The association between soyfoods or soybean products consumption and executive functioning among Chinese adolescents: A cross-sectional multicenter study.

BACKGROUND: The association of soyfoods or soybean products with executive functions in the brain has been less well studied. In this study, we investigated the consumption of soyfoods or soybean products and its association with executive functions in Chinese adolescents. METHODS: A three-stage stratified whole group sampling method was used to investigate the consumption of soyfoods or soybean products and executive functions among 1643 Chinese adolescents aged 13-15 years. One-way ANOVA and chi-square test were used to compare the basic conditions and executive functions of adolescents with different soyfoods or soybean products consumption. Linear regression analysis and logistic regression analysis were used to analyze the association between soyfoods or soybean products and executive functions. RESULTS: The proportions of Chinese adolescents with soyfoods or soybean products consumption ≤0 time/week, 1-3 time/week, and ≥4 time/week were 41.14 %, 46.80 %, and 12.05 %, respectively. Logistic regression analysis showed that with adolescents with soyfoods or soybean products consumption ≥4 time/week as a reference, adolescents with ≤0 time/week were less likely to have executive dysfunction in inhibiting functional (OR = 17.523, 95 % CI: 7.501, 40.938), 2back (OR = 3.384, 95 % CI: 1.729, 6.623), and switching functional (OR = 7.846, 95 % CI: 3.300, 18.657), were at higher risk of executive dysfunction (P < 0.001). CONCLUSION: Chinese adolescents' consumption of soyfoods or soybean products is inadequate and has a positive association with executive functions. The consumption of soyfoods or soybean products among Chinese adolescents should be increased in the future.

The checkmark association between gamma glutamyl-transpeptidase and body mass index in a large Chinese population.

BACKGROUND: Obesity has long been regarded as a risk factor for abnormal liver function, although the quantitative relationship between them is not clear. This study aimed to investigate the relationship between body mass index (BMI) and gamma-glutamyl transpeptidase (GGT) in different gender populations. METHODS: The cross-sectional study included 221,934 people aged over 18 years and under 90 years who underwent physical examinations at Yijishan Hospital in Wuhu City from 2011 to 2016. t-test and Chi-square test were used to compare the differences in demographic characteristics and biochemical indexes between men and women. Linear regression model and smooth curve method were used to investigate the relationship between BMI and GGT. RESULTS: The smooth curve shows a checkmark association between GGT and BMI. After adjusting for confounders, the cut-off BMI for the whole population was 19.5 kg/m2. When BMI was less than 19.5 kg/m2, GGT levels decreased with increasing BMI, and when BMI was greater than 19.5 kg/m2, GGT levels increased with increasing BMI. After gender stratification, there was a checkmark association between male and female GGT levels and BMI, but the trend of male GGT levels changing with BMI was more obvious than that of females. CONCLUSIONS: Our investigation demonstrated that the GGT level in obese Chinese people is significantly higher than that in non-obese people living in Wuhu City. BMI level can be considered as an early warning index for diseases related to liver function injury in the clinic, although the influence of gender difference should be specifically considered.

Clinical practice guidelines for prevention and treatment of postoperative gastrointestinal disorder with Integrated Traditional Chinese and Western Medicine (2023).

Postoperative gastrointestinal disorder (POGD) was a common complication after surgery under anesthesia. Strategies in combination with Traditional Chinese Medicine and Western medicine showed some distinct effects but standardized clinical practice guidelines were not available. Thus, a multidisciplinary expert team from various professional bodies including the Perioperative and Anesthesia Professional Committees of the Chinese Association of Integrative Medicine (CAIM), jointly with Gansu Province Clinical Research Center of Integrative Anesthesiology/Anesthesia and Pain Medical Center of Gansu Provincial Hospital of Traditional Chinese Medicine and WHO Collaborating Center for Guideline Implementation and Knowledge Translation/Chinese Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Center/Gansu Provincial Center for Medical Guideline Industry Technology/Evidence-based Medicine Center of Lanzhou University, was established to develop evidence-based guidelines. Clinical questions (7 background and 12 clinical questions) were identified through literature reviews and expert consensus meetings. Based on systematic reviews/meta-analyses, evidence quality was analyzed and the advantages and disadvantages of interventional measures were weighed with input from patients' preferences. Finally, 20 recommendations were developed through the Delphi-based consensus meetings. These recommendations included disease definitions, etiologies, pathogenesis, syndrome differentiation, diagnosis, and perioperative prevention and treatment.

Maximakinin reversed H2O2 induced oxidative damage in rat cardiac H9c2 cells through AMPK/Akt and AMPK/ERK1/2 signaling pathways.

Maximakinin (MK), a homolog of bradykinin (BK), is extracted from skin venom of the Chinese toad Bombina maxima. Although MK has a good antihypertensive effect, its effect on myocardial cells is unclear. This study investigates the protective effect of MK on hydrogen peroxide (H2O2)-induced oxidative damage in rat cardiac H9c2 cells and explores its mechanism of action. A 3-(4,5-Dimethyl-2-Thiazolyl)-2,5-Diphenyl Tetrazolium Bromide (MTT) assay was selected to detect the effect of MK on H9c2 cell viability, while flow cytometry was used to investigate the influence of MK and H2O2 on intracellular reactive oxygen species (ROS) levels. Protein expression changes were detected by western blot. In addition, specific protein inhibitors were applied to confirm the induction of ROS-related signaling pathways by MK. MTT assay results show that MK significantly reversed H2O2-induced cell growth inhibition. Flow cytometry Dichlorodihydrofluorescein diacetate (DCFH-DA) staining shows that MK significantly reversed H2O2-induced increases in intracellular ROS production in H9c2 cells. Moreover, the addition of specific protein inhibitors suggests that MK reverses H2O2-induced oxidative damage by activating AMP-activated protein kinase (AMPK)/protein kinase B (Akt) and AMPK/extracellular-regulated kinase 1/2 (ERK1/2) pathways. Finally, an inhibitor of bradykinin B2 receptors (B2Rs), HOE-140, was applied to investigate potential targets of MK in H9c2 cells. HOE-140 significantly blocked induction of AMPK/Akt and AMPK/ERK1/2 pathways by MK, suggesting a potentially important role for B2Rs in MK reversing H2O2-induced oxidative damage. Above all, MK protects against oxidative damage by inhibiting H2O2-induced ROS production in H9c2 cells. The protective mechanism of MK may be achieved by activation of B2Rs to activate downstream AMPK/Akt and AMPK/ERK1/2 pathways.

Plant-Growth-Promoting Rhizobacteria Modulate Carbohydrate Metabolism in Connection with Host Plant Defense Mechanism.

Plant-growth-promoting rhizobacteria (PGPR) could potentially enhance photosynthesis and benefit plant growth by improving soil nutrient uptake and affecting plant hormone balance. Several recent studies have unveiled a correlation between alterations in photosynthesis and host plant resistance levels. Photosynthesis provides materials and energy for plant growth and immune defense and affects defense-related signaling pathways. Photosynthetic organelles, which could be strengthened by PGPR inoculation, are key centers for defense signal biosynthesis and transmission. Although endophytic PGPRs metabolize plant photosynthates, they can increase soluble sugar levels and alternate sugar type and distribution. Soluble sugars clearly support plant growth and can act as secondary messengers under stressed conditions. Overall, carbohydrate metabolism modifications induced by PGPR may also play a key role in improving plant resistance. We provide a concise overview of current knowledge regarding PGPR-induced modulation in carbohydrate metabolism under both pathogen-infected and pathogen-free conditions. We highlight PGPR application as a cost-saving strategy amidst unpredictable pathogen pressures.

Chemically tailored molecular surface modification of bamboo pulp fibers for manipulating the electret performance of electret filter media.

The surface chemical composition of materials is essential for regulating their charge trapping and storage capabilities, which directly affect their electret performance. Although chemical modification of materials to alter electret performance has been investigated, the mechanism through which electret properties are regulated more systematically via chemical customization has not been elucidated in detail. Herein, p-phenylenediamine, benzidine and 4,4'-diaminotriphenyl, which have different conjugated strength functional groups, were selected to chemically tailor the surface of bamboo pulp fibers to regulate the electret properties and elucidate the regulatory mechanism more systematically. The results showed that the charge trapping and storage properties of materials could be regulated by introducing functional groups with different conjugated strengths to their surfaces, realizing the regulation of the electret properties. Moreover, the charge trapping and storage ability could be tailored more specifically by regulating the number of functional groups. By chemical customization to provide electrostatic effects to the materials, the purification time was reduced by approximately 45 %-52 %. More importantly, a relatively systematic mechanism was proposed to elucidate the effect of the conjugate group strength on the charge trapping and charge storage properties of the material. These findings will provide guidance for the investigation of chemical modifications to regulate the electret performance of materials.

Pipermotuoense, a new species of Piperaceae from Xizang, China.

Pipermotuoense X.W.Qin, F.Su & C.Y.Hao, a new species of Piperaceae from Xizang, China, is described and illustrated in this paper. The new species resembles P.yinkiangense and P.anisotis, but it can be readily distinguished from the compared species by several characteristics. Gonophyll leaves are chartaceous and the leaf secondary vein count is 7-9, with the outermost pair being very weak when there are nine veins. Additionally, the apical pair arises 2-4 cm above the base and the leaf base is asymmetrical, with bilateral petioles that cling and heal together. Pistillate floral bracts are sessile, with 3, 4 or 5 stigmas. The description of the new species includes photographs, detailed descriptions, notes on etymology, distribution and habitat, as well as comparisons with morphologically similar species.

Cancer Pain Management with Traditional Chinese Medicine: Current Status and Future Perspectives.

Cancer pain, especially the moderate-to-severe pain experienced by patients with advanced cancer, is still one of the most challenging clinical problems. The current mainstream pharmacological treatment for cancer pain involves applying opioid medications and other pain-killing drugs. However, analgesic drugs have many adverse effects such as addiction, tolerance, and other formidable clinical and social issues. Thus, finding a new therapeutic approach to treat cancer pain is essential. Traditional Chinese medicine (TCM) has been increasingly applied in clinical practice because of its good efficacy and few side effects. However, its mechanisms of action in treating pain are still under investigation. The most important mechanism of cancer pain is that a large amount of pain-causing substances are secreted from cancer cells and promote their growth and invasion. The physical and chemical stimulations of these substances exist along with the cancer growth, leading to constantly increased pain sensation. Whether cancer pain can be alleviated by inhibiting cancer cells from releasing the substances and changing the microenvironment around the cancer mass, or even by eliminating pain-causing substances, is largely unknown. Based on TCM theory, this study reported that the aforementioned approach could effectively manage different cancer pains by tonifying qi, clearing and activating channels and meridians, and strengthening body resistance. The TCM therapies activate blood circulation, remove blood stasis, and nourish the heart. Commonly used Chinese herbal drugs include Corydalis yanhusuo, Angelica dahurica, and Ligusticum chuanxiong. Instead of using conventional analgesics to reduce pain, we should focus on using TCM modalities to alleviate cancer pain and increase the quality of life in patients suffering from cancer pain. TCM should provide us with a new strategy for managing cancer pain.

Verification of surface-guided radiation therapy (SGRT) alignment for proton breast and chest wall patients by comparison to CT-on-rails and kV-2D alignment.

BACKGROUND: Surface-guided radiation therapy (SGRT) systems have been widely installed and utilized on linear accelerators. However, the use of SGRT with proton therapy is still a newly developing field, and published reports are currently very limited. PURPOSE: To assess the clinical application and alignment agreement of SGRT with CT-on-rails (CTOR) and kV-2D image-guided radiation therapy (IGRT) for breast treatment using proton therapy. METHODS: Four patients receiving breast or chest wall treatment with proton therapy were the subjects of this study. Patient #1's IGRT modalities were a combination of kV-2D and CTOR. CTOR was the only imaging modality for patients #2 and #3, and kV-2D was the only imaging modality for patient #4. The patients' respiratory motions were assessed using a 2-min surface position recorded by the SGRT system during treatment. SGRT offsets reported after IGRT shifts were recorded for each fraction of treatment. The agreement between SGRT and either kV-2D or CTOR was evaluated. RESULTS: The respiratory motion amplitude was <4 mm in translation and <2.0° in rotation for all patients. The mean and maximum amplitude of SGRT offsets after application of IGRT shifts were ≤(2.6 mm, 1.6° ) and (6.8 mm, 4.5° ) relative to kV-2D-based IGRT; ≤(3.0 mm, 2.6° ) and (5.0 mm, 4.7° ) relative to CTOR-based IGRT without breast tissue inflammation. For patient #3, breast inflammation was observed for the last three fractions of treatment, and the maximum SGRT offsets post CTOR shifts were up to (14.0 mm, 5.2° ). CONCLUSIONS: Due to the overall agreement between SGRT and IGRT within reasonable tolerance, SGRT has the potential to serve as a valuable auxiliary IGRT tool for proton breast treatment and may improve the efficiency of proton breast treatment.

Dyslipidemia and hyperuricemia: a cross-sectional study of residents in Wuhu, China.

BACKGROUND: While dyslipidemia has been recognized as a potential risk factor for hyperuricemia, there is currently a dearth of large-scale data specifically focused on studying the relationship between these two conditions. To address this gap, the present study analyzed a dataset of 298,891 physical examination records to investigate in greater detail the clinical classification and compositional relationship between hyperuricemia and dyslipidemia. METHODS: For this investigation, a cross-sectional research design was utilized to analyze physical examination data that was gathered from Yijishan Hospital in Wuhu, China between 2011 and 2016. Logistic regression was employed to examine the association between hyperuricemia and dyslipidemia. Furthermore, the association between hyperuricemia and dyslipidemia was evaluated based on the clinical classifications of dyslipidemia and its components. RESULTS: A total of 298,891 participants from China (124,886 [41.8%] females) were included in the study, with an age range of 18 to 90 years (mean [SD]: 47.76 [13.54] years). In multivariate analysis, the odds of hyperuricemia was 1.878 times higher in patients with dyslipidemia compared to those without dyslipidemia (95% confidence interval [CI]: 1.835-1.922). In the clinical classification of dyslipidemia, individuals with hypertriglyceridemia and mixed hyperlipidemia had 1.753 times (95% CI: 1.706-1.802) and 1.925 times (95% CI: 1.870-1.982) higher odds of hyperuricemia, respectively, compared to those without dyslipidemia. Among the components of dyslipidemia, the odds ratios for hyperuricemia in individuals in the fourth quartile compared to those in the first quartile were 3.744 (95% CI: 3.636-3.918) for triglycerides, 1.518 (95% CI: 1.471-1.565) for total cholesterol, and 1.775 (95% CI: 1.718 - 1.833) for non-high-density lipoprotein cholesterol. CONCLUSIONS: Dyslipidemia has been independently linked with hyperuricemia. Moreover, the elevation of triglycerides or total cholesterol levels, including conditions such as hypertriglyceridemia and mixed hyperlipidemia, have been observed to have a positive association with the development of hyperuricemia.

Differences in the Chromogenic Effect of Corn Starch and Potato Starch on Paprika Red Pigment and Structural Characterisation.

The present study aims to investigate the chromogenic effect and the interaction between starch-pigment complexes of corn starch (CS) and potato starch (PS) complexed with paprika red pigment. Compared to PS, CS showed 12.5 times higher adsorption capacity for paprika red pigment. Additionally, the a* value of CS-P (26.90 ± 0.23) was significantly higher than that of PS-P (22.45 ± 1.84), resulting in a corn starch-paprika red pigment complex (CS-P) with a more intense red colour. The addition of paprika red pigment significantly decreased the particle size and porosity of CS by 48.14 ± 5.29% and 17.01 ± 3.80%, respectively. Conversely, no significant impact on PS was observed. Additionally, the Fourier transform infrared (FT-IR) spectroscopy results revealed that the starch molecules and paprika red pigment were bound to each other through strong hydrogen bonds. X-diffraction (XRD) results indicated that the starch-paprika red pigment complexes have a V-shaped structure. Furthermore, the relative crystallinity of the complexes between starch and red pepper pigment showed an increasing trend, however, the relative crystallinity of CS increased significantly by 11.77 ± 0.99-49.21 ± 3.67%. Consequently, the CS-P colouring was good.

Epidemiology of Hemorrhagic Fever with Renal Syndrome and Host Surveillance in Zhejiang Province, China, 1990-2021.

Hemorrhagic fever with renal syndrome (HFRS) is caused by hantaviruses (HVs) and is endemic in Zhejiang Province, China. In this study, we aimed to explore the changing epidemiology of HFRS cases and the dynamics of hantavirus hosts in Zhejiang Province. Joinpoint regression was used to analyze long-term trends in the incidence of HFRS. The comparison of animal density at different stages was conducted using the Mann-Whitney Test. A comparison of HV carriage rates between stages and species was performed using the chi-square test. The incidence of HFRS shows a continuous downward trend. Cases are widely distributed in all counties of Zhejiang Province except Shengsi County. There was a high incidence belt from west to east, with low incidence in the south and north. The HFRS epidemic showed two seasonal peaks in Zhejiang Province, which were winter and summer. It showed a marked increase in the age of the incidence population. A total of 23,073 minibeasts from 21 species were captured. Positive results were detected in the lung tissues of 14 rodent species and 1 shrew species. A total of 80% of the positive results were from striped field mice and brown rats. No difference in HV carriage rates between striped field mice and brown rats was observed (χ2 = 0.258, p = 0.611).

Iron hydroxyphosphate electro-Fenton catalyst for efficient removal of sulfamethoxazole and resource recycling into slow-release fertiliser ammonium ferrous phosphate.

Although the electro-Fenton (EF) process is effective for wastewater treatment, recycling spent catalysts remain a major challenge. Therefore, we introduce a reuse strategy for spent catalysts where an iron hydroxyphosphate [Fe5(PO4)4(OH)3·2H2O] catalyst is utilized. Fe5(PO4)4(OH)3·2H2O obtained •OH and •O2- by activating in-situ produced H2O2, and the degradation rate of sulfamethoxazole reached 94.5% after 120 min and showed excellent stability (maintained above 90%) for 10 cycles. Finally, the used catalyst was converted into slow-release ammonium ferrous phosphate (NH4FePO4·H2O) fertiliser at a conversion rate of 85.6%. NH4FePO4·H2O significantly promoted plant and seed growth within 6 days, highlighting the contribution of the resource recycling of the spent catalyst. This study serves as a valuable reference for the efficient utilization of spent catalysts. This study successfully applied EF catalysts and explored the recycling of spent catalysts.

Couples' Cognition, Intimacy, and Activity Engagement: An Actor-Partner Interdependence Model Analysis.

OBJECTIVES: This study examines the actor and partner effects of cognition on activity engagement and the potential mediating role of intimate relationship in older couple dyadic context. METHODS: Data for this study were obtained from heterosexual couples who participated in the 2020 wave of the Health and Retirement Study. Constructing a dyadic model of couples' cognitions, activity engagement, and intimacy using structural equation modeling to analyze the relationship between variables and mediating effects. RESULTS: At the actor level, cognition was positively correlated with their activity participation. At the partner level, wives' cognition and husbands' activity engagement were positively correlated. Husband's cognitive score affect wife's subjective feelings about intimacy. The mediation effect of Wife's intimacy on the relationship between husband's cognition and wife's activity engagement was significant. CONCLUSIONS: In older couples, cognition influences activity engagement at a binary level, and this association is influenced by the level of intimacy. Improving intimacy can help increase activity engagement in older couples, which in turn promotes health. Clinical Implications Maintaining cognition helps older people enjoy good marriage and participation in activities. For women, the closer the partnership, the higher the frequency of participating in various activities.

Initial clinical evaluation of a novel combined biometric, radio-frequency identification, and surface imaging system.

PURPOSE: To evaluate and characterize the overall clinical functionality and workflow of the newly released Varian Identify system (version 2.3). METHODS: Three technologies included in the Varian Identify system were evaluated: patient biometric authentication, treatment accessory device identification, and surface-guided radiation therapy (SGRT) function. Biometric authentication employs a palm vein reader. Treatment accessory device verification utilizes two technologies: device presence via Radio Frequency Identification (RFID) and position via optical markers. Surface-guidance was evaluated on both patient orthopedic setup at loading position and surface matching and tracking at treatment isocenter. A phantom evaluation of the consistency and accuracy for Identify SGRT function was performed, including a system consistency test, a translational shift and rotational accuracy test, a pitch and roll accuracy test, a continuous recording test, and an SGRT vs Cone-Beam CT (CBCT) agreement test. RESULTS: 201 patient authentications were verified successfully with palm reader. All patient treatment devices were successfully verified for their presences and positions (indexable devices). The patient real-time orthopedic pose was successfully adjusted to match the reference surface captured at simulation. SGRT-reported shift consistency against couch readout was within (0.1 mm, 0.030). The shift accuracy was within (0.3 mm, 0.10). In continuous recording mode, the maximum variation was 0.2 ± 0.12 mm, 0.030 ± 0.020. The difference between Identify SGRT offset and CBCT was within (1 mm, 10). CONCLUSIONS: This clinical evaluation confirms that Identify accurately functions for patient palm identification and patient treatment device presence and position verification. Overall SGRT consistency and accuracy was within (1 mm, 10), within the 2 mm criteria of AAPM TG302.

[Electroacupuncture at acupoints of yangming meridians for sarcopenia: a randomized controlled trial].

OBJECTIVE: To observe the clinical effect of electroacupuncture at acupoints of yangming meridians for sarcopenia. METHODS: A total of 60 patients with sarcopenia were randomized into an observation group and a control group, 30 cases in each group. In the control group, conventional nutrition intervention for sarcopenia was adopted. In the observation group, on the basis of the treatment in the control group, acupuncture was applied at bilateral Binao (LI 14), Quchi (LI 11), Zusanli (ST 36), Yanglingquan (GB 34), etc.,ipsilateral Quchi (LI 11) and Zusanli (ST 36) were connected to electroacupuncture, with discontinuous wave, 2 Hz in frequency, 1-10 mA in intensity, 2 times a week, with a interval of 3 days. A total of 12-week treatment was required in the two groups. Before and after treatment, the appendicular skeletal muscle mass index (ASMI), grip strength, 6 m-walking time, body fat percentage and body moisture percentage were observed in the two groups. RESULTS: Compared with those before treatment, after treatment, ASMI and grip strength were increased while 6 m-walking time was shortened in the two groups (P<0.05); body fat percentage was decreased while body moisture percentage was increased in the observation group (P<0.05). After treatment, in the observation group, ASMI, grip strength and body moisture percentage were increased (P<0.05), 6 m-walking time was shortened and body fat percentage was decreased (P<0.05) compared with those in the control group. CONCLUSION: Electroacupuncture at acupoints of yangming meridians can effectively improve the skeletal muscle mass, muscle function, body fat percentage and body moisture percentage in patients with sarcopenia, and make the distribution of muscle and fat more reasonable.

Technical note: Clinical evaluation of a newly released surface-guided radiation therapy system on DIBH for left breast radiation therapy.

BACKGROUND: It has been shown that a significant reduction of mean heart dose and left anterior descending artery (LAD) dose can be achieved through the use of DIBH for left breast radiation therapy. Surface-guided DIBH has been widely adopted during the last decade, and there are mainly three commercially available SGRT systems. The reports of the performance of a newly released SGRT system for DIBH application are currently very limited. PURPOSE: To evaluate the clinical performance of a newly released SGRT system on DIBH for left breast radiation therapy. METHODS: Twenty-five left breast cancer patients treated with DIBH utilizing Varian's Identify system were included (total 493-fraction treatments). Four aspects of the clinical performance were evaluated: Identify offsets of free breathing post patient setup from tattoos, Identify offsets during DIBH, Identify agreement with radiographic ports during DIBH, and DIBH reference surface re-capture post patient shifts. The systematic and random errors of free breathing Identify offsets post patient setup were calculated for each patient, as well as for offsets during DIBH. Radiographic ports were taken when the patient's DIBH position was within the clinical tolerance of (± 0.3 cm, ± 30 ), and these were then compared with treatment field DRRs. If the ports showed that the patient alignment did not agree with the DRRs within 3 mm, a patient shift was performed. A new reference surface was captured and verification ports were taken. RESULTS: The all-patient average systematic and random errors of Identify offsets for free breathing were within (0.4 cm, 1.50 ) post tattoo setup. The maximum per-patient systematic and random errors were (1.1 cm, 6.20 ) and (0.9 cm, 20 ), and the maximum amplitude of Identify offsets were (2.59 cm, 90 ). All 493-fraction DIBH treatments were delivered and successfully guided by the Identify SGRT system. The systematic and random errors of Identify offsets for DIBH were within (0.2 cm, 2.30 ). Seven patients needed re-captured surface references due to surface variation or position shifts based on the ports. All patient DIBH verification ports guided by Identify were approved by attending physicians. CONCLUSION: This evaluation showed that the Identify system performed effectively for surface-guided patient setup and surface-guided DIBH imaging and treatment delivery. The feature of color-coded real-time patient surface matching feedback facilitated the evaluation of the patient alignment accuracy and the adjustment of the patient position to match the reference.

Influence of medical humanization on patients' attribution in negative medical situations with communication as the mediator: a questionnaire study.

Background: Patients' attribution in negative medical situations plays a vital role in reducing medical conflicts and developing high-quality healthcare. The purpose of this study was to investigate the triadic relations among patients' attribution, medical humanization and communication. Furthermore, the mediating effect of communication was tested. Methods: A cross-sectional study on the relationship between patients' attribution in negative medical situations and medical staff's humanization and communication was conducted, with 3,000 participants totally from 103 hospitals of three different levels in different regions. Results: There were significant positive correlations among medical staff's humanization, communication and patients' attributional styles (r = 0.112-0.236, p < 0.001 for all). Medical humanization had direct predictive effects on patients' attributional style in negative medical situations (ß = 0.14, p < 0.01). Mediation analysis also indicated the indirect predictive effect of medical humanization on patients' attributions through communication (ß = 0.02, p < 0.01). Conclusion: Patients' attribution in negative medical situations is predicted by patients' perception of medical staff's humanization in healthcare and physicians' communication skills. Medical humanization not only affects patients' attributions in negative situations directly, but also influences patients' attributions via communication indirectly. The humanistic care should be included in medical education for healthcare professionals, and professional training on medical staff's humanization and communication skills is strongly needed to establish healthy and harmonious doctor-patient relationship.

Staurantherafloribunda, a new species of Gesneriaceae from Yunnan, China.

Staurantherafloribunda F.Su, C.Y.Hao & K.Tan, a new species of Gesneriaceae from Yunnan, China, is described and illustrated here. It is morphologically similar to S.grandifolia Benth. in the shape of corolla, stigma, leaves and the number of stamens. However, it can be readily distinguished from the compared species by its dense cymes, leaf indumentum, lack of a corolla spur, calyx colour and stamen shape. The description of the new species, photographs, detailed descriptions, notes on etymology, distribution and habitat, as well as comparisons with morphologically similar species, are provided.

Gender-based relationship between serum creatinine and carotid plaque stability: A cross-sectional study in China.

OBJECTIVE: Carotid plaque instability is a risk factor for ischemic stroke, and changes in serum creatinine are associated with carotid plaque. However, the relationship between serum creatinine and carotid plaque stability is not well explained. This study aimed to interpret this relationship for clinical treatment of carotid plaque. METHODS: A total of 4363 subjects aged 29-86 from December 2013 to December 2018 were included in this study. The stability of carotid plaque was determined based on ultrasound echoes and divided into two groups: carotid plaque stable group and carotid plaque unstable group. The relationship between serum creatinine and carotid plaque stability was determined using curve fitting methods as well as logistic regression. RESULTS: After age stratification, there was an inverted U-shaped curve between the stability of right carotid plaque and serum creatinine in males, When serum creatinine levels were less than 84 µmol/L, the probability of carotid plaque instability gradually increased, and the carotid plaque became stable when creatinine levels were greater than 84 µmol/L. The relationship between left carotid female plaque stability and serum creatinine showed a U-shaped curve. When serum creatinine levels were less than 80 µmol/L, the carotid plaque stability stabilized, and the probability increased when creatitine levels were more than 80 µmol/L, as the carotid plaque instability rose. CONCLUSION: There was an inverted U-shaped relationship between the stability of carotid plaque in the right carotid artery and serum creatinine in males, and a U-shaped relationship between the stability of carotid plaque in the left carotid artery and serum creatinine in females.