Revisiting Computer-Aided Tuberculosis Diagnosis.

Tuberculosis (TB) is a major global health threat, causing millions of deaths annually. Although early diagnosis and treatment can greatly improve the chances of survival, it remains a major challenge, especially in developing countries. Recently, computer-aided tuberculosis diagnosis (CTD) using deep learning has shown promise, but progress is hindered by limited training data. To address this, we establish a large-scale dataset, namely the Tuberculosis X-ray (TBX11 K) dataset, which contains 11 200 chest X-ray (CXR) images with corresponding bounding box annotations for TB areas. This dataset enables the training of sophisticated detectors for high-quality CTD. Furthermore, we propose a strong baseline, SymFormer, for simultaneous CXR image classification and TB infection area detection. SymFormer incorporates Symmetric Search Attention (SymAttention) to tackle the bilateral symmetry property of CXR images for learning discriminative features. Since CXR images may not strictly adhere to the bilateral symmetry property, we also propose Symmetric Positional Encoding (SPE) to facilitate SymAttention through feature recalibration. To promote future research on CTD, we build a benchmark by introducing evaluation metrics, evaluating baseline models reformed from existing detectors, and running an online challenge. Experiments show that SymFormer achieves state-of-the-art performance on the TBX11 K dataset.

Compartmentalized regulation of NAD+ by Di (2-ethyl-hexyl) phthalate induces DNA damage in placental trophoblast.

Di (2-ethyl-hexyl) phthalate (DEHP) is a wildly used plasticizer. Maternal exposure to DEHP during pregnancy blocks the placental cell cycle at the G2/M phase by reducing the efficiency of the DNA repair pathways and affects the health of offsprings. However, the mechanism by which DEHP inhibits the repair of DNA damage remains unclear. In this study, we demonstrated that DEHP inhibits DNA damage repair by reducing the activity of the DNA repair factor recruitment molecule PARP1. NAD+ and ATP are two substrates necessary for PARP1 activity. DEHP abated NAD+ in the nucleus by reducing the level of NAD+ synthase NMNAT1 and elevated NAD+ in the mitochondrial by promoting synthesis. Furthermore, DEHP destroyed the mitochondrial respiratory chain, affected the structure and quantity of mitochondria, and decreased ATP production. Therefore, DEHP inhibits PARP1 activity by reducing the amount of NAD+ and ATP, which hinders the DNA damage repair pathways. The supplement of NAD+ precursor NAM can partially rescue the DNA and mitochondria damage. It provides a new idea for the prevention of health problems of offsprings caused by DEHP injury to the placenta.

Di (2-ethyl-hexyl) phthalate disrupts placental growth in a dual blocking mode.

Di (2-ethyl-hexyl) phthalate (DEHP) is a widely used plasticizer. Maternal DEHP exposure inhibits cell proliferation and reduces placentas size, which associates with fetal growth restriction and adulthood diseases. However, the mechanism of placental cell proliferation inhibition by DEHP remains elusive. This study investigated the effect of DEHP on placental cell proliferation from cell cycle arrest. Utilizing in vitro and in vivo experiments, we investigated cell cycle arrest, DNA double-strand break (DSB) repair, genotoxic stress response, and micronuclei formation. Most DEHP metabolizes to mono (2-Ethylhexyl) phthalate (MEHP) and distributes to organs quickly, so MEHP and DEHP were used in cultured cell and animal experiments, respectively. Here, a double blocking mode for the proliferation inhibition of the placental cell was revealed. One is that the classical DSB repair pathways were suppressed, which arrested the cell cycle at the G2/M phase. The other is that DEHP stimulated an elevated level of progesterone, which blocked the cell cycle at metaphase by disrupting chromosome arrangement. These two sets of events facilitated micronuclei formation and resulted in cell proliferation inhibition. This findings provide a novel mechanistic understanding for DEHP to inhibit placental cell proliferation.

Mandibular Reconstruction Using Free Fibular Flap Graft Following Excision of Calcifying Epithelial Odontogenic Tumor.

ABSTRACT: The calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic tumor, which usually presents with distension of affected tissues. Radiologically, the lesions are often associated with an unerupted tooth and may have spot calcification shadows. The authors report a case of a CEOT in a 48-year-old male involving the right mandibular jaw bone and mentum soft tissues. The authors performed hemimandibulectomy and enucleation followed by reconstruction of the mandible using a vascularized free fibular flap through a digital surgical technique in order to restore the patient's facial symmetry and prepare the area for functional restorations. The case illustrates who the free fibular flap graft can be used for satisfactory mandibular reconstruction and restoration of the morphology and functions.

The association between health literacy and psychosomatic symptoms of adolescents in China: a cross-sectional study.

BACKGROUND: Lower health literacy (HL) has been known to be involved in a range of common mental and physical disorders among adolescent students. Ample studies indicated low HL is associated with a series of chronic diseases even psychological diseases, nevertheless, little is known about this relationship among adolescents. In this context, the study aimed to examine associations between psychosomatic symptoms (physical and psychological symptoms) and HL in junior and senior high school students in China, and to provide guidance for improving the physical and mental health in Chinese adolescents. METHODS: A total of 22,628 junior and high school students in China were enrolled in this study. HL and psychosomatic symptoms were measured by self-report validated questionnaires. Multiple linear regression analyses were conducted to examine the associations between six sub-scales of HL and physical / psychological symptoms. RESULTS: Multiple linear regression analysis demonstrated that the sub-scales of HL showed a significantly negative association with physical symptoms and psychological symptoms (P <  0.05 for each). Physical symptoms was most strongly associated with IR (ß = - 0.134), followed by SM (ß = - 0.093), DB (ß = - 0.059), SA (ß = - 0.058) and PA (ß = - 0.054). No statistically significant difference was found between HA and physical symptoms (P > 0.05). Meanwhile, psychological symptoms were most strongly associated with IR (ß = - 0.160), followed by SA (ß = - 0.129), SM (ß = - 0.069), DB (ß = - 0.031), HA (ß = - 0.026) and PA (ß = - 0.021). CONCLUSION: These results indicated the importance of identifying the association of HL with physical and psychological symptoms, and provided the evidence that lower HL may serve as a critical and independent risk factor for poor health outcomes. Meanwhile, to maintain students' desirable healthy status public health efforts for enhancing their HL level are urgently needed in adolescents.

Association of health literacy and sleep problems with mental health of Chinese students in combined junior and senior high school.

OBJECTIVES: The aim of this study was to examine the association between health literacy (HL) and sleep problems with mental health of Chinese students in combined junior and senior high school. METHODS: A cross-sectional study was conducted among seven hundred and seventy-five students from a combined junior and senior high school in Shenyang on December 16, 2016. HL, sleep problems, anxiety symptoms and depressive symptoms were measured by self-reported validated instruments. Multiple logistic regression models were used to examine the association of HL and sleep problems with mental health problems. RESULTS: The prevalence of anxiety symptoms and depressive symptoms was 24.6% and 45.2%, respectively. Low HL was significantly associated with anxiety symptoms (OR = 2.457, 95%CI: 1.493-4.045) and depressive symptoms (OR = 5.164, 95%CI: 3.233-8.250). Sleep problems were significantly positively correlated with anxiety symptoms (OR = 4.237, 95%CI: 2.831-6.341) and depressive symptoms (OR = 3.170, 95%CI: 2.084-4.823). The students who had sleep problems with low HL had the highest risks of anxiety symptoms (OR = 11.440, 95%CI: 5.564-23.520) and depressive symptoms (OR = 19.470, 95%CI: 8.143-46.558). CONCLUSION: Our findings suggest that Chinese students in combined junior and senior high school who had sleep problems with low HL are at risk of exhibiting anxiety symptoms and depressive symptoms. Intervention programs of mental health problems should enhance HL level and improve sleep quality.

[Suggestion to construction of regulations from historical evolution of Chinese medicine processing legislation].

Chinese medicine is the treasure of China. It has been the safe guard of health in China for thousands of years. Processing of traditional Chinese medicine (TCM) is an important process of removing crude extracts from natural products and achieving pharmacological properties of TCM. The connotation and norms of herbal preparation in the past dynasties have been improved gradually, and have been included in the code system since the Tang Dynasty. The process of legislative evolution is closely related to the fate and development of TCM. In the era of full-scale rejuvenation of Chinese medicine, with the development of Chinese medicine industry to 4.0, the perfection of the standards and standard system with the construction of quality standardization of Chinese medicine as the core, especially under the Pharmacopoeia system, is the important support and guarantee for the promotion of the whole industry, which is also an important part of the rejuvenation of the entire Chinese medicine industry.

[Standardization system of industry decoction pieces based on whole process quality control concept].

Traditional Chinese medicine (TCM) decoction pieces refer to prescription drugs that can be used in clinical or preparation production after processing medicinal herbs. TCM decoction pieces industries are inherited from the culture of TCM and are important because of their independent intellectual property rights. The Chinese Pharmacopoeia (Ch. P) 2010 edition stipulated that "All drugs taken are decoction pieces", which raised the drug status to statutory law for the first time and clearly specified that TCM decoction pieces should be applied to TCM prescription deployment and production of proprietary Chinese medicines. It also pointed out that "The specifications of the decoction pieces used in the preparation should comply with the requirements of the actual process of the corresponding formulation type". For a long time, both the processing methods and the specification grades of the clinically used pieces of Chinese medicine were based on the inheritance and supported by the classical theory and method system centered on TCM processing. However, the theoretical research and specification standards of the decoction pieces used in the production of proprietary Chinese medicines based on modern industry are scarce, and this has led to a series of problems related to the industry, making the processing of decoction pieces becoming a limiting factor in the promotion of the Chinese medicine industry. Aiming at the existing problems of the TCM decoction pieces industry, this article was guided by the standardization system of TCM based on the concept of whole-process quality control, combined with the reference to the Japanese Kampo medicine industry's feeding mode and the reflection on the combination of traditional Chinese medicine processing and modern industry, as well as the study of the core law of the whole-process of TCM production, etc. Industrial decoction pieces and the idea of building a standardized system of TCM industry decoction pieces based on the whole-process quality control were discussed in this paper, which can provide insights for exploring the effective fusion between TCM processing theory and classic heritage and modern manufacturing and can provide the basis for the establishment of a standardized system for industrial decoction pieces based on whole-process quality control of TCM. It can also offer reference for the development of the advantages of geo-authentic crude drug and the establishment of high spots of industry decoction pieces.

Low health literacy and psychological symptoms potentially increase the risks of non-suicidal self-injury in Chinese middle school students.

BACKGROUND: Low health literacy (HL) has been known to be involved in various risk behaviors and mental disorder among adolescent. The purpose of this study was to examine the independent and interactive association between HL and self-reported mental health with non-suicidal self-injury (NSSI) in Chinese middle school students. METHODS: Twenty five thousand three hundred seventy-eight junior and high school students in China were enrolled in this study. The outcomes were self-reported HL, psychological symptoms and NSSI. Logistic regression models were conducted to examine relations between them. RESULTS: The prevalence of NSSI was 27.5 %. Low HL was significantly associated with NSSI (OR = 2.538, 95 % CI: 2.335-2.758). Psychological symptoms were significantly positively correlated with NSSI (OR = 3.872, 95 % CI: 3.637-4.123). Low HL and psychological symptoms were independently and interactively associated with increased risks of NSSI. CONCLUSIONS: These results suggest that Chinese middle school students with low HL and psychological symptoms are intending to exhibit NSSI. The intervention programs of mental health and behavior problems should enhance HL levels and attenuate the severity of psychological symptoms.

The influence of health-promoting lifestyles on the quality of life of retired workers in a medium-sized city of Northeastern China.

OBJECTIVES: The aim of this study was to clarify the actual state of retired workers' lifestyles and quality of life (QOL) in a medium-sized city of Northeastern China and to assess the relationship between these according to differences between gender groups. METHODS: The Chinese version of the Health Promotion Lifestyle Profile II (HPLP-II), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and demographic variables were used to measure 343 (aged 50-79 years) retired workers' lifestyles and QOL. The results were analyzed using the t test, one-way analysis of variance, correlation analysis, and multiple linear regression analysis. RESULTS: Among the six lifestyle subscales of HPLP-II, the highest mean score was for Interpersonal Relations (IR) and the lowest was for Health Responsibility (HR), which has not been reported previously. The youngest group (50-60 years) had higher scores for lifestyles and QOL than the other age groups. When the results were analyzed based on financial situation, the lowest income group (below ¥2000) had the poorest scores. Analysis according to gender group revealed different tendencies for the scores of lifestyle and QOL, as well as in the multiple regression analysis between variables. CONCLUSION: Our results suggest that an effective approach to maintain a desirable lifestyle and QOL for retired workers at the regional level would be to introduce daily activities to improve HR and to maintain and enhance social support for the low-income populations. Further research is needed to understand the complex causal pathways between regional health and welfare factors, health behavior, and QOL.

Tissue-protective effect of glutamine on hepatic ischemia-reperfusion injury via induction of heme oxygenase-1.

BACKGROUND/AIMS: Glutamine showed cytoprotective activity in vitro on anoxia-reoxygenation injury via induction of heme oxygenase-1 (HO-1). We thus investigated its in vivo tissue-protective effect in a rat liver ischemia-reperfusion (I/R) model. METHODS: Before the I/R procedure, animals were treated with glutamine. Liver injury was evaluated by serum liver enzymes, histological examination and apoptosis detection by transferase-mediated uridine nick end labeling staining. Meanwhile, expression and activities of HO-1 were measured by Western blot and a biochemical method. Liver blood flow was measured by using a laser Doppler flowmeter, and oxidative injury was investigated by the thiobarbituric acid-reactive substance (TBARS) assay. The inflammatory cytokine monocyte chemotactic protein (MCP)-1 was quantified by ELISA. RESULTS: I/R caused a large increase in levels of liver enzymes, remarkably inducing the necrosis and apoptosis of liver tissue, which was markedly inhibited by glutamine, during which HO-1 was upregulated significantly, and the HO-1 inhibitor zinc protoporphyrin nullified the effect of glutamine. Liver blood flow was greatly reduced after I/R; however, it was significantly improved by glutamine. Lipid peroxidation (TBARS) in liver tissue was largely induced which was significantly lowered by glutamine. Similar results were also observed for the production of MCP-1. CONCLUSION: Glutamine protected tissue against oxidative injury during rat hepatic I/R, by induction of HO-1 to fulfill antioxidative and antiapoptotic effects.

Relationship between lifestyle and lifestyle-related factors in a rural-urban population of Japan.

OBJECTIVE: To clarify the actual state of residents' lifestyle in a mixed rural-urban area in Japan, and to investigate the relationship between residents' lifestyle and lifestyle-related factors. METHODS: The Japanese version of Health Promoting Lifestyle Profile-II (HPLP-II), lifestyle-related factors developed through group work with residents of Town A, and demographic variables were used to evaluate 1176 community residents' lifestyles and associated factors. RESULTS: Factor analysis revealed that there were 4 factors related to healthy lifestyle. Nonparametric analysis revealed that female and elderly groups showed higher overall HPLP-II score than male and young groups. A significant correlation coefficient was seen between scores of overall HPLP-II and lifestyle-related factors (r = 0.611, p < 0.001). Multiple linear regression analysis demonstrated that HPLP-II was significantly associated with each lifestyle-related factor, showing a similar order in both gender and age groups. Finally, covariance structure analysis demonstrated that the score of health cognition and regional factors increased the score of HPLP-II, which then increased the score of self-rated health. CONCLUSIONS: The present research clarified the actual state of residents' lifestyles by age and gender in a mixed rural-urban area in Japan, demonstrating a vector model from health cognition and regional factors to self-rated health, via residents' lifestyle.

An intervention study to promote self-improvement of lifestyle in a Japanese community: a new health support program.

OBJECTIVE: To assess the effectiveness of two health support programs developed to improve the lifestyle of community residents through exercise, nutrition-based health education, and group dynamics. METHODS: A total of 171 subjects were selected from community residents showing an abnormal result in at least one metabolic syndrome-related laboratory test. The subjects were divided into two groups: a group participating only in the 5-month initiation program (i.e., the initial program; n = 83), and a group participating both the initiation program and the subsequent 6-month enhancing program (i.e., the total program; n = 88). Each group was followed up for 1 year after completing the intervention program. The effectiveness of the intervention was determined based on data from the Health Promoting Lifestyle Profile II and laboratory tests, which were collected four times during the 2-year follow-up. Thirty-nine individuals were selected as the control group, based on the same criteria, to confirm the effectiveness of completing the intervention program. RESULTS: The results demonstrate that completion of the initiation programe was an effective intervention in terms of individual improvements in lifestyle and laboratory test results. The improvements achieved by the end of the initiation program had been sustained at the end of the total program, and were similar in both groups. One year after the end of the total program, both groups showed similar findings, confirming the effectiveness of the intervention. CONCLUSION: The results of this study demonstrate the effectiveness of two health support programs for improving the lifestyle of community residents. It is worth noting that, at the end of the 2-year follow-up, the improvements in lifestyle due to the initiation program were similar to those of the total program.

A comparative study of health-promoting lifestyles in agricultural and non-agricultural workers in Japan.

OBJECTIVES: To clarify the difference in health-promoting lifestyles between agricultural and non-agricultural workers in Japan, a cross-sectional study was conducted on 627 residents living in a town with a mixed rural-urban population. METHODS: The subjects were divided into 8 groups by job (agricultural and non-agricultural), age (young and old), and gender (male and female). To evaluate the subjects' lifestyles, the Health Promoting Lifestyle Profile II (HPLP-II) was applied. The Bartlett test and the Kendall rank test were performed for statistical analysis. RESULTS: There was no significant difference in the overall score of the HPLP-II between the two job groups. However, for the HPLP-II subscales, a significantly higher score for "spiritual growth" and a significantly lower score for "physical activity" were seen in the agricultural group than in the non-agricultural group. In general, the old and female groups showed higher scores than the corresponding groups, regardless of job type. CONCLUSIONS: It was determined that the major countermeasures to maintain a healthy lifestyle in agricultural workers should be associated with how to introduce daily activities that maintain and enhance "spiritual growth" and improve "physical activity".