Radiographic Assessment of Cleft Alveolar Bone Defects: A Preliminary Comparison of Periapical and Cone Beam Computed Tomography Images.

BACKGROUND & PURPOSE: Accurate radiographic assessment of secondary alveolar bone grafting (SABG) is critical in evaluating SABG outcomes in patients with cleft lip and palate. This study compared Periapical (PA) and Cone beam computed tomography (CBCT) grading of SABG outcomes and conducted an analysis of agreement rate between the two imaging modalities. METHODS: A retrospective chart review was performed of patients who underwent secondary alveolar bone grafting at a single institution. Bone quality of the alveolar cleft site was assessed at three root levels of the adjacent teeth on PA and CBCT images. RESULTS: 48 patients had pre- or post-operative images with both CBCT and PA that were appropriate for comparison. A total of 174 alveolar bone sections (three root levels of adjacent teeth in 58 pairs) were graded on CBCT and PA images. Agreement of CBCT grading with PA grading was 41.3% (72/174) overall. CBCT assessments rated bone quality lower than PA grading in 51.2% (89/174) of sections. CBCT had higher grading than PA image grading in 7.5% (13/174) of sections. The weighted Cohen Kappa value for comparison of CBCT and PA readings was 0.17, indicating a low rate of agreement. Wilcoxon signed rank test demonstrated that the difference between grading on CBCT and PA assessments was statistically significant (P < .001). CONCLUSIONS: CBCT and PA readings demonstrated an overall low rate of agreement in the assessment of cleft alveolar bone. This investigation suggests that PA radiographs have lower sensitivity in detecting poor bone grafting outcomes.

Assessment of aortic to peripheral vascular stiffness and gradient by segmented upper limb PWV in healthy and hypertensive individuals.

Theoretically pulse wave velocity (PWV) is obtained by calculating the distance between two waveform probes divided by the time difference, and PWV ratio is used to assess the arterial stiffness gradient (SG) from proximal to distal. The aim was to investigate segmental upper-limb PWV (ulPWV) differences and the effects of hypertension and or aging on each ulPWV and SG. The study collected multi-waveform signals and conduction distances from 167 healthy individuals and 92 hypertensive patients. The results showed significant differences between ulPWVs (P < 0.001), with increased and then decreased vascular stiffness along the proximal transmission to the distal peripheral artery and then to the finger. Adjusted for age and sex, ulPWVs in hypertension exceeded that of healthy individuals, with significant differences between groups aged ≥ 50 years (P < 0.05). The hrPWV/rfPWV (heart-radial/radial-finger) was reduced in hypertension and differed significantly between the aged ≥ 50 years (P = 0.015); the ratio of baPWV (brachial-ankle) to ulPWV differed significantly between groups (P < 0.05). Hypertension affected the consistency of rfPWV with hfPWV (heart-finger). The findings suggest that segmented ulPWV is instrumental in providing stiffness corresponding to the physiological structure of the vessel. The superimposition of hypertension and or aging exacerbates peripheral arterial stiffness, as well as alteration in stiffness gradient.

Burden of Knee Osteoarthritis in 204 Countries and Territories, 1990-2019: Results From the Global Burden of Disease Study 2019.

OBJECTIVE: To report the global, regional, and national estimates of knee osteoarthritis (OA) burden and associated risk factors (high body mass index [BMI]) by age, sex, and sociodemographic index (SDI) for 204 countries from 1990 to 2019. METHODS: We analyzed the prevalence, incidence, years lived with disability (YLDs), and age-standardized rates of knee OA using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Estimates of the knee OA burden were derived from data modeled using a Bayesian meta-regression analytical tool (DisMod-MR 2.1). RESULTS: The global prevalence of knee OA in 2019 was ~364.6 million (95% uncertainty interval [95% UI] 315.3 to 417.4). The age-standardized prevalence in 2019 was 4,376.0 per 100,000 (95% UI 3,793.0 to 5,004.9), an increase of 7.5% between 1990 and 2019. There were ~29.5 million incident cases of knee OA in 2019 (95% UI 25.6 to 33.7), with an age-standardized incidence of 350.3 per 100,000 (95% UI 303.4 to 398.9). The global age-standardized YLD resulting from knee OA was 138.2 (95% UI 68.5 to 281.3) per 100,000 population in 2019, an increase of 7.8% (95% UI 7.1 to 8.4) from 1990. Globally in 2019, 22.4% (95% UI 12.1 to 34.2) of YLD resulting from knee OA was attributable to high BMI, an increase of 40.5% since 1990. CONCLUSION: The prevalence, incidence, YLDs, and age-standardized rates of knee OA increased substantially in most countries and regions from 1990 to 2019. Continuous monitoring of this burden is important for establishing appropriate public prevention policies and raising public awareness, especially in high- and high-middle SDI regions.

The Social Cost of Providing Care to Older Adults With and Without Dementia.

OBJECTIVES: Social participation is known to enhance well-being. Caregiving responsibilities are more intense when caring for an older adult with than without dementia and may affect caregivers' ability for social participation. We estimate social participation restrictions among caregivers for older persons with versus without dementia, variation within racial/ethnic group, and the mediating effect of care hours. METHODS: We use the 2017 National Health and Aging Trends Study (NHATS) and National Study of Caregiving (NSOC) to study family caregivers for older adults. We estimate the prevalence of social participation (e.g., visiting family/friends, religious activities, group/club activities, going out) that were important to the caregiver but missed due to caregiving. We use logistic models to test for differences in restrictions by the older adult's dementia status overall and within race/ethnic group, adjusting for caregiver and care receiver characteristics. RESULTS: One-third of family caregivers for older adults with dementia reported restrictions due to caregiving, double the prevalence among caregivers of an older adult without dementia (33.3% vs 16.0%; p < .001). This doubling gap persisted in adjusted models (odds ratio [OR] = 2.4; p < .01) but mainly for White, non-Hispanic caregivers (OR = 3.2; p < .001). Substantially greater caregiving hours for people with versus without dementia was found (104 vs 60 hr per month), which is responsible for about 21% of the total difference in restrictions (p < .05). DISCUSSION: More time spent among caregivers of persons with versus without dementia may be an important factor undermining social participation, but hours only partially explain the gap. Future interventions should consider how to facilitate social participation among caregivers.

Global tourist flows under the Belt and Road Initiative: A complex network analysis.

This study applies complex network analysis to examine global tourist flows network in the context of Belt and Road Initiative (BRI). Using tourist flows data between 221 countries/regions over 1995-2018, we investigate the nature and development patterns of structural properties of global network as well as factors influencing its formation. The descriptive analysis indicates that global tourist network was a sparse network with small world network characteristics. According to centrality characteristics, China showed the most influence in the BRI group, while Germany and the United States possessed key roles among non-BRI countries/regions. Exploratory analysis demonstrated significant influence of gravity variables in global, BRI and non-BRI tourist networks. This research advances existing tourism theory and provides practical implications for policymakers.

Water pollution incidents and their influencing factors in China during the past 20 years.

There is an urgent need to explore the current situation of China's water pollution incidents for policymaking, accident prevention, and risk mitigation. This study analyzed 1528 water pollution incidents in China from 2001 to 2020 and explored the spatiotemporal characteristics and causes of incidents and consequent damage. The frequency of water pollution accidents increased in 2004, peaked in 2006, and decreased thereafter with a significant decline in 2016. Due to the developed river networks, high population densities, and increasing environmental awareness, pollution incidents were mostly concentrated in China's relatively industrially developed eastern coastal regions. Illegal emission is the major cause, accounting for 51% of all incidents, but with pipeline construction gradually approaching a peak, pipeline leakage poses a noteworthy risk in the future. Although the severity of accidents has reduced recently, it is still necessary to strengthen the risk prevention strategies for general and major accidents. Furthermore, three key factors, including economic development, regulations and legal system, and public participation in pollution supervision and control, which affect the trends and characteristics of water pollution incidents in China, were discussed. This paper offers valuable insights and suggestions that may have useful implications for policymaking and the prevention of water pollution.

How Does Income Inequality Influence Environmental Regulation in the Context of Corruption? A Panel Threshold Analysis Based on Chinese Provincial Data.

The question of how the income inequality of residents affects the level of environmental regulation in the context of official corruption was the core research issue of this study. We analyzed this problem using the panel threshold regression model from 26 provinces in China from 1995 to 2017. We found that when there is no official corruption, the widening of the residents' income inequality promotes stricter environmental regulations; when the corruption problem is serious, the expansion of the residents' income inequality leads to the decline in environmental standards; that is, the impact of residents' income inequality on environmental regulation has a threshold effect due to corruption. In addition, the threshold effect due to corruption of all residents' income inequality on environmental regulation is mainly generated by the urban residents' income inequality and the urban-rural income inequality. This paper contributes to the literature that concentrates on the relationship between income inequality and environmental regulation, and shows that corruption is a key factor that can deeply influence that relationship. The research conclusion shows that increasing anti-corruption efforts can not only maintain national political stability, social fairness, and justice, but also be a powerful measure for environmental pollution governance.

Temporal and spatial evolution and obstacle diagnosis of resource and environment carrying capacity in the Loess Plateau.

Natural resources are scarce in the Loess Plateau, and the ecological environment is fragile. Sustainable development requires special attention to resource and environmental carrying capacity (RECC). This study selected 24 representative cities in five natural areas of the Loess Plateau; used the entropy-weight-based TOPSIS method to evaluate and analyze the RECC of each city and region from 2013 to 2018; established a diagnosis model to identify the obstacle factors restricting the improvement of RECC; and constructed the theoretical framework of the RECC system mechanism. The results show that the RECC of the Loess Plateau is increasing in general but is relatively small. The environmental and social subsystems have the highest and lowest carrying capacities, respectively. There is an evident contradiction between economic development and the environment. Population density, investment in technological innovation, per capita sown area, and per capita water resources are the main obstacles affecting the improvement of RECC in the Loess Plateau. Such evaluations and diagnoses can support ecological civilization and sustainable development.

An Integrated Individual Environmental Exposure Assessment System for Real-Time Mobile Sensing in Environmental Health Studies.

The effects of environmental exposure on human health have been widely explored by scholars in health geography for decades. However, recent advances in geospatial technologies, especially the development of mobile approaches to collecting real-time and high-resolution individual data, have enabled sophisticated methods for assessing people's environmental exposure. This study proposes an individual environmental exposure assessment system (IEEAS) that integrates objective real-time monitoring devices and subjective sensing tools to provide a composite way for individual-based environmental exposure data collection. With field test data collected in Chicago and Beijing, we illustrate and discuss the advantages of the proposed IEEAS and the composite analysis that could be applied. Data collected with the proposed IEEAS yield relatively accurate measurements of individual exposure in a composite way, and offer new opportunities for developing more sophisticated ways to measure individual environmental exposure. With the capability to consider both the variations in environmental risks and human mobility in high spatial and temporal resolutions, the IEEAS also helps mitigate some uncertainties in environmental exposure assessment and thus enables a better understanding of the relationship between individual environmental exposure and health outcomes.

Using rational strategies for children's scars based on more than 5 years assessment after burn.

BACKGROUND: Paediatric patients with scars after burn are regularly encountered. Discussion of rational strategies for management are of value. The objective of the study was to describe development and utilisation of strategies for paediatric burn scars up to five years after injury. METHODS: We included 164 cases aged from 5 to 8 years old in our study; all had burn scar deformities. RESULTS: Assessments were made up to December 31, 2019. The following strategies were used: sequential treatment, reconstruction based on facial aesthetic units, predicting the effect of surgery on development, releasing skin tension and application of photoelectric technology or other non-surgical measures. CONCLUSIONS: Using rational strategies for paediatric burn scars is very important.

Facilitating Phase Evolution for a High-Energy-Efficiency, Low-Cost O3-Type NaxCu0.18Fe0.3Mn0.52O2 Sodium Ion Battery Cathode.

The phase transition and lattice parameter evolution of O3 structure commonly occurs in O3-type sodium ion battery (SIB) cathodes, which might enlarge the voltage hysteresis and lower the energy efficiency. Given that the cost is one of the issues discouraging the application of SIBs in large-scale energy storage, here we focus on Co/Ni-free NaxCu0.18Fe0.3Mn0.52O2 (x = 0.8, 0.85, 0.9) and propose a convenient strategy to reduce the voltage hysteresis. It is found that when the Na content is 0.8, the highest energy efficiency of 95.4% after activation is achieved (2.5-4.0 V, 50 mA g-1, the 50th cycle), in addition to a satisfactory capacity retention (about 0.056% decay per cycle). The further characterizations reveal that Na0.8Cu0.18Fe0.3Mn0.52O2 owns a gentle O3-P3 phase transition process and does not undergo O3 phase lattice parameter evolution. The key point lies in the attainability of the O3/P3 composite of the material. This work will provide a simple strategy for the rational design of O3-type cathodes with a high energy efficiency and might offer inspiration to search for layered oxides with a higher O3/P3 critical Na content through element adjustments.

Geogenic nickel exposure from food consumption and soil ingestion: A bioavailability based assessment.

Accumulation and oral bioavailability of nickel (Ni) were rarely assessed for staple crops grown in high geogenic Ni soils. To assess exposure risk of geogenic Ni, soil, wheat, and rice samples were collected from a naturally high background Ni area and measured for Ni oral relative bioavailability (RBA, relative to NiSO4) using a newly developed mouse urinary Ni excretion bioassay. Results showed that soils were enriched with Ni (80.5 ± 23.0 mg kg-1, n = 58), while high Ni contents were observed in rice (2.66 ± 1.46 mg kg-1) and wheat (1.32 ± 0.78 mg kg-1) grains, with rice containing ∼2-fold higher Ni content than wheat. Ni-RBA was low in soil (14.8 ± 7.79%, n = 18), but high in wheat and rice with rice Ni-RBA (85.9 ± 19.1%, n = 9) being ∼2-fold higher than wheat (46.1 ± 21.2%, n = 16). A negative correlation (r = 0.61) was observed between Ni-RBA and iron content in rice and wheat, suggesting the low iron status of rice drives its high Ni bioavailability. The higher Ni accumulation and bioavailability for rice highlights that rice consumption was a more important contributor to daily Ni intake compared to wheat, while Ni intake from direct soil ingestion was negligible. This study suggests a potential health risk of staple crops especially rice when grown in high geogenic Ni areas.

Effective allocation of resources in water pollution treatment alternatives: a multi-stage gray group decision-making method based on hesitant fuzzy linguistic term sets.

With the significant economic shift, water pollution treatment has gradually become a key problem which needs to be deeply investigated for the sustainable development of China. In the face of specific water pollution incidents, multiple alternatives are often required to work together in order to achieve better results. However, due to the limitation of resources, alternatives must be ranked to realize the effective allocation of resources, which means the more highly ranked ones should possess more disposable resources. Furthermore, the water pollution treatment process is a multi-stage and multi-objective process. In each stage, decision-makers may have different emphasis and thus have different preferences for the treatment alternatives. How to effectively aggregate decision-makers' preferences in different stages into an overall preference so as to form a ranking of treatment alternatives under global constraints has turned into a problem worthy of discussion. Under such background, this paper proposes a multi-stage gray group decision-making method, where decision-makers use Group-G1 to rank and weight the criteria, and in this way, the weights of decision-makers and criteria in each stage could be determined. Considering the difference and deficiency of the cognitive level of decision-makers, this paper adopts the form of hesitant fuzzy linguistic term sets (HFITS) to express the evaluation information of decision-makers. And then, gray incidence analysis is selected to rank the alternatives. After ranking the alternatives in each stage, the multi-stage rankings will be aggregated into an overall ranking and the resource allocation is made according to the priorities of the alternatives. Finally, an example of water pollution treatment alternatives ranking based on a cyanobacterial bloom in Taihu Lake, China, is given to illustrate the proposed approach.

Non-doctoral factors influencing the surgical choice of Chinese patients with breast cancer who were eligible for breast-conserving surgery.

BACKGROUND: The rate of breast-conserving surgery (BCS) is low in China. Many patients choose mastectomy even when informed that there is no difference in the overall survival rate compared with that of BCS plus radiotherapy. This study aimed to investigate the factors that influenced the surgical choice in patients eligible for BCS. METHODS: Female patients with breast carcinoma were enrolled in a single center from March 2016 to January 2017. They made their own decision regarding the surgical approach. Univariate analysis was employed to determine the factors associated with the different breast surgical approaches. Significant factors (defined as P < 0.05) were then incorporated into multivariate logistic regression models to determine the factors that independently influenced patients' decision. RESULTS: Of the 271 patients included, 149 were eligible for BCS; 65 chose BCS and 84 chose mastectomy. On the basis of univariate analysis, patients with younger age, higher income and education, shorter admission to surgery interval, and shorter confirmed diagnosis to surgery interval were more likely to choose BCS than mastectomy (P < 0.05). Meanwhile, patients who resided in rural regions, did not have general medicare insurance, and were diagnosed with breast cancer preoperatively were more inclined to choose mastectomy than BCS (P < 0.05). The multivariate model revealed three independent influencing factors: age at diagnosis (P = 0.009), insurance status (P = 0.035), and confirmed diagnosis to surgery interval (P = 0.037). In addition, patients receiving neoadjuvant chemotherapy (NCT) were more inclined to choose mastectomy. CONCLUSION: Surgical choice of patients eligible for BCS was affected by several factors, and age at diagnosis, confirmed diagnosis to surgery interval, and insurance status were independent factors.

[Diagnosis accuracy of quick sequential organ failure assessment score for adult sepsis patient with soft tissue infection].

OBJECTIVE: To assess the diagnosis accuracy of the quick sequential organ failure assessment (qSOFA) score for adult sepsis patient with soft tissue infection, and to assess the prognostic accuracy of the qSOFA score for septic shock. METHODS: A retrospective study was conducted. The patients with soft tissue infection admitted to the general surgery department of Beijing Hospital and the burns and plastic surgery department of Fourth Medical Center of PLA General Hospital from January 2012 to December 2018 were enrolled. Patients were divided into the sepsis group and the non-sepsis group according to whether sepsis occurred within 48 hours after diagnosis of infection. The baseline data, prognosis, and qSOFA, the change of sequential organ failure assessment (ΔSOFA), systemic inflammatory response syndrome (SIRS) scores were compared between the two groups, and the receiver operating characteristic (ROC) curves were also drawn to assess the diagnosis accuracy of the qSOFA and SIRS scores for adult sepsis patients with soft tissue infection and to assess the prognostic accuracy of the qSOFA, ΔSOFA and SIRS scores for septic shock of these patients. RESULTS: 192 patients were included in the study. Sepsis occurred in 79 patients (41.1%) within 48 hours after diagnosis of infection. Septic shock occurred in 28 patients (14.6%) during 28-day hospitalization and 6 patients (3.1%) died. Compared with non-sepsis group, more proportion of necrotizing fasciitis, septic shock and patients received mechanical ventilation (21.5% vs. 4.4%, 31.6% vs. 2.7%, 16.5% vs. 4.4%, all P < 0.01), with higher mortality (7.6% vs. 0%, P = 0.003) in sepsis group. ROC curve analysis showed that when the cut-off value of qSOFA ≥ 2, the sensitivity, specificity, positive predictive value, negative predictive value and area under ROC curve (AUC) were 48.1%, 92.0%, 80.8%, 71.7% and 0.824 [95% confidence interval (95%CI) = 0.764-0.884, P < 0.01] respectively for diagnosis of sepsis caused by soft tissue infection. When the cut-off value of SIRS score ≥ 3, the sensitivity, specificity, positive predictive value, negative predictive value and AUC were 89.8%, 48.6%, 55.0%, 87.3% and 0.721 (95%CI = 0.677-0.765, P < 0.01) respectively for diagnosis of sepsis caused by soft tissue infection. All scores of qSOFA ≥ 2, ΔSOFA ≥ 2 and SIRS score ≥ 3 could be used to predict septic shock (all P < 0.01). The AUC of ΔSOFA, qSOFA and SIRS scores were 0.767 (95%CI = 0.665-0.869), 0.840 (95%CI = 0.757-0.923) and 0.716 (95%CI = 0.596-0.835) respectively. CONCLUSIONS: qSOFA ≥ 2 can be used as a rapid sepsis screening tool for adult patients with soft tissue infection. It is suggested that qSOFA or SIRS scores can be used to predict septic shock of adult patients with soft tissue infection initially.

Quantitative assessment of cerebral connectivity deficiency and cognitive impairment in children with prenatal alcohol exposure.

It is common knowledge that alcohol consumption during pregnancy would cause cognitive impairment in children. However, recent works suggested that the risk of drinking during pregnancy may have been exaggerated. It is critical to determine whether and up to which amount the consumption of alcohol will affect the cognitive development of children. We evaluate time-varying functional connectivity using magnetoencephalogram data from somatosensory evoked response experiments for 19 teenage subjects with prenatal alcohol exposure and 21 healthy control teenage subjects using a new time-varying connectivity approach, combining renormalised partial directed coherence with state space modeling. Children exposed to alcohol prenatally are at risk of developing a Fetal Alcohol Spectrum Disorder (FASD) characterized by cerebral connectivity deficiency and impaired cognitive abilities. Through a comparison study of teenage subjects exposed to alcohol prenatally with healthy control subjects, we establish that the inter-hemispheric connectivity is deficient for the former, which may lead to disruption in the cortical inter-hemispheric connectivity and deficits in higher order cognitive functions as measured by an IQ test, for example. We provide quantitative evidence that the disruption is correlated with cognitive deficits. These findings could lead to a novel, highly sensitive biomarker for FASD and support a recommendation of no safe amount of alcohol consumption during pregnancy.

Joint modeling of multiple repeated measures and survival data using multidimensional latent trait linear mixed model.

Impairment caused by Amyotrophic lateral sclerosis (ALS) is multidimensional (e.g. bulbar, fine motor, gross motor) and progressive. Its multidimensional nature precludes a single outcome to measure disease progression. Clinical trials of ALS use multiple longitudinal outcomes to assess the treatment effects on overall improvement. A terminal event such as death or dropout can stop the follow-up process. Moreover, the time to the terminal event may be dependent on the multivariate longitudinal measurements. In this article, we develop a joint model consisting of a multidimensional latent trait linear mixed model (MLTLMM) for the multiple longitudinal outcomes, and a proportional hazards model with piecewise constant baseline hazard for the event time data. Shared random effects are used to link together two models. The model inference is conducted using a Bayesian framework via Markov chain Monte Carlo simulation implemented in Stan language. Our proposed model is evaluated by simulation studies and is applied to the Ceftriaxone study, a motivating clinical trial assessing the effect of ceftriaxone on ALS patients.

An Analytical Framework for Integrating the Spatiotemporal Dynamics of Environmental Context and Individual Mobility in Exposure Assessment: A Study on the Relationship between Food Environment Exposures and Body Weight.

In past studies, individual environmental exposures were largely measured in a static manner. In this study, we develop and implement an analytical framework that dynamically represents environmental context (the environmental context cube) and effectively integrates individual daily movement (individual space-time tunnel) for accurately deriving individual environmental exposures (the environmental context exposure index). The framework is applied to examine the relationship between food environment exposures and the overweight status of 46 participants using data collected with global positioning systems (GPS) in Columbus, Ohio, and binary logistic regression models. The results indicate that the proposed framework generates more reliable measurements of individual food environment exposures when compared to other widely used methods. Taking into account the complex spatial and temporal dynamics of individual environmental exposures, the proposed framework also helps to mitigate the uncertain geographic context problem (UGCoP). It can be used in other environmental health studies concerning environmental influences on a wide range of health behaviors and outcomes.

An Innovative Context-Based Crystal-Growth Activity Space Method for Environmental Exposure Assessment: A Study Using GIS and GPS Trajectory Data Collected in Chicago.

Scholars in the fields of health geography, urban planning, and transportation studies have long attempted to understand the relationships among human movement, environmental context, and accessibility. One fundamental question for this research area is how to measure individual activity space, which is an indicator of where and how people have contact with their social and physical environments. Conventionally, standard deviational ellipses, road network buffers, minimum convex polygons, and kernel density surfaces have been used to represent people's activity space, but they all have shortcomings. Inconsistent findings of the effects of environmental exposures on health behaviors/outcomes suggest that the reliability of existing studies may be affected by the uncertain geographic context problem (UGCoP). This paper proposes the context-based crystal-growth activity space as an innovative method for generating individual activity space based on both GPS trajectories and the environmental context. This method not only considers people's actual daily activity patterns based on GPS tracks but also takes into account the environmental context which either constrains or encourages people's daily activity. Using GPS trajectory data collected in Chicago, the results indicate that the proposed new method generates more reasonable activity space when compared to other existing methods. This can help mitigate the UGCoP in environmental health studies.

HPLC-MS/MS determination of flavonoids in Gleditsiae Spina for its quality assessment.

Gleditsiae Spina, the thorn of Gleditsia sinensis Lam., has been used as an anti-inflammatory, anti-tumor, and anti-bacterial traditional medicine for hundreds of years in China. This study used high-performance liquid chromatography and tandem mass spectrometry combined with chemometric methods to allow the fast and accurate identification and quantification of the flavonoids compounds in Gleditsiae Spina, and created reliable criteria for accurate identification of Gleditsiae Spina and its adulterants. This research provides good evidence for the classification and quality evaluation of Gleditsiae Spina. Firstly, eight flavonoids compounds were detected and identified on the basis of their mass spectra, fragment characteristics, and comparison with published data. Then the mass spectroscopic fragmentation pathways of these compounds were determined and, in addition rutin, isoquercitrin, and quercitrin were detected in Gleditsiae Spina for the first time. The quantification was performed on a triple quadrupole tandem mass spectrometer in multi-reaction monitoring mode, and the baseline separation of the eight bioactive flavonoids components was achieved within 13 min. Furthermore, the proposed method was successfully applied for simultaneous quantitative determination of the eight Gleditsiae Spina compounds and adulterants obtained from different sources in China. Then, we built a classification model which showed a high level of accuracy predicting 100% of the samples, correctly.