Evaluation of the diagnostic performance of an immunochromatographic test for Chlamydia trachomatis.

Objectives: To evaluate the diagnostic performance of different brands of immunochromatographic test (ICT) reagents for Chlamydia trachomatis using homogenized samples to provide a reference for reagent quality control. Methods: Eight commercially available ICT reagents were evaluated, of which three used the latex method and five used the colloidal gold method. Analytical performance evaluation using a pure culture broth of C. trachomatis, as well as clinical application validation using cervical epithelial cell samples acquired from the research subjects, were conducted. The concentration of C. trachomatis was quantified using a nucleic acid amplification test. Results: The limit of detection (LOD) of different ICT reagents in the analytical performance evaluation varied from 9.5 × 103 to 1 × 105 IFU/mL, and only one reagent met the LOD specified in the manufacturer's instructions. Likewise, only one reagent in the clinical application validation achieved the analytical LOD, four reagents were 2.1-4.2-fold of the analytical LODs, and three reagents failed to detect positive results in clinical samples. Conclusions: The diagnostic performance of different methods and different brands of ICT reagents in clinical practice was different from the manufacturer's instructions and the results of laboratory evaluation. The diagnostic performance of reagents should be evaluated before they are actually used in clinical practice.

Association of cardiometabolic multimorbidity with all-cause and cardiovascular disease mortality among Chinese hypertensive patients.

BACKGROUND: Hypertension usually clusters with multiple comorbidities. However, the association between cardiometabolic multimorbidity (CMM) and mortality in hypertensive patients is unclear. This study aimed to investigate the association between CMM and all-cause and cardiovascular disease (CVD) mortality in Chinese patients with hypertension. METHODS: The data used in this study were from the China National Survey for Determinants of Detection and Treatment Status of Hypertensive Patients with Multiple Risk Factors (CONSIDER), which comprised 5006 participants aged 19-91 years. CMM was defined as the presence of one or more of the following morbidities: diabetes mellitus, dyslipidemia, chronic kidney disease, coronary heart disease, and stroke. Cox proportional hazard models were used to calculate the hazard ratios (HR) with 95% CI to determine the association between the number of CMMs and both all-cause and CVD mortality. RESULTS: Among 5006 participants [mean age: 58.6 ± 10.4 years, 50% women (2509 participants)], 76.4% of participants had at least one comorbidity. The mortality rate was 4.57, 4.76, 8.48, and 16.04 deaths per 1000 person-years in hypertensive patients without any comorbidity and with one, two, and three or more morbidities, respectively. In the fully adjusted model, hypertensive participants with two cardiometabolic diseases (HR = 1.52, 95% CI: 1.09-2.13) and those with three or more cardiometabolic diseases (HR = 2.44, 95% CI: 1.71-3.48) had a significantly elevated risk of all-cause mortality. The findings were similar for CVD mortality but with a greater increase in risk magnitude. CONCLUSIONS: In this study, three-fourths of hypertensive patients had CMM. Clustering with two or more comorbidities was associated with a significant increase in the risk of all-cause and cardiovascular mortality among hypertensive patients, suggesting more intensive treatment and control in this high-risk patient group.

Activation of A1 reactive astrocytes in the medullary dorsal horn of rats participates in the chronification of trigeminal neuralgia / 中南大学学报(医学版)

Objective:The activation of astrocytes is an important process in the formation of chronic pain.This study aims to observe the activation of A1 reactive astrocytes in the medullary dorsal horn in the rat model of trigeminal neuralgia,and to explore the mechanism of central sensitization caused by A1 reactive astrocyte. Methods:The adult male rats were randomly divided into a sham group and a chronic constriction injury of infraorbital nerve(ION-CCI)group.The facial mechanical pain threshold and thermal withdrawal latency were measured before the operation and on the 1st,3rd,7th,10th,and 14th day after the operation.After pain behavior observation,the expression of glial fibrillary acidic protein(GFAP)in the medullary dorsal horn was observed by immunohistochemistry and immunofluorescence colocalization of GFAP,complement 3(C3)/S100A10,and 4',6-diamidino-2-phenylindole(DAPI)was analyzed.Primary astrocytes were cultured and randomly divided into a naive group and a DHK group.The DHK group was treated with 1 mmol/L of astrocyte activation inhibitor dihydrokainic acid(DHK).Fura-2/AM was used to stain the astrocytes and the calcium wave of the 2 groups under the stimulation of high potassium was recorded and compared.The expression of C3 was detected by Western blotting. Results:The facial mechanical pain threshold and thermal withdrawal latency of the ION-CCI group were significantly lower than those of the sham group(both P<0.05).There were a large number of GFAP positive astrocytes in the medullary dorsal horn of the ION-CCI group.The fluorescence intensity of GFAP in the ION-CCI group was higher than that in the sham group(P<0.05).GFAP and C3/S100A10 were co-expressed in astrocytes.Compared with the sham group,the fluorescence intensity of C3 and the protein expression of C3 in the ION-CCI group were increased(both P<0.05).The expression of C3 in ION-CCI group was significantly increased(P<0.05).Compared with the naive group,the C3 protein expression was significantly decreased in the DHK group(P<0.05).The intensity of calcium fluorescence was increased after high potassium stimulation in both groups.Furthermore,the peak and increase amplitude of calcium fluorescence in the naive group were much higher than those in the DHK group(both P<0.05). Conclusion:A1 reactive astrocytes in the medullary dorsal horn of trigeminal neuralgia model rats are increased significantly,which may participate in central sensitization of trigeminal neuralgia by impacting astrocyte calcium wave.

CRISPR-assisted transcription activation by phase-separation proteins

The clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 system has been widely used for genome engineering and transcriptional regulation in many different organisms. Current CRISPR-activation (CRISPRa) platforms often require multiple components because of inefficient transcriptional activation. Here, we fused different phase-separation proteins to dCas9-VPR (dCas9-VP64-P65-RTA) and observed robust increases in transcriptional activation efficiency. Notably, human NUP98 (nucleoporin 98) and FUS (fused in sarcoma) IDR domains were best at enhancing dCas9-VPR activity, with dCas9-VPR-FUS IDR (VPRF) outperforming the other CRISPRa systems tested in this study in both activation efficiency and system simplicity. dCas9-VPRF overcomes the target strand bias and widens gRNA designing windows without affecting the off-target effect of dCas9-VPR. These findings demonstrate the feasibility of using phase-separation proteins to assist in the regulation of gene expression and support the broad appeal of the dCas9-VPRF system in basic and clinical applications.

An interpretable machine learning-based prediction model for risk of death for patients with ischemic stroke in intensive care unit / 南方医科大学学报

OBJECTIVE@#To construct an inherent interpretability machine learning model as an explainable boosting machine model (EBM) for predicting one-year risk of death in patients with severe ischemic stroke.@*METHODS@#We randomly divided the data of 2369 eligible patients with severe ischemic stroke in the MIMIC-Ⅳ(2.0) database, who were admitted in ICU in 2008 to 2019, into a training dataset (80%) and a test dataset (20%), and assessed the prognosis of the patients using the EBM model. The prediction performance of the model was evaluated by calculating the area under the receiver operating characteristic (AUC) curve. The calibration curve and Brier score were used to evaluate the degree of calibration of the model, and a decision curve was generated to assess the net clinical benefit.@*RESULTS@#The EBM model constructed in this study had good discrimination power, calibration and net benefit, with an AUC of 0.857 (95% CI: 0.831-0.887) for predicting prognosis of severe ischemic stroke. Calibration curve analysis showed that the standard curve of the EBM model was the closest to the ideal curve. Decision curve analysis showed that the model had the greatest net benefit rate at the prediction probability threshold of 0.10 to 0.80. The top 5 independent predictive variables based on the EBM model were age, SOFA score, mean heart rate, mechanical ventilation, and mean respiratory rate, whose significance scores ranged from 0.179 to 0.370.@*CONCLUSION@#This EBM model has a good performance for predicting the risk of death within one year in patients with severe ischemic stroke and allows clinicians to better understand the contributing factors of the patients' outcomes through the model interpretability.

Three-dimensional reconstruction reveals the correlation between the extent of alveolar clefts and secondary nasal deformity in adults / 华西口腔医学杂志

OBJECTIVES@#This study aimed to explore the relationship between alveolar cleft and secondary nasal deformity post unilateral cleft lip repair in adults.@*METHODS@#A total of 27 patients aged 16-30 years old with unilateral secondary nasal deformity and alveolar cleft were included, 13 of whom underwent bone grafting. Spiral CT data of all preoperative and postoperative patients who had alveolar bone grafting were collected. Then, Mimics software was used for three-dimensional reconstruction to evaluate the correlation between the width, height, and volume of the alveolar cleft and those of the nasal deformity. The difference in nasal deformity before and after alveolar bone grafting was also explored.@*RESULTS@#The width of the alveolar cleft was positively correlated with the difference in bilateral nostril floor width (P<0.05). As the effective depth of the alveolar cleft increased, the sub-alare inclination angle largened (P<0.05). However, no significant difference was found in the nasal deformity between before and after alveolar bone grafting.@*CONCLUSIONS@#Alveolar cleft is closely related to secondary nasal deformities post unilateral cleft lip repair, especially nasal floor deformities. Alveolar bone grafting benefits adult patients for the improvement of secondary nasal deformities post unilateral cleft lip repair.

Expression and significance of fork head box protein N2 and F2 in gliomas / 解剖学报

Objective To observe the expression levels of fork head box protein N2 (FOXN2) and fork head box protein F2 (FOXF2) in normal brain tissue, low-grade glioma and high-grade glioma, and to explore the relationship between the two and the grade of glioma, and then deduce their roles in the occurrence and development of glioma, to look for possibilities target of drug therapy. Methods From January 2016 to December 2020, 36 glioma specimens were collected from the Department of Pathology, Yijishan Hospital, Wannan Medical College. The expressions of F0XN2 and F0XF2 were detected by immunohistochemistry and immunofluorescence with the double-blind method, and analyzed by SPSS18. 0 software, with a statistical significance of P<0. 05. Then Western blotting and Real-time PCR experiments were carried out on fresh normal brain tissues, low-grade glioma tissues, high-grade glioma tissues during neurosurgery in Yijishan Hospital of Wannan Medical College from January 2020 to January 2021 (normal brain tissues were all trauma patients). Results The results of immunohistochemistry and immunofluorescence showed that the higher grade of glioma, the lower expressions of FOXN2 and FOXF2 would be (P<0. 05). Western blotting showed that the expressions of FOXN2 and FOXF2 in normal brain tissue and low-grade glioma were higher than those in high-grade glioma (P<0. 05). The result of Real-time PCR showed that the expressions of FOXN2 and FOXF2 in normal brain tissue were higher than those in high-grade glioma (P<0. 01). Conclusion FOXN2 and FOXF2 are expressed in normal brain tissues, and their expression is low in glioma in a grade-dependent manner, suggesting that FOXN2 and FOXF2 are related to the grade and poor prognosis of glioma. Enhancing the expression of F0XN2 and F0XF2 ma)' provide a new idea for target therapy of glioma.

Application research of objective teaching guided by immersion education theory in psychiatry practice teaching / 中华医学教育探索杂志

Objective:To explore the role of objective teaching guided by immersion education theory in the practice teaching of undergraduates majoring in psychiatry.Methods:Two classes of undergraduates majoring in psychiatry in Batch 2018 were randomly selected as the study group and the control group. A total of 35 students in the control group had traditional teaching, and 37 students in the study group had objective teaching guided by immersion education theory, both with half a semester of teaching. After the teaching, the theoretical knowledge examination scores and skills assessment scores, comprehensive ability (self-learning ability, communication ability, clinical thinking, innovation ability, and humanistic care ability), and teaching satisfaction of the two groups were compared. SPSS 26.0 was used for t-test, Chi-square test, and rank sum test. Results:After the teaching, the theoretical knowledge examination scores (basic medicine, clinical medicine, clinical psychology, and psychiatry), skill assessment scores (physical examination, and mental examination), self-learning ability, communication ability, clinical thinking, innovation ability, and humanistic care ability of the study group were all higher than those of the control group ( P<0.05). The teaching satisfaction degree of the study group was higher than that of the control group, and the difference was statistically significant ( P<0.05). Conclusion:Objective teaching guided by immersion education theory can improve the scores of professional theoretical knowledge scores and skills assessment scores of undergraduates majoring in psychiatry, and improve teaching satisfaction.

Correlation between platelet distribution width and anticoagulant stability of warfarin in patients with persistent atrial fibrillation / 中国医师杂志

Objective:To explore the correlation between platelet distribution width (PDW) and the stability of warfarin anticoagulant therapy in patients with persistent atrial fibrillation.Methods:138 patients with persistent atrial fibrillation treated with warfarin in Jiujiang First People′s Hospital from January 2018 to December 2019 were selected. They were divided into groups according to whether PDW increased (PDW decreased group, normal group, PDW increased group) and subgroups stratification was performed. After stratification, the relationship between PDW and the stability of warfarin anticoagulation treatment [expressed as the percentage of time of International normalized ratio(INR) within the treatment target range (TTR)] was analyzed. At the same time, the predictive value of PDW for the stability of warfarin anticoagulation treatment was analyzed.Results:There were significant difference in PDW and TTR among the PDW decreased group, normal group, PDW increased group ( F=30.322, 10.745, all P<0.01). The PDW distribution of patients with different anticoagulation quality was significantly different (χ 2=9.532, P<0.05). Receiver operating characteristic (ROC) curve showed that the area under curve (AUC) of PDW in predicting warfarin anticoagulant stability was 0.621(95% CI: 0.524-0.737). There was significant difference in PDW and TTR among the PDW<14%, 14%-<16%, 16-<18% and ≥18% groups( F=18.075, 11.638, all P<0.01). There was no significant difference in PDW and TTR among the three subgroups of PDW<14%, 14%-<16% and 16-<18% ( P=0.843, P=0.401). There were significant difference in PDW and TTR between the two subgroup of PDW 16-<18%、≥18% ( t=4.154, 6.712, all P<0.01). Conclusions:PDW is correlated with the standard rate of warfarin anticoagulant stability, and can be used to predict the standard rate of warfarin anticoagulant stability.

Development and preliminary application of the information monitoring system for radiological protection / 中华放射医学与防护杂志

Objective:To develop an information system for testing radiological protection that can interface with National Radiation Health Information Platform/Medical Radiation Monitoring Subsystem and to improve the testing efficiency.Methods:Complying with the relevant national regulations and standards, the analysis was carried out of demand investigation and system modeling. An information system for testing radiological protection was established using B/S architecture, comprising three modules such as testing, audit and system management. The users at four levels were set of administrator, inspector, auditor and report issuer.Results:Based on test result, the developed information system has been shown to realize the informatization of the whole process from filling, auditing, issuing, issuing of the testing report to data uploading, with improved testing efficiency.Conclusions:The developed information system for testing radiological protection can improve the testing efficiency, and can be successfully interfaced with the National Radiation Health Information Platform/Medical Radiation Protection Monitoring Subsystem.

Correlation between intestinal glucagon-like peptides-1 and major depressive disorder / 中华行为医学与脑科学杂志

Objective:To explore the pathogenesis of major depressive disorder(MDD) by comparing the serum glucose and lipid metabolism indicators, levels of glucagon-like peptide-1(GLP-1) in plasma and feces, and the content of specific intestinal flora ( Lactobacillus, Bifidobacterium) between patients with MDD who were diagnosed for the first time and healthy controls. Methods:Totally 80 MDD patients hospitalized from January 1, 2020 to March 30, 2021 and 80 healthy volunteers with normal physical examination in the same period were selected. Blood and fecal samples of patients with MDD and healthy controls were collected respectively. The indicators of serum glucose and lipid metabolism were detected by automatic biochemical analyzer, the concentrations of GLP-1 in plasma and feces were detected by ELISA, and the relative contents of Lactobacillus and Bifidobacterium in feces were detected by real-time PCR. The differences between two groups of glucose and lipid metabolism indicators, GLP-1 levels and the relative contents of Lactobacillus and Bifidobacterium in feces were analyzed. SPSS 22.0 software was used for statistical analysis. Independent sample t-test and analysis of variance were used for inter group comparison, and Pearson correlation analysis was used for correlation analysis. Results:Compared with the control group, the levels of serum TC, HDL, and LDL in the MDD group decreased ((3.99±0.85)mmol/L , (4.78±0.86)mmol/L; (1.18±0.29)mmol/L, (1.30±0.28)mmol/L; (2.64±0.70)mmol/L, (3.19±0.69)mmol/L; t=5.559, 2.371, 4.695, all P<0.05). The plasma and fecal GLP-1 levels of the MDD group were lower than those of the control group (plasma: (0.81±0.22)pmol/mL, (1.05±0.26)pmol/mL , t=4.509, P<0.01; feces: (2.23±0.46)pmol/mL , (2.47±0.37)pmol/mL, t=2.533, P<0.05). Compared with the control group, the relative contents of Lactobacillus(2.56±1.59, 3.51±2.21) and Bifidobacterium(2.24±1.89 , 3.17±2.08) in the MDD group decreased ( t=2.218, 2.082, both P<0.05). The level of plasma GLP-1 in the MDD group was negatively correlated with FPG, TG, and disease severity ( r=-0.281, -0.221, -0.437, P<0.05). The level of plasma GLP-1 in the control group was negatively correlated with FPG ( r=-0.580, P<0.01). The fecal GLP-1 level of the MDD group was negatively correlated with the severity of the disease ( r=-0.298, P<0.01), and the fecal GLP-1 level of the control group was positively correlated with fecal Lactobacillus and Bifidobacterium ( r=0.685, 0.428, P<0.01). Conclusion:MDD patients have abnormal glucose and lipid metabolism, decreased GLP-1 level and decreased relative content of intestinal Lactobacillus and Bifidobacterium. Changes in intestinal flora affect GLP-1 levels. GLP-1 can affect glucose and lipid metabolism and depressive symptoms in patients with MDD by binding to specific receptors in intestinal tract and central nervous system.

Q-marker prediction of Magnoliae Officinalis Cortex before and after "sweating" / 中国中药杂志

Magnoliae Officinalis Cortex, a common Chinese medicinal in clinic, should undergo "sweating" process in producing area according to Chinese Pharmacopoeia, which affects its genuineness and quality. In light of the concept and research mode of quality marker(Q-marker) for decoction pieces, the active components of Magnoliae Officinalis Cortex pieces which altered significantly before and after "sweating" were identified in this study. The main pharmacodynamic material basis was clarified by pharmacodynamic, pharmacokinetic and drug property research, followed by the prediction of Q-markers of Magnoliae Officinalis Cortex before and after "sweating", for better improving its quality standard.

Mechanism of Magnoliae Officinalis Cortex in treatment of peptic ulcer based on network pharmacology and molecular docking / 中国中药杂志

Magnoliae Officinalis Cortex(Houpo) can treat peptic ulcer disease(PUD), the mechanism of which remains unclear. In this study, network pharmacology and molecular docking were employed to predict the mechanism of Houpo in the treatment of PUD. Through literature review and TCMSP screening, 15 main active ingredients were obtained. The SwissTargetPrediction database was used to predict the potential targets of the ingredients, and Therapeutic Target Database(TTD), DrugBank, and Human Phenotype Ontology(HPO) to screen the disease-related targets. A total of 49 potential targets were obtained by the intersection of active ingre-dients-related targets and disease-related targets. Cytoscape 3.6.1 was employed to construct the protein-protein interaction network for the targets with high confidence(score>0.700) screened out by STRING. The DAVID database was used for GO and KEGG pathway enrichment of potential targets. GO enrichment analysis showed that the treatment mechanism was mostly related to nuclear receptor activity, ligand-activated transcription factor activity, and G protein-coupled acetylcholine receptor activity. KEGG enrichment analysis found that Houpo could regulate material metabolism, endocrine system, p53 signaling pathway, and PPAR signaling pathway. Molecu-lar docking verified that all 15 ingredients had good binding activities with key targets(CHRM1, CHRM2, FABP1, mTOR, and STAT3). The results mean that Houpo can treat PUD by participating in cell metabolism, inhibiting inflammatory cytokines, and regulating cell proliferation and apoptosis.

Unilateral vertebroplasty and kyphoplasty by digital subtraction angiography for the treatment of osteoporotic vertebral compression fractures / 中国骨伤

OBJECTIVE@#To explore the methods and efficacy of unilateral extra-pedicle precision puncture percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty(PKP) by digital subtraction angiography (DSA) for the treatment of osteoporotic vertebral compression fractures (OVCFs).@*METHODS@#The clinical data of 68 patients with osteoporotic vertebral compression fractures treated from August 2015 to December 2018 were retrospectively analyzed. There were 20 males and 48 females, aged 56 to 90(73.5±8.0) years, 40 cases of double segments, 28 cases of three segments, a total of 168 vertebrae. All the patients were performed PVP orPKP through unilateral extra pedicle precision puncture under the guidance of DSA. The vertebrae were distributed in T@*RESULTS@#All the punctures were successful in 68 patients. All the puncture needles reached the midline of vertebral body, and the bone cement was well dispersed in the vertebral body with symmetrical distribution. The operation time was 35 to 60 (41.6±3.2) minutes, and there was no puncture complications. The injection volume of bone cement was 3 to 5 (3.6±0.5) ml in each vertebra. There were 8 cases of bone cement leakage, with a leakage rate of 11.76%. All 68 patients were followed up from 12 to 27 (14.3±3.5) months in the study. VAS score and ODI at 3 days after surgery and at final follow-up time were significantly improved (@*CONCLUSION@#PVP or PKP under the guidance of DSA via a unilateral extrapedicular approach with precision puncture can effectively relieve pain, restore vertebral body height and spinal function, which is a safe, fast and effective method in the treatment of osteoporotic vertebral compression fractures.

Application and thoughts of team-based learning combined with flipped classroom in physiological teaching / 中华医学教育探索杂志

Objective:To explore the application and effect of team-based learning (TBL) combined with flipped classroom in the teaching of physiology.Methods:A total of 70 medical students were selected and randomly divided into two groups, experimental group ( n=34) and control group ( n=36). Both groups studied digestion physiology by different method. In the experimental group, the students were taught by TBL combined with flipped classroom. The control group was given traditional teaching. The students studied and discussed problems in a team, and shared the answers in the flipped classroom. The effects of teaching were evaluated by the final test scores and the self-made questionnaire. SPSS 17.0 was used for t test on data comparison between the two groups. Results:The test scores of digestion physiology in the experimental group were (5.47±1.02) points, which were significantly higher than those of the control group (4.42±1.63) points, with significant differences ( P=0.020). A total of 34 questionnaires were issued and 34 valid questionnaires were collected, with an effective rate of 100%. The questionnaire results showed that TBL combined with flipped classroom was accepted and approved by about 82% of students in the experimental group who agreed that the teaching model helps enhance students' initiative and interest in learning, develop their sense of cooperation and comprehensive application ability. Conclusion:TBL combined with flipped classroom is feasible and effective in the physiological teaching, and it can be popularized in medical courses.

The association of gene polymorphism related with alcohol metabolism with the risk of alcohol dependence and subjective response to alcohol / 中华行为医学与脑科学杂志

Objective:To explore the relationship between rs671 (ALDH2), rs1229984 (ADH1B), RS141973904 (ADH1C), RS1799971 (OPRM1), rs1997794 (PDYN) polymorphism and individual's alcohol subjective response and drinking behavior.Methods:From January to December 2018, patients with alcohol dependence who were hospitalized in the First Affiliated Hospital of Xinjiang Medical University and Xinjiang mental health center and met the DSM-IV were selected (alcohol dependence group, n=100). Alcohol dependence patients and normal healthy subjects (control group, n=100) completed general demographic questionnaire, including drinking behavior such as the frequency of drinking each week and the maximum alcohol consumption at one drink, and informed consent, then were extracted of venous blood for DNA test.After that, alcoholics completed the alcohol challenge test.Biphasic alcohol effect scale(BAES) and drug effect questionnaire (DEQ) were completed before drinking and after drinking 30, 60, 120, 180 minutes respectively.Hardy-Weinberg equilibrium for genetic linkage analysis was calculated by utility program.Pearson Chi-square test was used to analyze the odds ratio(OR) value, and the chi-square test of repeated measured variables were used to analyze the variation trend of individual subjective response to alcohol after drinking. Results:rs671 allele A was associated with alcohol dependence risk (χ 2=23.97, P<0.01, OR=7.11, 95% CI=2.93~17.30), and for rs1229984 polymorphism the dominant genetic model " T/T-C/T" was taken as the best fitting model ( P<0.01, OR=0.16, 95% CI=0.08-0.32), which was a protective factor for alcohol dependence.Alcoholics with TT genotype in rs1229984 had lower maximum alcohol consumption ( F=4.86, P=0.01) and weekly alcohol consumption ( F=4.51, P=0.01) than those with CC and CT genotype.The maximum alcohol consumption ( F=20.28, P<0.01) and weekly alcohol consumption ( F=12.46, P<0.01) of individuals with GG and GA genotype in rs1799971 were higher than those with AA genotype.The AA genotype of rs1799971 showed lower stimulative effect ( F=7.99, P=0.01), higher sedative effect ( F=57.04, P<0.01), and lower " like" ( F=13.38, P<0.01) and " more" effect ( F=26.37, P<0.01) than that with GG and GA genotype. Conclusion:rs671 and rs1229984 are more closely related to individual drinking behavior and volume of alcohol consumption.rs1799971 is not only related to individual drinking behavior, but also has a more closed relationship with subjective response to alcohol.

Role of T 2* mapping and ZOOMit IVIM in differentiating benign and malignant thyroid nodules / 中华放射学杂志

Objective:To evaluate the efficacy of T 2* mapping and zoomed imaging with parallel transmission technique (ZOOMit) intravoxel incoherent motion (IVIM) DWI in differentiating benign and malignant thyroid nodules. Methods:The data of 67 patients with thyroid nodules confirmed by surgery and pathology in Ma′anshan People′s Hospital from July 2019 to March 2020 were retrospectively collected. There were a total of 80 nodules, of which 39 were benign nodules and 41 were malignant nodules. All patients underwent MRI including T 2WI, T 2* mapping, and ZOOMit IVIM sequence scans before surgery to measure the T 2*, D, D *, and f values of the nodules. The comparison of the parameters between benign and malignant nodules was evaluated by independent sample t test or Wilcoxon rank sum test. A combined parameter model was established through two-class logistic regression and the predicted probability value was calculated. The ROC curve was used to evaluate the diagnostic efficacy of each parameter and the combined parameter model in differentiating between benign and malignant thyroid nodules. Results:The T 2*, D, f values of benign thyroid nodule group were higher than that in malignant group, and the difference was statistically significant ( P<0.05). The difference of D * value between two groups was not statistically significant ( Z=1.258, P= 0.215). The area under ROC curve (AUC) of T 2*, D, and f values for identifying benign and malignant nodules was 0.703, 0.892, and 0.743, the diagnostic sensitivity was 80.2%, 84.1%, and 80.0%, and the specificity was 65.6%, 81.3%, and 75.0%, respectively. The AUC of T 2*combined with D, T 2*with D * and T 2* with f was 0.925, 0.709, and 0.743, the diagnostic sensitivity was 96.2%, 80.4%, and 80.0%, and the specificity was 81.2%, 65.6%, and 75.0%, respectively. Conclusion:D, f and T 2* derived from ZOOMit IVIM have good value in differentiating between benign and malignant thyroid nodules, and the combination of T 2* and D parameters has the higher diagnostic efficacy.

Observation on Tuina plus needling the distal acupoints along the pathway of meridians for shoulder periarthritis / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of Tuina (Chinese therapeutic massage) plus needling the distal acupoints along the pathway of meridians for shoulder periarthritis (SP). Methods: A total of 70 patients with SP were divided into an observation group and a control group using the random number table method, with 35 cases in each group. The patients in the observation group were treated by Tuina combined with needling distal acupoints along the pathway of meridians, while those in the control group only received the same Tuina treatment as in the observation group. The visual analog scale (VAS) and shoulder joint function were scored before and after treatment, and the efficacy after treatment was evaluated. Results: After three courses of treatment, the total effective rate of the observation group was 94.3％, while the total effective rate of the control group was 80.0％, showing a statistical difference (P<0.05). After treatment, the VAS scores of the two groups were significantly lower than the baseline scores (P<0.01), and the VAS score of the observation group was lower than that of the control group (P<0.01). After treatment, the total scores of internal rotation, external rotation, back touching, ear touching and motion function in the two groups were significantly higher than those before treatment (P<0.01), and the above five scores in the observation group were significantly higher than those in the control group (P<0.01). Conclusion: Tuina combined with needling the distal acupoints along the pathway of meridians is more effective than Tuina alone in treating SP. The combined therapy can relieve the pain and improve joint function more effectively.

Genotype-phenotype and genetic analysis in five patients with Kallmann syndrome / 中华内分泌代谢杂志

To study the genotype-phenotype and genetic characteristics of Kallmann syndrome. Five patients with Kallmann syndrome were enrolled. Clinical data collection, chromosome karyotyping, whole exome sequencing (WES), and multiplex ligation-dependent probe amplification (MLPA) were used. All the five patients were males, aging from 2 months to 45 years old. Three of the five patients complained cryptorchidism, one complained gonadal dysgenesis, and one complained fasting hyperglycemia. The clinical feature was hypogonadotropic hypogonadism with anosmia, and all karyotype was 46 XY. Magnetic resonance imaging (MRI) showed undeveloped olfactory bulbs and tracts. Kallmann syndrome related gene novel variants were found in all the 5 patients. The hypoplasia of right kidney was found in a patient with c. 1795_1799del (p.Asn599Profs*66) of anosmin 1 (ANOS1) variant. Clinical heterogeneity and incomplete penetrance were seen in a patient with c. 2824A>G (p.Thr942Ala) of chromodomain helicase DNA binding protein 7 (CHD7). Besides, WES indicated a 109 bp-deletion on Xp22.31 (chrX: 8507699-8507804), which was the deletion of exon 10 on ANOS1 gene verified by MLPA. The deletion variant was inherited form his mother, and conformed to X-linked recessive inheritance. Kallmann syndrome is genetic and clinical heterogeneous. WES is helpful for early diagnosis. MLPA and genome copy number variation analysis (CNV) are also recommend if necessary.

How the clinical research community responded to the COVID-19 pandemic: An analysis of the COVID-19 clinical studies in ClinicalTrials.gov

ObjectiveThe novel coronavirus disease (COVID-19), broke out in December 2019, is a global pandemic. Rapidly in the past few months, a large number of clinical studies have been initiated worldwide to find effective therapeutics, vaccines, and preventive strategies. In this study, we aim to understand the landscape of COVID-19 clinical research and identify the gaps and issues that may cause difficulty in recruitment and the lack of population representativeness. Materials and MethodsWe analyzed 2,034 COVID-19 studies registered in the largest public registry - ClinicalTrials.gov. Leveraging natural language processing, descriptive analysis, association analysis, and clustering analysis, we characterized COVID-19 clinical studies by phase and design features. Particularly, we analyzed their eligibility criteria to understand: (1) whether they considered the reported underlying health conditions that may lead to severe illnesses, and (2) if these studies excluded older adults, either explicitly or implicitly, which may reduce the generalizability of these studies in older adults. ResultsThe 5 most frequently tested drugs are Hydroxychloroquine (N=148), Azithromycin (N=46), Tocilizumab (N=29), Lopinavir (N=20), and Ritonavir (N=20). Most trials did not have an upper age limit and did not exclude patients with common chronic conditions such as hypertension and diabetes that are prevalent in older adults. However, known risk factors that may lead to severe illnesses have not been adequately considered by existing studies. ConclusionsA careful examination of the registered COVID-19 clinical studies can identify the research gaps and inform future COVID-19 trial design towards balanced internal validity and generalizability.