Exploration of the characteristics of peri-implant microenvironment in rats based on bioinformatics analysis / 实用口腔医学杂志

Objective:To explore the differences of microenviroment between peri-implant tissue and oral mucosal tissue.Methods:The gene chip data GSE43744 was downloaded from the GEO database,bioinformatics tools were used to analyze the differentially ex-pressed genes between the peri-implant tissue and normal oral mucosal tissue in rat.Results:1315 differentially expressed important genes,including 797 upregulated genes and 518 downregulated genes,were screened out.Gene enrichment analysis showed that com-pared with normal oral mucosal tissue,the gene expression of innate immune activity,cell activation,inflammatory response,and func-tional expression related to external and bacterial stimuli in peri-implant tissue were significantly upregulated,while that of extracellular matrix tissue,adhesion,extracellular matrix polysaccharides,response to mechanical stimuli and response to toxic substances was sig-nificantly downregulated.Meanwhile,multiple molecular functions and biological pathways related to T cells were highly expressed,which may play an important role in the peri-implant microenvironment.In addition,PPI network was constructed,and screened 7 core genes including FCER1G,TYROBP,PTPRC,ITGB2,AIF1,EMR1 and RAC2,which may be target genes for studying peri-implant microenvironment.Conclusion:There is a significant difference of microenvironment characteristics between peri-implant tissue and o-ral mucosa.The target genes screened using PPI network may be the key to future research on the peri-implant microenvironment.

Quantitative evaluation of lumbar facet arthritis-induced cartilage injury by MR T2* mapping / 中国组织工程研究

BACKGROUND:Lumbar facet arthritis is one of the main causes of low back pain.At present,MRI is mainly used for preliminary diagnosis,and there is still a certain probability of missed diagnosis and misdiagnosis.Therefore,MR T2* mapping imaging technology is expected to become an important means of quantitative detection of cartilage damage in lumbar facet arthritis. OBJECTIVE:To investigate the application value of MR T2* mapping imaging technique in quantitative analysis of cartilage damage and degeneration of lumbar facet joint. METHODS:A total of 110 outpatient or inpatient patients with low back pain in Fourth Affiliated Hospital of Nanjing Medical University from April 2020 to March 2022 were collected and set as case group.At the same time,80 asymptomatic volunteers were recruited as the control group.T2* mapping transectal images and T2WI images were obtained by 3.0T MR Scanning for the facet joints of all included subjects L1-S1.Weishaupt grading and T2* value measurement were performed for all facet joint cartilage,and the data were collected for parallel statistical analysis.The comparison of T2* values of facet joint cartilage between different articular Weishaupt grades was performed by one-way analysis of variance. RESULTS AND CONCLUSION:(1)Statistical analysis found that the T2* value of lumbar facet joint cartilage in the case group(17.6±1.5)ms was significantly lower than that in the control group(21.4±1.3)ms(P<0.05).(2)In the case group,with the hierarchical increase of lumbar facet joint Weishaupt,the T2*value of facet joint cartilage also showed a gradual decreasing trend,and the difference was statistically significant(P<0.05).(3)It is concluded that T2*mapping can better display the early pathological changes of lumbar facet joint cartilage injury,and T2* value of lumbar facet joint cartilage can quantitatively evaluate the degree of lumbar facet joint cartilage injury.T2* mapping imaging technique can provide a good theoretical basis for the imaging diagnosis of the early cartilage injury induced by lumbar facet arthritis and has important clinical application value.

Effect of family-based weight management on cardiac function and readmission in elderly patients with heart failure / 中华全科医师杂志

Objective:To explore the effect of family-based body weight management on cardiac function and readmission in patients with chronic heart failure.Methods:The study was a single-blind randomized controlled trial. Elderly patients with heart failure who were treated in Yichuan Community Health Service Center of Putuo District from June 2019 to May 2020 were enrolled in the study. The patients were randomly divided into the control group and the intervention group. All patients were treated with anti-heart failure drugs; in addition, the intervention group received family-based weight management and the control group received the conventional weight management. The cognition of self-management and weight management of patients was assessed by the Heart Failure Patient Self-Management Scale and the Weight Management Scale, before intervention and after 12 months of intervention, respectively. At the same time, the 6-min walking test, the New York Heart Association (NYHA) cardiac function grading assessment were performed, plasma N-terminal proB-type natriuretic peptide (NT-proBNP) was measured, left ventricular ejection fraction (LVEF) was determined and body weight measurement was completed; and the readmissions of patients due to heart failure during follow-up were recorded.Results:A total of 249 patients aged (65.2±2.9) years, including 104 males (41.8%) were enrolled; there were 124 in the intervention group and 125 in the control group. There were no significant differences in age, gender, marital status and educational level between the two groups (all P>0.05). There were no significant differences in the baseline scores of the Heart Failure Patient Self-Management Scale between the two groups (all P>0.05). After intervention, all scores of the intervention group were significantly better than those of the control group (all P<0.01). There were no significant differences in the scores of the Weight Management Scale between the two groups before intervention (all P>0.05), whereas all scores of the intervention group were significantly better than those of the control group after intervention (all P<0.01). There was no significant difference in body weight between the two groups before intervention ( P=0.397), while the average body weight of the intervention group was significantly lower than that of the control group after intervention ( P=0.029). At baseline, there were no significant differences in the LVEF, NT-proBNP level, 6-min walking distance, and the proportion of NYHA patients with grade Ⅲ/Ⅳ heart function between the two groups (all P>0.05). After intervention, LVEF and 6-min walking distance of patients in the intervention group were significantly higher than those in the control group (all P<0.01); the plasma NT-proBNP level and the proportion of NYHA grade Ⅲ/Ⅳ were significantly lower than those in the control group (all P<0.01). During follow-up, the rate of readmission due to heart failure in the intervention group was lower than that in the control group ( P<0.001). Conclusion:Family-based weight management can improve heart function and reduce the readmission rate in elderly patients with heart failure.

Guanxin Danshen Dripping Pills Improve Quality of Life and Cardiovascular Prognoses of CHD Patients after PCI with Anxiety or Depression (GLAD Study): A Randomized Double-Blind Placebo-Controlled Study / 中国结合医学杂志

OBJECTIVE@#To assess the efficacy and safety of Guanxin Danshen Dripping Pills (GXDS) in the treatment of depression or anxiety in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).@*METHODS@#From September 2017 to June 2019, 200 CHD patients after PCI with depression and anxiety were included and randomly divided into GXDS (100 cases) and placebo control groups (100 cases) by block randomization and a random number table. Patients in the GXDS and control groups were given GXDS and placebo, respectively, 0.4 g each time, 3 times daily for 12 weeks. The primary outcomes were scores of Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Scale (GAD-7) and the Seattle Angina Pectoris Scale (SAQ). The secondary outcomes included 12 Health Survey Summary Form (SF-12) scores and the first onset time and incidence of major adverse cardiovascular events (MACEs). Other indices including blood pressure, blood lipids, microcirculation and inflammatory-related indices, etc. were monitored at baseline, week 4, and week 12.@*RESULTS@#In the full analysis set (200 cases), after treatment, the PHQ-9 and GAD-7 scores in the GXDS group were considerably lower than those in the control group (P<0.05). Compared with the baseline, the total PHQ-9 scores of the experimental and control groups decreased by 3.97 and 1.18, respectively. The corrected mean difference between the two groups was -2.78 (95% CI: -3.47, -2.10; P<0.001). The total GAD-7 score in the GXDS group decreased by 3.48% compared with the baseline level, while that of the placebo group decreased by 1.13%. The corrected mean difference between the two groups was -2.35 (95% CI: -2.95, -1.76; P<0.001). The degree of improvement in SAQ score, SF-12 score, endothelin and high-sensitive C-reactive protein levels in the GXDS group were substantially superior than those in the placebo group, and the differences between the two groups were statistically significant (P<0.05). Similar results were obtained in the per protocol population analysis of 177 patients. Three cases of MACES were reported in this study (1 in the GXDS group and 2 in the placebo group), and no serious adverse events occurred.@*CONCLUSIONS@#GXDS can significantly alleviate depression and anxiety, relieve symptoms of angina, and improve quality of life in patients with CHD after PCI. (Registration No. ChiCTR1800014291).

Review on exposure characteristics and health effects of per- and poly-fluoroalkyl substances / 环境与职业医学

Per- and poly-fluoroalkyl substances (PFAS) are a new type of persistent organic pollutants that have received extensive attention in recent years. This article reviewed the population characteristics of environmental exposure to PFAS, as well as the potential health effects. Previous studies have verified that people are exposed to PFAS mainly through ingestion, and food and water are the dominant contributors. In terms of exposure characteristics, geographical, gender, age, and occupational differences have an impact on the level of PFAS exposure in the corresponding populations by influencing their behavioral characteristics and metabolic levels, with occupational exposure receiving more attention, especially in the exploration of novel PFAS. PFAS associate with a variety of adverse health effects caused by hepatorenal toxicity, immunotoxicity, reproductive toxicity, neurotoxicity, and carcinogenicity. However, some of the conclusions are not completely consistent, and the published epidemiological studies have focused on children and young people, lacking relevant data of the elderly. Future research can pay more attention to the elderly population and carry out validation exploration on controversial conclusions.

Referral criteria of the SPOT Vision Screener for children under 6 years old / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To revise the referral criteria for the SPOT Vision Screener in children under 6 years old and assessed its accuracy based on the American Association for Pediatric Ophthalmology and Strabismus(AAPOS)uniform guidelines for instrument-based pediatric vision screen validation 2021.METHODS: Children who visited the Maternal and Child Health Center of Yuhuatai District in Nanjing city from January 2022 to April 2023 were included in the study and underwent SPOT refractive screening, cycloplegic retinoscopy, and other examinations. Abnormal children were defined according to AAPOS guidelines with amblyopia risk factors(ARFs)and visually significant refractive error(VSRE). Receiver operating characteristic(ROC)curve was used to calculate the optimal referral criteria and compared with manufacturer criteria, Wu's criteria, and Peterseim's criteria.RESULTS: A total of 959 children were examined, with 342 in the &#x003C;4-year-old group and 617 in the ≥4-year-old group. The optimal referral criteria for the &#x003C;4-year-old group were myopia ≤-2.75 D, hyperopia ≥+2.25 D, astigmatism ≤-2.75 D, and anisometropia ≥1.00 D. For the ≥4-year-old group, the criteria were myopia ≤-1.75 D, hyperopia ≥+2.00 D, astigmatism ≤-2.25 D, and anisometropia ≥1.00 D. The Youden index was 0.38 and 0.52, respectively, which were higher than other criteria.CONCLUSION: The use of new referral criteria for refractive screening in children under 6 years old demonstrates higher accuracy compared to previous criteria. It provides valuable guidance for pediatric eye care and vision health in children.

Research advances on dihydrofolate reductase inhibitors in the treatment of tumors and bacterial infections / 药学学报

Dihydrofolate reductase (DHFR) is a well-known key target in the treatment of tumors, bacterial infections, and parasitic infections; and it plays a critical role in the biosynthesis of cellular DNA. DHFR inhibitors interfere with one-carbon metabolism by inhibiting substrate binding to DHFR, thereby inhibiting cell proliferation. Research on DHFR inhibitors has continued since the 1940s. To date, a variety of DHFR inhibitors have come into the market, primarily used for anti-tumor, antibacterial, antiparasitic, and anti-inflammatory therapy. This review summarizes the research progress of DHFR inhibitors with antitumor or antibacterial effects in recent years based on the classification of single-target and dual-target and looks forward to the opportunities and challenges faced by the work in this field.

Multimorbidity Pattern and Risk for Mortality Among Patients With Dementia: A Nationwide Cohort Study Using Latent Class Analysis

Objective@#Individuals with dementia are at a substantially elevated risk for mortality; however, few studies have examined multimorbidity patterns and determined the inter-relationship between these comorbidities in predicting mortality risk. @*Methods@#This is a prospective cohort study. Data from 6,556 patients who were diagnosed with dementia between 1997 and 2012 using the Taiwan National Health Insurance Research Database were analyzed. Latent class analysis was performed using 16 common chronic conditions to identify mortality risk among potentially different latent classes. Logistic regression was performed to determine the adjusted association of the determined latent classes with the 5-year mortality rate. @*Results@#With adjustment for age, a three-class model was identified, with 42.7% of participants classified as “low comorbidity class (cluster 1)”, 44.2% as “cardiometabolic multimorbidity class (cluster 2)”, and 13.1% as “FRINGED class (cluster 3, characterized by FRacture, Infection, NasoGastric feeding, and bleEDing over upper gastrointestinal tract).” The incidence of 5-year mortality was 17.6% in cluster 1, 26.7% in cluster 2, and 59.6% in cluster 3. Compared with cluster 1, the odds ratio for mortality was 9.828 (95% confidence interval [CI]=6.708–14.401; p<0.001) in cluster 2 and 1.582 (95% CI=1.281–1.953; p<0.001) in cluster 3. @*Conclusion@#Among patients with dementia, the risk for 5-year mortality was highest in the subpopulation characterized by fracture, urinary and pulmonary infection, upper gastrointestinal bleeding, and nasogastric intubation, rather than cancer or cardiometabolic comorbidities. These findings may improve decision-making and advance care planning for patients with dementia.

Regulatory Mechanism of Mangiferin Combined with Bortezomib on Malignant Biological Behavior of Burkitt Lymphoma and Its Effect on Expression of CXC Chemokine Receptors / 中国实验血液学杂志

OBJECTIVE@#To analyze the effects of mangiferin combined with bortezomib on the proliferation, invasion, apoptosis and autophagy of human Burkitt lymphoma Raji cells, as well as the expression of CXC chemokine receptors (CXCRs) family, and explore the molecular mechanism between them to provide scientific basis for basic research and clinical work of Burkitt lymphoma.@*METHODS@#Raji cells were intervened with different concentrations of mangiferin and bortezomib alone or in combination, then cell proliferation was detected by CCK-8 assay, cell invasion ability was detected by Transwell chamber method, cell apoptosis was detected by Annexin V/PI double-staining flow cytometry, apoptosis, autophagy and Akt/mTOR pathway protein expression were detected by Western blot, and the expression changes of CXCR family was detected by real-time quantitative PCR (RT-qPCR).@*RESULTS@#Different concentrations of mangiferin intervened Raji cells for different time could inhibit cell viability in a concentration- and time-dependent manner (r =-0.682, r =-0.836). When Raji cells were intervened by combination of mangiferin and bortezomib, compared with single drug group, the proliferation and invasion abilities were significantly decreased, while the apoptosis level was significantly increased (P <0.01). Mangiferin combined with bortezomib could significantly up-regulate the expression of pro-apoptotic protein Bax and down-regulate the expression of anti-apoptotic protein Bcl-2 after intervention in Raji cells. Caspase-3 was also hydrolyzed and activated, and then induced the apoptosis of Raji cells. Mangiferin combined with bortezomib could up-regulate the expression of LC3Ⅱ protein in Raji cells, and the ratio of LC3Ⅱ/LC3Ⅰ in cells was significantly up-regulated compared with single drug or control group (P <0.01). Mangiferin combined with bortezomib could significantly inhibit the phosphorylation levels of Akt and mTOR, inhibit the proliferation and invasion of Raji cells by inhibiting Akt/mTOR pathway, and induce cell autophagy and apoptosis. Mangiferin and bortezomib could down-regulate the expressions of CXCR4 and CXCR7 mRNA after single-agent intervention in Raji cells, and the down-regulations of CXCR4 and CXCR7 mRNA expression were more significant when the two drugs were combined (P <0.01). Mangiferin alone or combined with bortezomib had no significant effect on CXCR5 mRNA expression in Raji cells (P >0.05), while the combination of the two drugs could down-regulate the expression of CXCR3 (P <0.05).@*CONCLUSION@#Mangiferin combined with bortezomib can synergistically inhibit the proliferation and invasion of Raji cells, and induce autophagy and apoptosis. The mechanism may be related to the inhibition of Akt/mTOR signaling pathway, down-regulation of anti-apoptotic protein Bcl-2 and up-regulation of pro-apoptotic protein Bax, and the inhibition of the expression of CXCR family.

SWI/SNF Complex Gene Mutations Promote the Liver Metastasis of Non-small Cell Lung Cancer Cells in NSI Mice / 中国肺癌杂志

BACKGROUND@#The switch/sucrose nonfermentable chromatin-remodeling (SWI/SNF) complex is a pivotal chromatin remodeling complex, and the genomic alterations (GAs) of the SWI/SNF complex are observed in several cancer types, correlating with multiple biological features of tumor cells. However, their role in liver metastasis of non-small cell lung cancer (NSCLC) remains unclear. Our study aims to investigate the role and potential mechanisms underlying NSCLC liver metastasis induced by the GAs of SWI/SNF complex.@*METHODS@#The GAs of SWI/SNF complex in NSCLC cell lines (H1299, H23 and H460) were identified by whole-exome sequencing (WES). ARID1A knockout H1299 cell was constructed with the CRISPR/Cas9 technology. The mouse model of liver metastasis from NSCLC was established to simulate lung cancer liver metastasis and observe the metastasis rate under different gene mutation conditions. RNA sequencing and Western blot were conducted for differential gene expression analysis. Immunohistochemistry (IHC) analysis was used to assess protein expression levels of SWI/SNF-regulated target molecules in mouse liver metastases.@*RESULTS@#WES analysis revealed intracellular gene mutations. The animal experiments demonstrated a correlation between the GAs of SWI/SNF complex and a higher liver metastasis rate in immunodeficient mice. Transcriptome sequencing and Western blot analysis showed upregulated expression of ALDH1A1 and APOBEC3B in SWI/SNF-mut cells, particularly in ARID1A-deficient H460 and H1299 sgARID1A cells. IHC staining of mouse liver metastases further demonstrated elevated expression of ALDH1A1 in the H460 and H1299 sgARID1A group.@*CONCLUSIONS@#This study underscores the critical role of the GAs of SWI/SNF complex, such as ARID1A and SMARCA4, in promoting liver metastasis of lung cancer cells. The GAs of SWI/SNF complex may promote liver-specific metastasis by upregulating ALDH1A1 and APOBEC3B expression, providing novel insights into the molecular mechanisms underlying lung cancer liver metastasis.

Urban-rural disparities of depression symptoms and its influencing factors among the elderly aged ≥65 years old in Anhui Province from 2019 to 2020 / 中华预防医学杂志

Objective: To analyze the difference in depression symptoms and influencing factors between urban and rural elderly people aged ≥65 years old in Anhui Province. Methods: Based on the data from a survey of 68 communities in Anhui Province that implemented the National Elderly Psychological Care Project from 2019 to 2020, the current status of depression symptoms in the elderly was evaluated using the Patient Health Questionnaire-9 (PHQ-9). The difference in the detection rate of depression symptoms between urban and rural elderly people with different characteristics was compared by using the χ2 test. The logistic regression model was used to analyze the relevant factors of depression symptoms in urban and rural elderly people. Results: A total of 15 532 elderly people aged≥65 years old were included in the survey. The detection rate of depressive symptoms was 7.12%, which was higher in rural areas (9.08%) than in urban areas (6.48%). Logistic regression showed that chronic diseases were risk factors for depressive symptoms in elderly people from both urban and rural areas. Positive attitudes towards aging and good mental resilience were protective factors for depressive symptoms in elderly people. Having hobby (OR=0.64, 95%CI: 0.45-0.91), good relationship with children (OR=0.56, 95%CI: 0.41-0.76), good relationship with spouse (OR=0.51, 95%CI: 0.37-0.71), and having at least 6 friends (OR=0.48, 95%CI: 0.32-0.71) were the protective factors for depressive symptoms in urban elderly people. A good relationship with neighbors (OR=0.58, 95%CI: 0.41-0.82) and having 1-2 friends (OR=0.40, 95%CI: 0.25-0.64) were the protective factors for depressive symptoms in rural elderly people. Women (OR=1.49, 95%CI: 1.06-2.10) and higher education level (OR=1.81, 95%CI: 1.19-2.74, compared with illiterate/semi-illiterate in primary school; OR=2.94, 95%CI: 1.82-4.76, compared with illiterate/semi-illiterate in junior high school and above) were the risk factors for depressive symptoms in rural elderly people. Conclusion: There are differences between urban and rural areas in depressive symptoms among elderly people in Anhui Province. The detection rate of depression symptoms among rural elderly people is higher, and the influencing factors of depressive symptoms between urban and rural elderly people are also different, which should be treated specifically in the implementation of intervention measures.

Urban-rural disparities of depression symptoms and its influencing factors among the elderly aged ≥65 years old in Anhui Province from 2019 to 2020 / 中华预防医学杂志

Objective: To analyze the difference in depression symptoms and influencing factors between urban and rural elderly people aged ≥65 years old in Anhui Province. Methods: Based on the data from a survey of 68 communities in Anhui Province that implemented the National Elderly Psychological Care Project from 2019 to 2020, the current status of depression symptoms in the elderly was evaluated using the Patient Health Questionnaire-9 (PHQ-9). The difference in the detection rate of depression symptoms between urban and rural elderly people with different characteristics was compared by using the χ2 test. The logistic regression model was used to analyze the relevant factors of depression symptoms in urban and rural elderly people. Results: A total of 15 532 elderly people aged≥65 years old were included in the survey. The detection rate of depressive symptoms was 7.12%, which was higher in rural areas (9.08%) than in urban areas (6.48%). Logistic regression showed that chronic diseases were risk factors for depressive symptoms in elderly people from both urban and rural areas. Positive attitudes towards aging and good mental resilience were protective factors for depressive symptoms in elderly people. Having hobby (OR=0.64, 95%CI: 0.45-0.91), good relationship with children (OR=0.56, 95%CI: 0.41-0.76), good relationship with spouse (OR=0.51, 95%CI: 0.37-0.71), and having at least 6 friends (OR=0.48, 95%CI: 0.32-0.71) were the protective factors for depressive symptoms in urban elderly people. A good relationship with neighbors (OR=0.58, 95%CI: 0.41-0.82) and having 1-2 friends (OR=0.40, 95%CI: 0.25-0.64) were the protective factors for depressive symptoms in rural elderly people. Women (OR=1.49, 95%CI: 1.06-2.10) and higher education level (OR=1.81, 95%CI: 1.19-2.74, compared with illiterate/semi-illiterate in primary school; OR=2.94, 95%CI: 1.82-4.76, compared with illiterate/semi-illiterate in junior high school and above) were the risk factors for depressive symptoms in rural elderly people. Conclusion: There are differences between urban and rural areas in depressive symptoms among elderly people in Anhui Province. The detection rate of depression symptoms among rural elderly people is higher, and the influencing factors of depressive symptoms between urban and rural elderly people are also different, which should be treated specifically in the implementation of intervention measures.

A "4D" systemic view on meridian essence: Substantial, functional, chronological and cultural attributes / 中西医结合学报

The term Jingluo, translated as meridian or channel, is a core component of traditional Chinese medicine (TCM) and has played a fundamental role in guiding the clinical practice of acupuncture for thousands of years. However, the essence of the meridian remains elusive and is a source of both confusion and debate for researchers. In this study, a "4D" systemic view on the essence of the meridian, namely substantial, functional, chronological, and cultural dimensions, was proposed based on a review of the ancient medical classics, recent research developments, and results from clinical practice. Previous studies have primarily focused on the substantial dimension of the meridian system, with scant interpretation about its functional domain. Neither systemic data nor evaluations have been adequately documented. Additionally, a limited but increasing number of studies have focused on the chronological and cultural dimensions. More investigations that embody the holistic concept of TCM and integrate the systemic modes and advanced techniques with dominant diseases of TCM need to be performed to obtain a more comprehensive understanding of the essence of meridians. The goal of this study is to yield useful information in understanding the essence of meridians and provide a reference and perspective for further research.

Relationship between frailty and orthostatic hypotension in the elderly in nursing homes / 中国实用护理杂志

Objective:To understand the predictive effect of orthostatic hypotension on frailty in nursing homes, and the effect of frailty on heart rate and blood pressure in supine positionand orthostatic position.Methods:A total of 214 elderly cases in three nursing homes (the Golden Years of Jinjialing Retirement Life Center, Hangzhou Boyang Pension Service Co., Ltd, Hangzhou Langhe International Medical Care Center) were interviewed by the general information questionnaire, the Frail Scale and Barthel Index. Systolic blood pressure, diastolic blood pressure, and heart rate were measured by electronic sphygmomanometer in supine position and orthostatic position of 1 and 3 minutes.Results:The incidence of frailty combined with orthostatic hypotension was 26.64%(57/214) in the elderly in nursing homes. The incidence of orthostatic hypotension in the robust elderly, pre-frailty and frailty gradually increased, 14.29%(5/35), 20.00%(12/60), 47.90%(57/119). The differences of heart rate and systolic blood pressure in supine position between the elderly with and without frailty were significant ( t=2.16, 3.25, P<0.05), the differences of systolic pressure difference in orthostatic position of 1 and 3 minutes between the elderly with and without frailty were significant ( H=3.16, 4.08, P<0.01). There was significant difference in systolic pressure between the prefrail elderly and the elderly without frailty in lying position ( t=2.02, P<0.05). The differences of systolic and diastolic pressure differences in orthostatic position of 3 minutes between the frail elderly and pre-frail elderly were significant ( H=3.13,2.44, P<0.05). Ordered Logistic regression analysis showed that orthostatic hypotension was a risk factor for frailty ( OR=2.425, 95% CI were 1.133-4.988, P<0.05). Conclusions:Elderly adults with orthostatic hypotension in nursing homes have a higher prevalence of frailty. Frailty also impairs blood pressure regulation during postural changes. Nurses should attach importance to the assessment, education and intervention of frailty and orthostatic hypotension.

Feasibility and safety of rapid frozen pathological examination of prostate biopsy tissue combined with RP in the diagnosis and treatment of prostate cancer / 中华泌尿外科杂志

Objective:To explore the feasibility and safety of the clinical application of the diagnosis and treatment mode combining rapid frozen pathological examination of prostate biopsy tissue with radical prostatectomy.Methods:Suspected prostate cancer patients with PSA>10 ng/ml and PI-RADS score ≥4 in, Northern Jiangsu People's Hospital from April to September 2021 were collected. The included patients underwent mpMRI/TRUS image fusion-guided transperineal prostate targeted biopsy with 16G biopsy needle, 2-3 needles for biopsy, and rapid frozen pathological examination. Robot-assisted laparoscopic radical prostatectomy (RALP) was performed immediately for patients with prostate cancer with rapid freezing pathology. For undiagnosed prostate cancer, 18G biopsy needle for prostate targeted + systematic biopsy were used, 18-22 needles for systematic biopsy, and routine pathological examination. The baseline data, frozen pathological results, perioperative conditions, pathological results and follow-up data of all patients were collected.Results:Eleven patients were included in the study, the mean age of the patients was 69.9(66-73) years, the mean BMI was 22.8(19-26) kg/m 2, the mean PSA was 23.2(14.25-32.00), the mean prostate volume was 45(32-52) ml, mean PSAD 0.54(0.33-0.75). PI-RADS score was 4 in 3 cases and 5 in 8 cases; digital rectal examination was positive in 5 cases. All 11 cases underwent rapid freezing and the pathological results showed that: 9 cases were prostate adenocarcinoma, and RALP was performed immediately. The operation time was 111.5(96-126) min, the intraoperative blood loss was 78.9(55-105) ml, and the postoperative extubation time was 4.3(3.5-5.0) days, postoperative hospital stay 5.8(5.0-6.5) days. Postoperative pathology showed that Gleason score 3+ 4=7 in 1 case, 4+ 3=7 in 3 cases, 8 points in 4 cases, and 10 points in 1 case; 3 cases had positive resection margins, and 1 case had seminal vesicle invasion, the average number of dissected lymph nodes was 10.9 (8.5-14.0), and there was no tumor metastasis. Pathological T staging included 2 cases of T 2b stage, 5 cases of T 2c stage, 1 case of T 3a stage, and 1 case of T 3b stage. Two patients were undiagnosed by rapid freezing pathology, of which one was prostate adenocarcinoma with a Gleason score of 4+ 3=7, and then received RALP; the other one was prostate inflammation. 11 patients were followed up; the postoperative follow-up time was 3-7 months, with an average of 5.2 months. Among the 10 patients who underwent RALP, 8 patients recovered urinary continence 2 weeks after surgery, and all recovered within 2 months after surgery. Three patients with positive surgical margins were given regular androgen deprivation therapy in the second week after surgery. PSA did not drop below 0.1 ng/ml in patients with positive margins and seminal vesicle invasion 3 months after surgery. No complications of Clavien grade Ⅰ or higher occurred after operation and during follow-up. Conclusions:For patients with high suspicion of prostate cancer, rapid frozen pathological examination of prostate biopsy tissue is performed. RALP is performed immediately for patients with prostate cancer. The results show that this diagnosis and treatment model could be safe and feasible.

Compound oleum lithospermi in improving clinical symptoms of mild to moderate diaper dermatitis: a multicenter, open-labeled, randomized controlled clinical study / 中华皮肤科杂志

Objective:To evaluate clinical efficacy and safety of topical compound oleum lithospermi in the treatment of mild to moderate diaper dermatitis.Methods:A multicenter, randomized, positive-drug parallel-controlled clinical trial was conducted in 19 hospitals from July 2019 to August 2020. Children aged 0 - 12 months with mild to moderate diaper dermatitis were enrolled and randomly divided into 2 groups using a random number table: test group topically treated with compound oleum lithospermi, and control group topically treated with zinc oxide cream. The treatment was carried out 6 - 8 times a day for 7 days. Visits were scheduled on days 0 and 7, and total response rate and clinical healing time were evaluated. Changes in the dermatitis family impact (DFI) score were compared between the test group and control group, and adverse events were recorded. Statistical analysis was carried out by using independent-sample t test for normally distributed continuous data, Wilcoxon rank sum test for non-normally distributed continuous data, and chi-square test or Fisher′s exact test for unordered categorical data; survival curves were drawn, and log-rank test was used for comparisons between two groups. Results:A total of 343 children with diaper dermatitis were enrolled in this study. Among them, 31 children violated the protocol, so 312 were included in the per protocol set, including 157 in the test group and 155 in the control group, and all completed the visits on days 0 and 7. The total response rate was significantly higher in the test group (87.26%, 137/157) than in the control group (78.71%, 122/155; χ2 = 4.04, P = 0.044) . The clinical healing time was significantly shorter in the test group (5.33 days) than in the control group (6.13 days; χ2 = 4.67, P = 0.025) . After 7-day treatment, the DFI score significantly decreased in both the 2 groups compared with that before the treatment, but there was no significant difference in the DFI score between the 2 groups (test group: 4.02 ± 6.96, control group: 3.58 ± 5.90, Z = -0.39, P = 0.686) . The incidence of adverse events was 2.92% (5/171) and 5.45% (9/165) in the test group and control group respectively, and there was no significant difference between the 2 groups ( χ2 = 0.03, P = 0.865) . Conclusion:Compound oleum lithospermi can markedly reduce the clinical severity of diaper dermatitis, improve the total response rate, shorten the clinical treatment period, and improve the quality of life of children′s families with a favorable safety profile.

Construction and Application of YOLOv3-Based Diatom Identification Model of Scanning Electron Microscope Images / 法医学杂志

OBJECTIVES@#To construct a YOLOv3-based model for diatom identification in scanning electron microscope images, explore the application performance in practical cases and discuss the advantages of this model.@*METHODS@#A total of 25 000 scanning electron microscopy images were collected at 1 500× as an initial image set, and input into the YOLOv3 network to train the identification model after experts' annotation and image processing. Diatom scanning electron microscopy images of lung, liver and kidney tissues taken from 8 drowning cases were identified by this model under the threshold of 0.4, 0.6 and 0.8 respectively, and were also identified by experts manually. The application performance of this model was evaluated through the recognition speed, recall rate and precision rate.@*RESULTS@#The mean average precision of the model in the validation set and test set was 94.8% and 94.3%, respectively, and the average recall rate was 81.2% and 81.5%, respectively. The recognition speed of the model is more than 9 times faster than that of manual recognition. Under the threshold of 0.4, the mean recall rate and precision rate of diatoms in lung tissues were 89.6% and 87.8%, respectively. The overall recall rate in liver and kidney tissues was 100% and the precision rate was less than 5%. As the threshold increased, the recall rate in all tissues decreased and the precision rate increased. The F1 score of the model in lung tissues decreased with the increase of threshold, while the F1 score in liver and kidney tissues with the increase of threshold.@*CONCLUSIONS@#The YOLOv3-based diatom electron microscope images automatic identification model works at a rapid speed and shows high recall rates in all tissues and high precision rates in lung tissues under an appropriate threshold. The identification model greatly reduces the workload of manual recognition, and has a good application prospect.

Stasis Caused by Depression and Coronary Heart Disease / 中国实验方剂学杂志

Anxiety and depression are common comorbidities of coronary heart disease and are considered as independent risk factors in addition to traditional cardiovascular risk factors. Anxiety，depression and other mental abnormalities belong to the category of "depressive syndrome" of traditional Chinese medicine，which can lead to stasis of blood due to the lack of Qi flow. "Blood stasis" involves abnormal blood rheology， vascular endothelial dysfunction， chronic inflammatory response， abnormal lipid metabolism and other comprehensive pathological changes， and is the core pathogenesis of coronary heart disease in traditional Chinese medicine. "Depressive syndrome"can aggravate the development of coronary heart disease by promoting blood stasis in multiple ways. Prescriptions and herbs of promoting blood circulation and removing blood stasis can have a clinical effect by promoting blood circulation （improving physiological functions） and removing blood stasis （eliminating pathological changes）. In clinical practice， strengthening the screening of the mental and psychological status of patients with coronary heart disease and providing early and effective psychological interventions and combined Chinese and Western medicine drug treatment can significantly improve the clinical symptoms and prognosis of patients. This article was the first to put forward the academic view of "stasis caused by depression" for the first time，and discuss the modern biological research progress of "depression" in Chinese medicine that promotes blood stasis and aggravates coronary heart disease，in order to provide a basis for the subsequent development of Chinese medicine in the prevention and treatment of coronary heart disease. The aim is to provide a theoretical basis for the subsequent systematic research on the prevention and treatment of coronary heart disease with emotional abnormalities in Chinese medicine.

The value of IL-6 in the diagnosis, treatment and prognostic improvement of urosepsis at 2 hours after percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective:To explore the value of IL-6 in the diagnosis, treatment and improving prognosis of urosepsis at 2 hours after percutaneous nephrolithotomy.Methods:Twenty-five patients with urosepsis undergoing percutaneous nephrolithotomy in the Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2019 to June 2021 were analyzed retrospectively, including 6 males and 19 females, aged (55.4±11.6) years, and there were 10 cases with hypertension, 11 cases with diabetes and 14 cases with hydronephrosis. There were 10 cases with Stone volume>353mm 2, 22 cases with pyuria, 12 cases with positive nitrite and 18 cases with positive urine culture before operation. Among them, 13 patients were classified into experimental group with the test of IL-6 at 2 hours after operation and 12 patients were classified into control group without the test of IL-6 at 2 hours after operation. IL-6>1 000 pg/ml at 2 hours after operation as the standard for diagnosis of urosepsis was used to guide the anti-infective treatment after percutaneous nephrolithotomy. The operation time, severity of urinary sepsis (severe sepsis and septic shock), diagnostic time of urosepsis after operation, and hospital stay after operation were compared between the two groups. Results:There were 13 patients including 9 females with average age of (52.4±12.2) years in the experimental group, and there were 6 cases with hypertension, 5 cases with diabetes and 9 cases with hydronephrosis, 5 cases with stone volume>353mm 2, 12 cases with pyuria, 7 cases with positive nitrite and 10 cases with positive urine culture before operation. There were 12 patients including 10 females with average age of (58.7±10.5) years in the control group, and there were 4 cases with hypertension, 6 cases with diabetes, 5 cases with hydronephrosis, 3 cases with stone volume>353mm 2, 10 cases with pyuria, 5 cases with positive nitrite, and 8 cases with positive urine culture before operation. There was no significant difference between the two groups in terms of gender( P=0.645), average age ( P=0.182), hypertension( P=0.688), diabetes( P =0.695), hydronephrosis( P=0.238), stone volume>353 mm 2( P=0.673), pyuria( P=0.593), positive nitrite( P=0.695), and positive urine culture( P=0.673). There was not significant difference in the general clinical data of gender, age, hypertension, diabetes, stone burden, hydronephrosis, pyuria, positive nitrite and positive urine culture between the two groups ( P>0.05). The mean value of IL-6 in the test group was (6 824.4±1 473.3) pg/ml. The operative time of the experimental group with (100.8±27.8) minutes was longer than that of the control group with (88.3±39.3) minutes, but the difference between the two groups was not statistically significant ( P=0.645). The diagnostic time of urosepsis after operation in the test group with (3.6±2.0) hours was shorter than that in the control group with (6.0±3.0) hours, and the difference between the two groups was statistically significant ( P=0.023). The postoperative hospital stay in the test group with (6.1±1.6) days was shorter than that in the control group with (8.2±2.3) days, and the difference between the two groups was statistically significant ( P=0.014). Three patients with severe sepsis and septic shock in the test group, which were less than that of eight patients with severe sepsis and septic shock in the control group, and the difference between the two groups was statistically significant ( P=0.047). Conclusion:The detection of IL-6 at 2 hours after percutaneous nephrolithotomy can early diagnose urosepsis, reduce the severity of postoperative urosepsis, shorten the postoperative hospital stay, and improve the prognosis.

Exploration of mechanism of Huoxue Jiedu Chinese Herbal Compatibility in anti-atherosclerosis: Based on network pharmacology and molecular docking / 中国药理学通报

Aim To explore the mechanism of Huoxue Jiedu Chinese Herbal Compatibility (angelica sinensis - lonicerae japonicae flos ) in anti-atherosclerosis by means of network pharmacology and molecular rloe- king.Methods The effective eomponents and related targets of angelica sinensis and lonicerae japonicae flos were sereened by the TCMSP database, and the dis¬ease related targets of atheroselerosis were obtained by using the Gene Cards database, DrugBank database and OMIM database.The common targets were ob¬tained by Venny2.1 , an online mapping tool.The pro- tein-protein interaction ( PPI) network was established by String 11.0, and the common target was analyzed by gene ontology(GO) enrichment analysis and kvoto en- cyelopedia of genes and genomes ( KEGG) enrichment analysis using metascape online platform.Cyto- seape3.8.2 was used to construct the " active ingredi¬ent-active target-pathway network map.Finally AutoDock and PyMOL softwares were applied for mo¬lecular docking.Results A total of 31 active compo¬nents of angelica sinensis-lonicerae japonicae flos com¬ patibility and 509 component targets were screened.Hie number of intersection targets with atherosclerosis was 210.GO function enrichment analysis revealed 2 961 biological process items and 242 molecular func¬tion items.KEGG pathway enrichment screened 250 signaling pathways, PI3K-Akt signaling pathway, MAPK signaling pathway, and fluid shear stress and atherosclerosis were the key pathways.Molecular doc¬king results showed that beta-sitosterol, ferulic acid, rutin, luteolin, quercetin could bind stably with MAPK (-1,-3), AKT1, PRKC ( A, B).Conclusions Huoxue Jiedu Chinese Herbal Compatibility ( angelica sinensis -lonicerae japonicae flos) containing multiple active ingredients may play an anti-atherosclerosis role through the signaling pathways of MAPK, P13K-Akt and PRKC, reflecting the advantages of the treatment of activating blood circulation and detoxification of tra¬ditional Chinese medicine in anti-atherosclerosis.