Sema3A secreted by sensory nerve induces bone formation under mechanical loads / 国际口腔科学杂志·英文版

Bone formation and deposition are initiated by sensory nerve infiltration in adaptive bone remodeling. Here, we focused on the role of Semaphorin 3A (Sema3A), expressed by sensory nerves, in mechanical loads-induced bone formation and nerve withdrawal using orthodontic tooth movement (OTM) model. Firstly, bone formation was activated after the 3rd day of OTM, coinciding with a decrease in sensory nerves and an increase in pain threshold. Sema3A, rather than nerve growth factor (NGF), highly expressed in both trigeminal ganglion and the axons of periodontal ligament following the 3rd day of OTM. Moreover, in vitro mechanical loads upregulated Sema3A in neurons instead of in human periodontal ligament cells (hPDLCs) within 24 hours. Furthermore, exogenous Sema3A restored the suppressed alveolar bone formation and the osteogenic differentiation of hPDLCs induced by mechanical overload. Mechanistically, Sema3A prevented overstretching of F-actin induced by mechanical overload through ROCK2 pathway, maintaining mitochondrial dynamics as mitochondrial fusion. Therefore, Sema3A exhibits dual therapeutic effects in mechanical loads-induced bone formation, both as a pain-sensitive analgesic and a positive regulator for bone formation.

Reliability and validity of general procrastination scale in the application of middle school students / 中华行为医学与脑科学杂志

Objective:To test the reliability and validity of the general procrastination scale (GPS) in the application of middle school students.Methods:The Chinese version of GPS, the irrational procrastination scale(IPS), and the Maslach burnout inventory(MBI) were utilized to survey 10 825 middle school students in Harbin City through stratified random sampling, and 4 498 students were retested after 4 weeks. Statistical analysis was performed using SPSS 27.0 and Mplus 8.0.Results:The entries were well differentiated.Exploratory and confirmatory factor analysis indicated that GPS was composed of two factors, including active avoidance and lack of planning.The model fit was good (CFI=0.914, TLI=0.901, RMSEA=0.069, SRMR=0.072). GPS was positively correlated with the total scores of IPS and MBI ( r=0.753, 0.677, both P<0.001). The Cronbach's α coefficient of GPS was 0.864, the folded half reliability was 0.870, and the retest reliability after 4 weeks was 0.756. Conclusion:The GPS has good reliability and validity among middle school students, which provides a standard for measuring the procrastination level of middle school students and carrying out related research.

Clinical results of surgical repair combining an occluder and a patch for ventricular septal rupture after myocardial infarction / 中国胸心血管外科临床杂志

@#Objective     To investigate the effect and prognosis of patients with ventricular septal rupture after myocardial infarction treated by surgical repair combining an occluder and a patch. Methods     Clinical data of 42 patients with myocardial infarction complicated with ventricular septal rupture admitted to the First Affiliated Hospital of Zhengzhou University from January 2010 to September 2021 were retrospectively analyzed. According to the surgical methods, 27 patients were divided into a traditional group, including 17 males and 10 females, with an average age of 62.81±6.81 years, who were repaired by patch only, and 15 patients were divided into a modified group, including 11 males and 4 females, with an average age of 64.27±9.24 years, who were repaired by surgery combining an occluder and a patch. Perioperative and follow-up data of the two groups were compared and analyzed. Results     There were statistical differences between the two groups in preoperative Killip grading, rate of intra-aortic balloon pump use, interval from myocardial infarction to operation, and the number of culprit artery (P<0.05). There was no statistical difference in other preoperative data, the cardiopulmonary bypass time, aortic cross-clamping time, postoperative hospital stay or in-hospital death rate between the two groups (P>0.05). No residual shunt occurred in the modified group, and the difference was statistically significant compared with the traditional group (P=0.038). There was no statistical difference in other complications between the two groups (P>0.05). The median follow-up time was 4 years. Two patients in the traditional group and one in the modified group died during follow-up. The follow-up cardiac function grading of patients in the modified group was statistically different from that in the traditional group (P=0.023). Conclusion     The perioperative  mortality of ventricular septal rupture after myocardial infarction is high, but the long-term effect is satisfactory. Surgical repair combining an occluder and a patch is a safe and effective treatment for ventricular septal rupture, which can effectively reduce postoperative residual shunt.

Bioinformatics analysis of regulatory network of long non-coding RNA LOC107987438 in depressive disorder / 中华行为医学与脑科学杂志

Objective:To investigate the regulatory role of defferentially expressed LOC107987438 in the pathogenesis of depressive disorder and provide a theoretical basis for its clinical application in depressive disorder.Methods:Differential expression of LOC107987438 was verified by quantitative real-time polymerase chain reaction(qRT-PCR)in peripheral blood monocular cells(PBMCs)of 60 patients with depressive disorder and 60 health controls. In addition, its diagnostic value was assessed by receiver operating characteristic(ROC)curves. Based on the ceRNA mechanism of lncRNA, the miRDB database was applied to predict the target miRNAs of LOC107987438, and the miRNAs with target score ≥ 80 among them were screened out.The screened miRNAs were then used to predict their potential target mRNAs through four databases which were TargetScan 8.0, miRTarBase, mirDIP and miRPathDB. Moreover, the predicted target mRNAs were annotated for gene ontology(GO)function annotation and tokoyo encyclopedia of genes and genomes(KEGG) pathway enrichment analysis via ClusterProfiler 4.0.5 package of R 4.1.1. Finally, a protein-protein interaction network was constructed using the STRING 11.5 platform to retrieve the interacting genes.Results:The qRT-PCR results showed that normalized expression of LOC107987438 in PBMCs of patients with depressive disorder was higher than that in health controls(depressive disorder: 2.084±1.357, health controls: 1.000±0.660, P<0.001). The ROC curve results showed that the area under curves(AUC)of LOC107987438 was 0.759(95% CI: 0.675-0.842, P<0.05), indicating its high potential diagnostic value. Bioinformatics analysis showed that hsa-miR-4670-3p, hsa-miR-619-3p, hsa-miR-6721-5p and hsa-miR-297 were the miRNAs with high bindings to LOC107987438. The results of KEGG signaling pathway enrichment revealed that hypoxia-inducible factor 1(HIF-1)signaling pathway, phosphatidylinositol 3-kinase-AKT(PI3K-Akt) signaling pathway and erythroblastic oncogene B(ErbB) signaling pathway were closely associated with depressive disorder. Among the top ten key genes screened by the protein-protein interaction network, kirsten rats arcomaviral oncogene homolog(KRAS), androgen receptor(AR), cyclic-AMP response binding protein1(CREB1), insulin-like growth factor 1(IGF1), cyclin-dependent kinase inhibitor 1B(CDKN1B) and calcium/calmodulin-dependent protein kinase type Ⅱ alpha(CAMK2A)were strongly associated with depressive disorder. Conclusion:The establishment of ceRNA regulatory network of LOC107987438 provides a theoretical basis for exploring the pathophysiology of depressive disorders.

Long-term follow-up of salivary gland protection and improvement of late xerostomia by optimizing clinical target volume in IIB region of nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective:To explore the effect of clinical target volume (CTV) optimization on long-term survival and late xerostomia of patients with nasopharyngeal carcinoma (NPC).Methods:Clinical data of 763 patients with NPC treated with intensity-modulated radiotherapy (IMRT) in the Jiangsu Cancer Hospital from January 2015 to November 2018 were retrospectively analyzed. All patients were divided into the modified and conventional CTV groups. Propensity score matching (PSM) was applied to balance the distribution of baseline features. The degree of xerostomia was evaluated by Radiation Therapy Oncology Group (RTOG) / European Organisation for Research and Treatment of Cancer (EORTC) standard and Jiangsu Cancer Hospital Multi-dimensional Radiotherapy-Induced Xerostomia scale. Survival analysis was performed by Kaplan-Meier method. The difference of xerostomia between two groups was compared by rank-sum test. The dose parameters of salivary glands were compared by independent sample t-test. Prognostic factors of survival and xerostomia were assessed by univariate / multivariate regression analyses. Results:There were no significant differences in overall survival, local recurrence-free survival, distant metastasis-free survival and progression-free survival between conventional and modified CTV groups before and after PSM. There were no significant differences in the incidence of late xerostomia above grade 2 of RTOG/EORTC standard between two groups. Using multi-dimensional scale criteria, NPC patients in the modified CTV group developed less late xerostomia than those in the conventional CTV group ( P<0.05). D mean and V 26 Gy of bilateral parotid glands, D mean and V 39 Gy of bilateral submandibular glands, and D mean of sublingual glands and mouths were reduced after optimization of CTV (all P<0.001). Univariate analysis showed that clinical staging, T staging and N staging were the independent prognostic factors of overall survival. Multivariate analysis demonstrated that clinical staging was the independent prognostic factor of overall survival. The risk factor for xerostomia during night sleep was the D mean of sublingual glands. Conclusion:The optimization of CTV in IIb region in NPC treated with IMRT can better protect salivary glands and reduce the incidence of late radiation-induced xerostomia on the premise of ensuring long-term survival.

AFR-BERT: Attention-based mechanism feature relevance fusion multimodal sentiment analysis model.

Multimodal sentiment analysis is an essential task in natural language processing which refers to the fact that machines can analyze and recognize emotions through logical reasoning and mathematical operations after learning multimodal emotional features. For the problem of how to consider the effective fusion of multimodal data and the relevance of multimodal data in multimodal sentiment analysis, we propose an attention-based mechanism feature relevance fusion multimodal sentiment analysis model (AFR-BERT). In the data pre-processing stage, text features are extracted using the pre-trained language model BERT (Bi-directional Encoder Representation from Transformers), and the BiLSTM (Bi-directional Long Short-Term Memory) is used to obtain the internal information of the audio. In the data fusion phase, the multimodal data fusion network effectively fuses multimodal features through the interaction of text and audio information. During the data analysis phase, the multimodal data association network analyzes the data by exploring the correlation of fused information between text and audio. In the data output phase, the model outputs the results of multimodal sentiment analysis. We conducted extensive comparative experiments on the publicly available sentiment analysis datasets CMU-MOSI and CMU-MOSEI. The experimental results show that AFR-BERT improves on the classical multimodal sentiment analysis model in terms of relevant performance metrics. In addition, ablation experiments and example analysis show that the multimodal data analysis network in AFR-BERT can effectively capture and analyze the sentiment features in text and audio.

Comparative study on the accuracy of different questionnaires in COPD screening / 中华健康管理学杂志

Objective:To compare the accuracy of different questionnaires in chronic obstructive pulmonary disease (COPD) screening.Methods:From January to April 2021, 1 153 subjects aged ≥35 years, visiting the Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of China Medical University, planning to take part in pulmonary function tests, and voluntarily participating in the survey were included. Before the pulmonary function test, the investigators used Lung Function Questionnaire (LFQ), COPD Population Screening Questionnaire (COPD-PS), COPD Diagnostic Questionnaire (CDQ), Revised-CDQ, Primary COPD Diagnosis Acute Exacerbation Risk Assessment Questionnaire (CAPTURE) and COPD Screening Questionnaire (COPD-SQ) to screen COPD patients. Participants were divided into the COPD group and the non-COPD group based on the global initiative for chronic obstructive lung disease (GOLD) 2021 guideline. The receiver operating characteristic (ROC) curve was used to evaluate the screening accuracy of the questionnaires.Results:A total of 720 patients were effectively enrolled, of which 150 were diagnosed with COPD, with a detection rate of 20.83%. The sensitivity and specificity of each questionnaire under the previously recommended cutoff values were: LFQ (86.00%, 48.07%), COPD-PS (78.67%, 58.25%), CDQ (73.33%, 57.19%), Revised-CDQ (85.33%, 46.49%), CAPTURE (80.67%, 41.23%) and COPD-SQ (68.00%, 62.98%). The accuracy of COPD-PS was better than COPD-SQ, LFQ was better than CDQ, COPD-SQ, and CAPTURE. The optimal cutoff value for LFQ was ≤16 points.Conclusion:The LFQ and COPD-PS are recommended for their simplicity and effectiveness in COPD screening.

Study on the compliance willingness and influencing factors of doctors′ clinical pathway compliance in DRG pilot hospitals / 中华医院管理杂志

Objective:To study the influencing factors of doctors′ compliance intention towards clinical pathways at diagnosis-related groups(DRG) pilot hospitals, as a reference in advancing the development of critical pathways management and the transition of DRG payment methods from pilot exploration to actual payment.Methods:With purposive sampling method, an online questionnaire survey was conducted on doctors at 4 tertiary hospitals involved in the DRG pilot in Wuhan from December 2020 to February 2021. The questionnaire covered doctors′ basic personal information, identification degree of three dimensions based on the theory of planned behavior, as well as their past compliance behavior and compliance willingness of clinical pathways. The influence of different factors on doctors′ clinical path compliance intention was analyzed by Kruskal-Wallis test and Wilcoxon signed-rank test, and the ordered multi-class logistic regression analysis was used in multivariate analysis.Results:335 valid questionnaires were obtained, of which 205(61.2%) doctors had high willingness to follow clinical pathways. Such factors as degree of attention to peer doctors′ attitudes towards clinical pathways( OR=16.44), sufficient understanding of the documents( OR=14.91), the adaptation between information systems and clinical pathways( OR=12.54), sufficient learning resources( OR=9.42), and high enrollment rate of their patients in charge in the past six months( OR=5.77), could positively affect the doctors′ willingness to follow clinical pathways. The high enrollment completion rate of patients cared by doctors in the past six months( OR=0.09) and the high mutation rate caused by medical prescriptions( OR=0.00) negatively affected doctors′ compliance intention towards clinical pathway. Conclusions:Most doctors at DRG pilot hospitals had high willingness to comply with the clinical pathways. The main factors affecting their willingness to follow the clinical pathway include, previous relevant work experience, the attitude of peer doctors, and support resources. To increase doctors′ compliance willingness towards clinical pathway, it is necessary to speed up the DRG payment process, adopt a flexible management model, enhance the sense of participation of doctors, and ensure adequate support vesources.

Four-dimensional echocardiography and left ventricular systolic strain measured via two-dimensional speckle-tracking for Danon disease: a case series.

BACKGROUND: Danon disease is an X-linked multisystemic disorder characterized by skeletal myopathy, cardiomyopathy, and intellectual disability. CASE SUMMARY: Herein, we describe two patients affected by Danon disease from the same family, a father (Patient 1) and his daughter (Patient 2). In Patient 1, a short PR interval with pre-excitation was evident. In Patient 2, over a 24-h period 2369 atrial premature beats and rare isolated ventricular ectopics were detected. Both patients exhibited left ventricular hypertrophy with non-compaction myocardium, and the left ventricular ejection fraction was impaired in Patient 1 and normal in Patient 2. In Patient 2, the total left ventricular strain value was reduced, and layer-specific strain revealed that subepicardial strain impaired more than in other layers. Late gadolinium enhancement was detected both in left and right ventricles in Patient 2, and cardiac fibrosis was more apparent in the subepicardium of left ventricular free wall. Four-dimensional (4D) echocardiography revealed that left atrial reservoir strain and left ventricular total longitudinal strain were induced. DISCUSSION: Novel 4D echocardiography and left ventricular systolic strain may play important role in diagnosis and myocardial functional evaluation in Danon disease.

Construction and Verification of a Radiation Pneumonia Prediction Model Based on Multiple Parameters.

OBJECTIVE: Patients with lung cancer are at risk of radiation pneumonia (RP) after receiving radiotherapy. We established a prediction model according to the critical indicators extracted from radiation pneumonia patients. MATERIALS AND METHODS: 74 radiation pneumonia patients were involved in the training set. Firstly, the clinical data, hematological and radiation dose parameters of the 74 patients were screened by Logistics regression univariate analysis according to the level of radiation pneumonia. Next, Stepwise regression analysis was utilized to construct the regression model. Then, the influence of continuous variables on RP was tested by smoothing function. Finally, the model was externally verified by 30 patients in validation set and visualized by R code. RESULTS: In the training set, there was 40 patients suffered≥ level 2 acute radiation pneumonia. Clinical data (diabetes), blood indexes (lymphocyte percentage, basophil percentage, platelet count) and radiation dose (V15 > 40%, V20 > 30%, V35 >18%, V40 > 15%) were related to radiation pneumonia (P < 0.05). Particularly, stepwise regression analysis indicated that the history of diabetes, the basophils percentage, platelet count and V20 could be the best combination used for predicting radiation pneumonia. The column chart was obtained by fitting the regression model with the combined indicator. The receiver operating characteristic (ROC) curve showed that the AUC in the development term was 0.853, the AUC was 0.656 in the validation term. And calibration curves of both groups showed the high stability in efficiently diagnostic. Furthermore, the DCA curve showed that the model had a satisfactory positive net benefit. CONCLUSION: The combination of the basophils percentage, platelet count and V20 is available to build a predictive model of radiation pneumonia for patients with advanced lung cancer.