Relationship between executive function and social adjustment in children with developmental dyslexia / 中国学校卫生

Objective@#To explore the characteristics of executive function of developmental dyslexic children and the relationship with social adaptability, in order to provide a scientific basis for promoting healthy development of developmental dyslexic children.@*Methods@#From June to September 2023, 85 students in the developmental dyslexia group, 85 students in the biological agematched group and 85 students in the reading levelmatched group were selected from the third to sixth grades of two elementary school in a region of Xinjiang by cluster random sampling method. Their executive function was assessed by the Stroop procedure, the 2-back procedure and the numerical conversion procedure, respectively, and their social adaptive ability was assessed by the Social Adaptation Scale for Children and Adolescents. An analysis of variance (ANOVA) was used to compare the differences in executive function and social adjustment among the three groups, and Pearsons correlation was used to analyze the relationship between executive function and social adjustment in developmental dyslexic children.@*Results@#Children in the developmental dyslexia group had lower correctness on the Stroop colorword task (0.72±0.21), the 2-back task (0.32±0.13), the digitswitching task (0.54±0.16) and the total score of social adjustment (165.39±31.36) than children in the biological agematched (0.80±0.19,0.38±0.11,0.61±0.15,181.71±31.85) and reading levelmatched group (0.79±0.17,0.35±0.07,0.58±0.15,175.71±27.48) (F=4.54,5.05,4.97,6.31,P<0.01). The inhibition (Stroop colorword task correct rate) and conversion subcomponent (digitswitching task correct rate) of the executive function of children in the developmental dyslexia group were both positively correlated with their social adaptive ability (r=0.34,0.43), and the refreshing subcomponent of the executive function (2-back task correct rate) was negatively correlated with their social adaptive ability (r=-0.27) (P<0.05).@*Conclusions@#Children with developmental dyslexia have executive function deficits and social maladjustment, and their executive function is related to social adjustment. Measures should be taken to improve the executive function of developmental dyslexic children and to improve their social adaptation.

Effects of different concentrations of morphine in combination with ropivacaine on proliferation,migration,invasion and cell cycle in MDA-MB-231 breast cancer cells / 中国现代医生

Objective To investigate the effects of different concentrations of morphine in combination with ropivacaine on proliferation,migration,invasion and cell cycle in MDA-MB-231 breast cancer cells.Methods MDA-MB-231 breast cancer cells were inoculated on the culture plate for 24h and randomly divided into 8 groups:Control group(C),ropivacaine 400μg/ml group(R),morphine 3μg/ml group(LM),morphine 30μg/ml group(MM),morphine 300μg/ml group(HM),ropivacaine 400μg/ml group+ morphine 3μg/ml group(R+LM),ropivacaine 400μg/ml+ morphine 30μg/ml group(R+MM),and ropivacaine 400μg/ml+ morphine 300μg/ml group(R+HM).After treaments of MDA-MB-231 breast cancer cells for 24h,these proliferation,migration,invasion and cell cycle were evaluated.Results When using morphine alone,the proliferation inhibitive effect was positively correlated with the concentration of morphine.The proliferation was significantly inhibited by morphine of LM,MM,HM group(P<0.05).When using ropivacaine alone,the proliferation was significantly inhibited(P<0.05).When using morphine combined with ropivacaine,the high concentration morphine group has a synergistic effect with ropivacaine group on proliferation inhibition(P<0.05).When using morphine alone,the migration rate decreases sequentially with the increase of morphine concentration.The migration rate was significantly inhibited by morphine of LM,MM,HM group(P<0.05).When using ropivacaine alone,the migration rate was inhibited(P<0.05).When using morphine combined with ropivacaine,the low and medium concentration morphine group have a synergistic effect with ropivacaine group on migration rate(P<0.05).When using morphine alone,the number of cell invasion was decreased with the concentration of morphine increasing(P<0.05).The MM and HM groups inhibited cell invasion ability.When using ropivacaine alone,the invasiveness of cells was also inhibited(P<0.05).When using morphine combined with ropivacaine,the medium and high concentration morphine groups have a synergistic effect with ropivacaine group on inhibiting cell invasion ability(P<0.05).When using morphine alone,the cell cycle progression was inhibited into G2/M Phase(P<0.05).When using ropivacaine alone,the cell cycle progression was inhibited into G2/M phase(P<0.05).The combination of low concentration morphine and ropivacaine has synergistic effect on arresting at G0/G1 and S phase(P<0.05).Conclusion Morphine combined with ropivacaine inhibits the Proliferation,migration and invasion of MDA-MB-231 breast cancer cells in a dose-dependent manner.

Influencing Factors of Live Birth of Embryo Transfer After Hysteroscopic Adhesiolysis / 中国微创外科杂志

Objective To investigate the clinical factors affecting live birth rate in patients who underwent hysteroscopic adhesiolysis and subsequent embryo transfer.Methods A total of 643 patients who had undergone hysteroscopic surgery to remove various degrees of intrauterine adhesion(IUA)and subsequently received embryo transfer between January 2018 and December 2020 were retrospectively analyzed.Postoperative treatment regimens and pregnancy outcomes after embryo transfer were collected.The primary endpoint was live birth rate.A multivariate logistic regression analysis was performed to further investigate the factors affecting pregnancy outcomes.Results Among the 643 IUA patients,20.5%(132/643)patients were diagnosed as having mild IUA,63.6%(409/643)patients moderate IUA,and15.9%(102/643)patients severe IUA.The median time from hysteroscopy to the first cycle of embryo transfer was 126(73,225)d.The clinical pregnancy rate was 32.7%(210/643)and the live birth rate was 24.7%(159/643).Logistic regression analysis found that age(OR =0.926,95%CI:0.880-0.974,P =0.003)and endometrial thickness on the day of transplantation(OR =1.188,95%CI:1.030-1.370,P =0.018)were prognostic factors of live birth.The live birth rate significantly decreased with age in the mild and moderate adhesion groups(P =0.004 and 0.018),while in the severe adhesion group,the live birth rate decreased with age,but the difference was not significant(P =0.526).Postoperative estrogen dosage,number of artificial cycles,interval between hysteroscopy and transplantation,fresh or frozen-thawed embryo transfer,and type of embryo transferred had no significant impact on live birth.Conclusions Maternal age and endometrial thickness on the day of transplantation are the most important predictors of live birth in patients undergoing embryo transfer after hysteroscopic adhesiolysis.Fresh or frozen-thawed embryo transfer after surgery and the interval between hysteroscopy and transplantation do not affect the live birth rate.

A case of tubulointerstitial nephritis and uveitis syndrome complicated with Fanconi syndrome and literature review / 中华肾脏病杂志

The clinical diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome combined with Fanconi syndrome is relatively rare. The paper reports a 47-year-old female patient of TINU syndrome with hypokalemia, hypophosphatemia, hypouricemia and renal impairment as initial symptoms followed by uveitis. Serological tests showed that the patient also met the diagnostic criteria of Fanconi syndrome. Renal tissue pathology confirmed tubular interstitial injury, manifested as interstitial nephritis with acute tubular injury. Ophthalmic examination confirmed iritis in the right eye. After excluding other primary diseases, the patient was diagnosed as TINU syndrome with Fanconi syndrome. After glucocorticoid therapy, ocular symptoms, renal impairment and electrolyte disturbance were significantly improved.

Expression and significance of immune cells in patients with hepatitis B virus-related acute-on-chronic pre-liver failure / 临床肝胆病杂志

Objective To investigate the expression of myeloid-derived suppressor cells (MDSC), regulatory T cells (Treg), IL-17-producing CD4 + T cells (Th17), and CD8 + T cells (Tc17) in hepatitis B virus-related acute-on-chronic pre-liver failure (pre-ACHBLF), and to provide ideas for the early treatment of acute-on-chronic hepatitis B liver failure (ACHBLF). Methods A total of patients with pre-ACHBLF and 15 patients with ACHBLF who were hospitalized in Shijiazhuang Fifth Hospital, from August 2018 to May 2019 were enrolled as subjects, and 15 patients with chronic hepatitis B (CHB) and 15 healthy controls (HC) who underwent physical examination were enrolled as controls. Flow cytometry was used to measure the expression levels of MDSC and Th17, Treg, and Tc17 cells in peripheral blood; a blood analyzer was used to measure routine blood parameters and calculate neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index(SIRS) to evaluate the degree of inflammation, and the correlation between the expression of immune cells and the degree of inflammation was analyzed. An analysis of variance for independent samples was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Nemenyi test was used for further comparison between two groups. A Pearson linear correlation analysis or Spearman's rank correlation analysis was used to investigate the correlation between variables. Results Compared with the CHB group, the ACHBLF and pre-ACHBLF groups had significant increases in the expression levels of Th17, Treg, and Tc17 cells, and the pre-ACHBLF group also had a significant increase in the expression level of MDSC (all P < 0.05). The correlation analysis showed that in pre-ACHBLF patients, MDSC were positively correlated with leukocyte count, neutrophil count, NLR, MLR, and SII ( r =0.775, 0.727, 0.571, 0.786, and 0.846, all P < 0.05), and Treg cells were only positively correlated with leukocyte count ( r =0.618, P =0.043); Th17/Treg ratio and Tc17 cells were negatively correlated with the number of lymphocytes ( r =-0.790 and -0.795, both P < 0.05). Conclusion Cellular immune dysfunction is observed in patients with pre-ACHBLF, and the expression of MDSC is closely associated with the degree of inflammation and should be taken seriously in the early stage.

Discussion on Bufei Decoction in the treatment of stable COPD based on theory of "Latent Toxin Entering Lung" / 国际中医中药杂志

Chronic obstructive pulmonary disease (COPD) is characterized by excess in nature and deficiency in superficiality. For COPD patients, the deficiency of lung and kidney is the basis for production of the latent toxin, and repeated exogenous infection is the main factor for the latent toxin to enter the lung. The key pathogenesis of stable COPD is the entry of latent toxin into the lung and the injury of lung and collaterals. Therefore, tonifying lung and kidney, removing toxins and dredging collaterals are the core treatment methods for COPD in stable period. Bufei Decoction is with good efficacy in the treatment of COPD in stable period, which can not only tonify lung and kidney to consolidate, but also dredging collaterals to remove toxins. Based on the pathogenesis of "latent toxin entering lung", the relevant mechanisms of Bufei Decoction in treating stable COPD were further understood and explored, in order to benefit clinical practice.

Effects of Paroxetine and Sulpiride in the Treatment of Social Phobia in Young Women and Its Effects on Neurotransmitter and Sleep Structure / 昆明医科大学学报

Objective To explore the effects of paroxetine and sulpiride in the treatment of social phobia in young women and the effects on neurotransmitters and sleep structure.Methods 102 young female patients with social phobia in our hospital from February 2021 to February 2023 were selected and divided into 2 groups with 51 cases in each group by random number table method.The control group was treated with Paxil,and the study group was treated with Paxil + sulpiride for 3 months.Treatment effect,neurotransmitters[5-hydroxytryptamine(5-HT),dopamine(DA),gamma-aminobutyric acid(GABA),myeloperoxidase(MPO)],sleep structure,social anxiety(LASA),social fear(SPS)and social Results The research group's overall effective rate of treatment is 88.24%,which is higher than the control group's 70.59%(P<0.05).1 month and 3 months after treatment,the research group's serum levels of DA and MPO are lower than those of the control group,while the levels of 5-HT and GABA are higher than those of the control group(P<0.05).1 month and 3 months after treatment,the research group's sleep transition frequency and the proportion of stage Ⅰ + stage Ⅱ are lower than those of the control group,while the proportion of stage Ⅲ + stage Ⅳ and REM stage are higher than those of the control group(P<0.05).1 month and 3 months after treatment,the research group's LASA,SPS,and SAFE scores are lower than those of the control group(P<0.05);The incidence of adverse events in the research group is 13.73%compared to 9.80%in the control group,with no statistically significant difference(P>0.05).Conclusion Paroxetine and sulpiride combined can improve the sleep structure of young women with social phobia,regulate serum neurotransmitter levels,alleviate social anxiety symptoms,improve social adaptability,and have a certain level of safety.

Change in plasma exosome α-synuclein in patients with rapid eye movement sleep behavior disorder or Parkinson disease / 中风与神经疾病杂志

@#Objective To quantitatively analyze the difference in the content of plasma exosome α-synuclein（α-syn）between Parkinson disease （PD） and idiopathic rapid eye movement sleep behavior disorder（iRBD），and to identify predictable biological markers. Methods A total of 20 patients with iRBD（iRBD group），21 PD patients without RBD （PD-nRBD group），and 20 healthy controls matched for age and sex（HC group） were enrolled. Rapid-Eye-Movement Sleep Behavior Disorder Questionnaire-Hong Kong（RBDQ-HK）was used to evaluate the nocturnal symptoms of all subjects，and the motor section of Unified Parkinson Disease Rating Scale Ⅲ（UPDRS Ⅲ）was used to evaluate motor impairment. ELISA was used to measure the content of plasma exosome α-syn，and the three groups were analyzed in terms of the content of plasma exosome α-syn and its correlation with RBDQ-HK score and UPDRS Ⅲ score. Results There was a significant difference in UPDRS Ⅲ score between the iRBD group，the PD-nRBD group，and the HC group（P=0.000 1），with a significant difference between any two groups （P<0.05）；there was also a significant difference in RBDQ-HK score between the three groups （P=0.000 1），and the iRBD group had a significantly higher score than the other two groups（P=0.000 1）.The iRBD group and the PD-nRBD group had a significantly higher content of plasma exosome α-syn than the HC group（P=0.001），and the iRBD group had a lower content of plasma exosome α-syn than the PD-nRBD group（P>0.05）. In the iRBD group，plasma exosome α-syn was positively correlated with RBDQ-HK score（r=0.842，P=0.000 1），and in the PD-nRBD group，plasma exosome α-syn was positively correlated with UPDRS Ⅲ score（r=0.817，P=0.000 1） and H-Y staging（r=0.592，P=0.005）. Conclusion The presence of plasma exosome α-syn is observed in iRBD patients，which is similar to that in PD-nRBD patients，and the content of plasma exosome α-syn is associated with the motor score of PD-nRBD and the nocturnal symptom score of iRBD. Therefore，plasma exosome α-syn is expected to become an early biomarker for predicting the conversion of iRBD to PD.

Chinese consensus of cardiopulmonary resuscitation guides prevention, treatment and rescue of cardiac arrest in pregnancy / 中华危重病急救医学

Pregnant women are a group of people in a special period, once sudden cardiac arrest (CA) occurs, it will threaten the life of both mother and child. It has become a great challenge for hospital, doctors and nurses to minimize maternal mortality during pregnancy. All the efforts should ensure the safety of both mother and child throughout the perinatal period. Because difference of the cardiopulmonary resuscitation strategies for common CA patients of the same age, the resuscitation strategies for CA patients during pregnancy need consider the patient's gestational age and fetal condition. Different resuscitation techniques, such as manual left uterine displacement (MLUD), will involve perimortem cesarean delivery (PMCD). At the same time, drugs should be reasonably used for different causes of CA during pregnancy, such as hypoxemia, hypovolemia, hyperkalemia or hypokalemia and other electrolyte disorders and hypothermia in 4Hs, as well as thrombosis, pericardial tamponade, tension pneumothorax and toxicosis in 4Ts. In view of the fact that many causes of CA in pregnancy are preventable, it is more necessary to introduce guidelines for CA in pregnancy in line with our national conditions for clinical guidance. This paper systematically reviewed the pathophysiological characteristics of CA during pregnancy, the high-risk factors of CA during pregnancy, and identified the correct resuscitation methods and prevention and treatment strategies of CA during pregnancy.

Evaluation of reliability and validity, and application on the Simplified Rating Questionnaire of Social Ecological Risks in Adolescents / 中国学校卫生

Objective@#To develop a simplified Rating Questionnaire of Social Ecological Risks in Adolescents and to evaluate the reliability and predictive validity of the brief questionnaire, so as to provide data and evidence support for building the evaluation system of cumulative social ecological risk exposure.@*Methods@#A large cross sectional was conducted in eight areas, including Shenzhen, Zhengzhou, Xuzhou, Nanchang, Shenyang, Taiyuan, Kunming and Chongqing, from October to December 2021. A total of 22 868 adolescents were included in the analysis. Data on healthy behaviors from 10 838 adolescents from Shenyang, Taiyuan, Kunming, Chongqing were used for item selection, based on factor analysis, validity and reliability evaluation. The data from Shenzhen, Zhengzhou, Xuzhou, Nanchang, including 12 030 adolescents, were used to define the partition values of the brief questionnaire, and evaluate the predictive validity.@*Results@#The brief questionnaire containing 25-item were developed by analyzing and choosing all items of original questionnaire, and covered seven dimensions including individual, family, school, community, policy, time and culture. The cumulative contribution rate of variance was 54.95%, the Cronbach coefficient was 0.79, and the split half coefficient was 0.70. Participants in the higher risk group had significantly higher risk of smoking ( OR =4.05, 95% CI = 2.78 -5.92), drinking ( OR =3.47, 95% CI =2.86-4.19), suicidal ideation ( OR =8.85, 95% CI =7.68-10.21), suicidal plans ( OR = 8.85, 95% CI =7.27-10.78), suicidal attempt ( OR = 8.86 , 95% CI =6.67-11.78) than individual in the lower risk group ( P < 0.05). After stratified by gender, the above positive correlations still remained significant( P <0.05).@*Conclusion@#The brief questionnaire, with good reliability and predictive validity, could be widely applicated in the further researches on social ecological risk factors.

Study on Impact of Diagnosis-Intervention Packet Reform on the Quality of Healthcare / 中国医院管理

Objective To analyze the change of healthcare quality after the Diagnosis-Intervention Packet(DIP)payment system reform and provide evidence for improving payment system reform in China.Methods It collected discharge records of hospitalized patients with employee basic medical insurance scheme in first DIP pilot hospitals of a city from July 2017 to June 2021.It included three death-related measures and two readmission-related mea-sures,which were all risk-adjusted considering the patient mix.It used t test to compare their differences before and after the DIP reform in July 2019.Results After the risk-adjustment,mortality rate of surgical patients,mortality rate of patients in low-risk DIP groups,all-cause readmission rate within 30 days after discharge and readmission rate with the same principal diagnosis within 30 days after discharge declined 0.06 percentage points(P=0.031),0.15 percentage points(P=0.001),0.47 percentage points(P＜0.001)and 0.72 percentage points(P＜0.001),respectively.Conclusion No current evidences indicated negative impacts of the DIP payment reform on the quality of healthcare in the city.Case-based payment pilot cities should closely monitor the change of healthcare quality after the reform.

S100A10 protein expression in psoriatic lesions and its effect on psoriasis-like skin inflammation in mouse models / 中华皮肤科杂志

Objective:To determine S100A10 protein expression in psoriatic lesions, and to investigate its effect on psoriasis-like skin inflammation in imiquimod (IMQ) -induced mouse models.Methods:From January 2020 to June 2022, skin lesions were surgically collected from 28 patients with psoriasis in the Department of Dermatology, the First Affiliated Hospital of Xinxiang Medical University; normal skin tissues were collected from 18 healthy subjects in the Department of General Surgery and Department of Ophthalmology during the same period, and served as a control group. Immunohistochemical staining was performed to determine the S100A10 protein expression in skin lesions from psoriasis patients and normal skin tissues from healthy controls. Ten wild-type (WT) C57BL/6J female mice and 10 S100A10 -/- C57BL/6J female mice were selected to establish the IMQ-induced mouse models of psoriasis-like skin inflammation. Then, the mice were randomly divided into gene knock-out (KO) /IMQ group, WT/IMQ group, KO/vaseline (VAS) group, and WT/VAS group by using a random number table, and there were 5 mice in each group. The mice in the KO/IMQ group and WT/IMQ group were topically treated with IMQ cream (62.5 mg) on the shaved back daily to establish the mouse models of psoriasis-like skin inflammation, while the mice in the KO/VAS group and WT/VAS group were topically treated with vaseline cream (62.5 mg) daily, and both treatments lasted 7 consecutive days. Skin lesions on the back were observed daily. On day 7, the mice were sacrificed by cervical dislocation, and their dorsal skin tissues were excised. The IMQ-induced psoriasis-like skin inflammation was evaluated by the psoriasis area and severity index (PASI), pathological manifestations of skin lesions were observed by hematoxylin and eosin staining, the expression of S100A10 and Ki-67 in skin lesions was determined by immunohistochemical staining, the expression of STAT3, IL-17A and other cytokines was determined by Western blot analysis, and IL-17 mRNA expression was determined by real-time fluorescence-based quantitative PCR (qPCR). Statistical analysis was carried out by using the independent sample t-test, nonparametric U test, and chi-square test. Results:Immunohistochemical staining showed that the S100A10 protein expression was significantly lower in the psoriasis vulgaris lesions than in the normal control skin tissues ( Z = -3.47, P < 0.001). In the mouse models, the S100A10 protein expression was significantly lower in the skin lesions of mice in the WT/IMQ group than in the skin tissues of mice in the WT/VAS group ( t = 3.64, P = 0.007), and the Ki-67 expression was significantly higher in the KO/IMQ group than in the WT/IMQ group ( t = 2.97, P = 0.041). Additionally, the mice in the KO/IMQ group presented with more severe clinical manifestations such as scales and infiltration compared with those in the WT/IMQ group. Western blot analysis showed that the phosphorylated STAT3/STAT3 expression and IL-17A protein expression was significantly higher in the KO/IMQ group than in the WT/IMQ group ( t = 3.27, 3.48, P = 0.031, 0.025, respectively), and qPCR revealed that the IL-17A mRNA expression was also significantly higher in the KO/IMQ group than in the WT/IMQ group ( t = 2.73, P = 0.029) . Conclusion:S100A10 protein was underexpressed in the skin lesions of psoriasis patients, and the deletion of S100A10 protein aggravated IMQ-induced psoriasis-like skin inflammation in mice, possibly by upregulating STAT3 phosphorylation in the epidermis.

Study on HPLC Fingerprint of Alpiniae Oxyphyllae Fructus Before and After Salt-Processing Based on Chemical Pattern Recognition / 中药新药与临床药理

Objective A HPLC fingerprint method of Alpiniae Oxyphyllae Fructus(AOF)before and after salt-processing was established,to compare the differences of chemical components between raw and processed AOF combined with chemical pattern recognition.Methods HPLC method was used to establish the fingerprint of raw and salt-processed AOF.Principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)were applied to explore the different components of raw and salt-processed AOF in different batches.Results Totally 30 and 32 common peaks in the HPLC fingerprint from the raw and salt-processed AOF were detected,respectively.And 8 of them were identified by comparison with the standards.They were peak X2(5-hydroxymethylfurfural),peak 1(protocatechuic acid),peak 2(protocatechualdehyde),peak 4(epicatechin),peak 21(chrysin),peak 22(kaempferide),peak 25(tectochrysin)and peak 26(nootkatone).The results of PCA and OPLS-DA showed that raw and salt-processed AOF can be grouped into two categories.A total of 12 components,which were considered as differential markers of raw and salt-processed AOF,were screened by method of variable importance in projection(VIP).The 12 components were peak X1,peak 26(nootkatone),peak 16,peak 3,peak X2(5-hydroxymethylfurfural),peak 25(tectochrysin),peak 15,peak 12,peak 8,peak 10,peak 17 and peak 20.Conclusion The combination of HPLC fingerprint and chemical pattern recognition can be used to analyze the quality differences of AOF before and after salt-processing.

Intervention effect of network mental health education based rehabilitation platform on patients with bipolar disorder in remission stage / 中华健康管理学杂志

Objective:To analyze the intervention effect of rehabilitation platform-based online psycho-education on patients with bipolar disorder (BD) in remission stage.Methods:In this randomized controlled study, 91 patients with BD in remission stage who attended the community health center in Xicheng District, Beijing from July to August 2021 were randomly divided into a test group (46 cases) and a control group (45 cases) according to a 1∶1 ratio using the random number table. Baseline data were collected from both groups, and the control group received conventional medication and community telephone follow-up, while the test group was given online mental health education in the form of a WeChat subscription number on this basis, including BD mental health education course push (twice a week) and disease self-management (daily recording of mood, sleep, medication, exercise and gratitude diary), and the intervention period was 6 months in both groups. During the intervention, one patient in the test group was admitted to hospital due to exacerbation of mental illness and the trial was terminated. A total of 90 cases were included in the study. The scores of Medication Adherence Rating Scale (MARS), Hamilton Depression Scale (HAMD), Young Mania Rating Scale (YMRS) and Perceived Devaluation-Discrimination Scale (PDD) were assessed at baseline, after 3 months and 6 months of intervention in both groups, respectively. And the differences in baseline data between the two groups were compared using two independent samples t test and χ2 test, and the repeated-measures ANOVA was used to compare the differences in MARS, HAMD, YMRS, and PDD scores between the two groups before and after the intervention, and to analyze the intervention effects of network mental health education based on the rehabilitation platform on patients in remission stage of BD. Results:After 6 months of intervention, MARS scores in the test group was significantly higher than that in the control group [(8.47±1.75) vs (7.47±1.85)], and was significantly higher than that at baseline (7.36±2.13) and after 3 months of intervention (8.04±1.68) (all P<0.05). YMRS and PDD scores in the test group were significantly lower than those at baseline after 3 and 6 months of intervention [YMRS, 2.0(1.0,4.0),2.0(0,3.0) vs 3.0(1.0,5.5); PDD, (31.18±4.65), (30.13±4.76) vs (32.51±4.51)] (all P<0.05); the differences in YMRS and PDD scores in the control group were not statistically significant (all P>0.05). There was no statistically significant difference in HAMD scores between the two groups before and after the intervention (all P>0.05). Conclusion:Combining mental health education based on rehabilitation platform with conventional medication and community management can significantly improve the medication compliance of patients with BD in remission stage, and improve their manic symptoms and reduce the stigma of the disease.

Study on the correlation between opioid-induced constipation and gene polymorphism / 中国药房

OBJECTIVE To investigate the effect of gene polymorphism on opioid-induced constipation. METHODS The target genes related to opioid-induced constipation were screened out through searching guidelines， databases and evidence-based medical data， and then 100 cancer pain patients who received opioid drugs for analgesia were included as the study subjects. According to whether there were adverse effects of constipation after medication or not， they were divided into test group and control group， with 50 cases in each group. The target gene was detected by PCR or fluorescence in situ hybridization. The SNPStats program was used to carry out Hardy-Weinberg balance test and correlation analysis between gene polymorphism and opioid-induced constipation. The multivariate Logistic regression analysis was used to explore the relevant predictive factors of opioid-induced constipation， and receiver operating characteristic （ROC） curve of subjects was drawn to analyze the effectiveness of each predictive factor in predicting opioid-induced constipation. RESULTS CYP2D6， CYP3A5*3， ABCB1 and OPRM1 were selected as target genes for detection. The results of genotype detection showed that the frequency distribution of CYP2D6 （rs1065852， rs1135822， rs16947， rs28371725， rs28371735）， CYP3A5*3 （058rs776746）， ABCB1 （062rs1045642）， OPRM1 （047rs1799971） alleles were consistent with Hardy-Weinbergbalance test. The correlation analysis results showed that the proportion of genotype GG and AG in CYP3A5*3 （058rs776746， 163.com A＞G） and genotype AA and AG in OPRM1 （047rs1799971， A＞G） of patients was significantly higher in test group than that in the control group （P＜0.05）. Multivariate Logistic regression analysis showed that medication duration， CYP3A5*3 and OPRM1 gene polymorphism could be used as predictors of opioid- induced constipation in patients （P＜0.05）. The ROC curve analysis results showed that the areas under the ROC curves for medication duration and CYP3A5*3， OPRM1 gene polymorphism were 0.648， 0.640 and 0.670， respectively， with the optimal cutoff values of 124.0， 0.5 and 0.5， respectively. CONCLUSIONS Genotype GG and AG in CYP3A5*3 （058rs776746，A＞G） and genotype AA and AG in OPRM1 （047rs1799971，A＞G） are associated with opioid-induced constipation， which are expected to become clinical predictors of opioid-induced constipation， and more attention should be paid to the occurrence of constipation in patients who have been taking opioids for a long time.

Levels and health risks of exposure to neonicotinoid insecticides among 5-year-old children: Based on Laizhou Wan Birth Cohort in Shandong Province / 环境与职业医学

Background Neonicotinoid insecticides (NEOs) are emerging synthetic insecticides that have been used in various pest management regimens worldwide as alternatives to conventional insecticides. Recently, several studies have indicated that humans are widely exposed to NEOs, but limited is known about the levels and associated health risks of NEOs exposure among children. Objective To estimate exposure levels of four kinds of NEOs in urine samples among 5-year-old children from Laizhou Wan, Shandong Province, and to evaluate health risks of single and cumulative exposure to NEOs among children in this area. Methods A total of 205 children who participated in the 5-year-old follow-up in Laizhou Wan Birth Cohort (LWBC) were included. Urinary concentrations of four NEOs [imidacloprid (IMI), acetamiprid (ACE), clothianidin (CLO), and thiamethoxam (THM)] were measured by high-performance liquid chromatography coupled with triple quadrupole mass spectrometry. Based on the detected NEOs concentrations, estimated daily intake (EDI) was calculated, and the health risk of exposure to single NEO was assessed using hazard quotient (HQ, risk threshold=1). A relative potency factor (RPF) approach was used to standardize the concentrations of the four NEOs by IMI to calculate their cumulative concentrations. Then, the health risk of cumulative exposure to the four NEOs was further evaluated based on the HQ method. Results The detection rates of the four NEOs in the 5-year-old children were all above 90%, and their median creatinine-adjusted urinary concentrations were in the order from high to low as follows: CLO (1.373 μg·g−1) > THM (0.628 μg·g−1) > IMI (0.310 μg·g−1) > ACE (0.073 μg·g−1). Of the four NEOs, the median EDI of IMI was 0.035 µg·kg−1·d−1, higher than those of CLO (0.032 µg·kg−1·d−1), THM (0.012 µg·kg−1·d−1), and ACE (0.002 µg·kg−1·d−1). The maximum HQ values of IMI, CLO, THM, and ACE were 0.168, 0.152, 0.055, and 0.022, respectively, which were all far lower than the risk threshold of 1. The median concentration of cumulative exposure to the four NEOs standardized by IMI was 21.241 μg·g−1, and its median EDI was 2.370 µg·kg−1·d−1. The maximum HQ of cumulative exposure to the four NEOs was only 0.694, which also did not exceed the risk threshold of 1. Conclusion NEOs exposure is common among the 5-year-old children in Laizhou Wan, Shandong. Although there is no obvious health risk associated with single and cumulative exposure to NEOs in the children in this area, their exposure levels of NEOs are higher than those in some foreign areas. The adverse health effects of long-term exposure to low dose of NEOs deserve our extensive attention.

Research progress of anti-tumor effect and mechanism of CDDO and its derivatives / 中国药房

2-cyano-3，12-dioxooleana-1，9 （11）-dien-28-oic acid （CDDO） is a compound synthesized by taking oleanolic acid， a natural triterpene， as a precursor or precursor， and transforming three modifiable functional groups in the molecule through a series of chemical structure modification. In order to improve its anti-tumor activity， CDDO derivatives are further synthesized. In this paper， the research results of anti-tumor effects and mechanisms of CDDO and its derivatives in recent years are summarized. It is found that CDDO and its derivatives have a wide range of anti-tumor effects， and can show significant anti-tumor effects on breast cancer， pancreatic cancer， lung cancer and ovarian cancer at low concentrations such as micromole or even nanomole， among which CDDO methyl ester compound （CDDO-Me） and CDDO imidazolidinone compound （CDDO-Im） have the most obvious effects. CDDO and its derivatives exert anti-tumor activity mainly by inducing tumor cell apoptosis， and regulating metabolic reprogramming and immune microenvironment. The involved pathways mainly include Janus protein tyrosine kinase （JAK）/ signal transduction and transcription activation protein 3（STAT3） signal pathway， nuclear factor E2-related factor 2 （NRF2） signal pathway， phosphatidylinositol 3 kinase （PI3K）/protein kinase B （also known as Akt）/mammalian rapamycin target protein （mTOR） signal pathway， Wnt/β-catenin signal pathway， nuclear factor κB signal pathway.

Clinical study of acupuncture of Zhukeyuanluo principle combined with Buzhong Yiqi Decoction for the patients with obstructive sleep apnea hypopnea syndrome / 国际中医中药杂志

Objective:To evaluate the effect of acupuncture of Zhukeyuanluo principle and Buzhong Yiqi Decoction on obstructive sleep apnea hypopnea syndrome (OSAHS).Methods:Randomized controlled trial. A total of 104 patients with OSAHS in our hospital from January 2017 to January 2022 who met the inclusion criteria were divided into 2 groups according to random number table method, with 52 patients in each group. The Traditional Chinese Medicine (TCM) group was treated with Buzhong Yiqi Decoction on the basis of conventional western medicine treatment, and the acupuncture and medicine group was treated with the combination of primary and primary collaterals and acupoints. Both groups were treated continuously for 2 months. Epworth Lethargy Scale and Stanford Self-Rated Lethargy Scale (SSS) were used to assess the degree of lethargy. The serum levels of TNF-α, IL-6 and IL-8 were detected by ELISA. The hemoglobin, RBC and mean RBC volume levels were detected by automatic blood cell analyzer. apnea hypopnea index (AHI), apnea index (AI), hypopnea index (HI) and arterial oxygen saturation (SaO 2) were monitored by polysomnographic sleep monitor to evaluate the clinical effect. Results:The total effective rate was 94.2% (49/52) in the acupuncture group and 82.7% (43/52) in the TCM group, and there was significant difference between the two groups ( χ2=6.73, P=0.035). After treatment, the Epworth Lethargy Scale and SSS scores in the acupuncture and medicine group were significantly lower than those in the TCM group ( t=-8.19 and -5.48, respectively, P<0.01); AHI [(15.64±2.81) times/h vs. (19.82±3.05) times/h, t=-7.27], HI [(5.53±1.28) times/h vs. (7.37±1.34) times/h, t=-7.16], AI [(8.13±1.95) times/h vs. (10.98±2.26) times/h, t=-6.89] in the acupuncture and medicine group were significantly lower than those in the TCM group ( P<0.01), SaO 2 [(92.77±2.91) % vs. (89.53±2.44) %, t=6.15] in the acupuncture and medicine group was significantly higher than that of the TCM group ( P<0.01). The levels of TNF-α, IL-6 and IL-8 in serum in the acupuncture and medicine group were significantly lower than those in the TCM group ( t=-2.62, -3.14 and -6.58, P<0.01). The levels of hemoglobin, RBC and mean red blood cell volume were in the acupuncture and medicine group were significantly lower than those in the TCM group ( t=-2.11, -2.92, -2.48, P<0.05 or P<0.01). Conclusion:The acupuncture of Zhukeyuanluo principle combined with Buzhong Yiqi Decoction can reduce the serum inflammatory cytokines level in OSAHS patients, increase SaO 2, reduce AHI, HI, AI and lethargy degree, and improve clinical effects.

Research progress on the effect of iron oxide nanoparticles in macrophage polarization / 生物医学工程学杂志

Macrophages are important immune effector cells with significant plasticity and heterogeneity in the body immune system, and play an important role in normal physiological conditions and in the process of inflammation. It has been found that macrophage polarization involves a variety of cytokines and is a key link in immune regulation. Targeting macrophages by nanoparticles has a certain impact on the occurrence and development of a variety of diseases. Due to its characteristics, iron oxide nanoparticles have been used as the medium and carrier for cancer diagnosis and treatment, making full use of the special microenvironment of tumors to actively or passively aggregate drugs in tumor tissues, which has a good application prospect. However, the specific regulatory mechanism of reprogramming macrophages using iron oxide nanoparticles remains to be further explored. In this paper, the classification, polarization effect and metabolic mechanism of macrophages were firstly described. Secondly, the application of iron oxide nanoparticles and the induction of macrophage reprogramming were reviewed. Finally, the research prospect and difficulties and challenges of iron oxide nanoparticles were discussed to provide basic data and theoretical support for further research on the mechanism of the polarization effect of nanoparticles on macrophages.

Post-stroke fatigue / 国际脑血管病杂志

Post-stroke fatigue is one of the common symptoms of stroke patients. Continuous fatigue will affect the rehabilitation of patients' limb functions, lead to the decline of daily living ability, and at the same time, make patients lack energy, lose the initiative of rehabilitation exercise, and seriously affect the quality of life and social function. This article reviews the epidemiology, clinical characteristics, evaluation scales, influencing factors, pathophysiological mechanism and treatment of post-stroke fatigue.