Surveillance of the progression and assessment of treatment endpoints for nonalcoholic steatohepatitis

Nonalcoholic steatohepatitis (NASH) is an aggressive form of nonalcoholic fatty liver disease (NAFLD) characterized by steatosis-associated inflammation and liver injury. Without effective treatment or management, NASH can have life-threatening outcomes. Evaluation and identification of NASH patients at risk for adverse outcomes are therefore important. Key issues in screening NASH patients are the assessment of advanced fibrosis, differentiation of NASH from simple steatosis, and monitoring of dynamic changes during follow-up and treatment. Currently, NASH staging and evaluation of the effectiveness for drugs still rely on pathological diagnosis, despite sample error issues and the subjectivity associated with liver biopsy. Optimizing the pathological assessment of liver biopsy samples and developing noninvasive surrogate methods for accessible, accurate, and safe evaluation are therefore critical. Although noninvasive methods including elastography, serum soluble biomarkers, and combined models have been implemented in the last decade, noninvasive diagnostic measurements are not widely applied in clinical practice. More work remains to be done in establishing cost-effective strategies both for screening for at-risk NASH patients and identifying changes in disease severity. In this review, we summarize the current state of noninvasive methods for detecting steatosis, steatohepatitis, and fibrosis in patients with NASH, and discuss noninvasive assessments for screening at-risk patients with a focus on the characteristics that should be monitored at follow-up.

Application of extracorporeal membrane oxygenation in the treatment of persistent pulmonary hypertension of the newborn / 中国当代儿科杂志

OBJECTIVES@#To study the clinical value of extracorporeal membrane oxygenation (ECMO) in the treatment of persistent pulmonary hypertension of the newborn (PPHN).@*METHODS@#A retrospective analysis was performed on the medical data of 11 neonates with PPHN who were treated with ECMO in the Neonatal Intensive Care Unit of Zhongshan People's Hospital from January 2015 to December 2021, involving the neonates' general information, clinical diagnosis, laboratory results, duration of ECMO treatment, complications during ECMO treatment, length of hospital stay, and outcome.@*RESULTS@#Of the 11 neonates, 10 (91%) had successful weaning from ECMO, and 8 (73%) survived. For the 11 neonates, the mean duration of ECMO treatment was (81±50) hours (range: 26 to 185 hours), the mean duration of ventilator use was (198±105) hours (range: 57 to 392 hours), and the mean length of hospital stay was (22±15) days (range: 2 to 49 days). The oxygenation index and blood lactate level were significantly improved after 24 hours of ECMO treatment among the 11 neonates (P<0.05). Ten neonates had significantly reduced pulmonary artery pressure after 24 hours of ECMO treatment (P<0.05). One neonate had a progressive increase in the pulmonary artery pressure during EMCO treatment, succumbing to death. This neonate was diagnosed with alveolar capillary dysplasia based on the histopathological findings of the lung tissue and whole-exome sequencing results. Among the 11 children, 5 had intracranial hemorrhage, 1 had disseminated intravascular coagulation, 1 had gastric hemorrhage, 2 had pulmonary hemorrhage, 1 had renal insufficiency, and 3 had bleeding at the puncture site during ECMO treatment.@*CONCLUSIONS@#ECMO is effective for the treatment of PPHN, however, the high incidence of complications of ECMO treatment suggests that it is important to carefully assess the indications and timing of ECMO treatment and improve the management of ECMO, which can improve the weaning rate and survival rate.

Endemic situation of schistosomiasis in Suzhou City from 2010 to 2020 / 中国血吸虫病防治杂志

Objective To analyze the endemic status of schistosomiasis in Suzhou City from 2010 to 2020, so as to provide the evidence for formulating the future schistosomiasis control strategy. Methods The data pertaining to the endemic status of schistosomiasis in Suzhou City from 2010 to 2020 were retrieved from the annual schistosomiasis control report, the information management platform of schistosomiasis (parasitic diseases) in Jiangsu Province and the Parasitic Diseases Control Information Management System of Chinese Center for Disease Control and Prevention, including snail survey data, snail control data and schistosomiasis examination data, and were retrospectively reviewed. Differences of proportions were tested for statistical significance with chi-square test, and the trends in proportions were evaluated using the chi-square test for trends. Results Elimination of schistosomiasis was achieved in Suzhou City in 2018, and there were 3.528 9 million residents living in schistosomiasis-endemic villages of 81 townships in 9 counties. A total of 707 600 labor-days were used for snail survey in 11 586 village-times in Suzhou City from 2010 to 2020, covering 18 572.73 hm2, and snail habitats were detected with an area of 68.61 hm2, including emerging snail habitats of 37.30 hm2. A total of 23 144 snails were dissected, and no Schistosoma japonicum infection was detected. Reemerging and emerging snail habitats were predominantly found in inlands. During the period from 2010 to 2020, snail control was performed in Suzhou City for 71 000 labor-times, and snail control was done covering 269.34 hm2 through chemical treatment and covering 3.48 hm2 through environmental improvements. A total of 674 002 person-times received serological tests for S. japonicum infections in Suzhou City from 2010 to 2020, with seroprevalence of 0.38%, and a total of 33 835 person-times received stool examinations, with no egg-positives identified. The sero-prevalence of S. japonicum infections appeared an overall tendency towards a rise in Suzhou City from 2010 to 2020 (χ2 = 129.48, P < 0.001). The sero-prevalence of S. japonicum infections appeared high among local residents in 2016, and remained stable in other years, while the sero-prevalence of S. japonicum infections appeared an overall tendency towards a rise among mobile populations (χ2 = 54.11, P < 0.001). There were 278 800 and 175 202 serological tests among local residents and mobile populations in Suzhou City from 2013 to 2020, and 0.50% and 0.35% sero-prevalence rates were detected, respectively. The sero-prevalence of S. japonicum infections was significantly higher among local residents than among mobile populations in Suzhou City (χ2= 54.76, P < 0.001). Conclusions There is a risk of rebound of schistosomiasis in Suzhou City. Integrated control should be reinforced to prevent the risk of rebound of schistosomiasis in Suzhou City.

Electroacupuncture on motor function in patients with primary osteoporosis: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture on motor function and muscle state in patients with primary osteoporosis (POP).@*METHODS@#A total of 60 female patients with POP were randomized into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 1 case dropped off). On the basis of adjusting lifestyle, caltrate was given orally in the control group, 2 pills a day for 4 weeks. On the basis of the treatment in the control group, electroacupuncture was applied at Zusanli (ST 36), Yanglingquan (GB 34), Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23), etc. in the observation group, with disperse-dense wave of 2 Hz/10 Hz in frequency, once every other day, 3 times a week for 4 weeks. The time of timed up-and-go test (TUGT) and the value of 10 m maximal walking speed (10 m MWS) before and after treatment were compared in the two groups, and the Young's modulus values of bilateral multifidus muscles in prone position and sitting position before and after treatment were compared by real-time shear wave elastography (SWE) in the two groups.@*RESULTS@#After treatment, the TUGT time was decreased compared before treatment in the observation group (P<0.01), and that in the observation group was shorter than the control group (P<0.01). After treatment, the value of 10 m MWS test was increased compared before treatment in the observation group (P<0.05). After treatment, the Young's modulus values of bilateral multifidus muscles in prone position and sitting position were increased compared before treatment in the observation group (P<0.01); except for the left side in sitting position, the Young's modulus values of multifidus muscles in the observation group were higher than those in the control group (P<0.01, P<0.05).@*CONCLUSION@#On the basis of oral caltrate, electroacupuncture can improve the motor function and muscle state in patients with POP.

Longitudinal study on the trajectory and influencing factors of cancer-related fatigue in patients with lung cancer during perioperative period / 中国实用护理杂志

Objective:To explore the changing track of cancer-related fatigue in patients with lung cancer during perioperative period and analyze its influencing factors.Methods:From December 2020 to May 2021, 162 eligible patients with lung cancer were selected in the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital by convenient sampling method. Mental resilience and social support were investigated before operation (T0);and cancer-related fatigue was investigated before operation (T0),3 days after operation (T1), 1 week after operation (T2), 2 weeks after operation (T3) and 1 month after operation (T4), and Latent Class Growth Model was used to identify the track categories. Logistic regression analysis was used to analyze the influencing factors.Results:Three cancer-related fatigue tracks were fitted in this study, which were no fatigue group (31.7%), increased fatigue group (36.0%) and sustained fatigue group (32.3%). Univariate analysis showed that smoking history ( χ2=14.83, P<0.05), BMI ( χ2=29.67, P<0.05), hemoglobin count ( F=4.57, P<0.05), mental resilience ( F=35.53, P<0.05), social support ( F=47.53, P<0.05) were related to the track category of cancer-related fatigue. Logistic regression analysis showed that smoking history, over weight/obesity, resilience and social support were the predictors of cancer-related fatigue locus ( P<0.05). Conclusions:Perioperative cancer-related fatigue of patients with lung cancer has different change trajectories, patients with higher BMI and lower resilience are more likely to have a tendency of persistent fatigue. Patients with smoking history and lower social support are more likely to have an upward trend of fatigue. For this kind of lung cancer patients, medical staff should take timely and effective intervention measures to improve their cancer-related fatigue.

Analysis of clinical characteristics of diagnosis and treatment of 18 patients with Caroli syndrome / 中华消化杂志

Objective:To summarize and analyze the clinical, laboratory and imaging characteristics of patients with Caroli syndrome (CS), so as to deepen the understanding of the disease and explore the possible methods for improving early diagnosis.Methods:From January 2008 to June 2021, the clinical data of 18 CS patients who were hospitalized in Peking Union Medical College Hospital and diagnosed by pathology or by clinical and imaging features were collected. The general data, clinical manifestations, laboratory examination (white blood cell count, hemoglobin, etc.), imaging features (ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI)), and diagnosis and treatment of the patients were retrospectively analyzed. Descriptive method was used for statistical analysis.Results:The median age of 18 CS patients was 18 years old (ranged from 1 to 39 years old); there were 10 male and 8 female patients with a male-to-female ratio of 5∶4. The median time from symptom onset to diagnosis was 24 months (ranged from 1 month to 28 years). At the time of diagnosis, 15 patients had already had portal hypertension-related complications, and 8 patients had biliary infections. The common symptoms included abdominal distension (6 cases), fever with or without abdominal pain (5 cases), and loss of appetite (3 cases). The common abnormal laboratory findings included peripheral white blood cell count, hemoglobin level and platelet count below the normal reference value range, alanine aminotransferase and bilirubin level above the normal reference value range, and 4 patients had positive autoantibodies. Four patients were clearly diagnosed according to the pathology of liver biopsy, 14 patients were clearly diagnosed by imaging. Among which the diagnostic rate of abdominal ultrasonography for CS was 4/18, CT was 11/15, and MRI or magnetic resonance cholangiopancreatography was 12/16. The typical features of abdominal ultrasonography were liver cysts with splenomegaly, typical manifestation of CT was intrahepatic bile duct dilatation with " central dot sign", and MRI typically manifested as multiple cystic dilatations of intrahepatic bile ducts. Among the 18 patients with CS, 1 case underwent right hepatectomy, 3 cases were waiting for liver transplantation, and the other 14 patients chose symptomatic treatment due to economic reasons.Conclusions:The clinical manifestations and laboratory findings of CS patients lack specificity, and the diagnosis of most patients is delayed. The lack of understanding of the disease by clinical and imaging doctors may be one of the reasons affecting the early diagnosis of CS patients. The findings of splenomegaly and liver cysts by abdominal ultrasound may provide clues for the diagnosis of CS for clinical and imaging doctors.

Effect of Ethyl Acetate Extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis on Intestinal Flora in ApoE-/- Mice with Atherosclerosis / 中国实验方剂学杂志

ObjectiveTo observe the effect of ethyl acetate extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis on high-fat diet-induced apolipoprotein E gene knockout （ApoE-/-） mice， and explore its mechanism of treating atherosclerosis by regulating intestinal flora. MethodThirty-two 8-week-old male ApoE-/- mice were randomly divided into model group， rosuvastatin group （10 mg·kg-1）， high-， low-dose groups of ethyl acetate extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis （75， 25 mg·kg-1）， with 8 mice in each group. Eight C57BL/6 mice were used as blank group. After 8 weeks of continuous administration， blood was taken to determine the blood lipid level. Enzyme-linked immunosorbent assay （ELISA） was used to detect the contents of related indexes in serum of mice. Hematoxylin-eosin （HE） staining was used to observe the formation of aortic plaque in mice. Cecal contents were collected and 16S rRNA amplicon sequencing was used to detect intestinal flora. ResultCompared with the blank group， the plaque area of the model group was significantly increased with inflammatory infiltration， the contents of triglyceride （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， inflammatory factors and inducible nitric oxide synthase （iNOS） were increased， while the content of high-density lipoprotein cholesterol （HDL-C） was decreased. Compared with the model group， rosuvastatin group and high- and low-dose groups of ethyl acetate extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis could improve the deposition of aortic plaque， reduce the contents of TG， TC， LDL-C， inflammatory factors and iNOS， and increase the content of HDL-C. Compared with the blank group， the relative abundances of Firmicutes and Proteobacteria in the model group increased， while the relative abundance of Bacteroidetes decreased. Alpha and Beta diversity analysis showed that samples of each group could be significantly isolated， and the total number and abundance of intestinal flora species in the model group were low. Compared with the model group， ethyl acetate extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis could increase the relative abundance of beneficial bacteria and decrease the relative abundance of pathogenic bacteria. ConclusionEthyl acetate extract of Acanthopanacis Senticosi Radix et Rhizoma seu Caulis was mainly composed of flavonoids， which can treat atherosclerosis by regulating the intestinal flora and improve the pathological changes in the aorta of ApoE-/- mice induced by high-fat diet. The mechanism may be related to its ability to reduce the level of inflammatory factors， improve antioxidant capacity and repair the disorder of intestinal flora structure.

Physical Activity and Functional Rehabilitation for Aging People Based on ICF: A Scoping Review / 中国康复理论与实践

Objective:To review the categories of physical activities and rehabilitation exercise for aging people based on the theory and method of the International Classification of Functioning, Disability, and Health (ICF). Methods:From the framework and coding of ICF, physical activities, rehabilitation exercise and functional improvement for the aging people were reviewed. Results:There were three typical physical activities: physical fitness, skills and sports, mainly including regular exercises, cognitive amusements, leisure sports activities, recreational sports activities, rehabilitation exercises, etc. Physical activities promoted the functioning of the aging people, including mental function (b1), pain and sensory dysfunction (b2), cardiovascular, blood, the function of the immune system and respiratory system (b4), digestion, metabolism and function of the endocrine system (b5), nerve musculoskeletal function related to movement (b7), the function of skin and related structures (b8), activity (d4), and community, social and civic life (d9), etc., especially body mass index, cardiovascular, physical fitness (muscular strength and endurance, aerobic endurance), balance, flexibility, upper and lower extremities strength, sleep, metabolic capability, cognitive function and anti-aging ability. There were more gains at individual levels, including promotion of subjective happiness, quality of life, reducing depression, risk of sarcopenia, dementia and falling, etc. The environmental and personal factors related to activity and participation in physical activities included the products and technologies (e1), natural environment and man-made changes to the environment (e3), support and interpersonal relationships (e3), attitude, service system and policy (e5), such as urban environment, building environment, street pavement behavior, weather, caregivers, accompany of family and friends, etc. Conclusion:The physical activities and rehabilitation exercise the aged joined include physical fitness activities, skills activities, and sports activities. The physical activities had effects on the rehabilitation of the aged including the function of the body(mental function, pain and sensory dysfunction, cardiovascular, blood, the function of the immune system and respiratory system, digestion, metabolism, and function of the endocrine system, nerve musculoskeletal function related to movement, the function of skin and related structures) and the participation in activities (activities, community, society and civic life). The function of the body works for the health of the aged to promote physical health, mental health, functional health, social adjustment and social well-being.

Physical Activity and Functional Rehabilitation for Children and Youth Based on ICF-CY: A Systematic Review / 中国康复理论与实践

Objective:To systematically review and develop the categories in the fields of recreational physical activities and rehabilitation exercise for the children and youth with disabilities based on the theory and method of International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY). Methods:The literatures about physical activities and rehabilitation exercise for children and youth with disabilities were retrieved with subject retrieval method, from the database of CNKl, Wanfang Data, PubMed and Web of Science, until December 31st, 2020. The authors, countries, published time, published journals, research objectives, object of the study and their ages, data collection tool, and the key findings were extracted. Results:A total of 1920 literatures were returned, and 26 of them were enrolled, which were published in eleven countries, and mainly from the journals of medicine, public health, exercise and rehabilitation for people with disabilities, and mainly published after 2010. The researches mainly used questionnaire survey, experimentation and measurement methods. There were three typical recreational physical activities: physical fitness activities, skills activities and sports activities, mainly including physical activities in daily life, recreational and leisure activities, sports activities, school physical education courses and rehabilitation training, etc. According to the framework of ICF-CY, physical activities might promote functional recovery for children and youth with disabilities, in b body functions, including bl mental function; b2 sensory function and pain; b4 cardiovascular, blood, the function of the immune system and respiratory system; b5 digestion, metabolism and function of the endocrine system; and b7 nerve musculoskeletal function related to movement; and d activities and participation, including d2 the general tasks and requirements; d4 activity; d5 self-care; d6 family life; d7 interpersonal communication and interpersonal relationship; d8 main area of life and d9 community, social and civic life. The evidences showed benefits of improvement in the fields of gross motor function, muscle strength, balance coordination, walking, running, dexterity and functioning of hand, cardio-respiratory fitness, body composition, and pain relief. Further more, there were gains at improvement of the quality of life, well-being, social support and self-efficacy, taking an active part in all kinds of leisure activities and physical activity, increasing the range of activities, etc. The environmental and personal factors might affect the participation and performance in physical activities for children and youth, including e1 products and technologies, e2 natural environment and man-made changes to the environment, e3 support and interpersonal relationships, e4 attitude, e5 service system and policy, including physical and built environment, assistive technology, activity facilities, transportation, physical accessibility and availability of community leisure and recreational activities, athletic ability, orientation of family activities, family environment, etc. Conclusion:The physical activities may promote the recovery of body function, and activities and participation for children and youth with disabilities. The environmental and personal factors may affect the participation and performance in physical activities.

Advances in the study of visual pathway injury in glaucoma and the neuroplasticity of the visual system after injury / 国际眼科杂志(Guoji Yanke Zazhi)

@#Glaucoma is a group of diseases characterized by progressive optic nerve atrophy and visual field defects. Some evidence demonstrate that glaucoma's pathological damage affects the retina and optic nerve and involves the entire visual pathway. Recent studies have found that the nerve injury is not completely irreversible but has certain plasticity. Furthermore, studies have shown that neurons in the visual pathway of glaucoma can be repaired and remodeled under certain conditions to restore visual function, which offers a new way to treat glaucoma.

Analysis of the first national public health practice skills competition among college students / 中华劳动卫生职业病杂志

To analyze the difficulty, distinction and result of the first national public health practice skills competition among college students, it showed the general situation of this competition, and discussed the present situation, problems and countermeasures of skills training for students majoring in preventive medicine. Based on such competition, educators can promote teaching reform and post competency training.

A human circulating immune cell landscape in aging and COVID-19

Age-associated changes in immune cells have been linked to an increased risk for infection. However, a global and detailed characterization of the changes that human circulating immune cells undergo with age is lacking. Here, we combined scRNA-seq, mass cytometry and scATAC-seq to compare immune cell types in peripheral blood collected from young and old subjects and patients with COVID-19. We found that the immune cell landscape was reprogrammed with age and was characterized by T cell polarization from naive and memory cells to effector, cytotoxic, exhausted and regulatory cells, along with increased late natural killer cells, age-associated B cells, inflammatory monocytes and age-associated dendritic cells. In addition, the expression of genes, which were implicated in coronavirus susceptibility, was upregulated in a cell subtype-specific manner with age. Notably, COVID-19 promoted age-induced immune cell polarization and gene expression related to inflammation and cellular senescence. Therefore, these findings suggest that a dysregulated immune system and increased gene expression associated with SARS-CoV-2 susceptibility may at least partially account for COVID-19 vulnerability in the elderly.

A human circulating immune cell landscape in aging and COVID-19

Age-associated changes in immune cells have been linked to an increased risk for infection. However, a global and detailed characterization of the changes that human circulating immune cells undergo with age is lacking. Here, we combined scRNA-seq, mass cytometry and scATAC-seq to compare immune cell types in peripheral blood collected from young and old subjects and patients with COVID-19. We found that the immune cell landscape was reprogrammed with age and was characterized by T cell polarization from naive and memory cells to effector, cytotoxic, exhausted and regulatory cells, along with increased late natural killer cells, age-associated B cells, inflammatory monocytes and age-associated dendritic cells. In addition, the expression of genes, which were implicated in coronavirus susceptibility, was upregulated in a cell subtype-specific manner with age. Notably, COVID-19 promoted age-induced immune cell polarization and gene expression related to inflammation and cellular senescence. Therefore, these findings suggest that a dysregulated immune system and increased gene expression associated with SARS-CoV-2 susceptibility may at least partially account for COVID-19 vulnerability in the elderly.

Influence of local anesthesia on the outcomes of non-surgical periodontal treatment / 中华医学杂志(英文版)

BACKGROUND@#There is limited evidence of the effects of local anesthesia (LA) on outcomes of non-surgical periodontal treatment (NSPT), in particular among the Chinese. This retrospective cohort study aimed to evaluate the effects of LA on short-term treatment outcomes of NSPT and to determine under what circumstances LA should be prescribed to improve these outcomes.@*METHODS@#Data from periodontal examinations of 3980 patients were used. The data were from 3-month re-evaluation records of an electronic periodontal charting record system in the Department of Periodontology of Peking University School and Hospital of Stomatology from June 2008 to January 2015. Descriptive analyses included changes in probing depth (PD) and the Mazza bleeding index (BI). Two-level (patient and tooth) logistic regression models and three-level (patient, tooth, and site) linear regression models were constructed to analyze the influence of LA on PD for all teeth/sites and teeth/sites with an initial PD ≥ 5 mm. Decreases in PD and BI at sites under LA using the initial PD were also compared.@*RESULTS@#A significantly higher mean decrease in PD after NSPT was found in the LA group than in the no local anesthesia (NLA) group (0.98 vs. 0.54 mm, t = 24.12, P  1 and BI > 2) for all teeth (16.7% vs. 13.8%, t = 3.75, P < 0.001; 34.7% vs. 28.1%, t = 6.73, P < 0.001) and PD for teeth with PD ≥ 5 mm (32.3% vs. 17.3%, t = 28.48, P < 0.001). The difference in PD between the LA and NLA groups increased as the initial PD increased. The difference between the two groups was 0.12 to 0.22 mm for sites with a baseline PD < 7 mm; however, it increased to 0.41 to 1.37 mm for sites with a baseline PD ≥ 7 mm.@*CONCLUSIONS@#LA improved the decrease in PD after NSPT. Root debridement at sites with initial PD ≥ 7 mm should be performed under routine LA.

Development of an artificial intelligence diagnostic model based on dynamic uncertain causality graph for the differential diagnosis of dyspnea / 医学前沿

Dyspnea is one of the most common manifestations of patients with pulmonary disease, myocardial dysfunction, and neuromuscular disorder, among other conditions. Identifying the causes of dyspnea in clinical practice, especially for the general practitioner, remains a challenge. This pilot study aimed to develop a computer-aided tool for improving the efficiency of differential diagnosis. The disease set with dyspnea as the chief complaint was established on the basis of clinical experience and epidemiological data. Differential diagnosis approaches were established and optimized by clinical experts. The artificial intelligence (AI) diagnosis model was constructed according to the dynamic uncertain causality graph knowledge-based editor. Twenty-eight diseases and syndromes were included in the disease set. The model contained 132 variables of symptoms, signs, and serological and imaging parameters. Medical records from the electronic hospital records of Suining Central Hospital were randomly selected. A total of 202 discharged patients with dyspnea as the chief complaint were included for verification, in which the diagnoses of 195 cases were coincident with the record certified as correct. The overall diagnostic accuracy rate of the model was 96.5%. In conclusion, the diagnostic accuracy of the AI model is promising and may compensate for the limitation of medical experience.

A human circulating immune cell landscape in aging and COVID-19

Age-associated changes in immune cells have been linked to an increased risk for infection. However, a global and detailed characterization of the changes that human circulating immune cells undergo with age is lacking. Here, we combined scRNA-seq, mass cytometry and scATAC-seq to compare immune cell types in peripheral blood collected from young and old subjects and patients with COVID-19. We found that the immune cell landscape was reprogrammed with age and was characterized by T cell polarization from naive and memory cells to effector, cytotoxic, exhausted and regulatory cells, along with increased late natural killer cells, age-associated B cells, inflammatory monocytes and age-associated dendritic cells. In addition, the expression of genes, which were implicated in coronavirus susceptibility, was upregulated in a cell subtype-specific manner with age. Notably, COVID-19 promoted age-induced immune cell polarization and gene expression related to inflammation and cellular senescence. Therefore, these findings suggest that a dysregulated immune system and increased gene expression associated with SARS-CoV-2 susceptibility may at least partially account for COVID-19 vulnerability in the elderly.

Evaluation of interference factors in creatinine measurement by using new guideline CLSI EP7-A3 / 中华检验医学杂志

Objective:To investigate the interfering factors in the determination of creatinine(Cr) using the American Clinical Laboratory Standards Association (CLSI) EP7-A3 document.Methods:According to the CLSI EP7-A3 document, fresh serum (no hemolysis, lipemia, and jaundice) was used on the day of the experiment and confirmed the interfering substances through the pairing difference experiment and the point-to-point analysis method was used in the dose effect experiment to clarify the difference of interfering substances.Results:Triglyceride (16.94 mmol/L), dobutamine hydrochloride (4.01 μmol/L), ascorbic acid (298 μmol/L) did not interfere with the determination of Cr. Free bilirubin (684 μmol/L), conjugated bilirubin (684 μmol/L), calcium hydroxybenzene sulfonate (144 μmol/L) and hemoglobin (10 g/L) were used as the maximum concentrations of interferences for the dose effect test, the results showed that the above interferences had negative interference on the determination of Cr.Conclusion:According to EP7-A3, it is valuable to evaluate the interference factors of creatinine determination.

Effect of thunder-fire moxibustion combined with vibration training on low back pain of primary osteoporosis / 中国针灸

OBJECTIVE@#To compare the therapeutic effect of thunder-fire moxibustion combined with vibration training and simple vibration training on low back pain of primary osteoporosis by 's modulus of ultrasonic wave, and seek an objective evaluating method.@*METHODS@#A total of 60 patients were randomized into an observation group and a control group, 30 cases in each one. The patients in the two groups were treated with vibration training using whole body vibration treatment bed. In the observation group, thunder-fire moxibustion was applied at Yaoyangguan (GV 3), Mingmen (GV 4), Ganshu (BL 18), Shenshu (BL 23) and Dachangshu (BL 25). The treatment was given once every other day, 3 times a week for 4 weeks. The visual analogue score (VAS), real-time shear wave elastography (RTSWE) and medical outcomes study 36-item short-form hearth survey (SF-36) were used to evaluate pain intensity, multifidus muscle tone ('s modulus) and quality of life before treatment, after 4-week treatment and 1 month after treatment.@*RESULTS@#Compared before treatment, the VAS scores, 's modulus of multifidus muscle and 5 dimensions of SF-36 (physical condition, body pain, general health, social function and mental health) after 4-week treatment and 1 month after treatment were significantly improved in the two groups (all <0.05), the physiological role in the observation group after 4-week treatment and 1 month after treatment were improved (both <0.05). In the observation group, the VAS scores, 's modulus of multifidus muscle and 3 dimensions of SF-36 (physiological role, body pain and general health) after 4-week treatment and 1 month after treatment were superior to the control group (all <0.05).@*CONCLUSION@#The therapeutic effect of thunder-fire moxibustion combined with vibration training is superior to simple vibration training in relieving low back pain intensity and multifidus muscle tone, and improving quality of life for primary osteoporosis. RTSWE technique can be an objective examination method to evaluate pain.

Grade Standard of Ginseng Radix et Rhizoma / 中国实验方剂学杂志

Objective:Through the analysis of the characteristics and main chemical components of Ginseng Radix et Rhizoma,the correlation between the characteristics and components of Ginseng Radix et Rhizoma was explored,and a new evaluation standard of Ginseng Radix et Rhizoma grade was established to provide a more comprehensive and scientific basis for the quality evaluation of Ginseng Radix et Rhizoma. Method:The appearance characteristics of 48 batches of Ginseng Radix et Rhizoma samples were quantitatively measured. The contents of 9 kinds of Ginseng Radix et Rhizoma were determined. The results of correlation analysis,principal component analysis and cluster analysis were used to classify ginseng medicinal materials according to the analysis results,and the grade evaluation criteria were constructed. Result:First-class ginseng medicinal materials:diameter of main root>1.72 cm,length of reed head>2.61 cm,weight of single branch>14.15 g,content of ginsenoside Rb1>0.612 1%,content of ginsenoside Re>0.385 8%,content of ginsenoside Rg1>0.320 8%,no scar,impurities,moth,mildew. Second-class ginseng medicinal materials:the diameter of main root is 1.55-1.72 cm,the length of reed head is 1.74-2.61 cm,the weight of single branch is 10.24-14.15 g,the content of ginsenoside Rb1 is 0.496 8%-0.612 1%,the content of ginsenoside Re is 0.323 3%-0.385 8%,the content of ginsenoside Rg1 is 0.263 6%-0.320 8%,and there are no scars,impurities,worms and mildew. Third-class ginseng medicinal materials:main root diameter 1.29-1.55 cm,reed head length 1.34-1.74 cm,single branch weight 6.90-10.24 g,ginsenoside Rb1 content 0.389 5%-0.496 8%,ginsenoside Re content 0.235 2%-0.323 3%,ginsenoside Rg1 content 0.217 1%-0.263 6%,no impurities,worms,mildew. Fourth-class ginseng medicinal materials:diameter of main root11Conclusion:The appearance indexes of ginseng medicinal materials were divided according to the standards of taproot diameter,reed head length and single ginseng weight,and the content of ginsenoside Rg1,Re,Rb1 was used as the internal quality evaluation index. Ginseng commercial specifications were divided into four grades,which integrated the appearance and internal indicators,and had more scientific and comprehensive characteristics,which could be used as the basis for the classification of Ginseng Radix et Rhizoma medicinal materials.

Application of L3 skeletal muscle index in evaluating prognosis of diseases / 第二军医大学学报

L3 skeletal muscle index (L3 SMI) is an emerging nutritional assessment tool. It has been well documented that L3 SMI can correctly reflect body skeletal muscle mass, and can be used to evaluate the prognosis of sarcopenia, chronic liver disease and many malignant tumors. Moreover, it can also be used to predict some surgical complications. This review sums up the recent advances of L3 SMI in evaluating prognosis of diseases.