Meta-analysis of the efficacy of invisible orthodontic appliances for maxillary molar distalization in adult patients / 口腔疾病防治

Objective@#To evaluate the clinical efficacy of invisible orthodontic appliances without brackets for the distal movement of maxillary molars to improve the ability of orthodontists to predict treatment outcomes.@*Methods@#Web of Science, Cochrane Library, Embase, PubMed, Wanfang Database, CNKI Database, and VIP Database were searched for studies investigating the efficacy of invisible orthodontic appliances for distal movement of maxillary molars in adult patients and published from database inception to August 1, 2023. A total of three researchers screened the studies and evaluated their quality and conducted a meta-analysis of those that met quality standards.@*Results@#This study included 13 pre- and postcontrol trials with a total sample size of 281 patients. The meta-analysis revealed no significant differences in the sagittal or vertical parameters of the jawbone after treatment when compared with those before treatment (P>0.05). The displacement of the first molar was MD=-2.34, 95% CI (-2.83, -1.85); the displacement was MD=-0.95, 95% CI (-1.34, -0.56); and the inclination was MD=-2.51, 95% CI (-3.56, -1.46). There was a statistically significant difference in the change in sagittal, vertical, and axial tilt of the first molar before and after treatment. After treatment, the average adduction distance of the incisors was MD=-0.82, 95% CI (-1.54, -0.09), and the decrease in lip inclination was MD=-1.61, 95% CI (-2.86, -0.36); these values were significantly different from those before treatment (P<0.05).@*Conclusion@#Invisible orthodontic appliances can effectively move the upper molars in a distal direction and control the vertical position of the molars. When the molars move further away, there is some degree of compression and distal tilt movement, which is beneficial for patients with high angles. The sagittal movement of incisors is beneficial for improving the patient's profile.

Study of discrepancy in subjective and objective cognitive function in patients with depressive disorder / 四川精神卫生

BackgroundThere exist differences in the subjective and objective cognitive functions of patients with depressive disorder， ane there are limited research on influencing factors of such phenomenon currently. ObjectiveTo explore the differences in subjective and objective cognitive function in patients with depressive disorder as well as influencing factors， and to provide references for further understanding of cognitive impairment in patients with depressive disorder. MethodsA total of 77 patients with depressive disorder who received outpatient or inpatient treatment in the Fourth People's Hospital of Chengdu from January 13， 2022 to December 11， 2023 were selected for the study. These patients also met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders， fifth edition（DSM-5）. Various tools were employed to assess patients in this study： Montgomery-Asberg Depression Rating Scale （MADRS） for the depressive symptoms， Perceived Deficits Questionnaire for Depression （PDQ-D） and Chinese Version of Brief Neurocognitive Test Battery （C-BCT） for the subjective and objective cognitive function， Sheehan Disability Scale （SDS） for the social function， and Clinical Global Impression-Severity of Illness（CGI-SI） for the severity of patient's condition. Pearson correlation analysis was used to examine the correlation of subjective and objective cognitive function and their differences with age， years of education， MADRS total score， SDS total score， and CGI-SI score. Multiple linear regression was used to explore the influencing factors of the differences between subjective and objective cognitive function. ResultsThere was a statistically significant difference in the total PDQ-D scores and the difference of subjective and objective cognitive function （D value） between depressive patients with and without medication （t=-4.228， -2.392， P<0.05 or 0.01）. There was no statistically significant correlation in subjective and objective cognitive function in patients with depressive disorder （r=-0.148， P>0.05）. Negative correlations can be observed between the PDQ-D total score and age or years of education （r=-0.333， -0.369， P<0.01）. The PDQ-D total score was positively correlated with MADRS total score， SDS total score and CGI-SI score （r=0.487， 0.637， 0.434， P<0.01）. D value was negatively correlated with age and years of education （r=-0.411， -0.362， P<0.01）， while positively correlated with MADRS total score， SDS total score and CGI-SI score （r=0.259， 0.468， 0.299， P<0.05 or 0.01）. Age （β=-0.328， P<0.01） and SDS total score （β=0.409， P<0.01） were two predictive factors for D value. ConclusionThe difference between subjective and objective cognitive function among patients with depressive disorder is related to several factors including age， years of education， severity of symptoms and impairment of social function. ［Funded by Surface Project of National Natural Science Foundation of China （number， 62173069）； Technological Innovation 2030-Major Project of "Brain Science and Brain-Like Research" （number， 2022ZD0211700）； Key R&D Support Program and Major Application Demonstration Project of Chengdu Science and Technology Bureau （number， 2022-YF09-00023-SN）］

Provincial distribution differences and influencing factors of self-assessed health among elderly population in China / 环境与职业医学

Background Regional differences in economic development, natural environment, health care level, and social structure may lead to differences in the provincial distribution of the health status of the elderly population. Objective To explore the provincial distribution characteristics, regional differences, and influencing factors of the self-assessed health of the elderly population, with the aim of providing a policy basis for improving the health of the elderly population and promoting healthy aging according to local conditions. Methods Using 31 provinces (municipalities and autonomous regions) in China as the basicstudy unit and based on the method of Wagstaff, the self-rated health data of the elderly population (aged 60 years and above) in each province from the 2010 and 2020 national censuses and the 2015 1% National Population Sample Survey were converted into ill-health scores as a measure of self-assessed health, and higher scores represented worse health status perception. Global Moran's I was used to evaluate spatial autocorrelation, range [−1, 1], with a value of 1 as a perfect clustered pattern. Local Moran's I was used to evaluate the tendency of local autocorrelation, and high-high aggregation/low-low aggregation indicated that both target province and its neighboring provinces showed higher/lower ill-health scores. Spatial econometric models were selected by Lagrange multiplier test and Hausman test to explore influencing factors of the self-assessed health of the elderly population. Results In 2010, 2015, and 2020, the national ill-health scores of the elderly population were 1.831, 1.873, and 1.547, respectively, and the corresponding Global Moran's I statistics were 0.347, 0.482, and 0.511, respectively (P<0.01), indicating that the ill-health scores of the elderly population showed a significant spatial positive autocorrelation, and the degree of spatial aggregation was increasing gradually. From 2010 to 2020, the high-high aggregation of ill-health scores among the elderly population was concentrated in the inland northwest, while the low-low aggregation was concentrated in the southeast coast, gradually showing a "southeast-central-northwest" stepped incremental pattern of differentiation. The Lagrange multiplier test and Hausman test suggested that the fixed-effects spatial lagged model was a better choice, and the regression model showed a spatial autocorrelation in the ill-health scores of the elderly population, with an autocorrelation coefficient of 0.3969 (P<0.001); the ill-health scores of the elderly population were negatively correlated with the natural logarithms of gross regional product per capita, and the number of beds in health care facilities per 1000 population, with regression coefficients of −0.8297 and −0.0454 (P<0.05) respectively, and positively correlated with the annual average concentration of PM2.5, illiteracy rate, and the number of health technicians per 1000 population, with regression coefficients of 0.0033, 0.0297, and 0.0765 (P<0.05), respectively. Conclusion From 2010 to 2020, the overall self-assessed health level of China's elderly population showed an upward trend and a spatial positive autocorrelation, with better self-assessed health in the southeast coast and poorer ratings in the northwestern inland. Additionally, there was a gradual decline in self-assessed health of the elderly population from the southeast to the central regions and further to the northwest in terms of spatial distribution. Economic development level, environmental pollution, health resource allocation, and education level are important factors influencing the self-assessed health of the elderly population.

Resenha do livro "Educação Física Menor" / Review of the book "Minor Physical Education" / Reseña del libro "Educación Física Menor"

O livro "Educação Física Menor" problematiza e propõe alternativas diante do chamado currículo cultural ou pós-crítico de Educação Física. Faz isso, a partir de dois gestos: problematizando algumas acepções culturalistas e almejando a singularização ou a minoração das perspectivas "maiores" do componente, a partir de uma conceitualização das filosofias de pensadores como Foucault, Deleuze e Guattari.

The book "Minor Physical Education" problematizes and proposes alternatives to the so-called cultural or post-critical curriculum of Physical Education. It does this from two gestures: problematizing some culturalist acceptations and aiming at the singularization or the minimization of the "major" perspectives of the component, from a conceptualization of the philosophies of thinkers such as Foucault, Deleuze and Guattari.

El libro "Educación Física Menor" problematiza y propone alternativas al llamado currículo cultural o postcrítico de la Educación Física. Lo hace a través de dos gestos: problematizando algunos conceptos culturalistas y apuntando a singularizar o disminuir las perspectivas "mayores" del componente, a partir de una conceptualización de las filosofías de pensadores como Foucault, Deleuze y Guattari.

Effect of inter-aural temporal envelope differences on inter-aural time difference thresholds for amplitude modulated noise

ABSTRACT Purpose The inter-aural time difference (ITD) and inter-aural level difference (ILD) are important acoustic cues for horizontal localization and spatial release from masking. These cues are encoded based on inter-aural comparisons of tonotopically matched binaural inputs. Therefore, binaural coherence or the interaural spectro-temporal similarity is a pre-requisite for encoding ITD and ILD. The modulation depth of envelope is an important envelope characteristic that helps in encoding the envelope-ITD. However, inter-aural difference in modulation depth can result in reduced binaural coherence and poor representation of binaural cues as in the case with reverberation, noise and compression in cochlear implants and hearing aids. This study investigated the effect of inter-aural modulation depth difference on the ITD thresholds for an amplitude-modulated noise in normal hearing young adults. Methods An amplitude modulated high pass filtered noise with varying modulation depth differences was presented sequentially through headphones. In one ear, the modulation depth was retained at 90% and in the other ear it varied from 90% to 50%. The ITD thresholds for modulation frequencies of 8 Hz and 16 Hz were estimated as a function of the inter-aural modulation depth difference. Results The Friedman test findings revealed a statistically significant increase in the ITD threshold with an increase in the inter-aural modulation depth difference for 8 Hz and 16 Hz. Conclusion The results indicate that the inter-aural differences in the modulation depth negatively impact ITD perception for an amplitude-modulated high pass filtered noise.

Central venous-to-arterial CO2 difference as a biomarker of outcome in children who underwent surgery for congenital heart disease / Diferencia arteriovenosa de CO2 como biomarcador de desenlace en niños operados de cardiopatías congénitas

Abstract Background: In congenital heart surgery, low cardiac output syndrome (LCOS) is a major cause of morbidity in the immediate post-operative period. A decrease in cardiac output leads to an increase in tissue oxygen consumption. Several biomarkers such as venous oxygen saturation (SvO2), arteriovenous oxygen difference (DavO2), and lactate can assess tissue perfusion in the presence of LCOS. Recently, central venous to arterial CO2 difference (ΔCO2) has been proposed as a biomarker of tissue ischemia that could be used as a predictor of death in neonatal patients. This study aimed to analyze the relationship between ΔCO2 and immediate post-operative outcomes in pediatric patients undergoing congenital heart surgery and its correlation with DavO2, SvO2, and lactate. Methods: We conducted a longitudinal study of patients aged 0-18 years who underwent congenital heart surgery with or without cardiopulmonary bypass at the Instituto Nacional de Pediatría, from March 2019 to March 2021. Results: Eighty-two patients were included; the median age was 17 months. About 59% had a ΔCO2 ≥ 6 mmHg. Patients with ΔCO2 ≥ 6 mmHg had a vasoactive-inotropic score > 5 (p < 0.001), DavO2 > 5 mL/dL (p = 0.048), and lactate > 2 mmol/L (p = 0.027), as well as a longer hospital stay (p = 0.043). Patients with ΔCO2 > 6 mmHg and vasoactive-inotropic score ≥ 10 were 12.6 times more likely to die. Conclusion: ΔCO2 is a good marker of tissue hypoperfusion and outcome in the post-operative period of congenital heart surgery.

Resumen Introducción: En la cirugía cardiaca de malformaciones congénitas, el síndrome de bajo gasto cardiaco (SBGC) es una de las principales causas de morbilidad en el postoperatorio inmediato. La caída del gasto cardiaco aumenta el consumo de oxígeno en los tejidos. Varios biomarcadores, como la saturación venosa de oxígeno (SvO2), la diferencia arteriovenosa de oxígeno (DavO2) y el lactato han sido utilizados como indicadores hipoperfusión tisular en presencia de SBGC. Recientemente, la diferencia arteriovenosa de CO2 (ΔCO2) se ha propuesto como otro biomarcador de isquemia tisular que podría utilizarse como predictor de muerte en pacientes en edad neonatal. El objetivo de este estudio fue analizar la relación entre la ΔCO2 y la evolución postoperatoria de pacientes pediátricos operados de cardiopatías congénitas y correlacionarlo con la DavO2, SvO2 y lactato. Métodos: Se realizó un estudio longitudinal en pacientes de 0 a 18 años operados de corazón con empleo de bomba de circulación extracorpórea en el Instituto Nacional de Pediatría. Resultados: Se incluyeron 82 pacientes; la mediana de edad fue de 17 meses. El 59% presentó un ΔCO2 > 6 mmHg. Los pacientes con un ΔCO2 > 6 mmHg mostraron un puntaje de inotrópicos > 5 (p < 0.001), DavO2 > 5 mL/dL (p = 0.048) y lactato > 2 mmol/L (p = 0.027), así como mayor estancia hospitalaria (p = 0.043). Los pacientes con ΔCO2 > 6 mmHg y un puntaje de inotrópicos ≥ 10 presentaron una probabilidad de muerte 12.6 veces mayor. Conclusiones: El ΔCO2 en el periodo postoperatorio de una cirugía cardiaca congénita es un buen marcador de hipoperfusión tisular y de desenlace.

3D Foot Anthropometric Measurements Under Two Weight- Bearing Conditions for Ergonomic Design of Foot-Related Products / Mediciones Antropométricas del Pie en 3D Bajo Dos Condiciones de Soporte de Peso para el Diseño Ergonómico de Productos Relacionados con los Pies

SUMMARY: This study collected 3D models of the left and right feet from 317 Chinese youth (155 females and 162 males) under half weight-bearing and no weight-bearing conditions. Thirteen dimensions and one angle were taken for each sample. By measuring 13 foot dimensions and 1 angle, this study comprehensively investigated the differences in foot shape between genders and the bilateral differences, as well as the foot shape differences under different conditions. The results showed that regardless of the condition, male foot dimensions were significantly larger than those of females. However, female foot shape was not simply a scaled-down version of male foot shape. On the contrary, the average angle of female feet was greater than that of males under both conditions, indicating a higher prevalence of hallux valgus in females. Both males and females exhibited significant correlation in foot dimensions between the left and right feet, with minimal differences. Under the half weight-bearing condition, the average foot length, width, and circumference were significantly larger than the corresponding measurements under the no weight-bearing condition, while the average height and angle were significantly smaller. Therefore, when designing footwear and foot-related medical rehabilitation aids, it is important to consider foot shape and dimensions under different conditions as a reference. The results of this study provide manufacturers of foot- related products with more detailed data support and are of significant value to the field of medical foot morphology research.

Este estudio recolectó modelos 3D de los pies izquierdo y derecho de 317 jóvenes chinos (155 mujeres y 162 hombres) en condiciones de carga media de peso y sin carga de peso. Para cada muestra se tomaron trece dimensiones y un ángulo. Al medir 13 dimensiones del pie y 1 ángulo, se investigó exhaustivamente las diferencias en la forma del pie entre ambos sexos y sus diferencias bilaterales, así como las diferencias en la forma del pie en diferentes condiciones. Los resultados mostraron que, independientemente de la condición, las dimensiones del pie de los hombres, estos eran significativamente más grandes que los de las mujeres. Sin embargo, la forma del pie femenino no era simplemente una versión reducida de la forma del pie masculino. Por el contrario, el ángulo promedio de los pies de las mujeres fue mayor que el de los hombres en ambas condiciones, lo que indica una mayor prevalencia de hallux valgus en las mujeres. Tanto hombres como mujeres exhibieron una correlación significativa en las dimensiones del pie, entre el pie izquierdo y el derecho, con diferencias mínimas. Bajo la condición de medio soporte de peso, la longitud, el ancho y la circunferencia promedio del pie fueron significativamente mayores que las medidas correspondientes bajo la condición sin soporte de peso, mientras que la altura y el ángulo promedio fueron significativamente más pequeños. Por lo tanto, al diseñar calzado y dispositivos médicos de rehabilitación relacionados con los pies, es importante tener en consideración la forma y las dimensiones del pie en diferentes condiciones como referencia. Los resultados de este estudio, brindan a los fabricantes de productos relacionados con los pies un soporte de datos más detallado y son de gran valor para el campo de la investigación médica de la morfología del pie.

Transferências intergovernamentais são capturadas pelos servidores municipais? Os determinantes da diferença salarial entre o setor público e o setor privado / ¿Las transferencias intergubernamentales son captadas por servidores municipales? Los determinantes de la brecha salarial entre los sectores público y privado / Do local civil servants capture intergovernmental transfers? The different wage determinants between the public and private sector

Resumo Esta pesquisa tem por objetivo investigar o efeito das transferências intergovernamentais na diferença salarial entre os servidores municipais e os funcionários do setor privado. A amostra foi formada por 5.449 municípios durante o período de 2000 a 2016, agrupados em 5.344 áreas mínimas comparáveis. Os procedimentos metodológicos quantitativos foram desenvolvidos em duas etapas. Na primeira, mediu-se a diferença salarial mediana entre os servidores municipais e os funcionários do setor privado por meio da regressão quantílica incondicional. Na segunda, a análise dos determinantes da diferença salarial foi realizada por meio de regressão múltipla com dados em painel, efeitos fixos e estimações adicionais com erros robustos a cluster, correlação temporal e correlação espacial. Os resultados indicaram que o aumento de 1% das transferências intergovernamentais per capita resulta em aumento de 0,067% na diferença salarial nos municípios brasileiros entre os servidores municipais e os funcionários do setor privado. Além disso, a elevação de 1% no Produto Interno Bruto (PIB) per capita resulta numa redução de 0,036% da diferença salarial. Por último, a pesquisa observou que o tamanho populacional aumenta enquanto a competição eleitoral reduz a diferença salarial nos municípios brasileiros.

Resumen Esta investigación tuvo como objetivo investigar el efecto de las transferencias intergubernamentales en la diferencia salarial entre los servidores municipales y los empleados del sector privado. La muestra estuvo conformada por 5.449 municipios durante el período 2000 a 2016, agrupados en 5.344 áreas mínimas comparables. Los procedimientos metodológicos cuantitativos se desarrollaron en dos etapas. En la primera, la mediana de la diferencia salarial entre los empleados municipales y los del sector privado se midió utilizando la regresión por cuantiles incondicionales. En la segunda etapa, el análisis de los determinantes de la brecha salarial se realizó mediante regresión múltiple con datos de panel, efectos fijos y estimaciones adicionales con errores robustos por clúster, correlación temporal y correlación espacial. Los resultados indicaron que un aumento del 1% en las transferencias intergubernamentales per cápita resulta en un aumento del 0,067% en la brecha salarial en los municipios brasileños entre los servidores municipales y los empleados del sector privado. Además, identificó que un aumento de 1% en el PIB per cápita se traduce en una reducción de 0,036% en la brecha salarial. Finalmente, la investigación observó que el tamaño de la población aumenta mientras la competencia electoral reduce la brecha salarial en los municipios brasileños.

Abstract This article examines the intergovernmental transfer effects on wage differences between local civil servants and private sector employees. The sample was composed of 5,449 Brazilian municipalities, working with data from 2000 to 2016 clustered in 5,344 minimum comparable areas (MCA). The methodological procedures were quantitative and developed in two steps. The first step was to assess the median wage difference between local civil servants and private sector employees through unconditional quantile regression. The second was the analysis of different wage determinants through multiple regression with panel data, fixed effects, and additional estimations such as cluster-robust standard errors, temporal correlation, and spatial correlation. The results demonstrated that when per capita intergovernmental transfers increase by 1%, the wage difference between local civil servants and private sector employees increases by 0.067%. Besides that, when per capita GDP increases by 1%, the wage difference decreases by 0.036%. Furthermore, the paper observed that populational size increases and electoral competition decreases wage differences between the public and private sectors in Brazilian municipalities.

A Morphometric Study of Head in the Population of Young Chinese Adults / Estudio Morfométrico de la Cabeza en la Población de Adultos Jóvenes Chinos

SUMMARY: Due to the complexity of head shape, limited 1D or 2D head anthropometry fail to fully capture its shape characteristics. Currently, there is limited research on clustering analysis of head shape from a shape difference perspective, especially for the head shape of Chinese people. Head shape is influenced by factors such as race, sex, and age, making it imperative to create a head shape database for Chinese individuals. In this study, three-dimensional head data of 339 Chinese young adult were collected, and the head shapes were clustered into 7 clusters using an improved k-medoids algorithm. The differences between clusters and the average head shape were further analyzed. It can be foreseen that the head shape database for Chinese young adult constructed in this study has important reference value for the ergonomic design of head-related products and head morphology research, among other fields.

Debido a la complejidad de la forma de la cabeza, la antropometría limitada de ésta, en 1D o 2D, no logra capturar completamente sus características de forma. Actualmente, existen estudios limitados sobre el análisis de agrupamiento de la forma de la cabeza, desde una perspectiva de diferencia de forma, especialmente en el caso de la población china. La forma de la cabeza está influenciada por factores como la raza, el sexo y la edad, por lo que resulta imperativo crear una base de datos sobre la forma de la cabeza de los individuos chinos. En este estudio, se recopilaron datos tridimensionales de la cabeza de 339 adultos jóvenes chinos, y las formas de la cabeza se agruparon en 7 grupos utilizando un algoritmo k-medoids mejorado. Las diferencias entre los grupos y la forma promedio de la cabeza se analizaron a profundidad. Se puede prever que la base de datos sobre la forma de la cabeza de adultos jóvenes chinos construida en este estudio, tiene un valor de referencia importante para el diseño ergonómico de productos relacionados con la morfología de la cabeza, entre otros campos.

Gender Disparities of Youths in Trust on Health Management System during Post-COVID-19 in Bangladesh / Disparidades de gênero de jovens na confiança em sistemas de gestão de saúde durante o período pós-COVID-19 em Bangladesh

Objective: The purpose of this paper is to find out the gender-based disparities in trust in the public health measures taken in Bangladesh during the post-COVID-19 pandemic. Methods: A cross-sectional study design and quantitative research approach were used to collect primary data. A total of 742 students from different socioeconomic backgrounds participated in the survey randomly by filling up a structured questionnaire from 15 June 2022 to 10 July 2022. The Wilks' λ statistic, MANOVA, and Regression analysis were performed in this study to find out the gender-based differences in trust in the public health measures taken in Bangladesh during the post-COVID-19 pandemic. Results: In a multivariate test, the p-value is 0.018 (p<0.05), which implies a significant difference between the trust of males and females among youths about public health measures during the post-COVID-19 pandemic in Bangladesh. This study provides that overall infrastructure, responsiveness, and attachments have a significant correlation with youth trust as all the p-values < 0.001. Conclusions: Health infrastructure and youths' attachment to the various networks and institutions have more impact on determining the level of trust in government health measures during the post-pandemic than the way of government responsiveness; policymakers and advocates will get significant insight from the findings of the study during post-COVID-19. Without gender-sensitive health policy measures, gaining citizens' trust in the government will be difficult.

Objetivo: descobrir as disparidades de confiança baseadas em gênero nas medidas de saúde pública tomadas em Bangladesh, durante a pandemia pós-COVID-19. Métodos: um desenho de estudo transversal e abordagem de pesquisa quantitativa foram usados para coletar dados primários. Um total de 742 estudantes de diferentes origens socioeconômicas participaram da pesquisa aleatoriamente, preenchendo um questionário estruturado de 15 de junho de 2022 a 10 de julho de 2022. A estatística λ de Wilks, MANOVA e a análise de regressão foram realizadas neste estudo para descobrir o sexo - diferenças baseadas na confiança nas medidas de saúde pública tomadas em Bangladesh, durante a pandemia pós-COVID-19. Resultados: em um teste multivariado, o p-valor é 0,018 (p<0.05), o que implica uma diferença significativa entre a confiança de homens e mulheres entre jovens sobre medidas de saúde pública durante a pandemia pós-COVID-19 em Bangladesh. Este estudo fornece que a infraestrutura geral, a capacidade de resposta e os vínculos têm uma correlação significativa com a confiança dos jovens, pois todos os valores de p < 0.001. Conclusões: a infraestrutura de saúde e o vínculo dos jovens às várias redes e instituições têm mais impacto na determinação do nível de confiança nas medidas governamentais de saúde durante o pós-pandemia do que na forma de resposta do governo; os formuladores de políticas e defensores obterão uma visão significativa das descobertas do estudo durante o período pós-COVID-19. Sem medidas de política de saúde sensíveis ao gênero, será difícil ganhar a confiança dos cidadãos para o governo.

Difference in Nocturnal Erectile Function Between SRPE Patients and Normal People / 中山大学学报(医学科学版)

ObjectiveTo compare the nocturnal erectile function between SRPE patients and normal people. MethodsFrom July 1st， 2019 to December 15th， 2022， a clinical comparative study was conducted on 29 SRPE patients （experimental group） and 58 volunteers （control group） who visited our urology department. The Rigiscan System was used to monitor sleep monitoring time， the number of nocturnal erections and the rigidity， duration and circumference growth of the penis when the erection reached 60%～79% and 80%～100%， respectively. The patients and volunteers were asked to make written records when they woke up， and then the total number of awakenings and the number of awakenings when the penis erection reached 60% and 80% were compared between the two groups. ResultsAge was eliminated by matching. There was no statistically significant difference in sleep monitoring time， rigidity， circumference growth and duration of the penis when the erection reached 60%～79% and 80%～100%. between the two groups. In terms of sleep， there was a statistically significant difference in the total number of awakenings between the two groups［3（2 ~ 4）vs 0（0 ~ 0），P<0.01］ .And the same was true for the number of awakenings when the penis erection exceeded 60%～79% ［1（0 ~ 1）vs 0（0 ~ 0），P<0.01］and 80%～100% ［2（1 ~ 3）vs 0（0 ~ 0），P<0.01］. ConclusionRigiscan monitoring showed that there was no difference between SRPE patients and normal male in nocturnal penile erection function. Painful awakening usually occurs when the penis erection reaches 60%～79% or 80%～100%， which reveals that SRPE may be caused by abnormal sensation of nocturnal erections or pain sensitivity in some of these patients.

Study on the differences in chemical composition of Scutellaria baicalensis leaves from different origins in Shanxi Province based on plant metabolomics and targeted quantitative analysis / 药学学报

By integrating plant metabonomics and target quantitative analysis methods, this study systematically analyzed the differences of chemical constituents in Scutellaria baicalensis leaves from different producing areas in Shanxi, so as to provide theoretical basis for rational and effective utilization of Scutellaria baicalensis leaves. Based on the idea of plant metabonomics, the liquid quality of 53 batches of Scutellaria baicalensis leaves from 8 different producing areas in Shanxi was analyzed by UPLC-QTOF-MS, and the collected data were imported into SIMCA 14.1 software for multivariate statistical analysis to screen the different chemical constituents among different habitats in Shanxi. Meanwhile, a method for simultaneous determination of 7 flavonoids and 3 organic acids in Scutellaria baicalensis leaves was optimized and established to quantitatively analyze the differences of chemical components in Scutellaria baicalensis leaves from different producing areas in Shanxi. The results of plant metabonomics showed that there were differences in the chemical composition of Scutellaria baicalensis leaves in northern Shanxi (Datong, Xinzhou), Jinzhong (Yangquan, Luliang) and southern Shanxi (Changzhi, Yuncheng, Jincheng, Linfen): there were 14 significant differences in chemical composition between northern Shanxi and Jinzhong; there were 18 significant differences in chemical constituents between southern Shanxi and central Shanxi. There were 15 significant differences in chemical constituents between northern Shanxi and southern Shanxi. Among them, scutellarin and isocarthamidin-7-O-glucuronide were the common differences among the three regions, and the content of scutellarin was the highest in southern Shanxi and the lowest in northern Shanxi. The content of isocarthamidin-7-O-glucuronide was the highest in Jinzhong area and the lowest in northern Shanxi area. Quantitative analysis further confirmed that the average contents of apigenin, naringenin and citric acid were the highest in northern Shanxi, scutellarin, caffeic acid, apigenin-7-O-glucuronide, malic acid and wogonoside were the highest in southern Shanxi, and wogonoside and baicalin were the highest in central Shanxi. This study is of great significance to the quality control of Scutellaria baicalensis leaf resources, and provides theoretical basis for rational and effective utilization of Scutellaria baicalensis leaf resources.

Mortality and years of life lost of lung cancer among residents in Pudong New Area of Shanghai from 1995 to 2021 / 上海预防医学

ObjectiveTo investigate the epidemiological traits and potential years of life lost associated with lung cancer mortality among inhabitants of Shanghai's Pudong New Area from 1995 to 2021， in order to serve as a reference for developing intervention approaches. MethodsThe death surveillance system was used to gather statistics on lung cancer deaths. Crude mortality rate （CMR）， standardized mortality rate （SMR）， potential years of life lost （PYLL）， average years of life lost （AYLL）， annual percent change （APC） of the lung cancer deaths were analyzed. The impact of age-structural and non-age-structural factors on changes in lung cancer mortality was quantified using difference decomposition. ResultsThe CMR and SMR of lung cancer among residents in Pudong New Area between 1995 and 2021 were 58.21/105 and 26.75/105， respectively. The CMR of lung cancer increased over the years （APC=1.91%， 95%CI=1.60%‒2.30%； Z=11.487， P<0.001）， and the SMR of lung cancer declined over the years （APC=-1.50%， 95%CI=-1.80%‒-1.20%； Z=-9.006， P<0.001）. Age structure factors and gender factors contributed to the increase of lung cancer mortality， while non-population age structure factors overall appeared to play a protective role which might be related to the improvements in factors such as tobacco control and environmental management. The PYLL of lung cancer was 160 296 person years， the PYLL rate was 2.24‰， and the AYLL was 3.86 years per person. ConclusionAge structure factors are a significant contributor to the disease burden and result in the increase in the crude lung cancer mortality rate of Pudong residents of shanghai. Comprehensive monitoring， preventive， and control methods should be implemented.

Experimental Study on Effects of Mitral Regurgitation on Hydrodynamic Performance of Aortic Valve / 中国医疗器械杂志

OBJECTIVE@#Aims researches on the interaction between heart valves is limited in clinical. Meanwhile the data of in vitro testing are insufficient. In this study, the in vitro hydrodynamic performance of an aortic valve was studied by using a model of mitral regurgitation that could finely adjust the regurgitant volume.@*METHODS@#The regurgitation of mitral valve was gradually increased under the certain condition of heart rate, stroke volume, and mean aortic pressure and captured the hydrodynamic performance of the aortic valve.@*RESULTS@#The study on the hydrodynamic performance of mechanical aortic valve (25AJ-501) by using a model of mitral regurgitation found that the effective orifice area and mean pressure difference of the aortic valve are negatively correlated with the degree of mitral regurgitation.@*CONCLUSIONS@#The method based on a model of mitral regurgitation that could finely adjust the regurgitant volume established in this study can be used to study the effect of mitral valve regurgitation on the hydrodynamic performance of the aortic valve.

Diurnal differences in acute gout attacks: A clinical study of male gout patients / 北京大学学报(医学版)

OBJECTIVE@#To observe the diurnal difference of acute gout attacks in men, and provide reference for accurate clinical prevention and treatment.@*METHODS@#Using a single-center, cross-sectional study design, the patients diagnosed with gout in the outpatient department of Rheumatology and Immuno-logy of PLA Joint Logistic Support Force No.980 Hospital from October 2021 to April 2022 were selected. The information about the patient's current/last acute gout attacks (less than 2 weeks from visit), date and time of attacks, joint symptoms and signs, medication use, and relevant biochemical tests on the day of visit was recorded. The diurnal time difference of acute gout attacks in male patients was analyzed, and univariate comparison and multivariate Logistic regression analyses were conducted to compare the diurnal difference of acute gout attacks with clinical characteristics and biochemical indicators.@*RESULTS@#A total of 100 male gout patients were included, and 100 acute attacks were recorded. Diurnal distribution of acute gout attacks: morning (6:00~11:59, 18, 18%), afternoon (12:00~17:59, 11, 11%), the first half of the night (18:00~23:59, 22, 22%), the second half of the night (0:00~05:59, 49, 49%); During the day (included morning and afternoon, 29, 29%) and at night (included the first half of the night and the second half of the night, 71, 71%). The rate of acute gout attack was significantly higher at night than in the day (about 2.5 ∶1). No matter the first or recurrent gout, no matter the duration of the disease, the number of acute gout attacks had the difference of less in the day and more in the night. Serum urate (SU) level was higher in the patients with nocturnal attack than in those with daytime attack (P=0.044). Comorbidities were significantly different in the day-night ratio of the number of acute gout attack (P=0.028). Multiple Logistic regression analysis showed that SU level (OR=1.005, 95%CI: 1.001-1.009) and comorbidities (OR=3.812, 95%CI: 1.443-10.144) were the correlative factors of nocturnal acute gout attacks.@*CONCLUSION@#No matter the first or recurrent gout, no matter the duration of the disease, it has a diurnal variation characterized by multiple attacks at night, increased SU level and comorbidities are correlative factors for nocturnal acute attack of gout.

Application of prone position in severe ARDS caused by pneumocystis jirovecii pneumonia after kidney transplantation / 器官移植

Objective To investigate the improvement of oxygenation after the treatment of prone position in patients with severe acute respiratory distress syndrome (ARDS) caused by pneumocystis jirovecii pneumonia (PJP) after kidney transplantation. Methods Clinical data of 5 cases of moderate and severe ARDS caused by PJP after kidney transplantation were analyzed retrospectively, and clinical characteristics, treatment regimen and prognosis were summarized. Results Clinical manifestations of 5 patients were fever, dry cough, chest tightness, shortness ofbreath,sweating and fatigue, and body temperature fluctuated between 38 ℃ and 39 ℃, percutaneous arterial oxygen saturation(SpO2) was gradually decreased, and respiratory distress symptoms were worsened. Pulmonary CT scan showed diffuse ground-glass shadow. After transfer to intensive care unit (ICU), immunosuppressive drugs were terminated, and all patients were given with compound sulfamethoxazole, caspofungin, low-dose glucocorticoids against pneumocystis jirovecii (PJ), oxygen therapy and other symptomatic supportive treatments. Four patients diagnosed with severe ARDS upon admission to ICU were treated in a prone position. One patient with moderate ARDS was not kept in a prone position. At 1 d after treatment in a prone position, partial pressure of arterial oxygen (PaO2) and oxygenation index were increased, whereas alveolar-arterial oxygen difference (A-aDO2) was decreased compared with before treatment (allP<0.05). Compared with 1 d after treatment, SpO2, PaO2 and oxygenation index were all increased, while A-aDO2 was decreased at 4 d after treatment (all P<0.05). Box diagram showed that oxygenation index showed an overall upward trend after prone-position treatment, whereas A-aDO2 showed an overall downward trend. The length of ICU stay of 5 patients was 14 (8, 29) d. All patients in a prone position did not develop complications, such as skin pressure sore, tube detachment and tube displacement, etc. Among 5 patients, 4 patients were mitigated, and 1 patient died of septic shock and multiple organ failure. Conclusions For both conscious and intubated patients, a prone position may significantly improve oxygenation and prognosis of patients with severe ARDS caused by PJP after kidney transplantation. Early diagnosis and accurate and standardized treatment play a pivotal role in enhancing cure rate.

Risk Perception and Emergency Preparedness Against Flood Affected Participants From the Primary Health Care Centre, Malaysia: A Comparison Between Genders

@#Introduction: Flooding has become a major natural disaster in Malaysia in recent decades. There may be a gender difference in many aspects related to flood response and practice. This study aimed to examine the gender gap in knowledge, attitudes, and practice of flood preparedness in Malaysia. Method: This cross-sectional study was conducted among patients attending the primary care clinic at Universiti Sains Malaysia health campus, Kelantan. A validated questionnaire was used for data collection. Results: 328 subjects were recruited, 56.1% of them were females. The female respondents were younger than the males (36 vs. 41 years old). However, females have better knowledge, and practice on flood preparedness compared to male respondents. Among those, women were more aware of the local emergency plan than males (p=0.01). More female respondents kept their vaccination and personal medical records in a waterproof container or sealed plastic bag during past and future flood preparations (3-5 day supply of non-perishable food) than male respondents (p<0.05). In addition, with the practice of keeping a one-week supply of medication, and having their medical records in a waterproof container along with a first-aid kit (p=0.001). For future flood preparation, more women would filter the cloudy water through clean clothes for boiling (p=0.035). The determinants of good preparedness for future floods for female were older-age (p=0.001), blue-collar (p=0.043); whereas male were lower household income (p=0.014), being blue collar (0.014) and white collar (0.039) compared with student/retiree based on multivariate logistic regression. Conclusion: Our study reported that the determinants of good preparedness for future floods were older-age, blue-collar and having a lower-household income.

Analysis on the implementation effect of single disease payment policy for day surgery based on difference-in-differences model / 中华医院管理杂志

Objective:To analyze the implementation effect of single disease payment policy for day surgery (hereinafter referred to as the policy), for references for the reform of medical insurance payment.Methods:By collecting the information of inpatients from 2017 to 2019 in a tertiary hospital, the research group took patients with colorectal benign tumor and nodular goitre as the policy implementation group and the control group respectively. 2017-2018 was the pre implementation stage of the policy, and 2019 was the post implementation stage of the policy. The difference-in-differences (DID) model was used to analyze the changes in indicators such as length of stay and hospitalization expenses after policy implementation, under whether the policy is implemented or not, as well as before or after policy implementation.Results:A total of 2 419 patients were included, including 927 patients with nodular goiter in the control group and 1 492 patients with colorectal benign tumors in the policy implementation group (688 patients before the policy implementation and 804 patients after the policy implementation). The results of DID showed that the hospital days for patients with colorectal benign tumor decreased by 56.53%, the hospitalization expenses decreased by 26.51%, the out-of-pocket expenses decreased by 26.66%, the treatment expenses increased by 11.96%, the drug expenses decreased by 50.29% and the consumables expenses decreased by 20.23% after the implementation of the policy.Conclusions:The implementation of the policy could reduce length of stay, hospitalization expenses and out-of-pocket expenses, optimize the structure of hospitalization expenses, improve the efficiency of hospital diagnosis and treatment, and help the hospital realize its transformation from a size expansion to a quality and benefit expansion.

Clinical characteristics analysis of 253 cases of pancreatic solid pseudopapillary neoplasm / 中华消化杂志

Objective:To summarize the clinical characteristics of pancreatic solid pseudopapillary neoplasm (pSPN).Methods:From March 2007 to August 2022, at the First Affiliated Hospital of Zhejiang University School of Medicine, the clinical data and follow-up results of 253 patients with pSPN and underwent surgical treatment were retrospectively analyzed. The diagnostic accuracy of preoperative ultrasound, magnetic resonance imaging (MRI), computed tomography (CT) and puncture biopsy of aspiration were compared and analyzed. Kaplan-Meier method was performed to calculate disease-free survival rate. The gender differences in the clinical and pathological features of pSPN were compared. According to whether recurrence and metastasis occurred after the primary operation, the patients with pSPN were divided into recurrence and metastasis group ( n=3) and disease-free survival group ( n=250). Univariate analysis was used to analyze whether gender, age, married status, with clinical symptoms, history of alcohol drinking or smoking, puncture biopsy of aspiration before operation, location and maximum diameter of tumor, surgical method (open surgery, minimally invasive surgery), type of surgery (parenchymal preservation surgery, conventional surgery), and pathological features (cellular atypia, invasion of adjacent organs, lymphovascular invasion, peripancreatic fat invasion, perineural invasion, capsular invasion and pancreatic parenchyma invasion) were predictive factors of recurrence and metastasis of pSPN. Two independent sample t test, chi-square test and Fisher′s exact test were used for statistical analysis. Results:Among 253 patients with pSPN, 49 (19.4%) were males and 204 (80.6%) were females. The diagnostic accuracy of MRI and CT were both higher than that of ultrasound (73.4%(124/169), 64.0%(146/228) vs. 33.3%(78/234)), and the diagnostic accuracy of MRI was higher than that of CT, and the differences were statistically significant ( χ2=62.93, 43.58 and 3.89, P<0.001, <0.001 and =0.049). The diagnostic accuracy of puncture biopsy of aspiration combined with immunochemistry was higher than that without combined immunochemistry (100.0%(23/23) vs. 8/13), and the difference was statistically significant (Fisher′s exact test, P=0.003). Eight cases missed during follow-up, and all the other 245 patients survived with the 5- year and 10-year disease-free survival rates of 99.2% and 97.2%, respectively. Male pSPN patients were older than female patients at diagnosis ((40.0±13.2) years old vs. (32.6±11.9) years old) and the maximum diameter of tumor was smaller than that of female patients ((3.88±2.05) cm vs. (4.87±3.05) cm), and the differences were statistically significant ( t=3.83 and -2.15, P<0.001 and =0.032). The results of univariate analysis showed that lymphovascular invasion was significantly correlated with pSPN recurrence and metastasis (Fisher′s exact test, P=0.012), and the other factors were not correlated with pSPN recurrence and metastasis (all P>0.05). Conclusions:CT, MRI and puncture biopsy of aspiration are comparatively reliable diagnostic method for pSPN before operation. There are significant differences in pSPN tumor growth and age of onset between genders. The postoperative recurrent rate of pSPN is low and the prognosis is good. Even if recurrence and metastasis occur, the patients can still survive for a long time after surgical treatment.

Predictive value of Pv-aCO 2/Ca-vO 2 combined blood lactate concentration for primary peritonitis-related septic shock in children / 中华危重病急救医学

Objective:To investigate the prognostic value of the ratio of veno-arterial carbon dioxide partial pressure difference to arterio-venous oxygen content difference (Pv-aCO 2/Ca-vO 2) in children with primary peritonitis-related septic shock. Methods:A retrospective study was conducted. Sixty-three children with primary peritonitis-related septic shock admitted to department of intensive care unit of the Children's Hospital Affiliated to Xi'an Jiaotong University from December 2016 to December 2021 were enrolled. The 28-day all-cause mortality was the primary endpoint event. The children were divided into survival group and death group according to the prognosis. The baseline data, blood gas analysis, blood routine, coagulation, inflammatory status, critical score and other related clinical data of the two groups were statistics. The factors affecting the prognosis were analyzed by binary Logistic regression, and the predictability of risk factors were tested by the receiver operator characteristic curve (ROC curve). The risk factors were stratified according to the cut-off, Kaplan-Meier survival curve analysis compared the prognostic differences between the groups.Results:A total of 63 children were enrolled, including 30 males and 33 females, the average age (5.6±4.0) years old, 16 cases died in 28 days, with mortality was 25.4%. There were no significant differences in gender, age, body weight and pathogen distribution between the two groups. The proportion of mechanical ventilation, surgical intervention, vasoactive drug application, and procalcitonin, C-reactive protein, activated partial thromboplastin time, serum lactate (Lac), Pv-aCO 2/Ca-vO 2, pediatric sequential organ failure assessment, pediatric risk of mortality Ⅲ in the death group were higher than those in the survival group. Platelet count, fibrinogen, mean arterial pressure were lower than those in the survival group, and the differences were statistically significant. Binary Logistic regression analysis showed that Lac and Pv-aCO 2/Ca-vO 2 were independent risk factors affecting the prognosis of children [odds ratio ( OR) and 95% confidence interval (95% CI) were 2.01 (1.15-3.21), 2.37 (1.41-3.22), respectively, both P < 0.01]. ROC curve analysis showed that the area under curve (AUC) of Lac, Pv-aCO 2/Ca-vO 2 and their combination were 0.745, 0.876 and 0.923, the sensitivity were 75%, 85% and 88%, and the specificity were 71%, 87% and 91%, respectively. Risk factors were stratified according to cut-off, and Kaplan-Meier survival curve analysis showed that the 28-day cumulative probability of survival of Lac ≥ 4 mmol/L group was lower than that in Lac < 4 mmol/L group [64.29% (18/28) vs. 82.86% (29/35), P < 0.05]. Pv-aCO 2/Ca-vO 2 ≥ 1.6 group 28-day cumulative probability of survival was less than Pv-aCO 2/Ca-vO 2 < 1.6 group [62.07% (18/29) vs. 85.29% (29/34), P < 0.01]. After a hierarchical combination of the two sets of indicator variables, the 28-day cumulative probability of survival of Pv-aCO 2/Ca-vO 2 ≥ 1.6 and Lac ≥ 4 mmol/L group significantly lower than that of the other three groups (Log-rank test, χ2 = 7.910, P = 0.017). Conclusion:Pv-aCO 2/Ca-vO 2 combined with Lac has a good predictive value for the prognosis of children with peritonitis-related septic shock.