Diarylheptanoids with neuroprotective effects from Alpinia officinarum rhizomes.

Forty-three diarylheptanoids were isolated from Alpinia officinarum rhizomes among them eight ones (1-6) were undescribed compounds whose structures were identified by UV, IR, HRESIMS, and NMR. The neuroprotective effects of these diarylheptanoids were evaluated on H2O2-damaged SH-SY5Y cells. Compounds 7, 10, 12, 20, 22, 25, 28, 33, 35, 37, and 42 presented significant neuroprotective effects than that of the positive control (EGCG) at the concentrations of 5, 10 or 20 µM. Compounds 10, 22, 25, and 33 significantly reduced the ROS levels and inhibited the generations of MDA and NO in oxidative injured cells to display neuroprotective effects. This study lay the foundation for the application of Alpinia officinarum rhizomes.

A single-agent fusion of human IL-2 and anti-IL-2 antibody that selectively expands regulatory T cells.

The occurrence of many autoimmune diseases takes root on the disrupted balance among Treg cells, Teff cells, etc. Low-dose interleukin-2 (IL-2) cytokine demonstrates promising clinical efficacy in the expansion of Treg cells and the treatment of autoimmune diseases. However, its clinical application is hindered by the small therapeutic index and short half-life. Previous studies have shown that non-covalent complex of human IL-2 and anti-IL-2 antibody biases cytokine activity towards Treg cells and extends IL-2's half-life. The clinical translation of such complex is non-trivial. In this study, we discover an anti-human IL-2 antibody and engineer a covalently-linked single-agent fusion of human IL-2 and its antibody that selectively expands Treg cells and exhibits superior disease control activity in animal models of ulcerative colitis and systemic lupus erythematosus, with proper safety profile and good developability. These studies pave the road for its clinical development in diverse autoimmune diseases.

Abietane diterpenoids with anti-neuroinflammation activity from Rosmarinus officinalis.

A total of 12 abietane diterpenoids were isolated and identified from Rosmarinus officinalis in which 6 ones were undescribed compounds. Their structures were illuminated by the HRESIMS, NMR, and ECD methods and named as rosmarinusin Q-V (1-6). It worthy mentioned that rosmarinusin Q was a novel abietane diterpenoid with 6/6/5 skeleton whose C ring was an α,ß-unsaturated five-element ketone. All the compounds and four compounds (13-16) reported in our previous paper were evaluated their anti-neuroinflammatory activities on the LPS-induced BV2 cells. Compounds 5, 8, 9, 11, and 15 displayed significant anti-neuroinflammatory activity at the concentration of 10, 20, and 40 µM respectively. These results confirmed that R. officinalis contained abundant abietane diterpenoids and these compounds showed potential values of anti-neuroinflammation which could be developed as neuroprotective agents for the treatment of nerve damage caused by inflammation.

Effects of 12-week aerobic exercise with different frequencies on executive function in preschool children: a cluster randomized controlled trial.

OBJECTIVE: To explore the effects of a 12-week aerobic exercise program with different frequencies on executive functions (EFs) in preschool children. METHOD: Four kindergartens, comprising 126 preschool children in Shanghai, were enrolled in this 12-week cluster randomized controlled trial with a 12-week follow-up period. Kindergartens were allocated to high-frequency (three times a week) or low-frequency (once a week) exercise groups using stratified block randomization. Three core sub-EFs, including inhibition, working memory, and cognitive flexibility, were assessed at baseline, post-intervention, and the 12-week follow-up. RESULTS: Compared to baseline, both groups showed significant improvements in inhibition and working memory after the intervention and at the 12-week follow-up. However, only the high-frequency exercise group demonstrated a significant improvement in cognitive flexibility after the follow-up period. Nonetheless, there were no significant differences in the core sub-functions of EFs between the two groups at the end of the intervention or the follow-up periods. CONCLUSION: A 12-week aerobic exercise of three times a week was insufficient to significantly improve EFs in preschool children compared to once a week. Future studies are needed to examine the dose-response relationship of aerobic exercise on EFs and to verify the effects of different exercise modalities on EFs in preschool children.

Association between walking speed and calcaneus stiffness index in older adults.

INTRODUCTION: The aim here is to examine the association between objectively measured usual walking speed (UWS) and bone status in community-dwelling older Chinese. MATERIALS AND METHODS: This is a cross-sectional study of a population of 1528 adults (817 females, mean age 68.5 ± 5.3; 711 males, mean age 69.1 ± 5.2) aged 60-79, living in communities in Shanghai. Walking speed was assessed using a 4-m walk test at a usual-pace walking speed a walking speed at which the subject felt relaxed-and bone status measured by quantitative ultrasound (QUS). The health-related characteristics of participants include family background, physical activity level, chronic disease, smoking and alcohol consumption, frequency of falls, vitamin intake, and hormone therapy. RESULTS: Multiple linear regression is used to analyses any association between UWS and bone status, adjusting for confounding factors showing a significant association between faster UWS and a higher calcaneal stiffness index (SI) (p < 0.01). Comparing the lowest quartile of the data set with the highest at UWS, a high SI is achieved with 5.34 (95% CI = 3.22, 7.46) (p < 0.01), after adjusting for confounders. An increase of 1 dm/s was associated with a 0.91 (95% CI = 0.53, 1.29) increase in SI. This relationship for most subgroups is consistent. CONCLUSION: Our findings suggest that UWS can be a sensitive indicator of calcaneal bone loss among an older population.

Physiological pharmacokinetic model of children and its application of modeling software / 药学学报

Developmental changes in children can affect drug disposition and clinical effects. A physiologically-based pharmacokinetic (PBPK) model is a mathematical model that can be used to predict blood drug concentrations in children and gain insight into age-dependent physiological differences in drug disposition impact. Pediatric PBPK (P-PBPK) models have attracted attention over the past decade. With the concerted efforts of academia, pharmaceutical companies, and regulatory agencies, there are more and more examples of pediatric clinical studies using PBPK models. Nevertheless, the number of P-PBPK models and their predictive performance still lag behind adult models. By referring to the literature, we study the process of children adapting to adult absorption, distribution, metabolism, and excretion (ADME) parameters and analyze the general principles of P-PBPK model establishment. In addition, we summarize the functions and application examples of commonly used P-PBPK modeling software to provide a basis for the rational application of modeling software.

Relationship Between Gross Motor Skills and Inhibitory Control in Preschool Children: A Pilot Study.

Purpose: Gross motor skills (GMS) and inhibitory control (IC) which are both development in preschool stage is significant for preschooler to healthy growth. However, the evidence of relationship between them in preschoolers are still insufficient, most of studies only focus on youth. Thus, the aim of this research is to examine the association between GMS and IC in preschool children. Methods: This cross-sectional study used baseline data from a previous intervention study of preschoolers conducted in 2018. GMS were assessed by using the Test for Gross Motor Development (2nd edition) in preschoolers, which includes two subtests of locomotor and object control skills. Total GMS is calculated from the sum of these two subtests. The Fish Flanker task was used to evaluate both accuracy and reaction time of IC. Multivariate linear regression models were established to analyze the relationships between GMS and IC. Results: A total of 123 preschool-age children (55 girls, 68 boys) were included in the final analysis. After adjusting for confounders, GMS (ß = -8.27 ms, 95%CI: -14.2, -2.34), locomotor (ß = -11.2 ms, 95%CI: -21.43, -0.97), and object control skills (ß = -12.15 ms, 95%CI: -22.07, -2.23) were all negatively related with reaction time of IC. Conclusion: There was a significant negative correlation between gross motor skills and the reaction time of inhibitory control in preschool children. Further research is needed to verify this finding in prospective and experimental studies.

The association between the health-related physical fitness and inhibitory control in preschool children.

BACKGROUND: Inhibitory control develops rapidly during the preschool stage, and development of inhibitory control in this period is significant for the healthy growth of the future. However, most studies paid more attention to children and adolescents in recent years, but less focus on preschool children. Therefore, the purpose of this study was to explore the association between the health-related physical fitness and inhibitory control in preschool children. METHODS: This cross-sectional study was based on a baseline data from randomized controlled trial by cluster sampling(including 128 preschoolers, 70 boys, 58girls).The health-related physical fitness T-score (HPFT) was obtained by adding standard scores of six indicators: body mass index, handgrip strength, standing long jump, one-leg balance, 2 × 10 m shuttle run test, and 20 m shuttle run test. Inhibitory control was assessed using the flanker task and reflected by reaction time and accuracy. RESULTS: A total of 120 preschoolers were included in the final statistical analysis. After adjusting the confounders, HPFT was associated with reaction time (ß=-2.49 ms, 95%CI: -4.22, -0.75). Similarly, a negative association was observed between one-leg balance and reaction time (ß=-12.04 ms, 95%CI: -18.94, -5.15), and between 20 m shuttle run test and reaction time (ß=-23.28 ms, 95%CI: -37.00, -9.56). Compared with the participants in the lowest tertile, HPFT (ß=-158.74, 95%CI: -309.63, -7.84), one-leg balance (ß=-267.25 ms, 95%CI: -420.71, -113.79) and 20 m shuttle run test (ß=-215.58 ms, 95%CI: -374.67, -56.49) were all negatively associated with reaction time of those in the highest tertile. CONCLUSIONS: Negative relationships between HPFT and RT of the inhibitory control were observed in preschoolers. To have better inhibitory control, it's suggested that HPFT of preschoolers should be at least 249. These findings are of great significance for the early improvement of HPFT and the development of inhibitory control in preschool children.

The Association of Different Sedentary Patterns and Health-Related Physical Fitness in Pre-schoolers.

Background: The results of sedentary time (ST) and health-related physical fitness (HPF) are not completely consistent and the studies concentrated on pre-schoolers are very limited. Methods: We measured ST and ST patterns (ST Bouts time, ST Breaks times) by accelerometer. The health-related physical fitness T-score (HPFT) was calculated by five indexes: height-weight standard score, 20 m shuttle-run test, grip strength, standing long jump and 2 × 10 m shuttle-run test. Results: We included 375 pre-schoolers (211 boys, 164 girls) in the final analysis. The total ST and ST Bouts times negatively correlated with HPFT in pre-schoolers. HPFT reduced by 1.69 and 0.70 points per 10 min increased in total ST and ST Bouts times, respectively. HPFT of the highest quartile group reduced by 9.85 points in total ST, and 10.54 points in ST Bouts time compared with the lowest quartile group. However, the HPFT increased by 0.09 points per 10 times increased in ST Breaks times; the HPFT increased by 16.21 and 15.59 points when moderate to vigorous physical activity (MVPA) replaced total ST and ST Bouts time. Conclusions: HPF negatively correlated with the Total ST and ST Bouts times, but positively correlated with ST Breaks times; and HPF significantly improved when MVPA replaced ST in pre-schoolers.

Effects of interrupting prolonged sitting on postprandial glycemia and insulin responses: A network meta-analysis.

PURPOSE: This study aimed to evaluate the effectiveness of physical activity (PA) interrupting prolonged sitting (PS) on postprandial glycemia and insulin responses among adults. METHODS: PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, PsycINFO, and the China National Knowledge Infrastructure databases were searched through September 30, 2020. Randomized controlled trials (RCTs) that examined the effect of all forms of PA interrupting PS on postprandial glycemia and/or insulin responses among adults without chronic diseases were included in this study. The risk of bias of included studies was evaluated based on the Cochrane tool. A network meta-analysis was performed to estimate the summary standardized mean differences (SMDs) with 95% confidence intervals (95%CIs) with random effects. RESULTS: Thirty crossover RCTs were included in our review. These RCTs included 9 types of interventions that interrupted PS. When compared to PS by itself, light-intensity PA intermittent interrupting (LPA-INT) PS and moderate-intensity PA intermittent interrupting (MPA-INT) PS significantly lowered postprandial glycemia (SMD = -0.46, 95%CI: -0.70 to -0.21; SMD = -0.69, 95%CI: -1.00 to -0.37, respectively) and significantly reduced postprandial insulin response (SMD = -0.46, 95%CI: -0.66 to -0.26; SMD = -0.47, 95%CI: -0.77 to -0.17, respectively). Results of the clustered ranking plot indicated that MPA-INT was the most effective intervention in lowering postprandial glycemia and insulin responses. CONCLUSION: Replacing PS with MPA-INT or LPA-INT has a positive effect in reducing postprandial glycemia and insulin responses, with MPA-INT being the optimal intervention strategy.

THE function and morphology study of eustachian tube based on sonotubometry and multi-slice spiral CT in normal subjects / 中华耳鼻咽喉头颈外科杂志

Objective: In order to assess ET more comprehensively, sonotubometry (STM)combined with CT images were applied to investigate the opening features of eustachian tube (ET) in normal subjects. STM was also used as a monitor training ET opening maneuver and optimizing CT scan parameters. Methods: Following ET opening training monitored by STM, STM data of ET opening duration and maximum sound pressure from 13 healthy volunteers (10 males and 3 females, 22 to 26 years old) were acquired using maneuvers of swallowing and Valsalva in standing and supine positions. Two trials of CT scan, setting A (slice thickness 6.0 mm, manually simulated to 0.6 mm, reconstruction thickness 0.6 mm) for normal and Valsalva scans and setting B(slice thickness 0.4 mm,reconstruction thickness 0.4 mm)for Valsalva scan, were conducted in each subject. The bone area and cartilage area of ET were measured respectively in reconstructed CT images. Statistical software SPSS 19.0 was employed in data analysis. Results: The duration of ET opening and maximum sound pressure by Valsalva were longer and stronger than those by swallowing in both positions. For Valsalva maneuver, standing position resulted in longer ET opening duration compared to supine position (P<0.05). Under setting A, ET cartilage area was measured larger by Valsalva scan than by normal scan (P<0.05). By Valsalva scan, setting A captured larger ET cartilage area compared to setting B (P<0.05). CT setting B resulted in longer scan time in comparison to setting A (P<0.05). Conclusions: Techniques of STM in supine position plus CT scan under setting A can be combined by Valsalva passive ET opening. Not only the invisible ET lumen through routine CT scan can be illustrated, but also relevant ET open-close process is shown, therefore, this study provides the technique for ET research of function and structure.

Distribution, diagnosis, and analysis of related risk factors of multidrug-resistant organism in patients with malignant neoplasms.

OBJECTIVE: In this study, we sought to investigate the distribution characteristics, early diagnosis, and related risk factors of multidrug-resistant organism (MDRO) in patients with malignant tumors. METHODS: A total of 278 patients with malignant tumors and infections were selected in the Department of Oncology for retrospective study, including 128 MDRO patients and 150 non-MDRO patients. The markers of bacterial culture were detected, and the serum procalcitonin (PCT), C-reactive protein (CRP), and serum amyloid A (SAA) levels were measured in patients' blood samples. The diagnostic value of PCT, CRP, and SAA for MDRO was evaluated, the distribution of MDRO in different years and different infection sites was analyzed, and the related risk factors of MDRO infection were studied. RESULTS: The PCT, CRP, and SAA in the MDRO group were significantly higher than those of the non-MDRO group (all P<0.001). The area under the curve of receiver operating characteristics for the diagnosis of MDRO by PCT, CRP, and SAA. The combination of the three was 0.792, 0.811, 0.755, and 0.842, respectively. The distribution of MDRO strains in different years was statistically different (P<0.05), as well as the distribution of MDRO in different infection sites (P<0.05). Multivariate regression analysis demonstrated that invasive operation, excessive bed rest, hypoproteinemia, PCT, and SAA were independent risk factors for MDRO infection in patients with malignant tumors (all P<0.05). CONCLUSION: The combination of CRP, PCT, and SAA displays a value for early diagnosis of MDRO infection. MDRO infections in malignant tumors mainly include carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Escherichia coli. There are differences in terms of MDRO strains in different years and different infection sites, and there are many risk factors regarding MDRO infection in patients with malignant tumors. Intervention should be taken in order to reduce the rate of MDRO infection.

The effects of chronic physical activity interventions on executive functions in children aged 3-7 years: A meta-analysis.

OBJECTIVES: To use a quantitative approach to examine the effects of chronic physical activity (PA) interventions on executive functions (EFs) in children aged 3-7 years. DESIGN: Systematic review and meta-analysis. METHODS: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, and the China National Knowledge Infrastructure were searched from their inception to December 2019. Intervention studies with a control group that examined the effects of chronic PA interventions on EFs among children aged 3-7 years were included in this meta-analysis. Lastly, subgroup analyses were conducted to examine the potential modifying effects of chronic PA intervention's characteristics and study quality. RESULTS: A total of 10 studies were included in this meta-analysis with a total of 716 participants. The fixed-effects model was used to estimate the pooled effect sizes since heterogeneity across included studies was not significant. The summary effects revealed that chronic PA interventions have a small but positive effects on participants' overall EFs [standardized mean difference (SMD) = 0.35, 95% CI: 0.20-0.50] as well as inhibition (SMD = 0.37, 95% CI: 0.12-0.62) and working memory (SMD = 0.24, 95% CI: 0.02-0.46) domains and a moderate effect on the cognitive flexibility domain (SMD = 0.66, 95% CI: 0.28-1.05). Lastly, the pooled effect was not significantly modified by intervention duration, session length, or frequency. CONCLUSIONS: Chronic PA interventions, especially PA plus cognitive challenges interventions, may be a promising way to promote the development of multiple aspects of EFs in children aged 3-7 years.

Analysis of Epidemic Situation of New Coronavirus Infection at Home and Abroad Based on Rescaled Range (R/S) Method

11.1 BackgroundThe outbreak of the new coronavirus infection broke out in Wuhan City, Hubei Province in December 2019, and has spread to 97 countries and regions around the world. Apart from China, there are currently three other severely affected areas, namely Italy, South Korea, and Iran. This poses a huge threat to Chinas and even global public health security, challenges scientific research work such as disease surveillance and tracking, clinical treatment, and vaccine development, and it also brings huge uncertainty to the global economy. As of March 11, 2020, the epidemic situation in China is nearing its end, but the epidemic situation abroad is in the outbreak period. Italy has even taken measures to close the city nationwide, with a total of 118,020 cases of infection worldwide. 1.2 MethodThis article selects the data of newly confirmed cases of COVID-19 at home and abroad as the data sample. Among them: the data of newly confirmed cases abroad is represented by Italy, and the span is from February 13 to March 10. The data of newly confirmed cases at home are divided into two parts: Hubei Province and other provinces except Hubei Province, spanning from January 23 to March 3, and with February 12 as the cutting point, it"s divided into two periods, the growth period and the recession period. The rescaled range (R / S) analysis method and the dimensionless fractal Hurst exponent are used to measure the correlation of time series to determine whether the time series conforms to the fractal Brownian motion, that is, a biased random process. Contrast analysis of the meaning of H value in different stages and different overall H values in the same stage. 1.3 ResultsBased on R / S analysis and calculated Hurst value of newly confirmed cases in Hubei and non-Hubei provinces, it was found that the H value of Hubei Province in the first stage was 0.574, which is greater than 0.5, indicating that the future time series has a positive correlation and Fractal characteristics; The H value in the second stage is 1.368, which is greater than 1, which indicates that the future epidemic situation is completely preventable and controllable, and the second stage has a downward trend characteristic, which indicates that there is a high probability that the future time series will decline. The H values of the first and second stages of non-Hubei Province are 0.223 and 0.387, respectively, which are both less than 0.5, indicating that the time series of confirmed cases in the future is likely to return to historical points, and the H value in the second stage is greater than that in the first stage, indicating that the time series of confirmed cases in the second stage is more long-term memory than the time series of confirmed cases in the first stage. The daily absolute number of newly confirmed cases in Italy was converted to the daily growth rate of confirmed cases to eliminate the volatility of the data. The H value was 1.853, which was greater than 1, indicating that the time series of future confirmed cases is similar to the trend of historical changes. The daily rate of change in cases will continue to rise. 1.4 ConclusionAccording to the different interpretation of the H value obtained by the R / S analysis method, hierarchical isolation measures are adopted accordingly. When the H value is greater than 0.5, it indicates that the development of the epidemic situation in the area has more long-term memory, that is, when the number of confirmed cases in the past increases rapidly, the probability of the time series of confirmed cases in the future will continue the historical trend. Therefore, it is necessary to formulate strict anti-epidemic measures in accordance with the actual conditions of various countries, to detect, isolate, and treat early to reduce the base of infectious agents.

Prediction of New Coronavirus Infection Based on a Modified SEIR Model

BACKGROUNDThe outbreak of the new coronavirus infection in Wuhan City, Hubei Province in December 2019, poses a huge threat to China and even global public health security. Respiratory droplets and contact transmission are the main routes of transmission of new coronaviruses. Compared with SARS and Ebola viruses, new coronavirus infections are infectious during the incubation period. Traditional SEIR (susceptibility-exposure-infection-Removal) There are some differences in conditions for the prediction of the epidemic trend of new coronavirus infection. The outbreak of the new coronavirus infection coincided with the Spring Festival before and after the Chinese Spring Festival.It is necessary to make appropriate optimization and amendments to the traditional model to meet the actual evolution of the epidemic situation. METHODSThe traditional SEIR model assumes that the virus-infected person is not infectious during the incubation period and that the infected person did not take isolation measures during the illness. The transmission of the new coronavirus no longer meets the basic assumptions of the classical kinetic system. Therefore, this article first establishes a modified SEIR model. Predict and analyze the changing trend of the epidemic situation, then estimate the parameters involved in the infection dynamics model, and then use Matlab to simulate the established dynamic equations based on public data and analyze the results. Recommendations for universal prevention and control of infectious diseases. RESULTSThe first case of new coronavirus infection was confirmed in Wuhan on December 8, 2019. When Wuhan City took no action, assuming the average daily number of contacts per infected person k = 5, the number of infected persons will reach about 2,384,803 people; If wuhan adopts the measures of sealing the city on January 22, 2020, under the premise of k=2, the number of infected people decreases by 19,773 compared with that on January 23, and there is no significant change in the time when the number of infected people reaches the peak. Under the premise of k = 1, the number of infected persons was reduced by 14,330 compared with the closure on January 23, and the time to reach the peak of the number of infected persons was reduced by 2 days. If Wuhan City is closed for one day, the number of infected persons will increase from 106,145 to 130,626 under the premise of k = 2; the number of infected persons will increase from 74,369 to 92,010 under the premise of k = 1. CONCLUSIONSComparing the number of confirmed diagnoses actually notified by the department with the number of infected people obtained from the simulation of the model, it can be seen that the city closure measures adopted by the Wuhan Municipal Government on January 23 and the first-level response measures adopted by the country are effective for the epidemic Prevention and control play a vital role. Wearing a mask when going out and avoiding close contact with people can effectively reduce the infection rate.

Associations between Daily Step Counts and Physical Fitness in Preschool Children.

PURPOSE: To investigate the relationships between daily step counts and physical fitness in preschool children. METHODS: Preschoolers' step counts were assessed by ActiGraph accelerometers consecutively for seven days. Physical fitness was assessed by a 20 m shuttle run test (cardiorespiratory fitness), the handgrip and standing long jump tests (musculoskeletal fitness), and the 2 × 10 m shuttle run test (speed/agility). A composite score was created from the mean of the standardized values of all physical fitness tests. RESULTS: A total of 301 preschoolers (134 girls, mean age 57.40 ± 5.47 months; 167 boys, mean age 58.10 ± 5.34 months) were included in the final analysis. Compared with the lowest tertile, boys and girls in the highest tertile of step counts achieved high physical fitness with odds ratio (OR) being 5.39 (95% CI = 1.65-17.59) and 4.42 (95% CI = 1.30-14.99), respectively, after adjusting for confounders. Meanwhile, a relationship was observed for each 1000 steps/day increment being associated with 43% (OR = 1.43, 95% CI = 1.10-1.85) and 62% (OR = 1.62, 95% CI = 1.20-2.19) increment for high physical fitness in boys and girls, respectively. In addition, significant non-linear relationship was observed between daily steps and physical fitness in boys, which indicated that accumulated 8000 steps/day was associated with the highest ratio to achieve high physical fitness. CONCLUSIONS: Positive relationships between step counts and physical fitness were observed in preschool children, and the relationships were strongest for those who accumulated 8000 steps/day in boys. To confirm the findings in this study, well-designed and large-scale longitudinal studies are needed in the future.

Analysis on sleep quality and characteristics of depression patients with different degrees of anxiety / 上海交通大学学报（医学版）

Objective: To compare the sleep quality of depressive patients with and without anxiety symptoms. Methods: Hamilton Depression Scale-17 (HAMD-17), Hamilton Anxiety Scale (HAMA) and Pittsburgh Sleep Quality Index Scale (PSQI) were used to assess the level of patients' depression, anxiety and sleep quality. The HAMA scores of patients ranged from 0 to 6 were in the anxiety-free group, 7 to 13 in the anxiety-prone group, and 14 or more in the anxiety group. Results: The PSQI scores of the group with anxiety were higher than those of anxiety-prone group and anxiety-free group (both P=0.000). Partial correlation analysis showed that, after controlling HAMD-17 scores, the correlation between HAMA scores and PSQI scores reduced gradually with the increase of anxiety level. The multiple linear regression analysis showed that sleep disorder was still an independent risk factor for depression after controlling HAMA score. Sleep latency, sleep time, hypnotics and daytime dysfunction were independent predictive factors of HAMD-17 score (all P<0.05). Conclusion: In patients with depressive disorder, the severity of sleep disorder increases with the increase of anxiety level. In the case of comorbidity anxiety, sleep disorder is still an independent risk factor for depressive disorder, and the relationship between depressive symptoms and sleep disorder indicators of different dimensions suggests that sleep disorder plays a comprehensive role in the pathogenesis of depressive disorder.

Are preschool children active enough in Shanghai: an accelerometer-based cross-sectional study.

OBJECTIVE: Engaging in physical activity (PA) plays an important role in promoting physical and mental health, but the PA data for Chinese preschool children are lacking. This study aims to objectively assess the PA levels of preschool children in Shanghai, China and to evaluate their PA levels relative to age-specific recommendations. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional study was conducted among preschool children in Shanghai, city of China. There were a total of 303 preschool children (boys, 174; girls, 129) recruited from eight kindergarten classes in the Yangpu and Baoshan Districts of Shanghai. MAIN OUTCOME MEASURES: Daily PA was assessed using ActiGraph GT3X+ accelerometers for seven consecutive days. Children were required to have data from at least 2 weekdays and 1 weekend day, with a minimum daily wear time of 480 min to be included in the analysis. RESULTS: Preschool children in Shanghai accumulated, on average, 70.9 min of moderate-to-vigorous PA (MVPA) and 168.0 min of total PA (TPA) per day (d). Boys engaged in more MVPA and TPA than girls (72.8 min/day vs 68.3 min/day and 171.9 min/day vs 162.9 min/day, respectively). Overall, 72.9% of the participants met the age-specific recommendations of MVPA, while 35.3% met TPA recommendations. CONCLUSIONS: Findings of this study warn of the insufficiency of PA in Shanghai preschool children, suggesting there is substantial room to improve their PA. TRIAL REGISTRATION NUMBER: ChiCTR-OOC-15007439; Results.

Evaluation and Countermeasures of the Implementation of Forensic Clinical Identification Standards Based on the Perspective of Accreditation / 法医学杂志

The new Standardization Law, implemented in 2018, has added a standard post-implementation evaluation system, aiming to continuously improve the quality of standards through post-implementation evaluation. Standards in the forensic science field are closely related to accreditation activities. Forensic science standards are not only the criteria on which accreditation activities are carried out, but also one of the key contents of the inspection of forensic science institutions in accreditation activities. Since 2018, the certification and accreditation policies in the forensic science field have also been changed, which has brought impacts on the construction of a standard system based on accreditation.This paper analyzes the standard data from China National Accreditation Center from Conformity Assessment on forensic clinical identification accreditation assessment. It points out that the current coverage of laboratory accreditation activities is limited, the development in different provinces is unbalanced, and there is overlap and crossover in the standards in use. It is emphasized that the construction of the national forensic science standardization technical committee, the improvement of the forensic science standard system, the establishment of the standard implementation evaluation index system, and promotion of the coordination of standards, and the certifications and accreditations should be accelerated, in order to continue to promote the standardization and accreditation activities in the field of forensic science.

The compression of L5 nerve root, single or double sites?-radiographic graded signs, intra-operative detect technique and clinical outcomes.

BACKGROUND: The L5 nerve root could be compressed at both L4-5 and L5-S1 regions. If L5 nerve root has confirmed compression at L4-5 level and questionable compression at L5-S1 foramina, performing both surgeries at L4-5 and L5-S1 levels may induce unnecessary extra surgery on L5-S1; however, ignoring foraminal stenosis of L5/S1 may require re-exploration. METHODS: Two hundred seventeen patients with L5 nerve root compressed at L4-5 lateral access were performed with L4-5 decompression and interbody fusion. Lee et al. grade classification was used to assess the foraminal stenosis of L5-S1 preoperatively. Nerve root probe was designed and used to detect if there were foraminal stenosis at L5-S1 level that compressing the exiting L5 nerve root. Visual analog scale (VAS) of low back pain, leg pain and Oswestry Disability Index (ODI) were used to assess clinical outcomes. RESULTS: For all of 217 patients who underwent L4-5 surgery, L5-S1 foramina were preoperatively assessed as: grade 0: 125 cases, grade 1: 58 cases, grade 2: 23 cases, and grade 3: 11 cases. After intra-operative L5 nerve root detection, 11/11 patients with grade 3 radiographic foraminal stenosis, 6/23 (26.1%) with grade 2 and 2/58 (3.4%) who had grade 1 underwent L4-5 and L5-S1 transforaminal lumbar interbody fusion (TLIF), the others received only L4-5 TLIF. Compared to pre-operative baseline data, both L4-5 TLIF and L4-5 and L5-S1 TLIF groups had significant decreased VAS of low back pain and leg pain, and ODI at 3 and 24 months after operation. CONCLUSIONS: We suggested that our novel nerve root probe combined with pre-operative radiographic grade may be helpful to surgeons to identify the single or double compression of L5 nerve root and make a more precise surgical strategy to improve surgical outcome than the method depended on pre-operative radiographic grade alone.