Factors influencing the development of executive function in adolescents / 中国学校卫生

Abstract@#Executive function is an advanced cognitive process aimed at the flexible coordination, optimization, and control of the cognitive processes of task solving in order to accomplish a specific task, ensuring that the individual produces effective behaviors, including inhibitory control, working memory, and cognitive flexibility. Given the sensitivities and specificities that characterize an individual s physical and mental development during adolescence, this period is critical for the development of executive function in adolescents. In the paper, the influencing factors of adolescents executive function development are systematically described from three dimensions, namely, biology, environment and lifestyle; by analyzing the mechanisms and differences in the effects of different influencing factors, this editorial provides a scientific basis for adolescents executive function improvement and intervention.

Analysis of copy number variation in AZF region of Y chromosome in patients with spermatogenic failure / 中华医学遗传学杂志

OBJECTIVE@#To explore the characteristics of copy number variation (CNV) within the Y chromosome azoospermia factor (AZF) region in patients with spermatogenesis disorders in the Shenzhen area.@*METHODS@#A total of 123 patients with spermatogenesis disorders who had visited Shenzhen People's Hospital from January 2016 to October 2022 (including 73 patients with azoospermia and 50 patients with oligozoospermia) and 100 normal semen males were selected as the study subjects. The AZF region was detected with multiplex ligation-dependent probe amplification (MLPA), and the correlation between the CNV in the AZF region and spermatogenesis disorders was analyzed using the chi-square test or Fisher's exact test.@*RESULTS@#19 CNV were detected among 53 patients from the 223 samples, including 20 cases (27.40%, 20/73) from the azoospermia group, 19 cases (38%, 19/50) from the oligozoospermia group, and 14 cases (14%, 14/100) from the normal control group. In the azoospermia, oligozoospermia, and normal control groups, the detection rates for CNV related to the AZFa region (including AZFab and AZFabc) were 5.48% (4/73), 2.00% (1/50), and 0 (0/100), respectively. The detection rates for the AZFb region (including the AZFbc region) were 6.85% (5/73), 0 (0/50), and 0 (0/100), respectively. The detection rates for gr/gr deletions in the AZFc region were 2.74% (2/73), 6.00% (3/50), and 9.00% (9/100), respectively, and those for b2/b4 deletions in the AZFc region were 2.74% (2/73), 10.00% (5/50), and 0 (0/100), respectively. The detection rates for complex rearrangements in the AZFc region were 6.85% (5/73), 18.00% (9/50), and 3.00% (3/100), respectively. Statistical analysis showed no significant difference in the detection rate of gr/gr deletions between the three groups (Fisher's Exact Test value = 2.712, P = 0.249); the differences in the detection rate of b2/b4 deletions between the three groups were statistically significant (Fisher's Exact Test value = 9.489, P = 0.002); the differences in the detection rate of complex rearrangements in the AZFc region between the three groups were statistically significant (Fisher's Exact Test value = 9.493, P = 0.006). In this study, a rare AZFa region ARSLP1 gene deletion (involving SY86 deletion) was detected in a patient with oligozoospermia.@*CONCLUSION@#CNV in the AZFa and AZFb regions have a severe impact on spermatogenesis, but partial deletion in the AZFa region (ARSLP1 gene deletion) has a minor impact on spermatogenesis. The b2/b4 deletion and complex rearrangement in the AZFc region may be risk factors for male infertility. The gr/gr deletion may not serve as a risk factor for male infertility in the Shenzhen area.

Prenatal diagnosis and genetic analysis of a fetus with partial deletion of Yq and mosaicism of 45,X / 中华医学遗传学杂志

OBJECTIVE@#To carry out prenatal diagnosis and genetic analysis for a fetus with disorders of sex development (DSDs).@*METHODS@#A fetus with DSDs who was identified at the Shenzhen People's Hospital in September 2021 was selected as the study subject. Combined molecular genetic techniques including quantitative fluorescence PCR (QF-PCR), multiplex ligation-dependent probe amplification (MLPA), chromosomal microarray analysis (CMA), quantitative real-time PCR (qPCR), as well as cytogenetic techniques such as karyotyping analysis and fluorescence in situ hybridization (FISH) were applied. Ultrasonography was used to observe the phenotype of sex development.@*RESULTS@#Molecular genetic testing suggested that the fetus had mosaicism of Yq11.222qter deletion and X monosomy. Combined with the result of cytogenetic testing, its karyotype was determined as mos 45,X[34]/46,X,del(Y)(q11.222)[61]/47,X,del(Y)(q11.222),del(Y)(q11.222)[5]. Ultrasound examination suggested hypospadia, which was confirmed after elective abortion. Combined the results of genetic testing and phenotypic analysis, the fetus was ultimately diagnosed with DSDs.@*CONCLUSION@#This study has applied a variety of genetic techniques and ultrasonography to diagnose a fetus with DSDs with a complex karyotype.

Study on pharmacokinetics of novel lung-targeted Docetaxel liposome in in-situ lung cancer model rabbit / 中国药房

OBJECTIVE To study the pharmacokinetic behavior of novel lung-targeted Docetaxel liposome （DTX-LP） in in- situ lung cancer model rabbit. METHODS The content of DTX in rabbit plasma was determined by UPLC-MS/MS， and methodology investigation was conducted. in-situ lung cancer model rabbit was made by the ultra-minimal invasive percutaneous puncture inoculation method. Model rabbits were randomly divided into Docetaxel injection （DTX-IN） group and DTX-LP group. The rabbits were given relevant medicine via ear vein at a dose of 1.0 mg/kg （calculated by DTX）； blood was taken at 5， 15， 30， 60， 90， 120， 240 and 480 minutes to measure the concentration of DTX in plasma. DAS 3.3 software was adopted for fitting and analysis， and to calculate pharmacokinetic parameters. RESULTS UPLC-MS/MS method used in this study was accurate and precise， which met the requirements of biological sample analysis. Compared with DTX-IN group， drug concentration-time curve of DTX-LP was smoother， the blood concentration at each time point was lower， and cmax， t1/2， AUC0→480 min and AUC0→∞ were significantly decreased （P＜0.05）. CONCLUSIONS The drug exposure of DTX-LP in plasma is significantly reduced than DTX- IN， indicating it can be rapidly distributed from systemic circulation to liver target organs.

Clinicopathological features of cystic neutrophilic granulomatous mastitis / 中华普通外科杂志

Objective:To investigate the etiology, clinical manifestations, clinicopathological features of cystic neutrophil granulomatous mastitis (CNGM).Methods:From Jan 2019 to Dec 2020, 95 CNGM cases diagnosed by biopsy pathology at Chongqing Hospital of Traditional Chinese Medicine and Chongqing Liangping District Hospitol of Traditional Chinese Medicine were reviewed.Results:There were 95 female patients, aged 21 to 50 years, with a median age of 32 years. Laboratory examination showed that 56% (53/95) cases had elevated rheumatoid antibody level, 27 % (26/95) had increased level of serum thyroid antibody, 15% (14/95) had elevated antineutrophil antibody, 35% (33/95) had increased ESR, 38% (36/95) had increased C-reactive protein. The positive rate of Gram-stained bacilli was 82% (78/95). Histology: pyogenic granuloma with lobule of breast as the center, the center of granuloma was cystic vacuole.Immunohistochemistry showed that the inflammatory cells in and around granuloma were mainly CD3 + cells, and CD4 + cells were more than CD8 + cells. Conclusions:The cystic neutrophilie granulo matous mastitis is a rare type of idiopathic granulomatous mastitis. The diagnosis of CNGM is dependent on its specific pathological features.

Role of NALCN in hippocampal dentate gyrus in social behavior of mice / 中华麻醉学杂志

Objective:To evaluate the role of the sodium leak channel (NALCN) in the hippocampal dentate gyrus (DG) in the social behavior of mice.Methods:Thirty-nine male wild-type C57BL/6 mice, aged 6-8 weeks, weighing 18-22 g, were used in this study. Three mice were sacrificed to verify the expression and co-expression of NALCN with neuronal nuclear antigen (NeuN) in the hippocampal DG using the immunofluorescent staining. The remaining 36 mice were divided into 2 groups ( n=18 each) by the random number table method: control group (group C) and NALCN gene knockdown group (group KO). NALCN-shRNA virus was injected in group KO, and scrambled-shRNA virus was injected in group C. The three box social test and open field test were performed at 3 weeks after the virus injection. Mice were sacrificed under anesthesia after the behavioral test, hippocampal tissues were collected, and the injection location of the virus was verified with a fluorescence microscope, and the NALCN protein and mRNA expression in the hippocampal DG was detected by Western blot and real-time polymerase chain reaction, respectively. Results:NALCN and NeuN co-expressed a lot on the same neuron in the hippocampal DG of mice, indicating that NALCN was widely expressed on the neurons in the hippocampal DG. Compared with group C, the expression of NALCN and mRNA in the hippocampal DG was significantly down-regulated, and the social novelty preference disappeared ( P<0.05), and no significant change was found in the social ability and each parameter in the open field test in group KO ( P>0.05). Conclusions:NALCN in the hippocampal DG is involved in the regulation of social memory in mice, and the down-regulated expression of NALCN can lead to the loss of social novelty preference in mice.

Comparative study of different diagnostic methods for malnutrition in the elderly with nervous system diseases / 中华老年医学杂志

Objective:To investigate the prevalence of malnutrition in elderly patients with neurological diseases and the of nutrition, and to explore their association with clinical outcomes.Methods:A retrospective study was conducted to analyze 566 elderly patients with neurological diseases in the database of the "National Multicenter Survey on the Dynamic Changes of Nutritional Status of Hospitalized Patients" by using the Global leadership Initiative on Malnutrition(GLIM)criteria and subjective global assessment(SGA). The two diagnostic tools for malnutrition were compared to explore the correlation between malnutrition and clinical outcomes.Results:Based on the GLIM criteria, 83 cases were diagnosed with malnutrition and the incidence of malnutrition was 14.66%(83/566), with 14.72%(48/326)in men and 14.58%(35/240)in women.Patients with moderate malnutrition accounted for 8.30%(47/566)and patients with severe malnutrition accounted for 6.36%(36/566). According to the SGA, the incidence of moderate malnutrition(SGA Grade B)was 15.55%(88/566), the incidence of severe malnutrition(SGA Grade C)was 1.94%(11/566), and all cases of malnutrition(SGA Grade B+ C)accounted for 17.49% of the participants(99/566). The total length of hospital stay was(15.46±6.49)days in the malnutrition group and(13.55±5.09)days in the non-malnutrition group, with a statistical difference between the two groups( t=-3.02, P<0.01). The body weight of the malnutrition group was significantly lower than non-malnutrition group[(52.0±8.5)kg vs.(65.2±9.6)kg, t=12.92, P<0.01]. There were also statistically significant differences in BMI(19.1±2.7 kg/m 2vs.23.9±2.6 kg/m 2, t=15.48, P<0.01), upper arm circumference[(22.3±2.5)cm vs.(28.3±3.9)cm, t=7.01, P<0.01], and lower leg circumference[(28.9±3.4)cm vs.(32.5±3.3)cm, t=6.81, P<0.01]between the two groups.Laboratory tests showed that there were significant differences in lymphocytes[(5.0±8.5)×10 9/L vs.(9.4±11.8)×10 9/L, t=3.61, P<0.01]and albumin[(38.5±4.4)g/L vs.(40.7±5.1)g/L, t=3.18, P<0.01]between the malnutrition group and the non-malnutrition group.The correlation between GLIM and SGA was good, and the consistency was reasonable(AUC=0.711). Conclusions:The incidence of malnutrition in elderly patients with neurological diseases is relatively high; The GLIM criteria are suitable for the diagnosis of malnutrition in elderly patients with neurological diseases, and the diagnostic results have a good correlation with those of SGA.Malnutrition is associated with anthropometric measurements, laboratory indicators, and clinical outcomes.

Analysis of correlation between nutritional status and frailty and sarcopenia in geriatric patients planning to receive major hepatopancreatobiliary surgery / 中华临床营养杂志

Objective:To analyze the correlation between nutritional status and frailty and sarcopenia in geriatric inpatients (GIPs) planning to receive major hepatopancreatobiliary (HPB) surgery.Methods:From December, 2020 to September, 2022, GIPs who were planning to receive major HPB surgery were recruited. Nutritional assessment was performed using nutritional risk screening 2002 (NRS-2002) and Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty and sarcopenia assessment were performed using Fried frailty phenotype (FFP) and Asian Working Group for Sarcopenia (AWGS) 2019 consensus on sarcopenia diagnosis and treatment. The prevalence and concurrence of malnutrition, frailty and sarcopenia were investigated, and the correlation between nutritional status and frailty and sarcopenia was analyzed.Results:A total of 144 participants at the mean age of (70.10±7.44) years were included. The prevalence of nutritional risk, malnutrition, and severe malnutrition were 73.6% ( n ?=?106), 68.1% ( n ?=?98), and 34.7% ( n ?=?50) respectively. The prevalence of frailty was 20.8% ( n ?=?30) and that of sarcopenia was 35.4% ( n ?=?51). The prevalence of severe malnutrition increased significantly in older participants and the prevalence of nutritional risk, malnutrition and severe malnutrition decreased significantly with higher BMI. The prevalence was 35.4% (51/144) for concurrent sarcopenia and malnutrition, 19.4% (28/144) for frailty and malnutrition, 14.6% (21/144) for sarcopenia and weakness, and 14.6% (21/144) for sarcopenia, malnutrition, and weakness. There was a positive correlation between nutritional risk and frailty ( r = 0.603, P < 0.001). The risk of pre-frailty and frailty in the nutritional risk group was higher than that in the non-nutritional risk group ( χ 2 = 31.830, P < 0.001). The risk of pre-frailty and frailty in the malnutrition group was higher than that in the normal nutrition group ( χ 2 = 36.727, P < 0.001). Logistic regression analysis showed that the risk of frailty in patients with severe malnutrition was 12.303 times higher than that in patients with normal nutrition status (95% CI: 2.592 to 58.409, P = 0.002). The risk of sarcopenia in the nutritional risk group was higher than that in the non-nutritional risk group ( χ 2 = 13.982, P < 0.001). The risk of sarcopenia in the malnutrition group was higher than that in the normal nutrition group ( χ 2 = 37.066, P < 0.001). Conclusions:The prevalence and concurrence rate of malnutrition, frailty, and sarcopenia are high in GIPs undergoing major HPB surgery. GIPs with malnutrition are susceptible to frailty.

The association of frailty status with nutritional risk and the effect on outcomes in elderly surgical inpatients / 中华临床营养杂志

Objective:To study the association of frailty status with nutritional risk and the effect on clinical outcomes among elderly surgical inpatients.Methods:Elderly inpatients from the surgery department of Beijing Hospital were enrolled from January to June 2021. Frail scale and nutritional risk screening 2002 (NRS 2002) were used for frailty evaluation and nutrition risk screening. The influence of frailty and associated nutrition risk in elderly surgical inpatients was analyzed.Results:487 elderly surgical patients were included, of whom 131 cases were in the non-frailty group, 279 cases were in the pre-frailty group and 77 cases were in the frailty group, according to the Frail scale score. 146 cases were at nutritional risk, of whom 8 (6.1% of 131) were in the non-frailty group, 87 (31.2% of 279) in the pre-frailty group and 51 (66.2% of 77) were in the frailty group. According to univariate/multivariate logistic regression analysis of frailty in elderly surgical patients, a higher NRS 2002 score, older age, and the presence of multiple concurrent diseases (≥ 5) were significantly associated with frailty ( P < 0.001). The Frail scale score was positively correlated with NRS 2002 score ( r = 0.448, P < 0.01). Multiple comparisons showed that frailty had statistically significant effects on hospital stay and medical costs in elderly surgical patients ( P < 0.05). Conclusions:The prevalence of frailty is higher in elderly surgical patients, and the prevalence of nutritional risk increases with the progression of frailty. Frailty can lead to prolonged hospital stays and increased hospital costs in elderly surgical patients.

Quality evaluation of Indigo Naturalis based on multi-component quantification combined with chemometrics / 中国药房

OBJECTIVE To evaluate the quality of Indigo Naturalis， and to provide reference for the quality control of Indigo Naturalis. METHODS UPLC-MS/MS method was used to determine the contents of 6 indole alkaloids （indigo， indirubin， isatin， tryptanthrin， indole and indole-3-carboxaldehyde） in Indigo Naturalis from different origins. Cluster analysis， principal component analysis and partial least squares-discriminant analysis （PLS-DA） were used to evaluate the quality of Indigo Naturalis from different origins. RESULTS The contents of indigo， indirubin， isatin， tryptanthrin， indole and indole-3-carboxaldehyde in Indigo Naturalis from different origins were 20 320.83-26 585.01， 1 327.69-3 102.25， 141.69-894.50， 2.17-5.27， 2.14-5.93 and 1.69-4.34 μg/g， respectively. The Indigo Naturalis from different areas were clustered into two categories by cluster analysis. Samples S1， S2， S4， S6， S7， S9 and S10 were clustered into category Ⅰ， and samples S3， S5， S8， S11 and S12 were clustered into category Ⅱ. Indigo Naturalis from different origins was evaluated with 3 principal components. The results showed that category Ⅰ sample scored higher and had better quality， while category Ⅱ sample scored lower and had worse quality. PLS-DA showed that indigo， indirubin， tryptanthrin and isatin were the main substances that reflected the quality difference of Indigo Naturalis. CONCLUSIONS The quality of Indigo Naturalis from different origins is different， and the quality of Indigo Naturalis of different batches from the same area is not stable. The quality evaluation method of Indigo Naturalis established in this paper is stable and reliable， which can provide a basis for the quality control of Indigo Naturalis.

Efficacy of combined local flaps in repair of larger defects in the nasal and perinasal region after Mohs micrographic surgery in 11 cases / 中华皮肤科杂志

Objective:To investigate efficacy and advantages of combined local flaps in repairing large defects in patients with nasal and perinasal non-melanoma skin cancers after Mohs micrographic surgery.Methods:From March 2018 to November 2020, 11 patients with nasal and perinasal non-melanoma skin cancers, who underwent Mohs micrographic surgery followed by repair with combined local flaps, were collected from Department of Dermatology, the Second Hospital of Hebei Medical University. According to the location and size of postoperative defects, flaps were designed based on the nasal aesthetic subunit principle. For large defects that could not be directly sutured or covered by a single local flap, 2 or 3 kinds of flaps were applied in combination, such as kite flap, modified diamond flap, nasolabial skin flap, bilobed skin flap, etc.Results:Among the 11 patients, 10 were diagnosed with basal cell carcinoma and 1 with squamous cell carcinoma, and the area of defects ranged from 2.0 cm × 2.3 cm to 2.7 cm × 3.6 cm. After Mohs micrographic surgery combined with local skin flap repair, all skin flaps survived well without blood supply obstruction, the texture, color and contour of the skin flaps were similar to those of the surrounding normal skin, and no obvious scars were formed. During the postoperative follow-up of 4 to 32 months, no recurrence of the tumors occurred, and the patients was satisfied with the appearance.Conclusion:To repair large defects using combined skin flaps of 2 or 3 kinds after Mohs micrographic surgery in patients with nasal and perinasal non-melanoma skin cancers can maintain the normal nasal or perinasal morphological structure and aesthetic appearance, and yield a satisfactory cosmetic effect.

Mechanism of penehyclidine hydrochloride alleviating endotoxin-induced lung injury in rats: relationship with Toll-like receptor 4 / 中华麻醉学杂志

Objective:To evaluate the role of Toll-like receptor 4 (TLR4) in the mechanism by penehyclidine hydrochloride alleviating lipopolysaccharide (LPS)-induced acute lung injury(ALI)in rats.Methods:Twenty-four healthy male Sprague-Dawley rats, aged 10 weeks, weighing 220-250 g, were divided into 4 groups ( n=6 each) according to the random number table method: normal saline group (NS group), endotoxin-induced ALI group (ALI group), penehyclidine hydrochloride + normal saline group (PHC+ NS group) and penehyclidine hydrochloride + endotoxin-induced ALI group (PHC+ ALI group). ALI was induced by intratracheal instillation of LPS 5 mg/kg in anesthetized animals. In group PHC+ ALI, penehyclidine hydrochloride 2 mg/kg was intraperitoneally injected immediately after intratracheal instillation of LPS. The equal volume of normal saline was injected into the airway in group NS, and penehyclidine hydrochloride 2 mg/kg was intraperitoneally injected immediately after intratracheal instillation of normal saline in group PHC+ NS. The rats were sacrificed at 6 h after intratracheal instillation of LPS or normal saline, and lungs were removed. The lung was lavaged and broncho-alveolar lavage fluid (BALF) was collected for determination of concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) by enzyme-linked immunosorbent assay. Lung tissues were obtained for microscopic examination of the pathological changes (with a light microscope) and for determination of wet to dry lung weight ratio (W/D ratio) and TLR4 protein and mRNA expression (by immuno-histochemistry or real-time polymerase chain reaction). Results:Compared with group NS and group PHC+ NS, the W/D ratio and concentrations of TNF-α and IL-1β in BALF were significantly increased, the expression of TLR4 protein and mRNA in lung tissues was up-regulated ( P<0.01), and the pathological changes of lung tissues were aggravated in group ALI . Compared with group ALI, the W/D ratio and concentrations of TNF-α and IL-1β in BALF were significantly decreased, the expression of TLR4 protein and mRNA in lung tissues was down-regulated ( P<0.01), and the pathological changes of lung tissues were significantly mitigated in group PHC+ ALI. Conclusions:The mechanism by which penehyclidine hydrochloride reduces endotoxin-induced lung injury may be related to reduction of TLR4 activity and thus inhibition of pulmonary inflammatory responses in rats.

Comparison of effects of different lung recruitment maneuvers in infants undergoing laparoscopic surgery / 中华麻醉学杂志

Objective:To compare the effects of different lung recruitment maneuvers in infants undergoing laparoscopic surgery.Methods:A total of 70 pediatric patients of either sex, aged 1-6 yr, weighing 10-24 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective laparoscopic surgery from September 2020 to June 2021 with expected operation time≤2 h, were divided into 2 groups ( n=35 each) by a random number table method: recruitment maneuver using incremental positive end-expiratory pressure (PEEP) group (PV group) and recruitment maneuver using controlled lung expansion group (RM group). The children underwent pressure-controlled ventilation after tracheal intubation, and lung recruitment was performed at 20 min after pneumoperitoneum, immediately after pneumoperitoneum, and at the end of operation and before tracheal extubation.In PV group, PEEP was gradually increased, the upper limit of airway pressure was 35 mmHg, PEEP was increased by 5 cmH 2O, ventilation was performed for 30 s, then PEEP was increased to 15 cmH 2O, ventilation was continued for 30 s, then the parameters were adjusted to the original ones, and ventilation was continued until the next lung recruitment.In RM group, manual ventilation mode was used, the pressure valve was adjusted to 30 cmH 2O, the pressure was increased to the maximum by rapid oxygenation, the breathing cuff was manually squeezed until the airway pressure achieved 30-35 mmHg, and 30 s later ventilation was performed with the original ventilation parameters, lasting for 30 s until the next lung recruitment.Peak airway pressure and mean airway pressure were recorded at 5 min after tracheal intubation (T 1), 20 min after pneumoperitoneum (T 2), immediately after pneumoperitoneum (T 3) and before extubation after surgery (T 4), and dynamic lung compliance was calculated.Blood gas analysis was performed at T 2 and T 4, and arterial partial pressure of oxygen and arterial partial pressure of carbon dioxide were recorded, oxygenation index, alveolar-arterial oxygen partial pressure difference and respiratory index were calculated.Lung ultrasonography scores were assessed before tracheal extubation (T 0) and at T 4 and 20 min after entering the postanesthesia care unit (T 5). The time of tracheal extubation and length of postoperative hospital stay were recorded.Hypoxemia in postanesthesia care unit and occurrence of pulmonary complications within 3 days after operation were recorded. Results:Compared with RM group, peak airway pressure and mean airway pressure were significantly decreased at T 2, 3, dynamic lung compliance was increased at T 2-4, arterial partial pressure of oxygen and oxygenation index were decreased , arterial partial pressure of carbon dioxide, alveolar-arterial oxygen partial pressure difference and respiratory index were increased at T 2 and T 4, lung ultrasonography scores were decreased at T 4 and T 5, and the incidence of postoperative hypoxemia was increased, and tracheal extubation time was prolonged in RM group ( P<0.05). Conclusions:Lung recruitment maneuver using incremental PEEP provides better efficacy than that using controlled lung expansion in infants undergoing laparoscopic surgery.

The prevalence of myopic refractive error and its associated risk factors among primary school students in a community in Shanghai / 上海预防医学

Objective To analyze the prevalence of myopic refractive error and its associated risk factors among primary school students in Shanghai Minhang Distict. Methods A total of 11 356 primary school students who participated in the children's refraction screening project in Meilong Community， Minhang District， Shanghai from January 1 to December 31， 2019 were selected for visual inspection and computer optometry Results The detection rate of myopic refractive error among 6-10 year-old students was 45.59%， with a higher rate in girls and older age group. The detection rates of 6-10 year-old students were 22.88% （6 year-old）， 31.77% （7 year-old）， 47.62% （8 year-old）， 60.53% （9 year-old） and 69.84% （10 year-old）， respectively， showing a linear trend（χ 2=1.31， P<0.001）. Multivariate logistic regression revealed that myopic refractive error was statistically significantly associated with gender， age and parents' myopic. Birth weight， preterm birth and body mass index （BMI） had no influence on refractive myopic in primary school students. Conclusion Myopic refractive error is still a major public health problem in primary school students. A combined strategies for myopic refractive error reduction should be called to focus on high risk persons and behaviors.

Effects of Buyang Huanwu Decoction on renal oxidative stress and NF-κB pathway in diabetic nephropathy rats / 国际中医中药杂志

Objective:To observe the effect of Buyang Huanwu Decoction on renal oxidative stress and NF-κB pathway in diabetic nephropathy rats.Methods:Sixty SD rats were randomly divided into normal group, model group, low, medium, and high dose of Buyang Huanwu Decoction groups and metformin group, with 10 rats in each group. The normal group was given ordinary diet every day, and the other groups were given high-fat and high-sugar diet for 6 weeks, then intraperitoneally injected 35 mg/kg STZ to establish diabetic nephropathy model. After successful modeling, the rats were orally injected with 7.42, 14.84 and 29.68 g/kg of low-dose, medium-dose and high-dose Buyang Huanwu Decoction and metformin group was orally given metformin solution 0.2 g/kg. After 6 weeks of feeding, the body weight, 24h urinary protein, serum creatinine and urea nitrogen were detected. The levels of GSH-Px, SOD, CAT and MDA in rats' kidney of each group were detected. The protein expression levels of NF-κBp65, p-NF-κBp65, TNF-α and IL-6 in rats' kidney in each group were detected by Western Blot.Results:Compared with model group, the body weight of the low, medium and high dose of Buyang Huanwu Decoction groups were increased ( P<0.01), the content of 24 h urinary protein, serum creatinine and urea nitrogen were decreased ( P<0.05 or P<0.01),the content of GSH-Px , SOD, CAT were significantly increased ( P<0.05 or P<0.01), the content of MDA was significantly decreased ( P<0.05 or P<0.01), the expression of NF-κB p65 (0.53±0.07, 0.46±0.09, 0.42±0.10 vs. 0.67±0.13), p-NF-κB p65 (0.51±0.12, 0.43±0.06, 0.34±0.17 vs. 0.59±0.07), TNF-α (1.21±0.08, 1.17±0.04, 1.05±0.22 vs. 1.43±0.21), IL-6 (0.92±0.04, 0.89±0.25, 0.73±0.09 vs. 1.06±0.08) were significantly decreased ( P<0.05 or P<0.01). Conclusion:Buyang Huanwu Decoction can improve oxidative stress state and inflammatory damage in renal tissue. The mechanism may be related to the inhibition of NF-κB signaling pathway.

Application of Global Leadership Initiative on Malnutrition criteria in the diagnosis of malnutrition in gastric cancer patients / 中华临床营养杂志

Objective:To retrospectively investigate the incidence of malnutrition in patients with gastric cancer in China, and to explore the applicability of Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria.Methods:Data were extracted from National Multi-center Investigation and Study on Dynamic Changes of Nutritional Status of Inpatients database led by Geriatric Nutrition Support Group of the Chinese Society of Parenteral and Enteral Nutrition. A retrospective analysis in patients with gastric cancer was conducted. Involuntary weight loss, low body mass index (BMI) and muscle mass loss were adopted as phenotypic indicators in GLIM criteria for malnutrition diagnosis and the application of GLIM criteria for malnutrition diagnosis in patients with gastric cancer was evaluated.Results:In a total of 563 gastric cancer patients, 203 cases were diagnosed with malnutrition per GLIM criteria and 193 cases without malnutrition were identified as control using 1:1 propensity score matching. There were significant differences in body weight, BMI, right calf circumference, right hand grip strength, total cholesterol, hemoglobin, albumin and total protein between malnutrition group and non-malnutrition group ( P < 0.05). After muscle mass loss was removed from the phenotype indicators in GLIM criteria, the hospitalization duration in patients with malnutrition was (16.15±7.04) days compared with (14.28±6.70) days in patients without malnutrition, demonstrating statistically significant difference ( χ2= 0.442, P = 0.007). Conclusions:Gastric cancer patients showed high incidence of malnutrition. The cut-off value of calf circumference reported in foreign populations may be unsuitable to apply in Chinese population. Further clinical researches are needed to determine the optimal cut-off calf circumference value for Chinese individuals.

A study on the correlation between nutritional status and frailty among elderly inpatients from cardiology department / 中华临床营养杂志

Objective:To analyze the relationship between nutritional status and frailty among elderly inpatients from cardiology department.Methods:A cross-sectional study was conducted in a total of 519 patients aged 65-92 years old who were admitted to cardiology department between September 2018 and February 2019. Mini nutritional assessment short form (MNA-SF) was used to assess the nutritional status. Fried phenotype was used to assess frailty status. The nutritional status and frailty in patients with different diseases, age and body mass index were analyzed, as well as the nutritional status of patients in different frailty strata.Results:The mean age was 75.12 years (range: 65-92 years). The prevalence of malnutrition risk was 28.9% (150/519), malnutrition 3.3% (17/519) and frailty 23.5% (122/519). When stratified by disease, the subgroup with chronic heart failure showed the highest prevalence of malnutrition and frailty (63.6% and 50.0%, respectively). The prevalence of malnutrition risk (22.8%, 35.5%), malnutrition (3.0%, 3.6%) and frailty (15.3%, 32.3%) were higher in patients ≥ 75 years compared with those aged 65 years - 75 years. MNA-SF score was negatively correlated with age( r = -0.134, P = 0.002). Fried phenotype score was positively correlated with age ( r = 0.319, P < 0.01). As for stratification based on BMI, the majority (62.6%) patients were overweight or obese (BMI ≥ 24.0 kg/m 2) and the prevalence of malnutrition risk in this subgroup was 21.2% (69/325). The prevalence of malnutrition risk in patients with normal BMI was 38.7% (70/181). The subgroup with BMI<18.5 were either at malnutrition risk or with malnutrition. MNA-SF score was positively correlated with BMI ( r = 0.353, P < 0.01). There was no significant difference in the prevalence of pre-frailty and frailty among different BMI groups. The prevalence of malnutrition was the highest in the frailty group (8.2%), followed by the pre-frailty group (2.0%). Fried phenotype score was negatively correlated with MNA-SF score( r = -0.291, P < 0.01). Logistic regression analysis showed that frailty was an independent risk factor for malnutrition, and the risk of malnutrition in frailty patients was 4.818 (95% CI:1.701～13.644) times higher than that in non-frailty patients. Conclusions:The prevalence of malnutrition risk and frailty was high in the elderly inpatients from cardiology department. Frailty patients had a higher incidence of malnutrition and required more attention.

Dynamic changes of in-hospital nutritional status per Global Leadership Initiative on Malnutrition criteria in elderly cancer patients / 中华临床营养杂志

Objective:To investigate the prevalence of malnutrition in hospitalized elderly patients with cancer in China using the Global Leadership Initiative on Malnutrition (GLIM) criteria.Methods:The data of 854 elderly cancer patients were extracted from the database of multi-center investigation and research on the dynamic changes of nutritional status of hospitalized patients in China led by the Geriatric Nutritional Support Group of Chinese Society of Parenteral and Enteral Nutrition. Changes in anthropometrics, nutritional risk and malnutrition prevalence from admission were collected at discharge and were compared among patients with different cancer types.Results:The prevalence of nutritional risk (NRS 2002 score ≥ 3 points) and malnutrition diagnosed per GLIM criteria were 63.23% and 42.74% at admission, and 69.44% and 42.86% at discharge. When further graded, prevalence of moderate malnutrition decreased from 24.12% at admission to 10.07% at discharge, and that of severe malnutrition increased from 18.62% to 32.79%, both with statistical significance. There were significant differences in anthropometric and laboratory parameters between malnutrition and non-malnutrition groups diagnosed per GLIM criteria.Conclusions:The GLIM criteria is applicable for the diagnosis of malnutrition in elderly cancer patients. Elderly cancer patients should be screened for nutritional risk, and GLIM criteria can be used to diagnose malnutrition. The changes of nutritional status should be dynamically monitored during hospitalization

The effects of naringenin on pancreatic fibrosis in chronic pancreatitis mouse model and activation, proliferation and apoptosis of pancreatic stellate cells / 中华胰腺病杂志

Objective:To study the effects of naringenin on pancreatic fibrosis in the mouse model of chronic pancreatitis (CP) and its effects on the activation, proliferation and apoptosis of pancreatic stellate cells (PSCs).Methods:Eighteen C57BL/6 mice were randomly divided into control group, CP group and naringenin group, with 6 mice in each group. The CP mouse model was established by intraperitoneal injections of caerulein. Naringenin group was given naringenin (200 mg/kg/day) by gavage once a day from the first day of the fourth week of modeling process to the day before the killing; the control group and CP group were treated by gavage with an equivalent amount of drug solvent containing 0.5% sodium carboxymethyl cellulose (CMC-Na). Mice were killed 5 days after the last caerulein injection, and their pancreatic tissues were collected for hematoxylin-eosin staining and Sirius Red staining, pathological scoring and collagen sedimentation detection. Naringenin with different concentrations (0, 5, 10, 20, 50, 100, 150, 200 μmol/L) were used to intervene HPSC for 24 hours, and CCK-8 method was used to detect the cell activity. TGF-β1 recombinant protein (2 ng/ml) was used to induce PSCs for 1 hour (TGF-β1 stimulation group), and naringenin with low (50 μmol/L), middle (100 μmol/L) and high (150 μmol/L) concentration was used to intervene for 36 hours after TGF-β1 stimulation, respectively. Western Blotting was used to detect the expression of PSC activation related proteins FN and COL1A1, cell proliferation marker p21, anti-apoptotic protein Bcl-xL, pro-apoptotic protein Bax and Bid.Results:The pathological scores of pancreatic tissue [(7.33±1.15), (4.67±1.15)] and the percentage of collagen positive areas [(46±4), (28±2)%] in CP group and naringenin group were higher than those in the control group [0, (4±2)%]. However, these indexes in the naringenin group were lower than those in CP group, and the differences were all statistically significant (all P value <0.05). The relative expression of FN in control group, TGF-β1 stimulation group and low, medium and high naringenin group was 0.02, 0.76, 0.67, 0.34 and 0.07, respectively; the expression of COL1A1 in these groups was 0.51, 1.71, 1.34, 0.84 and 0.11. The expression of FN and COL1A1 in TGF-β1 stimulation group was significantly higher than that in control group, and the expression of FN and COL1A1 in low, medium and high naringenin group was significantly lower than that in TGF-β1 stimulation group, and the differences were all statistically significant (all P value <0.05). The expression of p21 in the above five groups was 0.87, 1.18, 1.27, 1.22 and 1.00. The expression of p21 in TGF-β1 stimulation group was higher than that in control group, and the expression of p21 in high naringenin group was obviously lower than that in TGF-β1 stimulation group, and the differences were all statistically significant (all P value <0.05). In addition, the expression of Bcl-xL in these groups was 2.09, 2.21, 2.38, 2.50 and 2.12; the expression of Bax was 0.98, 0.88, 0.98, 1.00 and 0.88; the expression of Bid was 1.15, 1.09, 1.14, 1.18 and 1.18. There was no statistically significant difference among these groups (all P value >0.05). Conclusions:Naringenin could significantly alleviate the inflammation, atrophy and fibrosis in the CP mouse model, and inhibit the activation and proliferation of PSCs. However, naringenin had no significant effect on the apoptosis of PSCs, indicating that naringenin may be potentially used to treat pancreatic fibrosis in CP.

Development of rehabilitation medical resources in Jiangsu during Thirteenth Five-year Plan / 中国康复理论与实践

@#Objective To investigate the development of rehabilitation medical resources in Jiangsu during Thirteenth Five-year Plan.Methods The electronic questionnaire was issued uniformly to the medical and health institutions in 13 prefecture-level cities in Jiangsu Province through the Health Commission system, to survey the rehabilitation medical resources data from 2015 to 2019.Results Compared with those in 2015, the secondary and above general hospitals with rehabilitation medicine departments increased 3.42 percentage points and community-level medical and healthcare institutions providing rehabilitation medical services increased 5.67 percentage points at the end of 2019; while, the authorized beds increased 127 and actual beds increased 142 in the rehabilitation department per million population; the early rehabilitation intervention increased 4 326 person-times per million population; there were 91 more rehabilitation professionals per million population, including 25 rehabilitation physicians, 31 rehabilitation therapists, 29 rehabilitation nurses and six other rehabilitation practitioners; the practitioners with associate senior titles and above increased 1.65 percentage points, and those with master-degree or above increased 1.27 percentage points.Conclusion The allocation of various rehabilitation resources has been improved in Jiangsu province during Thirteenth Five-year Plan.