The paradox of Picroside II: As a natural antioxidant, but may instead futher aggravate liver injury by exacerbating mitochondrial oxidative stress.

Background: Picroside II (PII), an iridoid glycoside extracted from the rhizomes and stems of the genus Picroside, exhibits pronounced hepatoprotective properties. Pre-administration of PII protects against acute liver injury caused by D-galactosamine (D-Gal), carbon tetrachloride (CCl4), and acetaminophen (APAP). This study aimed to elucidate the ramifications of PII administration subsequent to the initiation of acute hepatic injury. Methods: Exploring the role of PII treatment in APAP-treated cell and rat models and in D-Gal and CCl4-treated rat models. Results: In rats, APAP treatment increased serum aspartate transaminase, alanine transaminase, and alkaline phosphatase levels and decreased glutathione activity and the fluidity of the liver mitochondrial membrane. In L-02 cells, APAP exposure resulted in a decrement in membrane potential, an augmentation in the liberation of reactive oxygen species, and an acceleration of apoptotic processes. Moreover, PII pre-administration protected against D-Gal-induced acute hepatic injury and CCl4-induced chronic hepatic injury in rodent models, whereas PII administration post-injury aggravated CCl4-induced chronic hepatic injury. Conclusions: Our results suggest that the effects of PII depend on the hepatic physiological or pathological state at the time of intervention. While PII possesses the potential to avert drug-induced acute hepatic injury through the mitigation of oxidative stress, its administration post-injury may exacerbate the hepatic damage, underscoring the critical importance of timing in therapeutic interventions.

The influence of physical activity on internet addiction among Chinese college students: the mediating role of self-esteem and the moderating role of gender.

OBJECTIVES: The significance of self-esteem in the relationship between physical activity and Internet addiction among college students cannot be over, as it lays a solid foundation for the prevention and control of Internet addiction. METHODS: A total of 950 college students were surveyed using the Physical Activity Rating Scale (PARS-3), Rosenberg Self-Esteem Scale (SES), and Chinese Internet Addiction Scale (CIAS-R) through a cluster random sampling method. Descriptive statistics, independent sample t-test, partial correlation analysis, mediation effect, moderation effect, and Bootstrap testing were conducted on the collected data to analyze and interpret the results. RESULTS: (1) Significant gender differences were found in the amount of physical activity and the degree of Internet addiction among college students(P&& lt;0.001); (2) Physical activity was significantly and positively correlated with self-esteem (r = 0.26, P < 0.001), but significantly and negatively correlated with Internet addiction (r=-0.23, P < 0.001); Meanwhile, self-esteem and Internet addiction were significantly and negatively related to self-esteem (r=-0.22, P < 0.001). (3) Mediating effect analyses showed that self-esteem played a partial mediating role in physical activity and Internet addiction among college students, accounting for a portion of 78.95%. (4) A moderating effect of gender on the relationship between physical activity and Internet addiction was discovered. CONCLUSION: The physical activity level of male students is significantly higher than that of female students, while the degree of internet addiction among female students is notably higher than that of male students. Physical activity can not only directly improve the issue of internet addiction among college students, but also indirectly improve it through self-esteem, with gender playing a moderating role in this process. This conclusion has practical reference significance for preventing and controlling internet addiction among college students, and provides evidence support for using physical activity as a reference solution in clinical applications. Additionally, it suggests that gender should be taken into account when preventing and intervening in internet addiction among college students, and different strategies and methods should be adopted for male and female students. Male students should be encouraged to participate more in physical activities, gradually increasing the frequency, duration, and intensity of their participation, in order to divert their attention and enhance their sense of achievement in sports, thereby reducing their use of mobile phones. For female students, on the other hand, it is important to strengthen real-life communication, change the form of sports participation, engage in group, collaborative, and different situational sports activities, and enhance their focus and attention in sports, in order to reduce their internet dependency, better guide them to use the internet reasonably, and enable them to achieve emotional release through sports.

Magnetic resonance imaging features for differentiating tuberculous from pyogenic spondylitis: a meta-analysis.

OBJECTIVE: To perform a meta-analysis comparing the MRI features of tuberculous and pyogenic spondylitis, using histopathological results and/or blood culture as the standard reference. MATERIALS AND METHODS: PubMed, Embase, Web of Science, and Cochrane Library were searched for English-language studies on the MRI features of tuberculous and pyogenic spondylitis published between January 2010 and February 2023. Risk for bias and concerns regarding applicability were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled MRI features' proportions were calculated using a bivariate random-effects model. RESULTS: Thirty-two studies met the inclusion criteria: 21 for tuberculous spondylitis, three for pyogenic spondylitis, and eight for both. Of the nine informative MRI features comparing tuberculous spondylitis to pyogenic spondylitis, involvement of ≥ 2 vertebral bodies (92% vs. 88%, P = .004), epidural extension (77% vs. 25%, P < .001), paravertebral collection (91% vs. 84%, P < .001), subligamentous spread (93% vs. 24%, P < .001), thin and regular abscess wall (94% vs. 18%, P < .001), vertebral collapse (68% vs. 24%, P < .001), and kyphosis (39% vs. 3%, P < .01) were more suggestive of tuberculous spondylitis, while disc signal change (82% vs. 95%, P < .001) and disc height loss (22% vs. 59%, P < .001) were more suggestive of pyogenic spondylitis. CONCLUSION: Involvement of ≥ 2 vertebral vertebral bodies, soft tissue attribution, thin and regular abscess wall, vertebral collapse, and kyphosis were MRI features more common in tuberculous spondylitis, while disc signal change and height loss were more common in pyogenic spondylitis.

Relationship between dry eye disease and physical and mental health in primary and secondary school teachers / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the relationship between dry eye disease(DED)and physical and mental health in teachers, and to explore its mechanism and propose intervention measures.METHODS:Cross-sectional study. A total of 183 teachers from three primary and secondary schools in the urban area of Linyi City, Shandong Province were enrolled in the study. DED symptoms were quantified using the ocular surface disease index(OSDI)questionnaire. A compact version of the depression, anxiety, and stress scale(DASS-21)was used to evaluate psychological state. The relationship between potential influencing factors and DED was evaluated by independent sample t-test of quantitative variables and χ2test of classified variables. Logistic regression analysis was used for multivariate analysis to determine the influencing factors of DED. Pearson correlation coefficient was used to analyze the correlation between OSDI score and depression, anxiety and stress.RESULTS: There were 183 teachers, including 44 males(24.0%)and 139 females(76.0%), aged from 22 to 57 years, with an average age of(34.2±8.6)years. The prevalence of DED was 60.0%(109/183; 95%CI 52.4%-66.7%). The prevalence of depression was 26.2%(48/183; 95%CI 19.8%-32.7%); anxiety prevalence was 39.3%(72/183; 95%CI 32.2%-46.5%); and stress prevalence was 23.0%(42/183; 95%CI 16.8%-29.1%). The univariate analysis showed that increased age, increased working years, increased visual display terminal(VDT)application time, longer written working hours, reduced sleep hours, less alcohol consumption, and high scores of depression, anxiety and stress were all factors affecting DED(all P&#x0026;#x003C;0.05). Using depression scores as the psychological index, multivariate Logistic regression analysis showed that years of work, VDT application time, written working hours, sleep time, alcohol consumption and depression score were the influencing factors of DED(all P&#x0026;#x003C;0.05); Using anxiety scores as the psychological index, multivariate Logistic regression analysis showed that years of work, VDT application time, written working hours and stress scores were the influencing factors of DED(all P&#x0026;#x003C;0.05); Using stress scores as the psychological index, multivariate Logistic regression analysis showed that years of work, VDT application time, written working hours and stress scores were the influencing factors of DED(all P&#x0026;#x003C;0.05). OSDI scores were positively correlated with depression, anxiety, and stress scores in the DED group(P&#x0026;#x003C;0.05)and across all participants(P&#x0026;#x003C;0.05). In the severe DED group, OSDI scores were positively related to depression, anxiety, and stress scores(P&#x0026;#x003C;0.05).CONCLUSION: The prevalence of DED is high among the teachers. Alcohol consumption, reduced sleep, longer working years, longer VDT usage and longer written working hours are the influencing factors of DED. In severe DED group, DED is highly correlated with depression, anxiety, and stress. We should pay attention to teachers' DED and related physical and mental health problems, and actively prevent and make early diagnosis and treatment.

Herbal Textual Research on Farfarae Flos in Famous Classical Formulas / 中国实验方剂学杂志

By consulting ancient and modern literature， the herbal textual research of Farfarae Flos has been conducted to verify the name， origin， producing area， quality evaluation， harvesting and processing methods， so as to provide reference for the development and utilization of the famous classical formulas containing Farfarae Flos. According to the research， the results showed that Farfarae Flos was first described as a medicinal material by the name of Kuandonghua in Shennong Bencaojing（《神农本草经》）， and the name was used and justified by later generations. The main origin was the folwer buds of Tussilago farfara， in addition， the flower buds of Petasites japonicus were used as medicine in ancient times. The ancient harvesting time of Farfarae Flos was mostly in the twelfth month of the lunar calendar， and the modern harvesting time is in December or before the ground freeze when the flower buds have not been excavated. Hebei， Gansu， Shaanxi are the authentic producing areas with the good quality products. Since modern times， its quality is summarized as big， fat， purple-red color， no pedicel is better. Processing method from soaking with licorice water in the Northern and Southern dynasties to stir-frying with honey water followed by micro-fire in the Ming dynasty， and gradually evolved to the modern mainstream processing method of honey processing. Based on the research results， it is suggested that the dried flower buds of T. farfara， a Compositae plant， should be selected for the development of famous classical formulas containing Farfarae Flos， and the corresponding processed products should be selected according to the specific processing requirements of the formulas， and raw products are recommended for medicinal use without indicating processing requirements.

Swyer syndrome with gonadal non-dysgerminoma malignant germ cell tumors: a report of 15 cases in a national medical center / 中华妇产科杂志

Objective: To evaluate the incidence, treatment, and survival outcomes of Swyer syndrome with gonadal non-dysgerminoma malignant germ cell tumor (MGCT-NDG). Methods: A retrospective study was performed on Swyer syndrome patients with MGCT-NDG between January 2011 and December 2022 in Peking Union Medical College Hospital to investigate their characteristics and outcomes. Results: A total of 15 patients (4.9%, 15/307) with Swyer syndrome were identified in 307 MGCT-NDG patients. The average age at diagnosis of MGCT-NDG and Swyer syndrome were (16.8±6.7) and (16.7±6.6) years, respectively. Six cases were preoperatively diagnosed as Swyer syndrome, of which 4 cases received bilateral gonadectomy with or without hysterectomy, while the other 2 cases underwent removal of gonadal tumor and unilateral gonadectomy with hysterectomy, respectively. Of the 9 patients postoperatively diagnosed as Swyer syndrome, unilateral gonadectomy, removal of gonadal tumor, and unilateral gonadectomy with hysterectomy were performed in 6 patients, 2 patients, and 1 patient, respectively. Mixed malignant germ cell tumor (MGCT;10 cases), yolk sac tumor (4 cases), and immature teratoma (1 case) were the pathological subtypes, in the descending order. There were International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ in 6 cases, stage Ⅱ in 3 cases, stage Ⅲ in 5 cases, and stage Ⅳ in 1 case, respectively. Eleven patients received reoperation for residual gonadectomy after a average delay of (7.9±6.2) months, including 8 MGCT-NDG patients and 1 gonadoblastoma patient, no tumor involved was seen in the remaining gonads in the other 2 cases. Ten patients experienced at least one recurrence, with a median event free survival of 9 months (5, 30 months), of which 2 patients received surgery only at the time of initial treatment. All patients with recurrence received surgery and combined with postoperative chemotherapy. After a median follow-up of 25 months (15, 42 months), 10 patients were disease-free, 3 patients died of the tumor, 1 died of side effects of leukemia chemotherapy, and 1 survived with disease. Conclusion: The incidence rate of Swyer syndrome in patients with MGCT-NDG is about 4.9%; timely diagnosis and bilateral gonadectomy should be emphasized to reduce the risk of reoperation and second carcinogenesis in this population.

Theta Oscillations Support Prefrontal-hippocampal Interactions in Sequential Working Memory / 神经科学通报·英文版

The prefrontal cortex and hippocampus may support sequential working memory beyond episodic memory and spatial navigation. This stereoelectroencephalography (SEEG) study investigated how the dorsolateral prefrontal cortex (DLPFC) interacts with the hippocampus in the online processing of sequential information. Twenty patients with epilepsy (eight women, age 27.6 ± 8.2 years) completed a line ordering task with SEEG recordings over the DLPFC and the hippocampus. Participants showed longer thinking times and more recall errors when asked to arrange random lines clockwise (random trials) than to maintain ordered lines (ordered trials) before recalling the orientation of a particular line. First, the ordering-related increase in thinking time and recall error was associated with a transient theta power increase in the hippocampus and a sustained theta power increase in the DLPFC (3-10 Hz). In particular, the hippocampal theta power increase correlated with the memory precision of line orientation. Second, theta phase coherences between the DLPFC and hippocampus were enhanced for ordering, especially for more precisely memorized lines. Third, the theta band DLPFC → hippocampus influence was selectively enhanced for ordering, especially for more precisely memorized lines. This study suggests that theta oscillations may support DLPFC-hippocampal interactions in the online processing of sequential information.

Experimental and Numerical Investigation of Shielding Gas Behaviors in Laser Welding of TC4 Alloy.

Gas protection is a crucial part of quality control in laser welding, especially for titanium alloy, which oxidizes easily at high temperatures. Substantial experiments concerning shielding gas characteristics in the welding process have been implemented. However, the common analysis conducted is simplistic and lacks a theoretical basis. This paper presented an investigation of the shielding gas behaviors based on numerical simulation and a titanium alloy laser welding experiment. The numerical model was established and validated by experiment. Subsequently, the temperature field and gas flow fields were calculated. By combining the two fields, the threshold temperature of gas protection was determined, and the influence of shielding gas parameters on the protection effect was examined. The results revealed that the protection of the high-temperature zone was primarily influenced by the nozzle height, nozzle inner diameter, and nozzle angle, while the plasma suppression effect was mainly correlated with the nozzle inner diameter and gas flow rate. These initial findings provide scientific guidance for the better quality production of laser beam welded components made of not only titanium alloy but also other metallic materials.

Starch nanoparticles as a new ice crystal nucleator in Lactobacillus bulgaricus CICC 6097 cryoprotection.

This work aimed at studying the cryoprotective effect of starch nanoparticles (SNPs) as ice nucleators on Lactobacillus bulgaricus CICC 6097 and exploring the protective mechanism. SNPs with a diameter of 363 nm were obtained, which possessed special properties to enhance ice nucleation and blunt ice crystals edges, and can be wrapped around the surface of bacteria form a protective barrier, thus maintaining the integrity of cell membranes and improving the survivability of L. bulgaricus CICC 6097 from 36.09% to 75.56%. However, SNCs solution formed ice crystals with obvious spikes during freezing, which was harmful to bacteria survival. Therefore, SNPs addition is a possible strategy for increasing viable cell counts during freezing. To the best of our knowledge, this report is the first to demonstrate the cryoprotective effect of ice nucleator on lactic acid bacteria.

Computed tomography findings in patients with pulmonary tuberculosis and diabetes at an infectious disease hospital in China: a retrospective cross-sectional study.

BACKGROUND: This study aimed to investigate the relationship between active pulmonary tuberculosis (TB) and type 2 diabetes mellitus (T2DM) by analysing the clinical features and computed tomography (CT) findings of patients with active pulmonary TB and comorbid T2DM (TB-DM) in the LiangShan Yi regions. METHODS: We collected data from 154 hospitalised patients with TB-DM initially confirmed at an infectious disease hospital in the Liangshan Yi Autonomous Prefecture between 1 and 2019, and 31 December 2021. These were matched by sex and age ± 3 years to 145 hospitalised patients with initially confirmed pulmonary TB without comorbid T2DM (TB-NDM) over the same period. The clinical characteristics of the two groups were analysed separately. Three group-blinded radiologists independently analysed the CT findings and classified them into mild-to-moderate and severe groups. Severe chest CT lesion refers to a lesion that is less diffused or moderately dense and either exceeds the total volume of one lung, a high-density fused lesion greater than one-third of the volume of one lung, or a cavitary lesion with a maximum diameter ≥ 4 cm. RESULTS: No significant differences were observed in the presentation of clinical features. Regarding the severity of chest CT manifestation, patients with TB-DM had significantly more severe TB than those with TB-NDM (89.61% vs. 68.97%, P < 0.0001). Regarding CT findings, patients with TB-DM had higher proportions of consolidation (79.22% vs. 52.41%, P < 0.0001), cavitary lesions (85.06% vs. 59.31%, P < 0.0001), bronchiectasis (71.43% vs. 31.03%, P < 0.0001), exudative lesions (88.96% vs. 68.28%, P < 0.0001), and fibrous lesions (93.51% vs. 68.97%, P < 0.0001) than patients with TB-NDM. In conclusion, patients with TB-DM have more severe pulmonary TB CT findings than those without. There were no significant differences in the distribution of lesions in the lung lobes between TB-DM and TB-NDM patients. CONCLUSIONS: Among patients hospitalised with pulmonary TB, those with T2DM had more severe findings on chest CT than those without T2DM. However, the clinical presentation was not significantly different.

Matrix stiffness induces an invasive-dormant subpopulation via cGAS-STING axis in oral cancer.

OBJECTIVES: Dormancy is a crucial machinery for cancer cells to survive hostile microenvironment. It is considered as the major cause of post-treatment relapse and metastases. However, its regulatory mechanism in oral squamous cell carcinoma (OSCC) remains unclear. Here we sought to decipher the impacts of matrix stiffness on OSCC-cell dormancy. MATERIALS AND METHODS: Clinicopathological relevance of matrix stiffness in OSCC was analyzed in a 127 patients' cohort. Impacts of stiffness-related mechanical stress (MS) on OSCC-cell behaviors were investigated in vitro and in vivo. Transcriptomic profiling of MS induced dormant cells were performed, following by mechanistic investigations on MS-induced dormancy. The functional relevance of cGAS in OSCC were analyzed through a bioinformatic approach. RESULTS: Stiffened matrix correlated with poor survival and post-surgical recurrence in OSCC. Stiffness-related MS induces a dormant subpopulation in OSCC cells, which showed increased drug resistance, enhanced tumor repopulating ability, and an unexpected upregulation of epithelial-mesenchymal transition (EMT) and invasiveness. Mechanistically, MS caused DNA damage, resulted in activation of cGAS-STING signaling. Either blocking of cGAS or STING dramatically impeded the MS-induced production of this invasive-dormant subpopulation. Moreover, cGAS was found being central to the cell-cycle regulation and correlated with poor prognosis in OSCC. DISCUSSION: We revealed a previously unsuspected role of cGAS-STING axis in mediating the induction of an invasive-dormant subpopulation in response to mechanical cues. Our findings indicated an adaptive machinery whereby tumor cells survive and escape from harsh microenvironment. Targeting this machinery may be a potential strategy for preventing post-therapeutic recurrence and lymphatic metastasis in OSCC.

Remote Sensing Image Characteristics and Typical Area Analysis of Taiyuan Xishan Ecological Restoration Area.

The Taiyuan Xishan Ecological Restoration Zone is located in the west of Taiyuan City and belongs to the Xishan Coalfield. Due to the resource development activity of coal mining, which is caused by coal gangue accumulation, surface vegetation degradation, bare surfaces, and other phenomena, it is most common in this area. These have an impact on the surface ecology; however, after ecological restoration, the surface ecology has been greatly improved. There are many extraction models of vegetation coverage based on pixel dichotomology combined with multispectral vegetation index, but we believe that the combination of visible light vegetation index to construct models is relatively unexplored. The main problem of how to use the RGB image data in order to quickly and accurately extract vegetation coverage information is still under investigation and needs researchers' attention. In this paper, through selecting the vegetation coverage as the evaluation index of ecological restoration effect, a new RGB vegetation coverage CIVE calculation model is innovatively proposed to solve the above problem, and on the basis of this model, the vegetation cover change analysis is carried out in the Xishan ecological restoration area of Taiyuan. According to the analysis of vegetation coverage change, relevant paper data, and the characteristics of multiple historical remote sensing images, the ecological restoration area of Taiyuan Xishan is divided into six typical areas. Through empirical evaluation, we summarize and analyze these six typical areas, which can provide typical demonstration roles for other ecological restoration areas. Our findings suggest that the proposed CIVE model realizes the extraction of vegetation cover information and long-term series dynamic monitoring of vegetation coverage.

Early and mid-term results of Fontan operation versus anatomic correction for congenitally corrected transposition of the great arteries: A retrospective cohort study in a single center / 中国胸心血管外科临床杂志

@#Objective     To compare the early and mid-term results between Fontan operation and anatomic correction for congenitally corrected transposition of the great arteries (ccTGA). Methods     The clinical data of 53 patients with ccTGA who underwent anatomic correction and Fontan operation from January 2009 to September 2021 in our hospital were reviewed, including 41 males and 12 females with a mean age of 55.02 (3-168) months. They were divided into an anatomic correction group (16 patients) and a Fontan operation group (37 patients) according to the operation. The hospitalization mortality, survival rate, postoperative complications, and free rate from re-intervention between the two groups were compared. Another 180 healthy children were recruited as a control group, and 14 children were matched with the propensity score matching method as a Fontan control group. The results of cardiopulmonary exercise testing (CPET) between the Fontan operation group and the Fontan control group were compared. Results     There were 2 (12.5%) early deaths and 3 (18.8%) early re-intervention in the anatomic correction group, while 1 death and 2 re-intervention in the Fontan operation group. In addition, there were 9 patients (56.3%) in the anatomic correction group and 6 (16.2%) patients in the Fontan operation group suffering from arrhythmia after operation, respectively. Compared with the anatomic correction group, cardiopulmonary bypass time, aortic cross-clamping time, intubation time and ICU stay were significantly shortened in the Fontan operation group (P<0.05). CPET results showed that, percent predicted max VO2 in the Fontan operation group was lower than that in the Fontan control group (0.84±0.11 vs. 0.99±0.12, P<0.05). The patients were followed up for 0.5-126.0 months. Two patients were lost in the Fontan operation group. There was no death and 1 re-intervention in the anatomic correction group, while no death or re-intervention in the Fontan operation group. The 1-year, 5-year and 10-year transplant-free survival rate of the anatomic correction group and the Fontan operation group was 87.5%, 87.5%, 87.5% and 97.3%, 97.3%, 97.3%, respectively (P>0.05). The 48 patients were classified as grade Ⅰ-Ⅱ in cardiac function in the last follow-up. Conclusion     There is no statistical difference in the transplant-free survival rate between the anatomic correction and the Fontan operation group. The postoperative complications in the Fontan operation group are decreased than those in the anatomic correction group. The Fontan operation is also a good choice, even though the patients with ccTGA meet the condition of the procedure of anatomic correction.

Clinical efficacy and learning curve of robot-assisted thymectomy via subxiphoid approach / 中国胸心血管外科临床杂志

@#Objective     To explore the clinical efficacy and learning curve of robot-assisted thymectomy via subxiphoid approach. Methods    The clinical data of patients with robot-assisted thymectomy surgery via subxiphoid approach performed by the same surgical team in the Department of Thoracic Surgery of Shanghai Pulmonary Hospital from February 2021 to August 2022 were retrospectively analyzed. The cumulative sum (CUSUM) analysis and best fit curve were used to analyze the learning curve of this surgery. The general information and perioperative indicators of patients at different learning stages were compared to explore the impact of different learning stages on clinical efficacy of patients. Results    A total of 67 patients were enrolled, including 31 males and 36 females, aged 57.10 (54.60, 59.60) years. The operation time was 117.00 (87.00, 150.00) min. The best fitting equation of CUSUM learning curve was y=0.021 2x3–3.192 5x2 +120.17x–84.444 (x was the number of surgical cases), which had a high R2 value of 0.977 8, and the fitting curve reached the top at the 25th case. Based on this, the learning curve was divided into a learning period and a proficiency period. The operation time and intraoperative blood loss in the proficiency stage were significantly shorter or less than those in the learning stage (P<0.001), and there was no statistical difference in thoracic drainage time and volume between the two stages (P>0.05). Conclusion    The learning process of robot-assisted thymectomy via subxiphoid approach is safe, and this technique can be skillfully mastered after 25 cases.

Improvement of types Ⅱ and Ⅲ biplane breast augmentation with endoscope-assisted axillary approach / 中华医学美学美容杂志

Objective:To discuss the advantages and importance of endoscope assisted type Ⅱ and type Ⅲ biplane technique in axillary augmentation mammoplasty, and to summarize the operation points and improvement.Methods:There were 49 patients enrolled in our study. After the posterior space of pectoralis major was formed and the pectoralis major was severed above the lower breast fold, the breast tissue above the broken end of pectoralis major was released and separated from pectoralis major by a self-made reverse stripper to form type Ⅱ and type Ⅲ biplane.Results:All the patients were followed up for 13-24 months. All cases got ideal breast shape and feeling, especially the plumpness of the lower breast pole. There was no capsular contracture, hematoma, infection and other complications. The breast with lower pole narrowing and/or sagging was basically corrected.Conclusions:The application of self-made reverse pectoralis major stripper can change the mechanical direction of the operation, easily separate and release the front of pectoralis major muscle, and form the exact type Ⅱ biplane, or even type Ⅲ biplane breast augmentation effect. It can further improve the stretching of the lower breast fullness, increase the fullness of the breast curve, and achieve the breast effect of aesthetic.

Reflections on the conduct of cell therapy clinical trials in medical institutes / 中华医学科研管理杂志

Objective:This paper introduces the concepts of " patient-centered cell therapy research management model", to provide reference for domestic medical institutions which conduct cell therapy clinical trials.Methods:We reviewed and summarized the experiences of conducting cell therapy at Peking University Shenzhen Hospital, including challenges and response plans regarding to the technology assessment, ethical evaluation risks and regulatory compliance. According to which, this paper aims to explore the reflections and practical experience of establishing a patient-centered, multi-stakeholder shared decision-making research management system.Results:The " patient-centered cell therapy research management model" ensures the reliability of research results through multi-stakeholder engagement in decision-making and management, adequate technical evaluation, effective ethical review and harmonized scientific research management, which not only meets the urgent health needs of the patient, but also promotes the standardized development of emerging technologies.Conclusions:The " patient-centered cell therapy research management model" is tailored for the cell therapy research, it is important to promote its further assessment and applications.

Characteristics of digestive system symptoms and abdominal computed tomography imaging of patients infected with severe acute respiratory syndrome coronavirus 2 Omicron variant / 中华消化杂志

Objective:To investigate the characteristics of digestive system symptoms and its relation with the time of nucleic acid continuous positive in population infected with severe acute respiratory syndrome coronavirus 2 Omicron variant, and to analyze the abdominal computed tomography (CT) features of patients infected with Omicron variant.Methods:From April 11 to May 23, 2022, a questionnaire survey was conducted in patients infected with Omicron variant admitted to the Shanghai National Convention and Exhibition Center Fangcang Hospital. The questionnaire included basic information, the start time of nucleic acid positive, respiratory symptoms, digestive system syptoms and outcomes, etc.Combined with the clinical data, the relation between digestive tract symptoms and the time of nucleic acid continuous positive were analyzed. Thoracic and abdominal CT were performed for patients with continuous positive nucleic acid results ≥10 d, and the relationship between the abdominal CT imaging characteristics and the time of nucleic acid continuous positive was analyzed. Independent sample t-test and multivariate logistic regression were used for statistical analysis. Results:A total of 4 360 valid questionnaires were collected, including 2 475 males and 1 885 females, with a hospital stay of (6.8±4.9) d. Among the 4 360 patients, 1 979 patients (45.4%) had gastrointestinal symptoms such as loss of appetite, abdominal discomfort or pain, constipation and diarrhea. The time of nucleic acid continuous positive in patients with gastrointestinal symptoms was (7.4±5.5) d, which was longer than that of patients without gastrointestinal symptoms (6.5±3.6) d, and the difference was statistically significant ( t=3.78, P<0.001). During the isolation period in the Fangcang Hospital, the time of nucleic acid continuous positive in patients with complete remission of digestive tract symptoms was shorter than that of patients with no remission of digestive tract symptoms ((7.3±5.2) d vs. (8.5±5.7) d), and the difference was statistically significant ( t=2.25, P=0.025). The results of multivariate logistic regression analysis showed that the combination of gastrointestinal symptoms was an independent risk factor for continuous positive nucleic acid result ≥10 d ( OR=1.316, 95% confidence interval 1.294 to 2.205, P=0.046). Among the 299 patients with continuous positive nucleic acid results≥10 d, 187 cases (62.5%) had gastrointestinal symptoms, and 146 cases (48.8%) had abdominal CT findings of thickening of the gastroduodenal wall, thickening of the small intestinal wall, indistinct mesenteric vessels of the small intestine, and dilatation and pneumatosis of the colon. In patients with continuous positive nucleic acid results ≥10 d, abdominal CT indicated that patients with gastrointestinal imaging changes had a longer time of nucleic acid continuous positive than those without gastrointestinal imaging changes ((16.0±2.8) d vs. (13.0±2.1) d), and the difference was statistically significant ( t=2.62, P=0.009). Conclusions:Digestive system symptoms are common in patients infected with Omicron variant. The time of nucleic acid continuous positive in patients with gastrointestinal symptoms is longer than those without gastrointestinal symptoms. Some patients may have gastrointestinal lesions on abdominal CT.

Role of α7nAChR in penehyclidine hydrochloride-induced reduction of endotoxin-induced acute lung injury in mice / 中华麻醉学杂志

Objective:To evaluate the role of α7 nicotinic acetylcholine receptor (α7nAChR) in penehyclidine hydrochloride-induced reduction of endotoxin-induced acute lung injury (ALI) in mice.Methods:Forty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 18-25 g, were divided into 4 groups ( n=10 each) using a random number table method: control group (group C), ALI group, penehyclidine hydrochloride group (PHC group), and α7nAChR inhibitor MLA group (MLA group). ALI was induced by intraperitoneal injection of lipopolysaccharide 15 mg/kg in anesthetized animals, while normal saline was given instead in group C. In PHC group, penehyclidine hydrochloride 2 mg/kg was intraperitoneally injected at 30 min before developing the model. MLA 10 mg/kg was intraperitoneally injected at 10 min before administration of penehyclidine hydrochloride in MLA group. Mice were sacrificed at 6 h after lipopolysaccharide administration, and lung tissues were collected for microscopic examination of the pathological changes (by HE staining) and for determination of the wet/dry weight ratio (W/D ratio), content of tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β) and IL-10 (by enzyme-linked immunosorbent assay) and expression of α7nAChR (by Western blot). Results:Compared with C group, the W/D ratio and contents of TNF-α and IL-1β were significantly increased, the content of IL-10 was decreased, and the expression of α7nAChR was up-regulated in ALI, PHC and MLA groups ( P<0.05). Compared with ALI group, the W/D ratio and contents of TNF-α and IL-1β were significantly decreased, the content of IL-10 was increased, and the expression of α7nAChR was up-regulated in PHC group ( P<0.05). Compared with PHC group, the W/D ratio and contents of TNF-α and IL-1β were significantly increased, the content of IL-10 was decreased, and the expression of α7nAChR was down-regulated in MLA group ( P<0.05). Compared with ALI group, the pathological changes of lung tissues were significantly mitigated in PHC group, while this effect of PHC was partially reversed by α7nAChR inhibitor MLA. Conclusions:α7nAChR is involved in penehyclidine hydrochloride-induced reduction of endotoxin-induced ALI in mice.