Relationship between self-reported occupational noise exposure and expression levels of plasma inflammatory cytokines in adult asthmatic patients / 公共卫生与预防医学

Objectives To investigate the relationship between self-reported occupational noise exposure and levels of plasma inflammatory cytokines in asthmatic patients. Methods A total of 910 adult asthmatic patients were selected as the study subjects, and their occupational noise exposure history and other related information were collected. The peripheral blood samples were collected from the patients, and the expression levels of plasma soluble CD14 (sCD14), complement factor D (CFD), Eotaxin-11 (CCL11), and IL-9 were determined. The relationship between self-reported occupational noise exposure and the expression levels of the four inflammatory cytokines in patients’ plasma were analyzed using multiple linear regression models. The interactions between confounding factors and self-reported occupational noise exposure were further analyzed by interaction analysis. Results The plasma CCL11, sCD14 and CFD expressions in asthmatic patients with self-reported occupational noise exposure were significantly higher than those in patients without the exposure (P<0.05). After adjusting for confounding factors, compared with patients reporting no occupational noise exposure, the plasma CFD expression was increased by 0.17 (95% CI: 0.02, 0.31) natural logarithm units in patients with self-reported occupational noise exposure. During remission, the levels of plasma CCL11 and sCD14 in asthmatic patients with self-reported occupational noise exposure were increased by 0.27 (95% CI: 0.05, 0.49) and 0.22 (95% CI: 0.02, 0.41) natural logarithm units, respectively, when compared with patients without the exposure. Interaction analysis showed that self-reported occupational noise exposure had significant multiplicative interaction with smoking or pet ownership on plasma CCL11 or CFD expressions in asthmatic patients (all P<0.05). Conclusion Self-reported occupational noise exposure is significantly associated with increased expression levels of plasma CFD, CCL11, and sCD14 in adult asthmatic patients.

Gradient Guided-Mode Resonance Biosensor with Smartphone Readout.

Integrating biosensors with smartphones is becoming an increasingly popular method for detecting various biomolecules and could replace expensive laboratory-based instruments. In this work, we demonstrate a novel smartphone-based biosensor system with a gradient grating period guided-mode resonance (GGP-GMR) sensor. The sensor comprises numerous gratings which each correspond to and block the light of a specific resonant wavelength. This results in a dark band, which is observed using a CCD underneath the GGP-GMR sensor. By monitoring the shift in the dark band, the concentration of a molecule in a sample can be determined. The sensor is illuminated by a light-emitting diode, and the light transmitted through the GGP-GMR sensor is directly captured by a smartphone, which then displays the results. Experiments were performed to validate the proposed smartphone biosensor and a limit of detection (LOD) of 1.50 × 10-3 RIU was achieved for sucrose solutions. Additionally, multiplexed detection was demonstrated for albumin and creatinine solutions at concentrations of 0-500 and 0-1 mg/mL, respectively; the corresponding LODs were 1.18 and 20.56 µg/mL.

A full-scale black soldier fly larvae (Hermetia illucens) bioconversion system for domestic biodegradable wastes to resource.

Domestic biodegradable wastes (DBW) pose a threat to environmental quality and human health. Bioconversion via black soldier fly larvae (BSFL; Hermitia illucens L.) is an expedient way for converting 'waste to resource' (insect protein and biofertilizer). Although researches abounded in laboratory-reared experiments and bioconversion mechanisms were pertinent, the void of data from actual and full-scale operation restricts the intensification of BSFL technology and its global adoption. Hence, a full-scale BSFL bioconversion system lasting 4 years in Hangzhou (China) was investigated, and the feasibility and efficiency of 15 tonnes of DBW per day were studied. Through continuous technical optimization, the average production of fresh larvae was increased from 8.5% in 2017 to 15.3% in 2020, along with bioconversion rate of final vermicompost decreased from 35.4% to 14.5%. The total biomass reduction rate in 2020 was 68.7 ± 17.4 kg/(m3 d), equivalent to 0.735 ± 0.215 kg/(kg d) in the form of fresh larvae. Crude fat in fresh larvae accounted for 13.4%, and crude protein accounted for 16.2% in which the determined amino acid profile bore a strong resemblance to fish meal only except histidine and tyrosine. Its economic benefits proved the feasibility of this technology, and the profit reached up to 35.9 US$ per tonne of DBW in 2019. In conclusion, BSFL bioconversion system under current 'insect-farm' operation was a promising solution for DBW treatment with value-added waste recycling.

Effect of surgical resection after preoperative immunotherapy combined chemotherapy on unresectable stage Ⅲ non-small cell lung cancer / 中华胸心血管外科杂志

Objective:Immune checkpoint inhibitors have a high remission rate in the preoperative application of resectable and potentially resectable non-small cell lung cancer when combined with chemotherapy. For the unresectable stage Ⅲ non-small cell lung cancer, whether the transformation can be achieved through this regimen to provide opportunities for surgical resection is controversial. In this study, we evaluated the pattern of transformation therapy by reviewing the efficacy and safety of preoperative therapy and surgery of this group.Methods:A review of 23 patients undergoing surgical resection after transformation therapy by preoperative immunotherapy combined chemotherapy between November 2019 and November 2021 was performed. All patients must clarify the pathological diagnosis of non-small cell lung cancer by biopsy. After the multi-disciplinary treatment team and preoperative imaging assessment, the diagnosis should be consistent with unresectable stage III as described in the Expert Consensus on Multidisciplinary Management of Stage Ⅲ Non-Small Cell Lung Cancer, 2019 Edition. After 2 to 4 cycles of preoperative anti-PD-1 monoclonal antibody combined with chemotherapy, the surgical team assessed the chance of resection and performed surgery. Important indicators such as surgical resection rate, R0 resection rate, MPR, pCR, incidence of grade 3-5 adverse reactions and various other perioperative data were counted.Results:In the whole group, initial imaging evaluation was 10 of stage cⅢA and 13 of stage cⅢB.15 cases had multiple stations N2 lymph nodes metastasis, 9 had enlarged fused N2 lymph nodes metastasis, 6 had large vessel invasion(T4), and 1 had contralateral mediastinal lymph node metastasis(N3). After preoperative neoadjuvant therapy, 17 cases achieved PR, 3 achieved SD and 3 achieved PD. The surgical resection rate of the whole group was 91.3%(21/23, 1 lobectomy combined with superior vena cava reconstruction, 2 sleeve lobectomy, 5 pneumonectomy, 12 lobectomy/combined lobectomy, 1 wedge resection and 2 unresectable cases), R0 resection rate was 95.2%(20/21). MPR was achieved in 13 cases, 8 of them reached pCR. There were no perioperative deaths, median surgical time was 260(190-460) min, median bleeding volume was 100(50-750) ml, median drainage time was 5(3-9) days, and median hospitalization was 7(5-11) days. Two cases got immunotherapy-related grade 3 adverse reactions, one was interstitial pneumonia and the other was immune-related injury involving the eye, oral and genital mucosa. Two cases got surgical complications and one was persistent lung leakage, which stopped after 46 days of conservative treatment; The other was pleural effusion, which was relieved after drainage.Conclusion:For the unresectable stage Ⅲ NSCLC, immunotherapy combined chemotherapy is an effective preoperative downstage method. It can convert 91.3% cases to resectable ones while achieving a good degree of pathological remission. Its side reactions are generally controllable and safety.

Efficacy and safety of bevacizumab combined with capecitabine in the treatment of advanced breast cancer / 国际肿瘤学杂志

Objective:To investigate the efficacy and safety of bevacizumab combined with capecitabine in the treatment of advanced breast cancer.Methods:Seventy-six patients with advanced breast cancer who were diagnosed in the Cancer Center of the People's Liberation Army Navy Anqing Hospital from August 2019 to May 2021 were selected. According to different treatment schemes, the patients were divided into the control group (using single drug capecitabine) and the test group (using bevacizumab combined with capecitabine), with 38 cases in each group. After 4 cycles of treatment, the clinical efficacy, progression-free survival (PFS), overall survival (OS) and adverse reactions were compared between the two groups, and the levels of vascular endothelial growth factor (VEGF) -121, VEGF-145, VEGF-165 and quality of life before and after treatment were compared.Results:The objective remission rate of the test group [57.89% (22/38) ] was higher than that of the control group [42.11% (16/38) ], but there was no statistically significant difference ( χ2=1.89, P=0.169) ; The disease control rate of the test group [81.58% (31/38) ] was better than that of the control group [55.26% (21/38) ], there was a statistically significant difference ( χ2=6.09, P=0.014). The median PFS of patients in the test group (6.3 months) was longer than that in the control group (4.2 months), there was a statistically significant difference ( χ2=0.48, P=0.003) ; The median OS of patients in the test group (14.8 months) was not significantly different from that in the control group (13.2 months) ( χ2=0.15, P=0.704). After treatment, the expression level of serum VEGF-121 [ (201.25±18.37) ng/L vs. (276.83±20.26) ng/L], VEGF-145 [ (102.24±12.16) ng/L vs. (170.39±15.28) ng/L], VEGF-165 [ (135.08±14.32) ng/L vs. (210.53±16.09) ng/L] in the test group was lower than that in the control group, there were statistically significant differences ( t=17.03, P<0.001; t=21.51, P<0.001; t=21.59, P<0.001). After treatment, patients in the test group were assessed according to 36-item Short-Form (SF-36) physiological function [ (80.18±13.96) score vs. (71.72±16.12) score], physiological function [ (67.19±30.62) score vs. (53.12±9.86) score], physical pain [ (70.01±17.97) score vs. (61.06±17.57) score], overall health [ (68.67±18.92) score vs. (57.96±20.97) score], vitality [ (78.39±19.37) score vs. (68.26±18.52) score], social function [ (82.24±19.73) score vs. (70.92±20.31) score], the scores of emotional function [ (73.81±28.86) score vs. (60.23±29.19) score] and mental health [ (76.19±12.82) score vs. (70.31±12.54) score] were higher than those of the control group, there were statistically significant differences ( t=2.45, P=0.017; t=2.03, P=0.046; t=2.19, P=0.031; t=2.34, P=0.022; t=2.33, P=0.023; t=2.46, P=0.016; t=2.04, P=0.045; t=2.02, P=0.047). The incidence of adverse reactions in the test group [18.42% (7/38) ] was lower than that in the control group [76.32% (29/38) ], there was a statistically significant difference ( χ2=25.54, P<0.001) . Conclusion:The combination of bevacizumab and capecitabine chemotherapy has a higher clinical effect on advanced breast cancer, which can significantly reduce the level of VEGF in patients, improve the quality of life of patients, with mild adverse reactions and high safety.

Construction of a novel time-specific NLRP3 transgenic mouse model by Cre-LoxP system / 中国药理学通报

Aim To construct and identify a new time-specific NLRP3 point mutation transgenic mouse model by Cre-LoxP system. Methods Cre-LoxP system was used to generate NL-RP3

Investigation on the mechanism of anti-drug-induced liver injury and related effector substances of traditional Chinese medicine from the perspective of metabolism / 药学学报

Drug-induced liver injury (DILI) is one of the common clinical adverse drug reactions and remains a major cause of drug restriction, development termination and withdrawal from the pharmaceutical market today. In recent years, a variety of chemical components and metabolites of traditional Chinese medicine (TCM), as well as the endogenous effector substances influenced by metabolism of both, have attracted much attention for their significant hepatoprotective activities. However, the mechanism of TCM against DILI is complex, the related effector substances are still unclear, and its metabolism-related studies are still relatively weak. Therefore, this review summarized the mechanisms of DILI and its treatment by TCM from the perspective of metabolism, and for the first time, innovatively classified the Chinese medicine effector substances into two categories: exogenous (active components and metabolites of TCM) and endogenous (intestinal probiotics and endogenous metabolites), in order to reduce the occurrence of DILI, explore and develop effective anti-drug-induced liver injury effector substances of TCM, and further develop clinical drugs with hepatoprotective effects.

Baimai Ointment relieves chronic pain induced by chronic compression of dorsal root ganglion in rats by regulating neuroactive ligand-receptor interaction and HIF-1 signaling pathway / 中国中药杂志

The Baimai Ointment with the effect of relaxing sinew and activating collaterals demonstrates a definite effect on Baimai disease with pain, spasm, stiffness and other symptoms, while the pharmacodynamic characteristics and mechanism of this agent remain unclear. In this study, a rat model of chronic compression of L4 dorsal root ganglion(CCD) was established by lumbar disc herniation, and the efficacy and mechanism of Baimai Ointment in the treatment of CCD were preliminarily explored by behavioral tests, side effect evaluation, network analysis, antagonist and molecular biology verification. The pharmacodynamic experiment indicated that Baimai Ointment significantly improved the pain thresholds(mechanical pain, thermal pain, and cold pain) and gait behavior of CCD model rats without causing tolerance or obvious toxic and side effects. Baimai Ointment inhibited the second-phase nociceptive response of mice in the formalin test, increased the hot plate threshold of normal mice, and down-regulated the expression of inflammatory cytokines in the spinal cord. Network analysis showed that Baimai Ointment had synergistic effect in the treatment of CCD and was related to descending inhibition/facilitation system and neuroinflammation. Furthermore, behavioral tests, Western blot, and immunofluorescence assay revealed that the pain-relieving effect of Baimai Ointment on CCD may be related to the regulation of the interaction between neuroactive ligand and receptors(neuroligands) such as CHRNA7, ADRA2A, and ADRB2, and the down-regulation of the expression of NOS2/pERK/PI3K, the core regulatory element of HIF-1 signaling pathway in spinal microglia. The findings preliminarily reveal the mechanism of relaxing sinew and activating collaterals of Baimai Ointment in the treatment of Baimai disease, providing a reference for the rational drug use and further research of this agent.

Mechanism of Mongolian drug Naru-3 in initiation of neuroinflammation of neuropathic pain from MMP9/IL-1β signaling pathway / 中国中药杂志

Neuropathic pain(NP) has similar phenotypes but different sequential neuroinflammatory mechanisms in the pathological process. It is of great significance to inhibit the initiation of neuroinflammation, which has become a new direction of NP treatment and drug development in recent years. Mongolian drug Naru-3 is clinically effective in the treatment of trigeminal neuralgia, sciatica, and other NPs in a short time, but its pharmacodynamic characteristics and mechanism of analgesia are still unclear. In this study, a spinal nerve ligation(SNL) model simulating clinical peripheral nerve injury was established and the efficacy and mechanism of Naru-3 in the treatment of NPs was discussed by means of behavioral detection, side effect evaluation, network analysis, and experimental verification. Pharmacodynamic results showed that Naru-3 increased the basic pain sensitivity threshold(mechanical hyperalgesia and thermal radiation hyperalgesia) in the initiation of SNL in animals and relieved spontaneous pain, however, there was no significant effect on the basic pain sensitivity threshold and motor coordination function of normal animals under physiological and pathological conditions. Meanwhile, the results of primary screening of target tissues showed that Naru-3 inhibited the second phase of injury-induced nociceptive response of formalin test in mice and reduced the expression of inflammatory factors in the spinal cord. Network analysis discovered that Naru-3 had synergy in the treatment of NP, and its mechanism was associated with core targets such as matrix metalloproteinase-9(MMP9) and interleukin-1β(IL-1β). The experiment further took the dorsal root ganglion(DRG) and the stage of patho-logical spinal cord as the research objects, focusing on the core targets of inducing microglial neuroinflammation. By means of Western blot, immunofluorescence, agonists, antagonists, behavior, etc., the mechanism of Naru-3 in exerting NP analgesia may be related to the negative regulation of the MMP9/IL-1β signaling pathway-mediated microglia p38/IL-1β inflammatory loop in the activation phase. The relevant research enriches the biological connotation of Naru-3 in the treatment of NP and provides references for clinical rational drug use.

Analysis of the risk factors for severe lung injury after radical surgery for tetralogy of fallot.

Objective: This study aimed to determine the risk factors for severe lung injury (SLI) (partial pressure of oxygen/fraction of inspired oxygen <150) after radical surgery for tetralogy of Fallot with pulmonary stenosis (TOF/PS) in children. Method: A retrospective analysis was conducted including a total of 287 children with TOF/PS aged below 10 years (including 166 males) who had undergone radical surgery at the Center of Pediatric Heart Disease of the Beijing Anzhen Hospital (China) from 2018 to 2020. Results: A total of 83 cases (28.9%) had SLI after surgery. Univariate analysis showed that age, weight, pulmonary artery index (PAI), cardiopulmonary bypass (CPB) time, and polymorphonuclear leukocyte (PMN) percentage on the first day after surgery were risk factors for postoperative SLI. Multivariate logistic regression analysis showed that PAI, PMN percentage on the first day postoperatively, and CPB time were independent risk factors for SLI after surgery. The prediction model was established as follows: Logit(P) = 2.236 + 0.009*CPB-0.008*PAI-0.035*PMN, area under the curve (AUC) = 0.683, P < 0.001, sensitivity 65.8%, and specificity 68.6%. Following surgery, static lung compliance was significantly lower in the SLI group compared with the routine group. Complication rates and mortality were significantly higher in the SLI than in the routine group. Ventilator support times, the length of intensive care unit stays, and the total lengths of hospital stay were significantly longer in the SLI than in the routine group. Conclusion: The occurrence of SLI following radical surgery for TOF in children significantly affected postoperative recovery, and PAI, PMN percentage on the first day postoperatively, and CPB time were independent risk factors for SLI.

Aquaporins: Important players in the cardiovascular pathophysiology.

Aquaporin is a membrane channel protein widely expressed in body tissues, which can control the input and output of water in cells. AQPs are differentially expressed in different cardiovascular tissues and participate in water transmembrane transport, cell migration, metabolism, inflammatory response, etc. The aberrant expression of AQPs highly correlates with the onset of ischemic heart disease, myocardial ischemia-reperfusion injury, heart failure, etc. Despite much attention to the regulatory role of AQPs in the cardiovascular system, the translation of AQPs into clinical application still faces many challenges, including clarification of the localization of AQPs in the cardiovascular system and mechanisms mediating cardiovascular pathophysiology, as well as the development of cardiovascular-specific AQPs modulators.Therefore, in this study, we comprehensively reviewed the critical roles of AQP family proteins in maintaining cardiovascular homeostasis and described the underlying mechanisms by which AQPs mediated the outcomes of cardiovascular diseases. Meanwhile, AQPs serve as important therapeutic targets, which provide a wide range of opportunities to investigate the mechanisms of cardiovascular diseases and the treatment of those diseases.

Insights on dissolved organic matter and bacterial community succession during secondary composting in residue after black soldier fly larvae (Hermetia illucens L.) bioconversion for food waste treatment.

Black soldier fly larvae (Hermetia illucens L. BSFL) bioconversion is a promising biotechnology for food waste treatment. However, the separated residues still do not meet criteria for use as land application biofertilizers. In this work, we investigated a full-scale BSFL bioconversion project to explore features of dissolved organic matter (DOM) and its associated responses of bacterial community succession in residue during secondary composting. Data showed that the concentrations of total nitrogen and ammonium nitrogen decreased by 11.8% and 22.6% during the secondary composting, respectively, while the nitrate nitrogen concentration increased 18.7 times. The DOM concentration decreased by 69.1%, in which protein-like, alcohol-phenol, and biodegradable aliphatic substances were metabolized by bacteria during the thermophilic phase together with the accumulation of humus-like substances, resulting in an increase in the relative concentration of aromatic compounds. The structure of the bacterial community varied at different stages of the bioprocess, in which Bacteroidetes, Actinobacteria, Proteobacteria, and Firmicutes were the dominant bacterial phyla. Lysinibacillus, Pusillimonas, and Caldicoprobacter were found to be key contributors in the degradation and formation of DOM. The DOM concentration (33.4%) and temperature (17.7%) were the prime environmental factors that promoted succession of the bacterial community. Through bacterial metabolism, the structural stability of DOM components was improved during the composting process, and the degrees of humification and aromaticity were also increased. This study depicted the dynamic features of DOM and the associated bacterial community succession in residue during secondary composting, which is conducive with the reuse of BSFL residue as biofertilizer for agriculture.

Trajectories of Neurological Recovery 12 Months after Hospitalization for COVID-19: A Prospective Longitudinal Study

Background/ObjectivesLittle is known about trajectories of recovery 12-months after hospitalization for severe COVID. MethodsWe conducted a prospective, longitudinal cohort study of patients with and without neurological complications during index hospitalization for COVID-19 from March 10, 2020-May 20, 2020. Phone follow-up batteries were performed at 6- and 12-months post-COVID symptom onset. The primary 12-month outcome was the modified Rankin Scale (mRS) comparing patients with or without neurological complications using multivariable ordinal analysis. Secondary outcomes included: activities of daily living (Barthel Index), telephone Montreal Cognitive Assessment (t-MoCA) and Neuro-QoL batteries for anxiety, depression, fatigue and sleep. Changes in outcome scores from 6 to 12-months were compared using non-parametric paired-samples sign test. ResultsTwelve-month follow-up was completed in N=242 patients (median age 65, 64% male, 34% intubated during hospitalization) and N=174 completed both 6- and 12-month follow-up. At 12-months 197/227 (87%) had [≥]1 abnormal metric: mRS>0 (75%), Barthel<100 (64%), t-MoCA[≤]18 (50%), high anxiety (7%), depression (4%), fatigue (9%) and poor sleep (10%). 12-month mRS scores did not differ significantly among those with (N=113) or without (N=129) neurological complications during hospitalization after adjusting for age, sex, race, pre-COVID mRS and intubation status (adjusted OR 1.4, 95% CI0.8-2.5), though those with neurological complications had higher fatigue scores (T-score 47 vs 44, P=0.037). Significant improvements in outcome trajectories from 6- to 12-months were observed in t-MoCA scores (56% improved, median difference 1 point, P=0.002), and Neuro-QoL anxiety scores (45% improved, P=0.003). Non-significant improvements occurred in fatigue, sleep and depression scores in 48%, 48% and 38% of patients, respectively. Barthel and mRS scores remained unchanged between 6 and 12-months in >50% of patients. DiscussionAt 12-months post-hospitalization for severe COVID, 87% of patients had ongoing abnormalities in functional, cognitive or Neuro-QoL metrics and abnormal cognition persisted in 50% of patients without a prior history of dementia/cognitive abnormality. Only fatigue severity differed significantly between patients with or without neurological complications during index hospitalization. However, significant improvements in cognitive (t-MoCA) and anxiety (Neuro-QoL) scores occurred in 56% and 45% of patients, respectively, between 6- to 12-months. These results may not be generalizable to those with mild/moderate COVID.

V-Y latissimus dorsi musculocutaneous flap for reconstruction of chest wall defects after local advanced breast cancer surgery: Report of 14 cases / 中华显微外科杂志

Objective:To demonstrate the clinical effect of latissimus dorsi musculocutaneous flap with primary closure in V-Y suture in the repair of major lesions in the anterior chest wall that was left after mastectomies with locally advanced breast cancer (LABC) surgery.Methods:From September 2018 to February 2021, the technique was employed on 14 female cancer patients who had LABC surgery in the Department of Breast Surgery of the First Affiliated Hospital of Kunming Medical University. The patients received radical mastectomies with major resection of cutaneous tegument. The defect areas in chest wall were 15.0 cm×15.0 cm-22.0 cm×35.0 cm. The sizes of flap were 12.0 cm×28.0 cm-18.0 cm×35.0 cm. The sizes of musculocutaneous flap were 12.0 cm×28.0 cm×2.0 cm~18.0 cm×35.0 cm×3.5 cm. All patients were entered the postoperative follow-up through out-patient clinic and telephone interviews.Results:The flap provided an efficient coverage in closing the defects among all 14 patients. Three patients presented small areas (1.0-3.0 cm) of superficial necrosis in Y-cross area of the flap. None of the patient had back swelling. The average operation time was 6.3 hours. Postoperative follow-up varied from 4 to 41 months(18 months in average). The colour, texture, elasticity of the flaps were acceptable, with good shapes. Function of upper limbs was normal in 13 cases without lymphedema, except 1 who had lymphedema of affected limb at 3 years after surgery. Eleven cases had radiotherapy after surgery with good tolerance. None of the cases had local recurrence of breast cancer. Five cases had metastasis, 3 cases died of metastasis.Conclusion:The latissimus dorsi musculocutaneous flap with primary closure in V-Y suture is easy to perform and an reliable and efficient technique in repairing large defects in the anterior chest wall left after a LABC surgery.

Clinicopathological features and prognosis of high-grade B-cell lymphoma with MYC and bcl-2 and/or bcl-6 rearrangements / 中华病理学杂志

Objective: To investigate the clinicopathological characteristics and prognosis of high-grade B-cell lymphoma (HGBL) involving combined rearrangements of MYC, bcl-2 and bcl-6. Methods: A total of 1 138 cases of large B cell lymphoma (LBL) that were treated at the Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2017 to September 2020 were analyzed using fluorescence in situ hybridization (FISH) with probes against MYC, bcl-2 and bcl-6. The clinical and pathological data of the 45 patients with HGBL that had rearrangements of MYC and bcl-2 and/or bcl-6 were collected and retrospectively analyzed. Results: Among the 1 138 LBL, 45 (4.0%) cases had combined rearrangements of MYC, bcl-2 and/or bcl-6 that included 6 HGBL cases with MYC, bcl-2 and bcl-6 rearrangements, 14 HGBL cases with MYC and bcl-2 rearrangements, and 25 HGBL cases with MYC and bcl-6 rearrangements. Of these 45 patients, 29 patients were male, and 16 patients were female, aged 29 to 83 years. HGBL with MYC, bcl-2 and bcl-6 rearrangements and HGBL with MYC and bcl-2 rearrangement were reclassified as the germinal center B-cell (GCB) subtype using the Hans algorithm. HGBL with MYC and bcl-6 rearrangement were reclassified as the GCB subtype (68.0%) and the non-GCB subtype (32.0%). The vast majority of HGBL cases had a high Ki-67 proliferation index. Most HGBL patients had advanced stage disease with a high IPI score and an increased LDH level. Also, some patients had clinical features including elevated plasma β2-microglobulin levels, B symptoms, and bone marrow involvement. The IPI scores and LDH levels were significantly different between the HGBL cases with MYC, bcl-2 and bcl-6 rearrangements and the HGBL cases with MYC and bcl-6 rearrangements (P<0.05). Compared with the HGBL cases with MYC, bcl-2 and bcl-6 rearrangements, the HGBL cases with MYC and bcl-2 or bcl-6 rearrangements had a lower incidence of bone marrow involvement (P<0.05). There were no significant differences in the prognosis among HGBL cases with MYC, bcl-2 and bcl-6 rearrangements, the cases with MYC and bcl-2 rearrangements, and the cases with MYC and bcl-6 rearrangements (P>0.05). Conclusions: HGBL with MYC, bcl-2 and/or bcl-6 rearrangements are rare types of B-cell lymphoma with high degree of malignancy and have a short overall survival. To reduce misdiagnosis and improve diagnostic accuracy, it is necessary to assess the patients' clinical features and conduct histopathological, immunohistochemical and FISH analyses.

Peer relationship and depression symptoms in adolescents: the mediating effect of core self-evaluation and social withdrawal / 中华行为医学与脑科学杂志

Objective:To explore the chain mediating effect of core self-evaluation and social withdrawal on the relationship between peer relationship and depression symptoms of adolescents.Methods:From September 2020 to October 2020, a sample of 1 936 students from grade 4 to grade 9 of different schools completed a cross-section questionnaire survey including the inventory of parent and peer attachment, core self-evaluation scale, child social preference scale-R and depression self-rating scale for children.SPSS 21.0 and SPSS PROCESS macro program were used for data statistics.The statistical methods included analysis of variance, correlation analysis and intermediary effect test.Results:(1) Peer relationship (94.78±17.27) was positively correlated with core self-evaluation (34.14±7.52) ( r=0.50, P<0.01), and negatively correlated with depression (12.21±6.02) and social withdrawal (32.34±11.45) ( r=-0.55, -0.58, both P<0.01). Core self-evaluation was negatively associated with social withdrawal and depression symptoms ( r=-0.48, -0.67, both P<0.01), while social withdrawal and depression was positively correlated ( r=0.54, P<0.01). (2) Peer relationship had a significant direct effect on depression symptoms (the effect value=-0.205, P<0.01). Core self-evaluation and social withdrawal respectively separate mediated the effect of peer relationship on depression symptoms (the effect value=-0.231, -0.088, 95% CI=-0.261--0.202, -0.110--0.068), while the chain mediating effect of the two was significant, and the effect value was -0.025(95% CI=-0.033--0.019). Conclusion:Good peer relationship can lead to higher core self-evaluation and less social withdrawal behaviors in adolescents that serves as buffer from depression.

Effects of puerarin on blood pressure and aortic endothelial function in obese mice / 中国药理学通报

Aim To explore the effeet of puerarin (Pue) on aortic function and blood pressure in hyper-tensive mice induced by high-fat diet.Methods Thirty male mice were divided into five groups named as normal diet group ( Con ) , high-fat diet group (1)10), high-fat diet + low-dose puerarin group (20 mg 'kg-1 •(!"'), high-fat diet + medium-dose puera¬rin (40 mg • kg"1 • d ~1 ) group and high-fat diet + high-dose puerarin group (80 mg 'kg-1 • d~l).Hie mice were injected intraperitoneally with Pue for eight weeks.Body weight, blood pressure and blood glucose were measured.Serum was collected to detect blood lipid.Aortas were separated from aortic endothelial cells to test the vasodilative function.Aortic endotheli¬al cells from 1)10 mice were isolated to perform Iran-swell and cell proliferation experiments.Results I High-rlose puerarin treatment could reduce the body weight, body fat, blood glucose and blood pressure in obese mice ( P < 0.01 ) ; 2 High dose of puerarin could improve the vasodilative function of aortas com¬pared with those from 1)10 mice (P <0.01 ) ; (3) The migration ability of primary endothelial cells from 1)10 + Pue group was improved compared with that from 1)10 group (P <0.01 ).Conclusions Puerarin can significantly reduce blood pressure in obese mice in¬duced by high fat diet by improving the aortic diastolic function and endothelial cell proliferation and migra-tion.

Chain mediating effect of anxiety, depression and metacognition between somatic symptoms and fear of disease progression among gynecological tumor patients / 中华行为医学与脑科学杂志

Objective:To explore the chain mediating effects of anxiety/depression and metacognition between somatic symptoms and fear of disease progression (FoP) in gynecological tumor patients.Methods:A total of 208 gynecological tumor patients were investigated by general demographic data, fear of progression questionnaire-short form(FoP-Q-SF), hospital anxiety and depression scale(HADS), metacognition questionnaire(MCQ) and somatic symptom scale(SSS). SPSS 25.0 was used for Pearson correlation analysis. The significance of mediating effect was tested by deviation corrected nonparametric percentile Bootstrap method using SPSS macro program PROCESS.Results:The scores of FoP-Q-SF, depression, anxiety, MCQ and SSS were (32.41±10.43), (6.43±4.17), (7.51±4.10), (68.44±16.04), (20.58±15.70) respectively. 48.56% of gynecological tumor patients had dysfunctional fear of disease progression. Correlation analysis showed that FoP was significantly positively correlated with somatic symptoms ( r=0.394, P<0.01), anxiety ( r=0.640, P<0.01), depression ( r=0.533, P<0.01) and metacognition ( r=0.489, P<0.01). Mediating effect test showed that anxiety, depression and metacognition played a complete chain mediating role between somatic symptoms and FoP in gynecological tumor patients.The total effect of somatic symptoms on FoP was 0.320. Somatic symptoms indirectly affected FoP by influencing anxiety and metacognition, and the intermediary effect value was 0.242. Somatic symptoms indirectly affected FoP by influencing depression and metacognition, and the intermediary effect value was 0.212. Conclusion:Somatic symptoms can indirectly affect FoP through the chain mediation of anxiety/depression and metacognition.

Clinical practice of double lumen cannula for veno-venous extracorporeal membrane oxygenation in adults / 中华危重病急救医学

Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a life support technique for patients with severe respiratory failure. In the past, single lumen cannula was mostly used to constract the vascular pathway of extracorporeal membrane oxygenation. Compared with single-lumen cannula, double lumen cannula (DLC) can reduce recirculation fraction, reduce complications such as infection and bleeding, and facilitate patient's rehabilitation. DLC requires accurate positioning of the catheter. It has been gradually applied in China. This paper will review the key points related to the use of DLC, such as the insertion, position, and complications, etc. to provide guidance for clinical application practice.

Application effect of MOOC+CBL teaching mode in practice teaching of nuclear medicine SPECT/CT / 中华医学教育探索杂志

Objective:To explore the application effect of massive online open course (MOOC) + case-based learning (CBL) in SPECT/CT practice teaching of nuclear medicine.Methods:Twenty-nine interns of nuclear medicine SPECT/CT in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 2020 to October 2020 were selected as the research group and received MOOC + CBL teaching. Taking 31 interns from January 2019 to October 2019 as the control group, and the traditional teaching method was conducted. At the end of the internship, the students' theoretical and operational skills were assessed. Their learning motivation and thinking ability were evaluated by using the study process questionnaire (SPQ) and the Chinese version of California critical thinking disposition inventory (CTDI-CV), and the two groups' satisfaction with teaching was compared. SPSS 22.0 was used for Chi-square test and t-test. Results:The results of theoretical knowledge, PET/CT case analysis and image diagnosis in the study group were higher than those in the control group ( P<0.05). The total scores of surface motivation, deep motivation and SPQ in the study group were higher than those in the control group ( P<0.05). The self-confidence scores of open mind, analytical ability, systematization ability, and critical thinking and CTDI-CV total scores of the study group were higher than those of the control group ( P<0.05). The study group was more satisfied with the teaching and the enhancement of self-study ability than the control group ( P<0.05). Conclusion:MOOC + CBL teaching for nuclear medicine SPECT/CT interns can improve their examination results, learning motivation and thinking ability, and also enhance their self-study ability.