Progress of research on health effects and healthy risk assessment of ionizing radiation / 中国辐射卫生

Occupational exposure to ionizing radiation represents a critical factor contributing to health risks in workplaces. Previous experimental and clinical studies have demonstrated that ionizing radiation affects human health. Therefore, scientific assessment of health risk caused by ionizing radiation and effective protection against ionizing radiation are of great importance to formulate the preventive interventions against occupational exposure to ionizing radiation. This review summarizes the advances in the research on health effects, health risk assessment methods, and protective interventions of ionizing radiation. We call for research on the health effects of low-dose radiation, individual difference, and optimization of preventive strategies. In addition, improved mechanisms of health monitoring, periodical healthy examinations, and monitoring of radiation doses should be implemented. Moreover, strict compliance to operating procedures and occupational preventive interventions are recommended. These measures aim to minimize the potential harmlessness of occupational exposure to ionizing radiation, thereby safeguarding the health and safety of individuals exposed to ionizing radiation.

Mechanism of ferroptosis induced by endoplasmic reticulum stress in sepsis related lung injury / 安徽医科大学学报

Objective @#To explore the mechanism of ferroptosis induced by endoplasmic reticulum stress (ERs ) in acute respiratory distress syndrome (ARDS) .@*Methods @#In order to determine the effects of LPS on oxidative stress and Fe2 + level of mouse capillary alveolar epithelial cells (MLE12 cells ) , the cells were treated with LPS (0 , 1 , 2 , 5 μg/ml) for 24 h . To verify the role of ferroptosis in lipopolysaccharide ( LPS)-induced cell death , MLE12 cells were divided into control ( Con ) group , iron removal inhibitor ( Fer-1) group , LPS group and LPS + Fer-1 group . LPS + Fer-1 group was pretreated with 10 μmol/L Fer-1 for 6 h , then the cells were exposed to 5 μg/ml LPS for 24 h . Con group was treated with solvent DMSO for 24 h . Fer-1 group was pretreated with 10 μmol/L Fer-1 for 6 h , and then treated with DMSO for 24 h . The cells in LPS group were exposed to 5 μg/ml LPS for 24 h . The MLE12 cells were divided into three groups : Con + Vector group , Con + sequence similarity family 134 mem ber B ( FAM134B ) group , LPS + Vector group and LPS + FAM134B group . After transfected with vector or FAM134B overexpression plasmid for 48 h , the cells were exposed or not exposed to 5 μg/ml LPS for 24 h . Cell viability was measured by CCK-8 . The levels of malondialdehyde (MDA) , glutathione and iron , the protein levels of ferroptosis markers [ cyclooxygenase 2(PTGS2) , glutathione peroxidase 4(GPX4)] and ERs markers [glucose reg ulatory protein 78( GRP78) , activated transcription factor 4 ( ATF4) and C/EBP homologous protein ( CHOP)] were measured in different groups . In order to further confirm the results of in vitro cell experiments , 40 mice were randomly divided into Con + Vector group , Con + FAM134B group , LPS + Vector group and LPS + FAM134B group , with 10 mice in each group . LPS induced sepsis models were established in LPS + Vector group and LPS + FAM134B group , and the levels of GPX4 and ERs in lung tissue were evaluated by immunofluorescence staining and protein blot. @*Results @#LPS treatment increased the levels of PTGS2 and MDA , and decreased the levels of GPX4 and GSH in MLE12 cells in a dose dependent manner. Compared with LPS group , the cell viability , GPX4 and GSH levels in LPS + Fer-1 group increased significantly (P < 0.05) , while the PTGS2 protein level and MDA level decreased significantly (P < 0.05) . Compared with LPS + Vector group , LPS + FAM134B group significantly increased cell viability (P < 0.05) , decreased PTGS2 protein level (P < 0.05) and increased GPX4 level ( P < 0.05) . At the same time , the level of MDA in LPS + FAM134B group was lower than that in LPS + Vector group (P < 0.05) , and the level of GSH was higher than that in LPS + Vector group (P < 0.05) . In animal experiment , compared with LPS + Vector group , the expression levels of 4 HNE , ATF4 and CHOP in lung tissue of LPS + FAM134B group decreased significantly ( P < 0.05 ) , and the expression levels of GPX4 , FAM134B group in creased significantly (P < 0.05) .@*Conclusion @#LPS induces ferroptosis and ERs in MLE12 cells in a dose depend ent manner. Activating the endoplasmic reticulum autophagy associated FAM134B receptor helps to inhibit ERs and alleviate cell ferroptosis .

Application of subspecialty group collaboration combined with disease checklist-driven learning for professional postgraduate training / 中华医学教育探索杂志

Objective:To explore the value of subspecialty group collaboration combined with disease checklist-driven learning in overcoming the impact of the specialized disease treatment mode in subspecialty establishment on the cultivation of professional postgraduate students.Methods:In the teaching of general surgery and gastroenterology, sixty professional postgraduate students of grade 2019 were randomly divided into control group and experimental group, with 30 students in each group. The control group received traditional teaching, while the experimental group received the teaching mode of subspecialty group collaboration combined with disease checklist-driven learning. The teaching effectiveness and the degree of satisfaction with teaching were compared between the two groups. The data were analyzed using the t test and the chi-squared test using SPSS 20.0. Results:In actual teaching, compared with the control group, the experimental group showed significantly higher scores of theoretical assessment (71.51±11.32 vs. 87.23±10.51, P<0.05) and case analysis (73.61±6.82 vs. 92.37±6.87, P<0.05). The rates of satisfaction with theoretical knowledge learning, application of clinical thinking ability for diseases, teaching organization forms, and teaching effectiveness were 90.00%(27/30), 86.67%(26/30), 96.67%(29/30), and 93.33%(28/30) in the experimental group, respectively, which were significantly higher than those of the control group [40.00%(12/30), 23.33%(7/30), 40.00%(12/30), and 46.67%(14/30), respectively; all P<0.05]. Conclusions:The subspecialty group collaboration combined with disease checklist-driven learning mode can overcome the problems of "narrow disease spectrum and narrow knowledge scope" in specialized postgraduate education, and guide students to break the teaching barriers generated by subspecialty construction to create a new form of comprehensive and multi-disease learning, with good prospects for promotion and application.

Analysis of individual dose monitoring results for radiation workers in Shandong province from 2016 to 2020 / 中华放射医学与防护杂志

Objective:To summarize the levels of individual dose to radiation workers in Shandong province from 2016 to 2020, and to analyze the trends in their change in order to provide scientific basis for radiation workers′ health management.Methods:The experimental detection and quality control were carried out in compliance with the national standards Specifications for individual monitoring of occupational external exposure (GBZ 128-2019) and the Testing criteria of personnel dosimetry performance for external exposure (GBZ 207-2016). The result of the personal dose monitoring of occupational external exposure of all radiation workers monitored by the Centers for Disease Control and Prevention in 16 cities of Shandong province were retrospectively analyzed by using SPSS 23.0 software.Results:The total number of monitored workers were 25 523 with an average annual individual effective dose of 0.28 mSv. There were statistically significant differences among radiation workers in different years ( H= 2 815.91, P<0. 001). The average annual individual effective dose showed an upward trend followed by a downward trend. The average annual effective dose of 0.55 mSv for nuclear medicine radiation workers in medical applications was the highest, with statistically significant differences among different occupational radiation workers ( H=310.37, P<0.001). The average annual effective dose of 0.37 mSv for radioactivity logging workers in industrial applications was the highest, with statistically significant differences among different occupational radiation workers ( H=448.07, P<0. 001). The average annual effective dose to radiation workers in medical applications was higher than in industrial applications ( Z = -14.93, P<0.001). Conclusions:The average annual effective dose to nuclear medicine radiation workers in medical applications and logging radiation workers in industrial applications are relatively high. There would be a push to furthe improve workplace protection measures and strengthen the management and supervision of radiological workers.

Association between atrial fibrillation reoccurrence and new-onset ischemic stroke among patients with nonvalvular atrial fibrillation / 中华心血管病杂志

Objective: Explore the association between atrial fibrillation (AF) reoccurrence and new-onset ischemic stroke (IS) in patients with nonvalvular AF, and explore whether there is a high-risk period of IS after recurrent episodes of AF. Methods: A nested case-control study design was used. A total of 565 nonvalvular AF patients with new-onset IS after a follow-up of at least 2 years in the China-AF cohort were enrolled as the case group, and 1 693 nonvalvular AF patients without new-onset IS were matched as the control group at a ratio of 1∶3. Frequency and types of recurrent AF in the previous 1 or 2 years were compared between two groups, and the adjusted associations of AF reoccurrence with new onset IS were explored using conditional logistic regression analysis. The proportion of recurrent AF was compared between the case period and control period, and conditional logistic regression analysis was performed to calculate adjusted associations of case-period AF with IS. Results: The nested case-control study design results showed that the proportion of at least one record of recurrent AF in the previous 1 year was higher in the case group than in the control group (72.0% vs. 60.8%, P<0.05), and the recurrent AF was positively correlated with new-onset IS (adjusted OR=1.80, P<0.001). Similar results were also observed in the previous 2 years period. The case-crossover study design analysis showed that among 565 patients with new-onset IS, recurrent AF in the case period was positively correlated with IS (adjusted OR=1.61, P=0.003). Conclusion: Recurrent AF is associated with IS, and there may be a high-risk period of IS after recurrent episodes of AF.

Establishment of a rapid method for detection of influenza A/B virus' antigens / 中华预防医学杂志

This study aims to develop a rapid and convenient test card for simultaneous detection of influenza A and influenza B viruses using quantum dot-based immunochromatographic assay. The test card consists of a test strip and a plastic casing. The test strip is composed of absorbent paper, a buffer pad, nitrocellulose membrane (NC membrane), sample pad, quantum dot-labeled antibody pad, and polyvinyl chloride (PVC) board. The NC membrane is coated with mouse monoclonal antibodies against influenza A and influenza B viruses for the T lines (test lines), and reference proteins A and B for the C line (control line). The quantum dot-labeled antibody pad contains mouse monoclonal antibody-quantum dot conjugates against influenza A and influenza B viruses. The results showed that the detection limit of the test card for both viruses ranged from 1.51 ×102 to 2.71×103 TCID50/ml, indicating its sensitivity for accurate detection of influenza A and influenza B viruses without being affected by various variants. The test card exhibited specific reactions with different subtypes of influenza A and influenza B virus culture fluids and showed no cross-reactivity with adenovirus, novel coronavirus, Mycoplasma pneumoniae, respiratory syncytial virus, Staphylococcus aureus, and other pathogens. Overall, the sensitivity and specificity of the test card for simultaneous detection of influenza A and influenza B viruses meet the requirements for clinical use. It offers the advantages of simplicity, rapidity, and no requirement for special equipment, enabling quick auxiliary diagnosis to prevent disease transmission.

Research progress on the preventive and therapeutic effects of exercise on gestational diabetes mellitus / 中华预防医学杂志

Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy, which poses a serious health risk to mothers and infants. In recent years, many studies have revealed the important role of exercise in preventing GDM, regulating blood glucose and ameliorating insulin resistance, as well as its potential value as an emerging therapeutic approach in improving maternal and infant outcomes and long-term health. This review discusses the latest research progress on the effect of exercise on the prevention and treatment of GDM, aims to deepen the knowledge of exercise therapy for GDM and provides guidance and assistance for the clinical treatment of GDM.

Association between atrial fibrillation reoccurrence and new-onset ischemic stroke among patients with nonvalvular atrial fibrillation / 中华心血管病杂志

Objective: Explore the association between atrial fibrillation (AF) reoccurrence and new-onset ischemic stroke (IS) in patients with nonvalvular AF, and explore whether there is a high-risk period of IS after recurrent episodes of AF. Methods: A nested case-control study design was used. A total of 565 nonvalvular AF patients with new-onset IS after a follow-up of at least 2 years in the China-AF cohort were enrolled as the case group, and 1 693 nonvalvular AF patients without new-onset IS were matched as the control group at a ratio of 1∶3. Frequency and types of recurrent AF in the previous 1 or 2 years were compared between two groups, and the adjusted associations of AF reoccurrence with new onset IS were explored using conditional logistic regression analysis. The proportion of recurrent AF was compared between the case period and control period, and conditional logistic regression analysis was performed to calculate adjusted associations of case-period AF with IS. Results: The nested case-control study design results showed that the proportion of at least one record of recurrent AF in the previous 1 year was higher in the case group than in the control group (72.0% vs. 60.8%, P<0.05), and the recurrent AF was positively correlated with new-onset IS (adjusted OR=1.80, P<0.001). Similar results were also observed in the previous 2 years period. The case-crossover study design analysis showed that among 565 patients with new-onset IS, recurrent AF in the case period was positively correlated with IS (adjusted OR=1.61, P=0.003). Conclusion: Recurrent AF is associated with IS, and there may be a high-risk period of IS after recurrent episodes of AF.

Establishment of a rapid method for detection of influenza A/B virus' antigens / 中华预防医学杂志

This study aims to develop a rapid and convenient test card for simultaneous detection of influenza A and influenza B viruses using quantum dot-based immunochromatographic assay. The test card consists of a test strip and a plastic casing. The test strip is composed of absorbent paper, a buffer pad, nitrocellulose membrane (NC membrane), sample pad, quantum dot-labeled antibody pad, and polyvinyl chloride (PVC) board. The NC membrane is coated with mouse monoclonal antibodies against influenza A and influenza B viruses for the T lines (test lines), and reference proteins A and B for the C line (control line). The quantum dot-labeled antibody pad contains mouse monoclonal antibody-quantum dot conjugates against influenza A and influenza B viruses. The results showed that the detection limit of the test card for both viruses ranged from 1.51 ×102 to 2.71×103 TCID50/ml, indicating its sensitivity for accurate detection of influenza A and influenza B viruses without being affected by various variants. The test card exhibited specific reactions with different subtypes of influenza A and influenza B virus culture fluids and showed no cross-reactivity with adenovirus, novel coronavirus, Mycoplasma pneumoniae, respiratory syncytial virus, Staphylococcus aureus, and other pathogens. Overall, the sensitivity and specificity of the test card for simultaneous detection of influenza A and influenza B viruses meet the requirements for clinical use. It offers the advantages of simplicity, rapidity, and no requirement for special equipment, enabling quick auxiliary diagnosis to prevent disease transmission.

Research progress on the preventive and therapeutic effects of exercise on gestational diabetes mellitus / 中华预防医学杂志

Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy, which poses a serious health risk to mothers and infants. In recent years, many studies have revealed the important role of exercise in preventing GDM, regulating blood glucose and ameliorating insulin resistance, as well as its potential value as an emerging therapeutic approach in improving maternal and infant outcomes and long-term health. This review discusses the latest research progress on the effect of exercise on the prevention and treatment of GDM, aims to deepen the knowledge of exercise therapy for GDM and provides guidance and assistance for the clinical treatment of GDM.

Research on the Existing Problems and Countermeasures of Home-based Elderly Care Services in China / 中国医学伦理学

At present, China’s response to the aging population situation is unprecedentedly urgent, and the construction and planning of the pension system face great challenges. Home-based elderly care services stand out in institutional-based elderly care and family-based elderly care due to their unique advantages in meeting the individual needs of the elderly. By sorting out the main types, policy lines, and supply and demand status of home-based elderly care service, this paper indicated that there are five aspects of problems in home-based elderly care service, including weak professional talent team construction, relatively insufficient capital investment, weak supply-demand matching, imperfect operating mechanism, and imperfect supporting facilities. It was proposed that in the future home-based elderly care services should strive to strengthen the construction of professional talent teams, widen financing channels, fully play the leading role of the government, perfect the operational mechanism and the construction of supporting facilities of home-based elderly care services, so as to provide reference for the optimization of the home-based elderly care service system in China.

Chinese Guideline on the Management of Polypoidal Choroidal Vasculopathy (2022) / 中国医学科学杂志(英文版)

Background In mainland China, patients with neovascular age-related macular degeneration (nAMD) have approximately an 40% prevalence of polypoidal choroidal vasculopathy (PCV). This disease leads to recurrent retinal pigment epithelium detachment (PED), extensive subretinal or vitreous hemorrhages, and severe vision loss. China has introduced various treatment modalities in the past years and gained comprehensive experience in treating PCV.Methods A total of 14 retinal specialists nationwide with expertise in PCV were empaneled to prioritize six questions and address their corresponding outcomes, regarding opinions on inactive PCV, choices of anti-vascular endothelial growth factor (anti-VEGF) monotherapy, photodynamic therapy (PDT) monotherapy or combined therapy, patients with persistent subretinal fluid (SRF) or intraretinal fluid (IRF) after loading dose anti-VEGF, and patients with massive subretinal hemorrhage. An evidence synthesis team conducted systematic reviews, which informed the recommendations that address these questions. This guideline used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach to assess the certainty of evidence and grade the strengths of recommendations. Results The panel proposed the following six conditional recommendations regarding treatment choices. (1) For patients with inactive PCV, we suggest observation over treatment. (2) For treatment-na?ve PCV patients, we suggest either anti-VEGF monotherapy or combined anti-VEGF and PDT rather than PDT monotherapy. (3) For patients with PCV who plan to initiate combined anti-VEGF and PDT treatment, we suggest later/rescue PDT over initiate PDT. (4) For PCV patients who plan to initiate anti-VEGF monotherapy, we suggest the treat and extend (T&E) regimen rather than the pro re nata (PRN) regimen following three monthly loading doses. (5) For patients with persistent SRF or IRF on optical coherence tomography (OCT) after three monthly anti-VEGF treatments, we suggest proceeding with anti-VEGF treatment rather than observation. (6) For PCV patients with massive subretinal hemorrhage (equal to or more than four optic disc areas) involving the central macula, we suggest surgery (vitrectomy in combination with tissue-plasminogen activator (tPA) intraocular injection and gas tamponade) rather than anti-VEGF monotherapy. Conclusions Six evidence-based recommendations support optimal care for PCV patients' management.

Current use of oral anticoagulation therapy and influencing factors among coronary artery disease patients with nonvalvular atrial fibrillation in China / 中华心血管病杂志

Objective: To investigate current use of oral anticoagulant (OAC) therapy and influencing factors among coronary artery disease (CAD) patients with nonvalvular atrial fibrillation (NVAF) in China. Methods: Results of this study derived from "China Atrial Fibrillation Registry Study", the study prospectively enrolled atrial fibrillation (AF) patients from 31 hospitals, and patients with valvular AF or treated with catheter ablation were excluded. Baseline data such as age, sex and type of atrial fibrillation were collected, and drug history, history of concomitant diseases, laboratory results and echocardiography results were recorded. CHA2DS2-VASc score and HAS-BLED score were calculated. The patients were followed up at the 3rd and 6th months after enrollment and every 6 months thereafter. Patients were divided according to whether they had coronary artery disease and whether they took OAC. Results: 11 067 NVAF patients fulfilling guideline criteria for OAC treatment were included in this study, including 1 837 patients with CAD. 95.4% of NVAF patients with CAD had CHA2DS2-VASc score≥2, and 59.7% of patients had HAS-BLED≥3, which was significantly higher than NVAF patients without CAD (P<0.001). Only 34.6% of NVAF patients with CAD were treated with OAC at enrollment. The proportion of HAS-BLED≥3 in the OAC group was significantly lower than in the no-OAC group (36.7% vs. 71.8%, P<0.001). After adjustment with multivariable logistic regression analysis, thromboembolism(OR=2.48,95%CI 1.50-4.10,P<0.001), left atrial diameter≥40 mm(OR=1.89,95%CI 1.23-2.91,P=0.004), stain use (OR=1.83,95%CI 1.01-3.03, P=0.020) and β blocker use (OR=1.74,95%CI 1.13-2.68,P=0.012)were influence factors of OAC treatment. However, the influence factors of no-OAC use were female(OR=0.54,95%CI 0.34-0.86,P=0.001), HAS-BLED≥3 (OR=0.33,95%CI 0.19-0.57,P<0.001), and antiplatelet drug(OR=0.04,95%CI 0.03-0.07,P<0.001). Conclusion: The rate of OAC treatment in NVAF patients with CAD is still low and needs to be further improved. The training and assessment of medical personnel should be strengthened to improve the utilization rate of OAC in these patients.

New research advances in the prospective cohort study of gestational diabetes mellitus / 中华预防医学杂志

Gestational diabetes mellitus (GDM) is associated with an increased risk of suffering diverse adverse pregnancy outcomes, threating maternal and child health seriously, with an increasing incidence rate year by year. However, the exact cause of GDM is still unknown. Prospective cohort studies obtain data through follow-up, which is helpful to clarify the causal relationship, so as to draw more accurate and reliable conclusions. In recent years, numerous prospective cohort studies on the GDM have emerged. This article elaborates along the occurrence and development process of GDM, in order to provide useful reference for the establishment of relevant high-quality prospective cohort studies in China.

Expert consensus on late stage of critical care management / 中华内科杂志

We wished to establish an expert consensus on late stage of critical care (CC) management. The panel comprised 13 experts in CC medicine. Each statement was assessed based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principle. Then, the Delphi method was adopted by 17 experts to reassess the following 28 statements. (1) ESCAPE has evolved from a strategy of delirium management to a strategy of late stage of CC management. (2) The new version of ESCAPE is a strategy for optimizing treatment and comprehensive care of critically ill patients (CIPs) after the rescue period, including early mobilization, early rehabilitation, nutritional support, sleep management, mental assessment, cognitive-function training, emotional support, and optimizing sedation and analgesia. (3) Disease assessment to determine the starting point of early mobilization, early rehabilitation, and early enteral nutrition. (4) Early mobilization has synergistic effects upon the recovery of organ function. (5) Early functional exercise and rehabilitation are important means to promote CIP recovery, and gives them a sense of future prospects. (6) Timely start of enteral nutrition is conducive to early mobilization and early rehabilitation. (7) The spontaneous breathing test should be started as soon as possible, and a weaning plan should be selected step-by-step. (8) The waking process of CIPs should be realized in a planned and purposeful way. (9) Establishment of a sleep-wake rhythm is the key to sleep management in post-CC management. (10) The spontaneous awakening trial, spontaneous breathing trial, and sleep management should be carried out together. (11) The depth of sedation should be adjusted dynamically in the late stage of CC period. (12) Standardized sedation assessment is the premise of rational sedation. (13) Appropriate sedative drugs should be selected according to the objectives of sedation and drug characteristics. (14) A goal-directed minimization strategy for sedation should be implemented. (15) The principle of analgesia must be mastered first. (16) Subjective assessment is preferred for analgesia assessment. (17) Opioid-based analgesic strategies should be selected step-by-step according to the characteristics of different drugs. (18) There must be rational use of non-opioid analgesics and non-drug-based analgesic measures. (19) Pay attention to evaluation of the psychological status of CIPs. (20) Cognitive function in CIPs cannot be ignored. (21) Delirium management should be based on non-drug-based measures and rational use of drugs. (22) Reset treatment can be considered for severe delirium. (23) Psychological assessment should be conducted as early as possible to screen-out high-risk groups with post-traumatic stress disorder. (24) Emotional support, flexible visiting, and environment management are important components of humanistic management in the intensive care unit (ICU). (25) Emotional support from medical teams and families should be promoted through"ICU diaries"and other forms. (26) Environmental management should be carried out by enriching environmental content, limiting environmental interference, and optimizing the environmental atmosphere. (27) Reasonable promotion of flexible visitation should be done on the basis of prevention of nosocomial infection. (28) ESCAPE is an excellent project for late stage of CC management.

Catheter ablation versus medical therapy for atrial fibrillation with prior stroke history: a prospective propensity score-matched cohort study / 老年心脏病学杂志（英文版）

BACKGROUND@#Patients with atrial fibrillation (AF) and prior stroke history have a high risk of cardiovascular events despite anticoagulation therapy. It is unclear whether catheter ablation (CA) has further benefits in these patients.@*METHODS@#AF patients with a previous history of stroke or systemic embolism (SE) from the prospective Chinese Atrial Fibrillation Registry study between August 2011 and December 2020 were included in the analysis. Patients were matched in a 1:1 ratio to CA or medical treatment (MT) based on propensity score. The primary outcome was a composite of all-cause death or ischemic stroke (IS)/SE.@*RESULTS@#During a total of 4.1 ± 2.3 years of follow-up, the primary outcome occurred in 111 patients in the CA group (3.3 per 100 person-years) and in 229 patients in the MT group (5.7 per 100 person-years). The CA group had a lower risk of the primary outcome compared to the MT group [hazard ratio (HR) = 0.59, 95% CI: 0.47-0.74, P < 0.001]. There was a significant decreasing risk of all-cause mortality (HR = 0.43, 95% CI: 0.31-0.61, P < 0.001), IS/SE (HR = 0.73, 95% CI: 0.54-0.97, P = 0.033), cardiovascular mortality (HR = 0.32, 95% CI: 0.19-0.54, P < 0.001) and AF recurrence (HR = 0.33, 95% CI: 0.30-0.37, P < 0.001) in the CA group compared to that in the MT group. Sensitivity analysis generated consistent results when adjusting for time-dependent usage of anticoagulants.@*CONCLUSIONS@#In AF patients with a prior stroke history, CA was associated with a lower combined risk of all-cause death or IS/SE. Further clinical trials are warranted to confirm the benefits of CA in these patients.

Relationship between nucleoprotein TAR DNA/RNA binding protein 43 and mouse amyotrophic lateral sclerosis / 解剖学报

Objective Transgenic mice expressing human TAR DNA/RNA binding protein 43 (hTDP-43) mutant protein in spinal cord motor neurons were constructed using HB9 promoter to establish a disease model of amyotrophic lateral sclerosis ( ALS) and explore the mechanism of ALS induced by hTDP-43 mutation. Methods HB9 promoter junction mutant hTDP-43 vector was constructed in vitro, and the positive transgenic mouse strains were prepared by prokaryotic injection and screened (There were 8-10 mutations at Q331K and M337V). Gait analysis, rotary rod fatigue test, and suspension test were used to detect locomotion ability of mice. Immunohistochemistry, immunofluorescence staining and Western blotting were used to detect hTDP-43, phosphorylated HTDP-43 ( p-hTDP-43) , Caspase-3, cleaved Caspase-3, respectively. Expression of ubiquitin, (3-tubulinIH(Tujl) , Ki67 and cyclin-dependent kinase 5 (CDK5) proteins were also detected. Results In transgenic mice expressing mutant hTDP-43 protein in spinal motor neurons, both hind limbs were atrophied to the trunk side, and motor function showed progressive decline with increasing age. hTDP-43, p-hTDP-43, Caspase-3, and cleaved Caspase-3 were observed in spinal motor neurons Caspase-3 positive staining and ubiquitin protein positive inclusion body, and in vitro isolation and culture of spinal motor neurons, it was found that hTDP-43 and ubiquitin protein co-located in choline acetyl translocation enzyme ( ChAT) positive motor neurons, accompanied by ectopic expression of CDK5. Conclusion The mutant HDP 43 protein expressed in mouse spinal cord motor neurons can promote the re-entry of differentiated mature neurons into the cell cycle, leading to the occurrence of ALS.

The protective effect of scalp acupuncture on cerebral neurons in rats with ischemic stroke and its influence on PI3K/AKt pathway / 西安交通大学学报(医学版)

【Objective】 To investigate scalp acupuncture’s protective effect on brain neurons and its effect on motor function in ischemic stroke rats and the possible mechanisms. 【Methods】 The rat model of ischemic stroke was prepared by the modified Longa suture method； the rats were randomly divided into model group， scalp acupuncture treatment group， inhibitor group， scalp acupuncture treatment + inhibitor group， and sham operation group. After a series of interventions， we evaluated the neurological， behavioral and motor functions of rats in each group after the treatment was over. TTC staining was used to detect cerebral infarction area. Neuron morphology was observed by Nissl staining. qPCR and Western blotting were used to detect the mRNA and protein expression levels of genes related to phosphatidyl inositol-3-kinase （PI3K）/serine-threonine protein kinase （AKt） pathway in the ischemic brain tissue of the rats. 【Results】 In the inhibitor group， the model group， the scalp acupuncture treatment group， and the scalp acupuncture treatment+inhibitor group， the neurological impairment and motor function score gradually decreased， the escape latency gradually shortened， the target quadrant residence time prolonged， the proportion of cerebral infarction area decreased， the number of Nissl bodies increased， the relative expressions of PI3K and AKt mRNA and protein increased （P<0.05）， and the neuronal morphology improved. 【Conclusion】 Scalp acupuncture can protect cerebral neurons of rats with ischemic stroke and enhance their motor function. The mechanism may be related to the regulation of PI3K/AKt signaling pathway.

Analysis of influencing factors for the development of gallstone in population of Beijing / 中华消化外科杂志

Objective:To investigate the influencing factors for the development of gall-stone in population of Beijing.Methods:The retrospective cross-sectional survey was conducted. From November 2016 to September 2020, patients living in Beijing (registered residence in Beijing ≥12 months) who visited the biliary outpatient of Department of General Surgery of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences for the first time were recruited to participate as respondents. The survey was conducted by the questionnaire survey on correlation between dietary habits and incidence of gallstones, in which the information of gender, age, body mass index (BMI), gallstone status, metabolic indicators (hypercholesterolemia, history of diabetes mellitus, reproductive times for female, menopause status of female, duration of menopause for female, history of weight loss), dietary indicators (dietary mix of meat and vegetable dishes, times of coffee intake per month, times of alcohol consumption per month, times of greasy diet intake per month, times of breakfast skipping per week, average overnight fasting time of breakfast skipping, times of supper skipping per week, average overnight fasting time of supper skipping), family history of gallstones, lifestyle indicators (times of staying up late per month, average overnight fasting time when staying up late, daily sedentary time, weekly physical activity score). Observation indicators: (1) results of questionnaire survey; (2) analysis of influencing factors for the occurrence of gallstone. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were expressed as absolute numbers or percentages. Univariate and multivariate analyses were performed using the Logistic regression model. Results:(1) Results of questionnaire survey. A total of 1 036 questionnaires were distributed, and 1 004 complete questionnaires were recovered. Of the 1 004 patients who completed the questionnaire survey, there were 329 males and 675 females, aged (44±12)years. The BMI of 1 004 patients was (24±3)kg/m 2. Of the 1 004 patients, there were 659 cases with a history of cholecystolithiasis and 345 cases without. (2) Analysis of influencing factors for the occurrence of gallstone. Results of univariate analysis showed that age, history of diabetes mellitus, history of weight loss, times of coffee intake per month, times of greasy diet intake per month, family history of gallstone and daily sedentary time were related factors for the development of gallstone in 1 004 patients ( odds ratio=1.03, 2.26, 1.74, 1.01, 1.01, 2.22, 1.06, 95% confidence intervals as 1.02?1.05, 1.09?5.18, 1.22?2.53, 1.00?1.03, 1.00?1.01, 1.60?3.11, 1.01?1.11, P<0.05). Results of multivariate analysis showed that age, history of diabetes mellitus, history of weight loss, times of greasy diet intake per month, family history of gallstone and daily sedentary time were independent influencing factors for the development of gallstone in 1 004 patients ( odds ratio=1.03, 2.26, 1.82, 1.01, 2.22, 1.06, 95% confidence intervals as 1.02?1.05, 1.11?5.13, 1.28?2.62, 1.00?1.02,1.60?3.09, 1.01?1.12, P<0.05). Conclusion:Age, history of diabetes mellitus, history of weight loss, times of greasy diet intake per month, family history of gallstone and daily sedentary time are independent influencing factors for the development of gallstone in population of Beijing.

Survey of current radiological health capabililty of 16 disease control centers at prefecture-level in Shandong province / 中华放射医学与防护杂志

Objective:To survey the current radiological health capability of 16 perferture-level disease control centers (CDCs) in Shandong province and analyze their shortcomings and disadvantages, in order to provide relevant reference basis for the radiological health capability building of such CDCs.Methods:Survey was carried out of radiology department, radiological health staff, equipment allocation, capabillity building and scientific research of these CDCs, together with the relevant data obtained being statistically analyzed.Results:In these CDCs of 16 cities in Shandong province, there were 70 staff engaged in radiological health, with 3 cities having independent radiological departments in place. There were statistically significant differences between independent departments and non-independent departments in the exclusive use of X-ray diagnostic examination equipment, medical electron accelerator examination equipment and on-site quality control testing work ( χ2=0.04, 0.01, 0.04, P<0.05). Between inland and coastal cities there was statistically significant difference in the capability dealing with nuclear and radiological emergency ( χ2=0.02, P<0.05). Conclusions:Independent departments are more conducive to the implement of government′s functional tasks than non-independent departments. There exist shortcomings and weaknesses in human resources, equipment allocation, in-food radioactivity testing, nuclear and radiological emergency in 16 prefectures and cities, so that the capability building needs to be further improved.