[Qualitative and quantitative PET/MRI in the evaluation of axillary lymph node metastasis in patients with breast cancer].

Objective: To investigate the value of qualitative and quantitative PET/MRI in the evaluation of axillary lymph node metastasis in patients with breast cancer. Methods: A total of 33 patients with breast cancer underwent preoperative PET/MRI examinations in Jingling Hospital from February to August in 2022 were retrospectively collected. All these patients were female, aged from 34 to 73 (51.4±11.3) years. Histopathological results and follow-up data were deemed as the referent standard, and the images were independently evaluated by two experienced breast imaging radiologists. The qualitative PET/MRI evaluation procedures were designed to evaluated the MRI alone to classify the axillary lymph nodes firstly, and then, the axillary lymph nodes status was reclassified by combining MRI and PET images. The net reclassification improvement index (NRI) was calculated using the R Programming Language (RStudio). The quantitative PET/MRI evaluation of the maximum standard uptake value (SUVmax) of axillary lymph nodes were measured by two radiologists, respectively, and the average value was compared with the referent standard to conduct a receiver operating characteristic (ROC) curve to select the optimal cutoff value of SUVmax. Based on the cutoff value and MRI classification results, axillary lymph nodes status was divided into quantitative PET/MRI positive or negative. The sensitivity, specificity and accuracy of MRI and quantitative PET/MRI in evaluating axillary lymph node metastasis were compared, and the area under the ROC curve (AUC) was compared. Results: There was no significant difference in sensitivity, specificity and accuracy between MRI and quantitative PET/MRI in evaluating lymph node metastasis of breast cancer (81.82% vs 95.46%; 81.82% vs 100%; 81.82% vs 96.97%) (all P>0.05). The AUC had a statistically significant difference [0.82 (0.65 to 0.93) vs 0.98 (0.85 to 1.00), P=0.026)]. According to the referent standard, in the 11 cases without ipsilateral axillary lymph node metastasis, the SUVmax was 0.83±0.18, while in the 22 cases with ipsilateral axillary lymph node metastasis, the SUVmax was [4.36 (1.77, 5.85)]. Compared with MRI alone, the NRI of qualitative PET/MRI in evaluating lymph node metastasis was 36.36% (P=0.021). Conclusion: Compared with MRI alone, quantitative PET/MRI has a higher AUC for evaluating axillary lymph node metastasis in patients with breast cancer, and qualitative PET/MRI had a better reclassification power in the evaluation of axillary lymph node metastasis.

[Research progress on influencing factors of hyperopia reserve in children].

In recent years, myopia among children and adolescents has become widespread, younger, and more severe in China. As the predecessor of the onset of myopia, hyperopia reserve has received increasing attention. Premature depletion of the hyperopia reserve predicts myopia's rapid and premature onset. Depleting the hyperopia reserve in children is influenced by many factors, such as pregnancy complications, pregnancy nutrition, premature birth, breastfeeding, growth velocity, outdoor activities, prolonged work and sleeping. This paper reviews the physiological changes in children's hyperopia reserve and the factors influencing children's hyperopia reserve, aiming to provide evidence for the prevention and control of myopia in children and adolescents at an early age.

[Prevalence and correlates of HIV infection among cross-border families in Dehong Dai and Jingpo Autonomous Prefecture].

Objective: To study the prevalence and correlations of HIV infection among cross-border couples in the Dehong prefecture. Methods: A cross-sectional mass screening study with questionnaire interview and HIV testing was conducted among 17 594 registered cross-border couples from May 2017 through June 2018. Results: Among 32 400 participants, the overall prevalence of HIV infection was 2.27% (736/32 400), 2.44% (375/15 372) for Chinese citizens, and 2.12% (361/17 028) for foreign spouses. Among all the 13 853 couples with both spouses receiving HIV testing, 13 415(96.84%) were seroconcordant-negative couples, 142(1.03%) were serocondordant-positive couples, and 296(2.13%) were serodiscordant couples, including 167(1.20%) couples with positive husband and negative wife and 129(0.93%) couples with positive wife and negative husband. Multiple logistic regression analyses indicated that HIV infection was associated with drug use and risky sexual behaviors for male spouses. In contrast, HIV infection was associated with risky sexual behaviors for female spouses. Conclusion: The prevalence of HIV among cross-border couples in Dehong prefecture is high, underscoring the urgent need to scale up HIV testing, prevention, and behavioral intervention.

[The development and national norm of the assessment of spinal health of youths].

Objective: To develop the Assessment of Spinal Health of Youths (ASHY), and evaluate its reliability and construct validity and further definite the national norm. Methods: According to literature review and expert consultation, the ASHY included 37 items within 4 dimensions, named symptoms of neck-shoulder and low back, the dysfunction of neck-shoulder and low back, daily risk behaviors and health-seeking behaviors. Between December 2015 and March 2016, a total of 15 096 students were purposively selected from Shenyang, Zhengzhou, Shenzhen and Jiangxi province. Item analysis, factor analysis and reliability evaluation methods were used to select items and evaluate the questionnaire. Between November 2017 and January 2018, a total of 14 500 students were purposively selected from Shenzhen, Zhengzhou, Nanchang and Guiyang. These data were used to develop a national norm of ASHY in adolescents. Results: The ASHY consisted of 4 dimensions covering 34 items. Variance cumulative contribution rate was 68.37%. Internal consistency test showed that Cronbach's α coefficient of the questionnaire was 0.91 and Cronbach's α coefficient of each dimension was between 0.76 and 0.93. The split-half coefficient of the questionnaire was 0.78 and ranged from 0.62 to 0.77 for each dimension. Confirmatory factor analysis results showed that the value of RMSEA was 0.067, and the values of NFI, RFI, CFI, GFI, AGFI were all above 0.80, which had a good fitting degree. The 90th percentile was used as the cutoff point about total scores of 92 for junior high school students, 102 for senior high school students and 98 for the overall middle school students. Conclusions: The ASHY is consistent with the evaluation standard of psychometrics. It can be used as a tool to evaluate the spinal health in adolescents.

[The relationship between migration time and the prevalence of myopia of children and adolescents aged 6-18 years old in Shenzhen].

Objective: To analyze the relationship between migration time and the prevalence of myopia of children and adolescents aged between 6 and 18 years old in Shenzhen. Methods: From April to May 2019, 26 618 children and adolescents from 14 schools in six streets of Baoan District, including Fuyong, Shajing, Xin'an, Xixiang, Songgang and Shiyan, were included in the study by using random cluster sampling method. The demographic characteristics, migration status, self-reported myopia, screen time in the last seven days, outdoor activities in the last one month and other information were collected through the questionnaire. The differences of myopia among children and adolescents with different characteristics were compared by χ2 test, and the relationship between migration time and the prevalence of myopia was analyzed by multivariate unconditional logistic regression model. Results: The age of 26 618 study participants was (12.37±3.49) years old, and the overall prevalence of myopia was 49.4%. Multivariate logistic regression analysis showed that after controlling for relevant confounding factors, compared with migrant children and adolescents of migrant workers who migrated for 1-2 years, those of migrant workers who had migrated for more than 6 years had a higher risk of myopia [OR (95%CI): 1.48 (1.14-1.92)]. After being grouped by phase of school, in the lower grade group of primary school, the children and adolescents of migrant workers who had migrated for more than 6 years had a higher risk of myopia compared with those of migrant workers who migrated for 1-2 years [OR (95%CI): 1.96 (1.20-2.74)]. In the high school group, compared with the children and adolescents of migrant workers who migrated for 1-2 years, those of migrant workers who had migrated for 3-5 years and ≥6 years had a higher risk of myopia [OR (95%CI): 6.03 (1.29-28.15) and 6.52 (1.51-28.11), respectively]. Conclusion: The migration time is related to the prevalence of myopia of the children and adolescents of migrant workers.

[Epidemiological analysis on 1 052 cases of COVID-19 in epidemic clusters].

Objective: To understand the epidemiological characteristics of the cases of COVID-19 epidemic clusters, and explore the influence of family factors and social factors such as group activities on the spread of the disease. Methods: The data of cases of COVID-19 epidemic clusters from 19 January, 2020 to 25 February, 2020 were collected from the official platforms of 36 cities in 6 provinces in China. Descriptive statistical methods, χ(2) test and curve fitting were used to analyze the epidemiological characteristics of the clustered cases. Results: By 25 February, 2020, the data of 1 052 cases in 366 epidemic clusters were collected. In these clustered cases, 86.9%(914/1 050) occurred in families. Among the 1 046 cases with gender information, 513 were males (49.0%) and 533 were females (51.0%). The cases were mainly young adults between 18 and 59 years old, accounting for 68.5% (711/1 038). In the 366 epidemic clusters , the clusters in which the first confirmed cases with the history of sojourn in Wuhan or Hubei accounted for 47.0%(172/366). From 19 January to 3 February, 2020, the first confirmed cases with Wuhan or Hubei sojourn history accounted for 66.5%. From 4 to 25 February, the first confirmed cases who had Wuhan or Hubei sojourn history accounted for only 18.2%. The median of interval between the first generation case onset and the second generation case onset was 5 (2-8) days. The median of onset- diagnosis interval of the initial cases was 6 (3-9) days, and the median of onset-diagnosis interval of the secondary cases was 5 (3-8) days. Conclusions: Epidemic clusters of COVID-19 were common in many cities outside Wuhan and Hubei. Close contact in family was one of the main causes for the spread of household transmission of the virus. After 4 February, the epidemic clusters were mainly caused by the first generation or second generation cases in local areas, and the time for diagnosis became shorter.

[Immune function of myeloid-derived suppressor cells and its mechanism in obstructive sleep apnea syndrome].

Objective: To investigate the immune function of myeloid-derived suppressor cells (MDSC) and its mechanism in obstructive sleep apnea syndrome (OSAS). Methods: Twenty OSAS patients who were diagnosed by polysomnography (Apnea Hyponea Index>30 events/h) from Sleep Disorders Center at First Affiliated Hospital between January 2015 and December 2016 were selected. The percent of CD14(+) low expression or lack of human leukocyte antigen DR (HLA-DR(-/low)) MDSC in the CD14(+) monocyte from both OSAS patients and healthy people were analyzed by flow cytometry. In vitro assay, MDSC from OSAS patients and health people were sorted by flow cytometry and T cells were sorted with negative isolation kit. For T-cell proliferation assays, the carboxyfluorescein diacetate succinimidyl ester (CFSE)-labeled T cells were respectively incubated with autologous MDSC. CFSE fluorescence intensity of T cells was detected by flow cytometry. Enzyme-linked immunosorbent assay (ELISA) and Western blot analysis were used to evaluate the concentrations of interleukin (IL)-6, tumor necrosis factor-α (TNF-α), IL-10, transforming growth factor-ß(1) (TGF-ß(1)), positive rate of programmed death ligand-L1 (PD-L1), relative transcript level of Arginase 1 (Arg1), inducible nitric oxide synthase (iNOS), hypoxic inducible factor-1α (HIF-1α) expressed by MDSC. Results: Comparing to healthy people, the percentage of CD14(+)HLA-DR(-/low) MDSC in CD14(+) monocyte was significantly elevated [(12.5±1.5)% vs (3.5±0.4)%, P<0.05]. In vitro, OSAS patient-derived MDSC exhibited a stronger suppressive effect on T-cell proliferation [(23.2±1.1)% vs (53.7±3.2)%, P<0.05]. Further analysis revealed that OSAS patient-derived MDSC secreted much higher concentrations of IL-6, TNF-α, IL-10 and TGF-ß(1) [(1 316±163) vs (642±72) ng/L, (316±35) vs (167±18) ng/L, (385±42) vs (108±26) ng/L and (44 276±4 589) vs (9 557±1 124) ng/L] (all P<0.05). The percentage of membrane molecule PD-L1-positive cells in OSAS patient-derived MDSC was obviously higher than that in healthy people-derived MDSC [(75.6±7.9)% vs (30.6±2.5)%, P<0.05]. Compared with healthy people-derived MDSC, the relative transcript level of Arg1, iNOS and HIF-1α in OSAS patient-derived MDSC was also increased by (4.6±0.5), (2.8±0.3) and (4.3±0.4) fold, respectively (all P<0.05). Conclusions: OSAS may be capable of inducing the proliferation of MDSC and its expression of immunosuppressive molecules by activating HIF-1α signal, thereby enhancing the immunosuppressive ability of MDSC.

[Clinical effects of application of antibiotic bone cement in wounds of diabetic foot ulcers].

Objective: To explore the clinical effects of antibiotic bone cement in the treatment of diabetic foot ulcers. Methods: According to the treatment methods, 18 patients with diabetic foot ulcers (11 males and 7 females, aged 53-79 years), who were conformed to the study criteria and admitted to our hospital from January 2016 to January 2017, were enrolled in traditional group; 18 patients with diabetic foot ulcers (11 males and 7 females, aged 55-80 years), who were conformed to the study criteria and admitted to our hospital from February 2017 to February 2018, were enrolled in bone cement group. Wounds of patients in traditional group were treated with vacuum sealing drainage after conventional debridement. Wounds of patients in bone cement group were covered with antibiotic bone cement after conventional debridement. The number of patients with positive bacterial culture in wound exudate in the 2 groups on admission and 3, 6, 9, and 15 days after surgery, the length of hospital stay, the number of operation, and the wound complete healing time were retrospectively recorded. Data were processed with Fisher's exact probability test and independent sample t test. Results: Compared with (29±10) d and (4.6±1.2) times of patients in traditional group, the length of hospital stay [(9±3) d] of patients was obviously shortened, the number of operation [(1.3±0.6) times] of patients was obviously reduced, the number of patients with positive bacterial culture in wound exudate at each time point post surgery was obviously reduced (t=8.177, 9.896, P<0.05 or P<0.01) in bone cement group. There were no statistically significant differences in the number of patients with positive bacterial culture in wound exudate on admission and wound complete healing time between patients in the 2 groups (t=0.175, P>0.05). Conclusions: The antibiotic bone cement treatment of diabetic foot ulcers can reduce the number of patients with positive bacterial culture in wound exudate and the number of operation, as well as shorten the length of hospital stay.

[Correlation of health literacy and mobile phone use dependence with psychopathological symptoms in middle school students].

Objective: To explore the correlation of health literacy and mobile phone use dependence with psychopathological symptoms in middle school students. Methods: 22 628 middle school students in Shenyang, Bengbu, Xinxiang, Ulanqab, Chongqing and Yangjiang were enrolled by multistage cluster sampling method from November 2015 to January 2016. Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ), Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) and Multidimensional Sub-health Questionnaire of Adolescents (MSQA) were applied to acquire basic characteristics, health literacy, mobile phone use dependence and psychopathological symptoms of subjects. Subjects were classified into three groups, low level (P(75)), according to the percentile of the questionnaire score. Multivariate logistic regression model was used to analyze the correlation of health literacy, mobile phone with psychopathological symptoms. Results: The students were (15.4±1.8) years old with 10 990 boys (48.6%). The score of health literacy of students were (104.1±18.7) points. The rate of mobile phone use dependence was 25.4% (5 752/22 628) and the rate of psychopathological symptoms was 29.1% (6 581/22 628). Compared with high health literacy level, medium and low health literacy levels were related to psychopathological symptoms, with OR (95%CI) about 2.30 (2.10-2.52) and 5.40 (4.89-5.97), respectively. Compared with mobile phone use independence, mobile phone use dependence was related to psychopathological symptoms, with OR (95%CI) about 3.60(3.37-3.85). The highest rate of psychopathological symptoms occurred in students with mobile phone use dependence and low health literacy level [68.0% (1 345/1 977)], with OR (95%CI) about 19.59 (17.07-22.48). Conclusion: Health literacy and mobile phone use dependence are related factors of psychopathological symptoms in middle school students.

[Interactive effects between health literacy and mobile phone dependence as well as its relation with unintentional injuries in middle school students].

Objective: To investigate the interaction between health literacy, mobile phone dependence and unintentional injuries in middle school students, and to provide guidance for prevention on unintentional injuries in adolescents. Methods: From November 2015 to January 2016, a questionnaire survey was conducted among 22 628 middle school students in Shenyang of Liaoning province, Bengbu of Anhui province, Xinxiang of Henan province, Ulanqab of Inner Mongolia Autonomous Region, Chongqing and Yangjiang of Guangdong province. Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ), Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU), and Unintentional Injuries Assessment Scale and demographic variables were used to measure the health literacy, mobile phone dependence and unintentional injuries among the Chinese middle school students. Results: The detection rates of mobile phone dependence and unintentional injuries were 25.4% and 46.7%, respectively. The rates of unintentional injuries of middle school students with mobile phone dependence and with low, medium and high health literacy were 53.6%, 44.4% and 48.8%, 48.1%, 41.7%. Factors as mobile phone dependence, low and middle health literacy were positively related to unintentional injuries (OR=1.452, 1.196, 1.364). However, the multiplicative interaction between mobile phone dependence and health literacy on unintentional injuries was noticed significant (OR=1.217, 95%CI: 1.041-1.422). Conclusions: Our results showed that the prevalence of unintentional injuries was relatively high in middle school students. Health literacy and mobile phone dependence seemed related to unintentional injuries. Interaction between health literacy and mobile phone dependence on unintentional injuries appeared significant.

[Effects of human erythropoietin on transforming growth factor ß1/Smad3 signal transduction pathway in acute wounds of rats].

Objective: To explore the effects of human erythropoietin (hEPO) on healing related transforming growth factor ß1 (TGF-ß1)/Smad3 signal transduction pathway in acute wounds of rats. Methods: Seventy-two healthy Sprague Dawley rats were divided into normal saline control group, low dose group, middle dose group, and high dose group according to the random number table, with 18 rats in each group, after round acute wounds with diameter of 2.5 cm were inflicted on the back of rats. Rats in the 4 groups had debridement routinely. Wounds of rats in normal saline control group were covered by gauzes infiltrated with 1 mL normal saline, while wounds of rats in low dose group, middle dose group, and high dose group were respectively covered by gauze infiltrated with 1 mL hEPO in doses of 50, 100, and 150 U every day, and then the wounds were bandaged with 6 layers of dry gauze. Dressing change was performed once every day. On treatment day (TD) 3, 7, and 14, 6 rats from each group were taken for general observation and calculation of wound healing rate. Then the wound tissue samples were harvested after the rats were sacrificed for observation of expressions of CD31 and transforming growth factor ß1 (TGF-ß1) with immunohistochemical method. Protein expression of phosphorylated Smad3 of the wound tissue of 3 rats were detected by Western blotting. Data were processed with analysis of variance of factorial design, one-way analysis of variance, least-significant difference test, and Bonferroni correction. Results: (1) On TD 3, obvious exudation and scab were observed in the wounds of rats in the 4 groups. On TD 7, the wounds of rats in low dose group, middle dose group, and high dose group were reduced compared with those in normal saline control group. On TD 14, all wounds of rats in the 4 groups were healed. On TD 7, the wound healing rates of rats in middle dose group and high dose group were significantly higher than the rate in normal saline control group (P<0.01). At the other time points, the wound healing rates of rats in the 4 groups were close (P>0.05). (2) CD31 mainly expressed in blood vessels. Except for those in low dose group on TD 3 and 7 (P>0.05), the expressions of CD31 in wound tissue of rats in low dose group on TD 14 and in middle dose group and high dose group on TD 3, 7, and 14 were significantly higher than those in normal saline control group (P<0.01). Except for those on TD 3 (P>0.05), the expressions of CD31 in wound tissue of rats in middle dose group and high dose group on TD 7 and 14 were significantly higher than those in low dose group (P<0.01). Except for that on TD 3 (P>0.05), the expressions of CD31 in wound tissue of rats in high dose group on TD 7 and 14 were significantly higher than those in middle dose group (P<0.01). (3) Except for that in low dose group on TD 3 (1.9±0.7, P>0.05), the expressions of TGF-ß1 in wound tissue of rats in low dose group on TD 7 and 14 (3.3±1.0, 3.7±0.7), and in middle dose group and high dose group on TD 3, 7, and 14 (3.3±1.0, 3.6±1.0, 3.9±0.9, 3.4±0.7, 3.8±0.8, 4.2±0.4) were significantly higher than those in normal saline control group (1.7±0.5, 2.7±1.0, 3.0±0.9, P<0.01). Except for those on TD 7 (P>0.05), the expressions of TGF-ß1 in wound tissue of rats in middle dose group and high dose group on TD 3 and 14 were significantly higher than those in low dose group (P<0.01). Except for that on TD 14 (P<0.01), the expressions of TGF-ß1 in wound tissue of rats in high dose group on TD 3 and 7 were close to those in middle dose group (P>0.05). (4) Except for those in low dose group on TD 3 and 14 and in middle dose group and high dose group on TD 14 (P>0.05), the protein expressions of phosphorylated Smad3 in wound tissue of rats in the 3 groups at the other time points were significantly higher than those in normal saline control group (P<0.01). Except for those on TD 14 (P>0.05), the protein expressions of phosphorylated Smad3 in wound tissue of rats in middle dose group and high dose group on TD 3 and 7 were significantly higher than those in low dose group (P<0.01). Except for that on TD 14 (P>0.05), the protein expressions of phosphorylated Smad3 in wound tissue of rats in high dose group on TD 3 and 7 were significantly lower than those in middle dose group (P<0.01). Conclusions: Exogenous hEPO can increase the expressions of CD31, TGF-ß1, and phosphorylated Smad3 in acute wounds of rats, promote angiogenesis of wounds, and activate TGF-ß1/Smad3 signal transduction pathway to promote wound healing.

Single sample sequencing (S3EQ) of epigenome and transcriptome in nucleus accumbens.

BACKGROUND: High-throughput sequencing has been widely applied to uncover the molecular mechanisms underlying neurological and psychiatric disorders. The large body of data support the role of epigenetic mechanisms in neurological function of both human and animals. Yet, the existing data is limited by the fact that epigenetic and transcriptomic changes have only been measured in separate cohorts. This has limited precise correlation of epigenetic changes in gene expression. NEW METHOD: Single Sample Sequencing (S3EQ) is an innovative approach to analyze both epigenetic and transcriptomic regulation within a single neuronal sample. Using this method, we analyzed chromatin immunoprecipitation (ChIP)- and RNA-sequencing data from the nucleus accumbens (NAc) of the same animal. RESULTS: ChIP-S3EQ of neuronal nuclei reliably identified hPTM enrichment in the adult mouse NAc with high precision. Comparing cellular compartments, we found that the spliceosome of whole cell RNA-seq was more closely recapitulated by cytosolic RNA-S3EQ than nuclear RNA-seq. Finally, S3EQ showed increased sensitivity for correlating chromatin modifications with gene expression, especially for lowly expressed transcripts. COMPARISON WITH EXISTING METHODS: S3EQ accurately generates both RNA- and ChIP-seq from a single sample, providing a clear advantage over existing methods which require two samples. ChIP-S3EQ performance was comparable to ChIP-seq, while RNA-S3EQ generated an almost identical expression profile to nuclear-enriched and whole cell RNA-seq. Finally, we directly compared RNA-seq by cellular compartments, addressing a limitation of RNA-seq studies limited to neuronal nuclei. CONCLUSION: The S3EQ method can be applied to improve the correlative power of transcriptomic and epigenomic studies in neuronal tissue.

[Application of continuous serratus plane block with patient-controlled analgesia on postoperation analgesia after thoracoscopic surgery].

Objective: To investigate the application of ultrasound-guided continuous serratus plane block with patient-controlled analgesia on postoperation analgesia after thoracoscopic surgery, and influence on postoperative rehabilitation. Methods: Sixty patients scheduled for thoracoscopic surgery were randomly divided into two groups. PCNA group (n=30) received ultrasound guided continuous serratus plane block with patient-controlled nerve analgesia, with continuous infusion of 0.2% ropivacaine and 30 ml of 0.3% ropivacaine for the first does. PCIA group(n=30) received patient-controlled intravenous analgesia, with continuous infusion of sufentanil. Postoperative visual analogue scale (VAS) and prince henry pain scale (PHPS) were recorded at 1 hour (T(1)), 4 hour (T(2)), 8 hour (T(3)), 24 hour (T(4)), 2 days (T(5)), 3 days (T(6)), 4 days (T(7)), before discharge (T(8)), 30 days (T(9)) after surgery. Adverse reactions and the time of postoperative first out-of-bed activity, passage of gas by anus, bowel movement, chest tube removal, discharge was also recorded. Results: The resting VAS score of T(3), T(4), T(5) in group PCNA and group PCIA were 0(0) vs 0(2.0), 0(0) vs 2.0(2.0), 0(0) vs 0(2.0), the resting VAS score was lower in group PCNA than in group PCIA (Z=-2.524, -3.944, -3.652, P<0.05 or P<0.01). The upper arm activity VAS score of T(2), T(3), T(4), T(5), T(6), T(7) in group PCNA and group PCIA were 0(0) vs 0(2.0), 0(0) vs 2.0(2.5), 0(2.0) vs 2.0(2.0), 0(2.0) vs 2.0(2.0), 0(0) vs 2.0(2.0), 0(0) vs 0(2.0), the upper arm activity VAS score was lower in group PCNA compared with group PCIA (Z=-2.984, -3.915, -4.484, -4.450, -3.422, -2.456, P<0.05 or P<0.01). The coughing VAS score T(3), T(4), T(5), T(6), T(7) in group PCNA and group PCIA were 2.0(2.0) vs 2.0(2.5), 2.0(2.5) vs 4.0(4.0), 2.0(2.5) vs 4.0(4.0), 2.0(2.0) vs 3.0(2.0), 2.0(2.0) vs 2.0(2.0), the coughing VAS score was lower in group PCNA compared with group PCIA (Z=-3.432, -3.410, -2.643, -3.210, -2.746, P<0.05 or P<0.01). The PHPS score was significantly lower in group PCNA at T(3)[1.0(1.3) vs 2.0(2.0)], T(4)[1.0(2.0) vs 3.0(1.0)], T(5)[1.0(1.3) vs 2.0(1.3)], T(6)[1.0(1.3) vs 2.0(2.0)], T(7)[1.0(1.0) vs 1.0(2.0)] compared to group PCIA (Z=-3.149, -3.662, -3.369, -3.681, -2.815, all P<0.01). And the time of out-of-bed activity, passage of gas by anus of the PCNA group were (20.0± 6.9)h, ( 16.0± 8.0)h, which was advanced more than PCIA group [(23.9± 7.1)h, (34.3± 13.2)h, t=-2.20, -6.47, all P<0.05]. Furthermore, PCNA group had better sleep quality from the 2nd night to the 4th night , and with lower adverse reactions (all P<0.05). Conclusion: The application of ultrasound-guided continuous serratus plane block after thoracoscopic surgery can reduce postoperative pain and enhance recovery after surgery.

Role of free electrons in phosphorescence in n-type wide bandgap semiconductors.

Long persistent phosphorescence is generally known as a phenomenon involving carrier traps induced by defects or impurities in crystals. In this paper, phosphorescence sustained for tens of minutes was found in intentionally undoped ZnO and it was proposed to be a universal phenomenon in wide bandgap semiconductors upon satisfying several conditions. A new model was built to understand this attractive phenomenon within the framework of the traditional trapping-detrapping model but it was modified by considering the free electrons in the conduction band as a significant contributor to the long persistent phosphorescence besides the electrons trapped by shallow donors. This model, explicitly expressed as I(t) ∝ [1 + M(1 - Fe-γt)-2]e-γt, is not only capable of giving a quantitative description of the non-exponential decay of phosphorescence in a wide temperature range but also enables one to determine the depth of shallow donors in semiconductors. The participation of free electrons in phosphorescence was further confirmed by another carefully designed experiment. Thus, this study may represent significant progress in understanding phosphorescence.

[Investigation of influencing factors associated with neck-shoulder symptoms among middle school students in three cities in China].

Objective: The aim of this study was to describe the distribution of neck-shoulder symptoms among middle school students, and to explore its influence factors. Methods: A cross-sectional survey was conducted on 24 middle schools in Shenyang, Zhengzhou and Shenzhen by purposive sampling method. In each middle school, 3 to 4 classes were selected from each grade all the students in the selected class would be recruited to the survey to investigate the demographic characteristics, neck-shoulder symptoms, physical exercise time, academic stress, screen behavior, sedentary behavior and other information by questionnaire. A total of 10 566 questionnaires were issued and 10 270 valid questionnaires were withdrawn. The prevalence of neck-shoulder symptoms among students were compared by different characteristics. Logistic regression models were applied to examine influencing factors associated with neck-shoulder symptoms. Results: The prevalence of neck-shoulder symptoms among middle school students was 19.2% (1 968/10 270), while it was 22.6% (1 137/5 039) among girls and 15.9% (831/5 231) among boys; the difference showed statistical significance (P<0.001). The prevalence of neck-shoulder symptoms was separately 13.3% (253/1 901) in seventh grade, 16.8% (326/1 942) in eighth grade, 18.5% (299/1 617) in ninth grade, 21.8% (417/1 915) in sophomore, 21.4% (345/1 611) in junior, 25.5% (328/1 284) in senior; the difference showed statistical significance (P<0.001). The multivariate logistic regression analysis showed that in the last 3 months, students who always playing mobile phone ≥40 min continuously (OR=4.66, 95%CI: 3.95-5.49), watching TV ≥40 min continuously (OR=4.01, 95%CI: 3.39-4.73), using computer ≥40 min continuously (OR=3.61, 95%CI: 3.09-4.23), doing homework ≥60 min continuously (OR=3.25, 95%CI: 2.79-3.79), the average daily sitting time ≥10 h (OR=4.95, 95%CI: 4.25-5.77), and always sitting ≥90 min continuously (OR=5.18, 95%CI: 4.42-6.06) were risk factors of neck-shoulder symptoms. Conclusion: The prevalence of neck-shoulder symptoms was high among middle school students in China, especially girls in senior grades. Long time, high frequency video behaviors and sedentary behaviors were related to the occurrence of neck-shoulder symptoms among middle school students.

[Study of association between adverse experiences in childhood, social support, and physical and psychological sub-health status among middle school students in 3 cities in China].

Objective: To explore the relationship between adverse experience in childhood, social support, and physical and psychological sub-health status among middle school students in 3 cities in China. Methods: 15 278 adolescents were selected as subjects from 20 junior and senior middle schools located in 3 cities of China by stratified cluster sampling method. The survey collected the demographic information, ACEs, social support and physical-psychological status. A total of 14 820 valid questionnaires were retained for analysis. We assessed ACE score (count of six categories of childhood adversity), social support (adolescent social support questionnaire), and the prevalence of two outcomes: physiological and psychological sub-health status. Logistic regression was used to analyze the relationship between adverse childhood experiences, social support, and physiological and psychological sub-health status. Results: The prevalence of physiological and psychological sub-health status were 26.4% (3 917/14 820) and 24.1%(3 572/14 820), respectively. A total of 89.4% (13 247/14 820) reported at least 1 adverse childhood experiences. The rates of physiological and psychological sub-health status were higher among girls (28.1%(2 092/7 443), 26.0%(1 932/7 443)) than boys (24.7%(1 825/7 377), 22.2%(1 640/7 377)). Among adolescents without ACEs, the rate of physiological and psychological sub-health status were 15.4%(243/1 573) and 10.4%(163/1 573), for those with 5-6 ACEs, the rate were 40.9%(636/1 556) and 43.6%(678/1 556). Among adolescents with higher social support, the rate of physiological and psychological sub-health status were 19.9%(724/3 635) and 13.0%(474/3 635) for those with lower social support, the rate of physiological and psychological sub-health status were 35.9%(1 403/3 913) and 39.0%(1 528/3 913). The rates of physiological and psychological sub-health status were higher with more ACE exposure or less social support. At each level of ACE exposure, physiological and psychological sub-health status were less in those with greater social support. For example, among adolescents reporting 5-6 ACEs, those in the lowest tertile of social support increased the risk of physiological sub-health status than those in the highest tertile (adjusted prevalence ratio (95%CI)=1.79 (1.23-2.56)); for those reporting no ACEs, the ratio was 3.04 (1.91-4.83). Among adolescents reporting 5-6 ACEs, those in the lowest tertile of social support increased the risk of psychological sub-health status than those in the highest tertile (adjusted prevalence ratio (95%CI)=3.77 (2.57-5.52)); for those reporting no ACEs, the ratio was 3.97(2.33-6.76). Conclusion: The findings suggest that ACEs should be considered as risk factors for physiological and psychological sub-health status among middle school students. Across a range of exposures to ACEs, less social support was associated with more physiological and psychological sub-health status. Identifying those with ACE exposure who also have lower social support could be used to improve the health of adolescents.

[Study on relationship between outdoor activities and self-reported myopia among middle school students].

Objective: To examine the relationship between the prevalence of self-reported myopia and outdoor activities among middle school students and to explore the influence factors of the self-reported myopia. Methods: A total of 12 979 participants were recruited from junior and senior middle school students in in Shenzhen, Nanchang, Zhengzhou and Shenyang by random cluster sampling method between December 2015 and March 2016. All participants completed an anonymous questionnaire to collect the information of demographic characteristics, self-reported myopia, outdoor activities, etc. 12 603 out of 12 979 copies of questionnaire were valid. The prevalence of self-reported myopia was compared among middle school students with different characteristics. Logistic regression models were used to analyze the relationship between myopia and outdoor activities. Results: The prevalence of self-reported myopia among middle school students was 69.6% (8 766/12 603); which was separately 52.1% (1 216/2 335) in seventh grader, 61.6% (1 459/2 369) in eighth grader, 69.0%(1 470/2 129) in ninth grader, 80.0% (1 812/2 265) in freshmen, 79.4% (1 622/2 042) in sophomore, and 81.1%(1 187/1 463) in junior. The prevalence of self-reported myopia showed an increasing trend with the increase of grade (χ(2)=639.67, P<0.001). The prevalence of self-reported myopia was separately 63.5%(4 927/7 756) in non-myopic parents group, 78.0%(2 664/3 415)in either myopic parent group, and 82.1%(1 175/1 432) in both myopic parents group(χ(2)=328.28, P<0.001). Outdoor activities were associated with self-reported myopia. Binary logistic regression analysis showed that the risk of self-reported myopia was significantly increased by always staying at home in extracurricular time among the middle school students (OR=1.58, 95%CI: 1.36-1.82). The risk of self-reported myopia were significantly decreased by always physical exercise and recreational activities after school among middle school students: the ORs were separately 0.67 (95%CI: 0.57-0.78) for physical exercise and 0.77 (95%CI: 0.64-0.92) for recreational activities. After stratified analysis by the parents' myopia status, in non-myopic parents group, exercise and recreational activities after school among middle school students decreased the risk of myopia: the ORs were separately 0.68 (95%CI: 0.55-0.82) for physical exercise and 0.76 (95%CI: 0.61-0.95) for recreational activities; in either myopic parent group, OR(95%CI) were separately 0.65 (0.47-0.90) and 0.68 (0.47-0.98). Conclusion: Outdoor activities was negatively associated with self-reported myopia among middle school students. However, the parents' myopia status may affect the protective effect.

[Influences of high-voltage electrical burns on microcirculation perfusion on serosal surface of small intestine of rats and the interventional effects of pentoxifylline].

Objective: To investigate influences of high-voltage electrical burns on microcirculation perfusion on serosal surface of small intestine of rats and the interventional effects of pentoxifylline (PTX). Methods: Totally 180 SD rats were divided into sham injury group, simple electrical burn group, and treatment group according to the random number table, with 60 rats in each group. The electrical current was applied to the outside proximal part of left forelimb of rats and exited from the outside proximal part of right hind limb of rats. Rats in simple electrical burn group and treatment group were inflicted with high-voltage electrical burn wounds of 1cm×1cm at current entrances and exits, with the voltage regulator and experimental transformer. Rats in sham injury group were sham injured through connecting the same equipments without electricity. At 2 min post injury, rats in sham injury group and simple electrical burn group were intraperitoneally injected with 2 mL normal saline, and rats in treatment group were injected with 2 mL PTX injection (50 mg/mL). At 15 min before injury and 5 min, 1 h, 2 h, 4 h, and 8 h post injury, 10 rats in each group were selected to collect blood of heart respectively. Serum were separated from the blood to determine the level of soluble vascular cell adhesion molecule-1(sVCAM-1) with enzyme-linked immunosorbent assay method. The number of adhesional leukocyte in mesenteric venule of rats was determined with Bradford variable projection microscope system. The microcirculation perfusion on serosal surface of small intestine of rats was detected with laser Doppler perfusion imager. Data were processed with analysis of variance of factorial design and LSD test. Results: (1) At 5 min, 1 h, 2 h, 4 h, 8 h post injury, the serum content of sVCAM-1 in rats of simple electrical burn group were (8 502±1 158), (11 793±3 310), (9 960±2 146), (9 708±1 429), (7 292±1 386) ng/mL respectively, higher than that in sham injury group and treatment group [ (1 897±946), (1 882±940), (1 882±938), (1 888±946), (1 884±942) ng/mL, and (6 840±1 558), (6 742±2 465), (5 625±2 593), (2 373±1 463), (5 187±2 797) ng/mL, respectively, with P values below 0.001]. The serum content of sVCAM-1 in rats of sham injury group and treatment group at all time points post injury, except 4 h post injury of treatment group, was higher than that of the same group at 15 min before injury (with P values below 0.001). (2) At all time points post injury, the number of adhesional leukocyte in mesenteric venule of rats in simple electrical burn group was higher than that in sham injury group and treatment group (with P values below 0.001). The number of adhesional leukocyte in mesenteric venule of rats in simple electrical burn group and treatment group at all time points post injury was higher than that of the same group at 15 min before injury (with P values below 0.001). (3) At all time points post injury, the microcirculation perfusion on serosal surface of small intestine of rats in simple electrical burn group was lower than that in sham injury group and treatment group (with P values below 0.001). The microcirculation perfusion on serosal surface of small intestine of rats in simple electrical burn group and treatment group at all time points post injury was lower than that of the same group at 15 min before injury (with P values below 0.001). Conclusions: High-voltage electrical burns can increase the serum content of sVCAM-1, the number of adhesional leukocyte in mesenteric venule, and reduce microcirculation perfusion on serosal surface of small intestine of rats. PTX can inhibit secretion of serum sVCAM-1, reduce the number of adhensional leukocyte in mesenteric venule to alleviate microcirculation disturbance caused by high-voltage electrical burns.

[The mid- to long-term effect of Wallis lumbar interspinous dynamic stabilization on the adjacent segment degeneration].

Objective: To explore the mid- to long-term effect of Wallis interspinous dynamic stabilization system on the adjacent segment degeneration. Methods: From March 2009 to June 2010, in Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, 24 patients with L4-5 monosegmental lumbar disc herniation were treated with posterior lumbar decompression combined with Wallis interspinous dynamic fixation. Clinical outcomes were evaluated with visual analogue score (VAS) (back pain), VAS (leg pain) and oswestry disability index (ODI) score. Intervertebral disc height (IDH) and range of motion (ROM) of the upper and lower adjacent segments were measured on X-ray. The degneration of lumbar intervertebral disc was evaluated on MRI. paired-t test was used to compare preoperative VAS, ODI, IDH, ROM and the degeneration of lumbar intervertebral disc with those at the final follow-up. Results: Twenty patients had a mean follow-up time of (65.2±4.7) months. At the final follow-up, VAS (back pain), VAS (leg pain) and ODI showed significant improvement (all P<0.01). At the final follow-up, IDH of the upper and lower adjacent segment showed no significant difference compared with those preoperatively (P>0.05); ROM of the upper adjacent segment increased (P<0.05), while ROM of the lower adjacent segment did not change significantly compared with that preoperatively (P>0.05). The degeneration of intervertebral discs at the upper and lower segments showed no significant changes at the final follow-up (P>0.05). Conclusions: Posterior decompression combined with Wallis interspinous dynamic stabilization system for monosegmental lumbar disc herniation can achieve satisfactory clinical results. More than five years' follow-up confirmed that the Wallis system will not accelerate adjacent segment degeneration.