring with 6LiF-7LiF and CR39 at the same time. The monitoring results were analyzed. Results For most of the workers, the personal neutron dose equivalent Hp(10) was less than the minimum detectable level. The results with the two monitoring methods differed in 6 of 26 workers. Conclusion Both 6LiF-7LiF and CR39 monitoring methods can be used for individual neutron dose monitoring for radiation workers, but the difference between 6LiF-7LiF and CR39 (in threshold energy, energy response, etc.) should be considered so that different types of radiation workers receive appropriate individual neutron dose monitoring.

Research progress in personal neutron dose monitoring / 中国辐射卫生

With the extensive use of neutron sources in industry, medicine, and scientific research, the number of people exposed to neutron has been increasing, which highlights the importance of personal neutron dose monitoring in the field of radiation protection. In the past decades, researchers have developed and improved a variety of techniques and methods for personal neutron dose monitoring. This paper focuses on the problems and research progress of track dosimeters (solid-state nuclear track dosimeters and fluorescent nuclear track dosimeters), luminescent dosimeters (thermoluminescent dosimeters and optically stimulated luminescent dosimeters), and bubble dosimeters in personal neutron dose monitoring.

Efficacy and safety of Kangxian Huanji Granule as adjunctive treatment in acute exacerbation of idiopathic pulmonary fibrosis: An exploratory randomized controlled trial / 中西医结合学报

BACKGROUND@#Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is an important occurrence in the natural history of idiopathic pulmonary fibrosis (IPF), associated with high hospitalization rates, high mortality and poor prognosis. At present, there is no effective treatment for AE-IPF. Chinese herbal medicine has some advantages in treating IPF, but its utility in AE-IPF is unclear.@*OBJECTIVE@#The treatment of AE-IPF with Kangxian Huanji Granule (KXHJ), a compound Chinese herbal medicine, lacks an evidence-based justification. This study explores the efficacy and safety of KXHJ in patients with AE-IPF.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS@#We designed a randomized, double-blind, placebo-controlled, exploratory clinical trial. A total of 80 participants diagnosed with AE-IPF were randomly assigned to receive KXHJ or a matching placebo; the treatment included a 10 g dose, administered twice daily for 4 weeks, in addition to conventional treatment. Participants were followed up for 12 weeks after the treatment.@*MAIN OUTCOME MEASURES@#The primary endpoints were treatment failure rate and all-cause mortality. Secondary endpoints included the length of hospitalization, overall survival, acute exacerbation rate, intubation rate, the modified British Medical Research Council (mMRC) score, and the St George's Respiratory Questionnaire for IPF (SGRQ-I) score.@*RESULTS@#The rate of treatment failure at 4 weeks was lower in the intervention group compared to the control group (risk ratio [RR]: 0.22; 95% confidence interval [CI]: 0.051 to 0.965, P = 0.023). There was no significant difference in all-cause mortality at 16 weeks (RR: 0.75; 95% CI: 0.179 to 3.138; P > 0.999) or in the acute exacerbation rate during the 12-week follow-up period (RR: 0.69; 95% CI: 0.334 to 1.434; P = 0.317). The intervention group had a shorter length of hospitalization than the control group (mean difference [MD]: -3.30 days; 95% CI, -6.300 to -0.300; P = 0.032). Significant differences in the mean change from baseline in the mMRC (between-group difference: -0.67; 95% CI: -0.89 to -0.44; P < 0.001) and SGRQ-I score (between-group difference: -10.36; 95% CI: -16.483 to -4.228; P = 0.001) were observed after 4 weeks, and also in the mMRC (between-group difference: -0.67; 95% CI: -0.91 to -0.43; P < 0.001) and SGRQ-I (between-group difference: -10.28; 95% CI, -15.838 to -4.718; P < 0.001) at 16 weeks. The difference in the adverse events was not significant.@*CONCLUSION@#KXHJ appears to be effective and safe for AE-IPF and can be considered a complementary treatment in patients with AE-IPF. As a preliminary exploratory study, our results provide a basis for further clinical research.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry (ChiCTR1900026289). Please cite this article as: Li JS, Zhang HL, Guo W, Wang L, Zhang D, Zhao LM, Zhou M. Efficacy and safety of Kangxian Huanji Granule as adjunctive treatment in acute exacerbation of idiopathic pulmonary fibrosis: an exploratory randomized controlled trial. J Integr Med. 2023; 21(6): 543-549.

Correlation between four limbs perfusion index and lactic acid in patients with severe neurological diseases / 中华危重病急救医学

OBJECTIVE@#To observe the correlation between the four limbs perfusion index (PI) and blood lactic acid in patients with neurosis, and evaluate the predictive value of PI on microcirculation perfusion metabolic disorder in patients with neurosis.@*METHODS@#A prospective observational study was conducted. Adult patients admitted to the department of neurological intensive care unit (NICU) of the First Affiliated Hospital of Xinjiang Medical University from July 1 to August 20 in 2020 were enrolled. Under the condition of indoor temperature controlled at 25 centigrade, all patients were placed in the supine position, and the blood pressure, heart rate, PI of both fingers and thumb toes and arterial blood lactic acid were measured within 24 hours and 24-48 hours after NICU. The difference of four limbs PI at different time periods and its correlation with lactic acid were compared. Receiver operator characteristic curve (ROC curve) was used to evaluate the predictive value of four limbs PI on patients with microcirculatory perfusion metabolic disorder.@*RESULTS@#A total of 44 patients with neurosis were enrolled, including 28 males and 16 females; average age (61.2±16.5) years old. There were no significant differences in PI of the left index finger and the right index finger [2.57 (1.44, 4.79) vs. 2.70 (1.25, 5.33)], PI of the left toe and the right toe [2.09 (0.85, 4.76) vs. 1.88 (0.74, 4.32)] within 24 hours after entering the NICU, and the PI of the left index finger and the right index finger [3.17 (1.49, 5.07) vs. 3.14 (1.33, 5.36)], PI of the left toe and the right toe [2.07 (0.75, 5.20) vs. 2.07 (0.68, 4.67)] at 24-48 hours after NICU admission (all P > 0.05). However, compared to the PI of the upper and lower limbs on the same side, except for the 24-48 hours after ICU of the PI difference between the left index finger and the left toe (P > 0.05), the PI of the toe was lower than that of the index finger at the other time periods (all P < 0.05). The correlation analysis showed that the PI value of four limbs of patients in both time periods were significantly negatively correlated with arterial blood lactic acid (the r values of the left index finger, the right index finger, the left toe and the right toe were -0.549, -0.482, -0.392 and -0.343 respectively within 24 hours after entering the NICU; the r values of the left index finger, the right index finger, the left toe and the right toe were -0.331, -0.292, -0.402 and -0.442 respectively after entering the NICU 24-48 hours, all P < 0.05). Taking lactic acid ≥ 2 mmol/L as the diagnostic standard for metabolic disorder of microcirculation perfusion (total 27 times, accounting for 30.7%). The efficacy of four limbs PI in predicting microcirculation perfusion metabolic disorder were compared. ROC curve analysis showed that the area under the curve (AUC) and 95% confidence interval (95%CI) of left index finger, right index finger, left toe and right toe predicting microcirculation perfusion metabolic disorder were 0.729 (0.609-0.850), 0.767 (0.662-0.871), 0.722 (0.609-0.835), 0.718 (0.593-0.842), respectively. There was no significant difference in AUC compare with each other (all P > 0.05). The cut-off value of PI of right index finger for predicting microcirculation perfusion metabolic disorder was 2.46, the sensitivity was 70.4%, the specificity was 75.4%, the positive likelihood ratio was 2.86, and the negative likelihood ratio was 0.30.@*CONCLUSIONS@#There are no significant differences in PI of bilateral index fingers, bilateral toes in patients with neurosis. However, unilateral upper and lower limbs showed lower PI in the toe than in the index finger. There is a significantly negatively correlation between PI and arterial blood lactic acid in all four limbs. PI can predict the metabolic disorder of microcirculation perfusion, and its cut-off value is 2.46.

Human Gingival Stem Cells Prevent Diabetes in NOD Mice by Reducing Follicular B Cells / 中山大学学报(医学科学版)

BackgroundType 1 diabetes is caused by a chronic immune response that destroys islet beta cells， resulting in elevated blood glucose. Mesenchymal stem cells can prevent and treat the development of diabetes and its complications. However， little is known about the effects and potential mechanisms of Gingival mesenchymal stem cells （GMSCs） in preventing diabetes. The aim of this study is to investigate the mechanism of GMSCs in preventing type 1 diabetes in mice and to find targets for clinical treatment of diabetes. MethodsWe injected human GMSCs into NOD mice to observe the trend of blood glucose， observed the survival of pancreatic β-cells by immunohistochemistry， and detected the change of immune cells in the spleen of mice by flow analysis. Finally， the immune cells in NOD mice were transfused into NOD-SCID mice to observe the onset of diabetes in NOD-SCID mice. ResultsGMSCs significantly reduced the incidence of diabetes in NOD mice， with 64% of control mice developing diabetes at 27 weeks of age compared with 35% in the GMSC group， P=0.013. The percentage of Follicular B cells（FO B cell） in the spleen of GMSCs-treated mice decreased from （52.2±4.1）% to （43.2±5.3）%， P=0.008， while other types of immune cells did not change significantly. The immunohistochemical results showed that GMSCs could effectively improve the survival of pancreatic β-cells， which could continuously produce insulin to control blood glucose. Finally， we found the spleen cells transfusion could prevent the development of diabetes in NOD-SCID mice. ConclusionGMSCs can reduce diabetes in mice by reducing FO B cells in the spleen.

Effects of lifestyle changes on body weight and metabolic parameters during the early stage of COVID-19 epidemic and regular epidemic prevention period in physical examination population / 中华健康管理学杂志

Objective:To analyze the influence of lifestyle changes on body weight and metabolic parameters during the early stage of corona virus disease 2019 (COVID-19) epidemic and regular epidemic prevention period in physical examination population.Methods:A total of 801 subjects from Nanjing enterprises and institutions who underwent physical examination in the Department of Health Promotion Center, the First Affiliated Hospital of Nanjing Medical University in May of 2019 to 2021 were included in this study. The basic information and data of body mass index, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride and uric acid were collected. Information about dietary and exercise habits was obtained through pre-examination questionnaires. The data of 2019 was set as baseline data, data of 2020 represented information during the early stage of COVID-19 epidemic and data of 2021 represented information in regular epidemic prevention period. The subjects were divided into underweight group, normal weight group, overweight group, and obese group according to the body mass index at baseline. The Friedman test was applied to compare changes in body mass index and metabolic parameters across the population. Chi-square test was used to compare changes in dietary and exercise habits. Multivariate logistic regression analysis was adopted to explore the influencing factors of body mass index changes.Results:During the early stage of COVID-19 epidemic, the proportion of weight gain was the highest in the underweight group (42.9%), the proportion of weight loss was the highest in the overweight group (24.2%), and the obese group has the most stable body weight (70.6%) ( P=0.004). Men ( OR=0.56, 95% CI: 0.36-0.87) were less likely to gain weight than women ( P=0.010). There was no significant differences in weight change among all groups in the regular epidemic prevention period ( P=0.380). During the early stage of COVID-19 epidemic, the levels of fasting blood glucose, total cholesterol and LDL-C were significantly lower than those of baseline [4.98 (4.66, 5.42) vs 5.23 (4.91, 5.66) mmol/L, 4.98 (4.36, 5.67) vs 5.11 (4.54, 5.77) mmol/L, 2.90 (2.45, 3.33) vs 3.23 (2.77, 3.74) mmol/L], and the uric acid level was higher [333.0 (275.5, 397.0) vs 311.0 (257.5, 368.0) μmol/L] (all P<0.001). In regular epidemic prevention period, the levels of body mass index, fasting blood glucose, total cholesterol and LDL-C were significantly higher than those in the early stage of the epidemic [24.0 (21.9, 26.3) vs 23.8 (21.7, 26.1) kg/m 2, 5.18 (4.85, 5.62) vs 4.98 (4.66, 5.42) mmol/L, 5.12 (4.42, 5.76) vs 4.98 (4.36, 5.67) mmol/L, 3.06 (2.59, 3.57) vs 2.90 (2.45, 3.33) mmol/L], while the uric acid was significantly lower [319.0 (265.0, 377.0) vs 333.0 (275.5, 397.0) μmol/L] (all P<0.001). During the early stage of the epidemic, the reduction proportion of unhealthy diet in the home group was significantly higher than that in the outing group (19.5% vs 11.4%), and the increment proportion of exercise in the outing group was significantly higher than that in the home group (5.1% vs 1.6%) (both P<0.05). In regular epidemic prevention period, the increase rate of unhealthy diet in the home group was significantly higher than that in the outing group (26.8% vs 13.0%) ( P<0.001), and there was no significant difference in exercise between the two groups ( P=0.325). During the early stage of COVID-19 epidemic and in the regular epidemic prevention period, unhealthy diet>3 times per week ( OR=3.85, 3.01, 95% CI: 1.74-8.51, 1.41-6.39) was positively correlated with weight gain, and regular exercise ( OR=4.35, 2.61, 95% CI: 2.05-9.23, 1.15-5.91) was positively correlated with weight loss (all P<0.05). Conclusions:During the early stage of COVID-19 epidemic and in the regular epidemic prevention period, the lifestyle in the physical examination population has an impact on body weight and metabolic indicators. In the early stage of the epidemic, unhealthy diet and exercise decreased, and metabolic indicators such as blood glucose and lipids decreased. People with low body weight tend to gain weight. In the regular epidemic prevention period, the subjects′ exercise increased but unhealthy diet also increased, and blood glucose, lipid and body weight elevated significantly.

Efficacy of concurrent chemoradiotherapy with S-1 vs. radiotherapy alone for elderly patients with esophageal cancer: a meta-analysis / 中华放射肿瘤学杂志

Objective:To evaluate the efficacy of concurrent radiotherapy combined with S-1 (CCRT) versus radiotherapy (RT) alone in elderly patients with esophageal cancer by Meta-analysis.Methods:The Cochrane Library, PubMed, Web of science, EMbase, CBM, CNKI, VIP and Wanfang database were searched. The eligible studies were subject to evaluation of methodological quality. The Meta-analysis was performed by the Revman 5.3 software.Results:A total of 1693 patients were enrolled in 23 studies. The results showed that CCRT increased the incidence of CR [ OR=2.08,95% CI (1.66-2.61), P<0.001] and PR [ OR=1.31,95% CI (1.08-1.60), P=0.007] and total response rate [ OR=2.99,95% CI (2.37-3.77), P<0.001]. Furthermore, CCRT improved the 1-year survival rate [ OR=2.56, 95% CI (1.94-3.38), P<0.001] and 2-year survival rate [ OR=2.33, 95% CI (1.77-3.08), P<0.001]. Meanwhile, CCRT reduced the incidence of leucopenia, thrombocytopenia, radioactive esophagitis, nausea and vomiting (all P<0.05), but there was no significant difference in the incidence of anemia and radiation pneumonia between two groups (both P>0.05). Conclusions:Available evidence suggests that CCRT combined with S-1 can improve therapeutic efficacy and prolong survival time in elderly patients with esophageal cancer, but CCRT may increase the incidence of treatment-related side effects. Due to the limitations of the number and quality of the included studies, the above conclusions need to be verified by more high-quality studies.

Bifidobacterium animalis subsp. lactis BB-12 alleviates hippocampal neuroinflammation and cognitive dysfunction of mice after whole brain irradiation / 中华放射医学与防护杂志

Objective:To investigate the effects of Bifidobacterium animalis subsp. lactis BB-12 on hippocampal neuroinflammation and cognitive function of mice after whole brain radiotherapy. Methods:A total of sixty male C57BL/6J mice aged 7-8 weeks were randomly divided into 5 groups with 12 mice in each group: control group (Con group), probiotic group (BB-12 group), irradiation group (IR group), irradiation and Memantine group (IR+ Memantine group), irradiation and probiotic group (IR+ BB-12 group). The model of radiation-induced brain injury of mice was established by 10 Gy whole brain radiotherapy with a medical linear accelerator. Y-maze test was used to evaluate the cognitive function. The activation of microglia and astrocytes was observed by immunofluorescence staining. The expressions of inflammatory cytokines interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) were detected by quantitative real-time reverse transcription polymerase chain reaction (QRT-PCR) and Western blot.Results:Y-maze test showed that, compared with Con group, the percentage of the times of reaching the novel arm in the total times of the three arms decreased significantly in the IR group ( t=5.04, P<0.05). BB-12 mitigated radiation-induced cognitive dysfunction ( t=4.72, P<0.05). Compared with Con group, the number ( t=3.05, 7.18, P<0.05) and circularity index ( t=6.23, 2.52, P<0.05) of Iba1 and GFAP positive cells were increased, the microglia and astrocytes were activated in the hippocampus of IR group, but these alterations were eliminated by BB-12. After whole brain IR, the mRNA and protein expression levels of inflammatory cytokines IL-1β, IL-6 and TNF-α in the hippocampus of mice were significantly increased compared with Con group ( tmRNA =4.10, 3.04, 4.18, P<0.05; tprotein=11.49, 7.04, 8.42, P<0.05), which were also significantly reduced by BB-12 compared with IR group ( tmRNA=4.20, 3.40, 2.84, P<0.05; tprotein=6.36, 4.03, 3.75, P<0.05). Conclusions:Bifidobacterium animalis BB-12 can suppress neuroinflammation mediated by microglia and astrocytes in the hippocampus of mice after radiotherapy and alleviates IR-induced cognitive dysfunction. Therefore, BB-12 has potential application in alleviating radiation induced brain injury.

Quantitative evaluation of global left ventricular myocardial work in patients with hepatitis B cirrhosis by pressure-strain loop / 中华肝脏病杂志

Objective: To quantitatively evaluate myocardial work in patients with hepatitis B cirrhosis by using left ventricular pressure-strain loop. Methods: 70 cases with hepatitis B cirrhosis who were hospitalized in Henan Provincial People's Hospital from March to December 2020 were selected as the study group. Patients were divided into three subgroups according to the Child-Pugh score of liver cirrhosis (Child-Pugh class A, B, and C groups: 25, 25, and 20 patients, respectively). At the same time, 25 healthy volunteers were included as the control group. Global longitudinal strain (GLS), global myocardial work index (GWI), global work efficiency (GWE), global constructive work (GCW), and global wasted work (GWW) were obtained by applying pressure-strain loops. The differences were analyzed and compared among the four groups parameters. Results: Compared with the control group, the Child-Pugh class A group had decreased GLS, while Child-Pugh class B and C had decreased GLS, GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Compared with Child-Pugh class A group, Child-Pugh class B group had decreased GLS, GWE, and increased GWW, while Child-Pugh class C group had decreased GLS,GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Compared with Child-Pugh class B group, Child-Pugh class C group had decreased GLS, GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Conclusion: The pressure-strain loop can detect early myocardial dysfunction, and has a certain value in the diagnosis, treatment and prognosis evaluation of myocardial function changes in patients with hepatitis B cirrhosis.

Meta-analysis of chrono-chemotherapy combined with radiotherapy for locally advanced nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective:To systematically compare the efficacy and safety of chrono-chemotherapy combined with radiotherapy in patients with locally advanced nasopharyngeal carcinoma.Methods:Seven databases were searched, including the Cochrane Library (Issue 5, 2021), PubMed, Embase, CBM, CNKI, VIP and Wanfang Database. The method ological quality of the eligible studies was evaluated. The Meta-analysis was performed by the Revman 5.3 software.Results:Sixteen studies consisting of 1275 patients were finally included. Among them, 642 patients were treated with chrono-chemotherapy combined with radiotherapy and 633 patients received conventional chemotherapy combined with radiotherapy. Results showed that compared with conventional chemotherapy group, the effective rate was significantly elevated ( OR=1.66, 95% CI: 1.17-2.34, P=0.004), the incidence of leucopenia, thrombocytopenia, gastrointestinal reaction, grade 3-4 oral mucosal reaction and grade 3-4 radiothermitis was significantly reduced (all P<0.001), and the quantity of CD3, CD4 and CD4/CD8 was significantly increased in the chrono-chemotherapy group. Conclusion:Current evidence shows that compared with conventional chemotherapy, chrono-chemotherapy combined with radiotherapy could improve the effective rate, reduce adverse reactions and mitigate the destruction of immune function simultaneously.

Value of high frequency ultrasonography for diagnosis of superficial intravascular tumors / 中华超声影像学杂志

Objective:To explore the high-frequency ultrasonographic and clinical features of superficial intravascular tumors.Methods:Thirteen superficial intravascular tumor patients who underwent ultrasound examination form Beijing Jishuitan Hospital during 2016-2020 were retrospectively analyzed. The location, anatomic blood vessels, shape, size, boundary, internal echo, blood flow and clinical characteristics of the tumors were analyzed.Results:Among the 13 cases, most of the tumors were oval like or long strip, and a few were round like. All 11 cases of primary intravascular tumors showed hypoechoic mass; 2 cases of intravascular metastasis or recurrence showed solid hypoechoic with hyperechoic mass. Arterial blood flow spectrum was detected in 12 cases. Two patients with glomus tumor showed typical tenderness at the fixed point. Two patients had a history of bone tumors in the upper or lower extremities.Conclusions:High frequency ultrasound can clearly recognize the location of the superficial intravascular tumors, describe the morphological characteristics and sonographic features of the tumor, then help to make a more accurate qualitative diagnosis.

Results and analysis of national personal dose monitoring intercomparison in 2021 / 中国辐射卫生

Objective@#To improve radiation testing institutions’ ability and levels of personal dose monitoring for external exposure and standardize monitoring work.@*Methods@#According to Testing Criteria of Personnel Dosimetry Performance for External Exposure (GBZ 207—2016), the intercomparison programme was made, the 2021 class-based personal dose monitoring intercomparison were organized by the National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention and provincial monitoring institutions.@*Results@#A total of 150 institutions participated in the 2021 national intercomparison of personal dose monitoring capability. Of them, 143 (95.3%) passed the assessment, including 51 excellent institutions (excellent rate, 34.0%), and 7 (4.7%) failed to pass the assessments.@*Conclusion@#The 2021 national personal dosimetry performance intercomparison showed great improvements in the pass rate and excellent rate compared with previous national assessments. However, still seven institutions failed to pass this assessment, including four institu- tions with class A qualifications. The testing institutions need to find out the reasons to increase their testing ability. This class-based intercomparison improved the point-to-plane relationship between the organizing and testing institutions, help- ing the organizing institution focus on improving the testing ability of provincial testing institutions and class A radiation health service institutions.

Clinical effects of free peroneal artery perforator flaps in repairing forefoot skin and soft tissue defect wounds assisted with three-dimensional computed tomography angiography / 中华烧伤杂志

Objective: To investigate the clinical effects of free peroneal artery perforator flaps in repairing forefoot skin and soft tissue defect wounds assisted with three-dimensional computed tomography angiography (3D-CTA). Methods: A retrospective observational study was conducted. From March 2017 to September 2019, 15 patients with skin and soft tissue defect wounds in the forefoot were treated in the Department of Burn and Plastic Surgery of Yidu Central Hospital of Weifang, including 12 males and 3 females, with age of 18-60 years. The wound area on admission was 3.0 cm×3.0 cm-9.0 cm×8.0 cm. The 3D-CTA examination before operation was performed to select the peroneal artery perforating vessels with appropriate length of vascular pedicle and good blood perfusion. According to the wound area and the perforating vessels of the peroneal artery located by 3D-CTA, the peroneal artery perforator flaps of 3.5 cm×3.5 cm-9.5 cm×8.5 cm carried with lateral sural cutaneous nerve was designed and cut, and the nerve was anastomosed with the nerve of the wound. The wound in the donor site of the flap was directly sutured or covered with medium-thickness skin graft from the thigh. The consistencies of type, diameter, and perforating position of perforating vessel of the peroneal artery detected by 3D-CTA before the operation with those of the actual measurement during operation were observed. The length of time for flap cutting and the survival of the flap after operation were recorded. During follow-up of 12 months after the operation, the patients were instructed to evaluate the foot function according to the Maryland foot function score standard, and the wound healing in the donor area and the occurrence of complications affecting the motor function of limb were observed. Data were statistically analyzed with paired sample t test. Results: The types of peroneal artery perforating vessels in patients measured during the operation were septocutaneous perforator of 12 cases, musculocutaneous perforator of 2 cases, and musculomuscular septal perforator of 1 case, which were consistent with those measured by preoperative 3D-CTA. The diameter of the peroneal artery perforating vessel measured by preoperative 3D-CTA was (1.38±0.17) mm, which was close to (1.40±0.19) mm measured during the operation (t=0.30, P>0.05). The horizontal distance from the starting point of the perforating vessel to the outer edge of the shank was (42±6) mm, and the vertical distance from the starting point of the perforating vessel to the level of the lateral ankle tip was (219±14) mm measured by preoperative 3D-CTA, which were respectively close to (43±6) and (221±15) mm of intraoperative measurement (with t values of 0.46 and 0.38, respectively, P>0.05). The length of time for cutting flap was (31±6) min. All flaps survived post operation without vascular crisis. During follow-up of 12 months after the operation, the foot function was evaluated as excellent in 11 cases, good in 3 cases, and fair in 1 case, the donor site wound healed well, the scar was not noticeable with no contracture, and the motor function of joints was not affected. Conclusions: Free peroneal artery perforator flap is one of the effective methods to reconstruct skin and soft tissue defect wounds in the forefoot, and the risk of surgery can be reduced when the anatomical location of the perforating vessels is confirmed by 3D-CTA.

Characteristics of Traditional Chinese Medicine Syndromes and Treatments of COVID-19 Patients from Two Hospitals Based on “Treatment of Disease in Accordance with Three Conditions” / 中国实验方剂学杂志

ObjectiveTo explore the guidance value of “treatment of disease in accordance with three conditions” theory in the prevention and treatment of corona virus disease 2019（COVID-19） based on the differences of syndromes and traditional Chinese medicine（TCM） treatments in COVID-19 patients from Xingtai Hospital of Chinese Medicine of Hebei province and Ruili Hospital of Chinese Medicine and Dai Medicine of Yunnan province and discuss its significance in the prevention and treatment of the unexpected acute infectious diseases. MethodDemographics data and clinical characteristics of COVID-19 patients from the two hospitals were collected retrospectively and analyzed by SPSS 18.0. The information on formulas was obtained from the hospital information system （HIS） of the two hospitals and analyzed by the big data intelligent processing and knowledge service system of Guangdong Hospital of Chinese Medicine for frequency statistics and association rules analysis. Heat map-hierarchical clustering analysis was used to explore the correlation between clinical characteristics and formulas. ResultA total of 175 patients with COVID-19 were included in this study. The 70 patients in Xingtai，dominated by young and middle-aged males，had clinical symptoms of fever， abnormal sweating，and fatigue. The main pathogenesis is stagnant cold-dampness in the exterior and impaired yin by depressed heat， with manifest cold， dampness， and deficiency syndromes. The therapeutic methods highlight relieving exterior syndrome and resolving dampness， accompanied by draining depressed heat. The core Chinese medicines used are Poria，Armeniacae Semen Amarum，Gypsum Fibrosum，Citri Reticulatae Pericarpium，and Pogostemonis Herba. By contrast，the 105 patients in Ruili， dominated by young females， had atypical clinical symptoms， and most of them were asymptomatic patients or mild cases. The main pathogenesis is dampness obstructing the lung and the stomach， with obvious dampness and heat syndromes. The therapeutic methods are mainly invigorating the spleen， resolving dampness， and dispersing Qi with light drugs. The core Chinese medicines used are Poria，Atractylodis Macrocephalae Rhizoma，Glycyrrhizae Radix et Rhizoma，Coicis Semen，Platycodonis Radix，Lonicerae Japonicae Flos， and Pogostemonis Herba. ConclusionThe differences in clinical characteristics， TCM syndromes， and medication of COVID-19 patients from the two places may result from different regions，population characteristics， and the time point of the COVID-19 outbreak. The “treatment of disease in accordance with three conditions” theory can help to understand the internal correlation and guide the treatments.

Regularity of prescriptions for intermediate and advanced lung cancer based on latent structure combined with association rules / 中国中药杂志

The present study explored the regularity of prescriptions for the treatment of intermediate and advanced lung cancer to provide references for clinical medication. CNKI, Wanfang, VIP, and CBM were searched for the research papers on the treatment of lung cancer by Chinese medicine published from database inception to May 31, 2021. The relevant information of qualified papers was extracted to establish a database. The Chinese medicines with frequency >3% underwent analysis of the latent structure and association rules by Lantern 5.0 and SPSS Molder 14.1, respectively, and the prescription regularity in the treatment of intermediate and advanced lung cancer was analyzed based on the frequency description. A total of 713 papers were included, involving 327 Chinese medicines with a cumulative frequency of 12 794 and 106 prescriptions with a cumulative frequency of 824. The commonly used Chinese medicines were dominated by deficiency-tonifying, heat-clearing, phlegm-resolving, and cough/dyspnea-relieving drugs, such as Astragali Radix, Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Ophiopogonis Radix, Poria, and Hedyotis Diffusa, which are cold, warm, and plain in nature and sweet, bitter, and pungent in flavor, and mainly act on lung, spleen, and stomach meridians. Commonly used prescriptions included Shashen Maidong Decoction, Liujunzi Decoction, and Baihe Gujin Decoction. The latent structure analysis revealed 32 latent variables and 65 hidden classes. Six comprehensive clustering models and 11 core prescriptions were obtained by professional knowledge inference. The common syndromes of intermediate and advanced lung cancer were inferred to be Qi and Yin deficiency in the lung, Qi deficiency in the lung and spleen, Yin deficiency in the liver and kidney, combined phlegm and stasis, phlegm-heat obstructing lung, and Qi stagnation and blood stasis. Forty-four strong associations were screened out by association rules analysis, including four pairwise strong associations(Polygonati Odorati Rhizoma→Ophiopogonis Radix, Polygonati Odorati Rhizoma→Glehniae Radix, Amomi Fructus→Atractylodis Macrocephalae Rhizoma, and Polygonati Rhizoma→Astragali Radix) and 40 triplet strong associations(such as Trichosanthis Radix+Glehniae Radix→Ophiopogonis Radix, Polygonati Odorati Rhizoma+Glehniae Radix→Ophiopogonis Radix, Trichosanthis Radix+Ophiopogonis Radix→Glehniae Radix, and Scutellariae Barbatae Herba+Codonopsis Radix→Hedyotis Diffusa). In the treatment of intermediate and advanced lung cancer, Qi-replenishing and Yin-nourishing drugs are mainly employed, assisted with cancer-resisting, toxin-removing, spleen-invigorating, phlegm/stasis-resolving, and blood-activating drugs based on syndrome differentiation. The roots were treated following the principles of tonifying lungs and replenishing the spleen, and symptoms following the principles of removing the toxin, dispelling stasis, and resolving phlegm.

Research progress in estimation and monitoring of individual exposure dose based on mobile phones / 中国辐射卫生

In case of accidental exposure, a rapid assessment of radiation dose is of great significance for taking timely countermeasures. Finding an alternative portable emergency dosimeter is crucial for people who have been exposed to accidental radiation but are not equipped with a personal dosimeter. In addition, the real-time monitoring of radiation dose level in the normal environment can meet the needs of the public to know their health status in time. Thus, the portability and intelligence of mobile phones attract researchers to carry out related work. This article reviews the research progress in individual exposure dose estimation and monitoring based on mobile phones.

Analysis of pathological data and epidemiological characteristics of 10 684 cases of renal biopsy in Xinjiang Uygur Autonomous Region / 中华肾脏病杂志

Objective:To investigate the composition of the renal disease spectrum and epidemiological characterisics for renal biopsy cases in Xinjiang Uygur Autonomous Region.Methods:The clinical and pathological data of 10 684 renal biopsy cases from 12 hospitals in Xinjiang Uygur Autonomous Region from August 1986 to December 2019 were collected and the composition of renal diseases and pathological types were analyzed retrospectively.Results:Among the 10 684 renal biopsy cases with 5 595 males and 5 089 females, 7 804 cases (73.04%) were Han nationality, 2 357 cases (22.06%) were Uygur nationality and 523 cases (4.90%) were other nationalities. Among the 10 684 cases of renal biopsy, primary glomerular disease, secondary glomerular disease, tubulointerstitial disease, end-stage renal disease, genetic and congenital disease and post transplant glomerular disease were 8 533 cases (79.87%), 1 740 cases (16.29%), 229 cases (2.14%), 121 cases (1.13%), 46 cases (0.43%) and 15 cases (0.14%), respectively. The distribution of kidney diseases in Han, Uygur and other nationalities (except Han and Uygur in this region) was the same as that in general. There was no significant difference in disease type composition between Han and Uygur, Han and other nationalities, and Uygur and other nationalities (all P>0.05). Among the 8 533 cases of primary glomerular diseases, the top five pathological types were IgA nephropathy (3 095 cases, 36.27%), mesangial proliferative glomerulonephritis (2 008 cases, 23.53%), membranous nephropathy (1 503 cases, 17.61%), minimal glomerulopathy (567 cases, 6.64%) and focal segmental glomerulosclerosis (494 cases, 5.79%). The top five pathological types of primary glomerular diseases were different between Han and Uygur, and Han and other nationalities (both P<0.01). There was no statistically significant difference between Uygur and other nationalities in the top five pathological types of primary glomerular diseases ( P=0.113). Among 1 740 cases of secondary glomerular diseases, the top five pathological types were lupus nephritis (517 cases, 29.71%), Henoch-Sch?nlein purpura nephritis (304 cases, 17.47%), diabetic glomerulosclerosis (285 cases, 16.38%), benign renal arteriosclerosis (196 cases, 11.26%) and systemic vasculitis (101 cases, 5.80%). It was different between Han and Uygur, Han and other nationalities, and Uygur and other nationalities in the top five pathological types of secondary glomerular diseases. Conclusions:Primary glomerular disease accounts for 79.87% of renal diseases in Xinjiang Uygur Autonomous Region. IgA nephropathy is the main pathological type, followed by mesangial proliferative glomerulonephritis and membranous nephropathy. The most common pathological type of secondary glomerular disease in this region is lupus nephritis, followed by Henoch-Sch?nlein purpura nephritis and diabetic glomerulosclerosis. The top five pathological types of primary glomerular diseases and secondary glomerular diseases are different in different ethnic groups in Xinjiang Uygur Autonomous Region.