Objective: To investigate the clustering of risk factors among populations at high risk of cardiovascular diseases in Shaoxing City, Zhejiang Province, so as to provide the evidence for formulating the cardiovascular disease control measures among populations at high risk of cardiovascular diseases. Methods: The populations with hypertension, diabetes, dyslipidemia and a history of cardio-cerebrovascular disease at ages of 35 to 70 years were sampled from 6 districts (counties) of Shaoxing City using a multi-stage cluster random sampling method from May to July 2021. Participants' demographics, history of disease, smoking, alcohol consumption and drug use were collected through questionnaires, and height, body weight and blood lipid were measured. The participants at high risk of cardiovascular diseases were enrolled, and the prevalence and clustering of five risk factors were investigated, including current smoking, current alcohol consumption, overweight/obesity, never exercise and daily sedentary duration of 3 hours and longer. Factors affecting the clustering of risk factors were identified with an ordinal logistic regression model. Results: Totally 1 695 participants were enrolled, including 940 men (55.46%) and 755 women (44.54%), with a mean age of (62.56±6.08) years old. There were 213 participants with a history of cardio-cerebrovascular disease (12.57%), and the prevalence of hypertension, diabetes and dyslipidemia was 78.53%, 61.95% and 46.78%, respectively, and there were 32.63% of participants with current smoking, 35.99% with current alcohol consumption, 49.38% with overweight/obesity, 62.12% with never exercise and 61.24% with daily sedentary duration of 3 hours and longer, respectively. There were 28.85% of participants with two risk factors, and 46.90% with three to five risk factors. Ordinal logistic regression analysis showed that male (OR=5.430, 95%CI: 4.389-6.726), and development of hypertension (OR=1.655, 95%CI: 1.313-2.090) led to present more numbers of clustering of risk factors, and annual household income of 20 000 to 50 000 Yuan (OR=0.620, 95%CI: 0.473-0.812), a history of cardio-cerebrovascular diseases (OR=0.430, 95%CI: 0.324-0.572), presence of diabetes (OR=0.592, 95%CI: 0.476-0.736) led to less numbers of clustering of risk factors among populations at high risk of cardiovascular diseases. Conclusions There is clustering of risk factors among populations at high risk of cardiovascular diseases in Shaoxing City. Men, income, history of cardio-cerebrovascular diseases, hypertension and diabetes are factors affecting the clustering of risk factors.

Objective: To investigate sleep quality among patients with hypertension and diabetes, so as to provide the basis for improving the health of patients with chronic diseases. Methods: From May to August 2022, patients with hypertension and diabetes under the community management in 4 counties and cities (districts) of Shaoxing City, Zhejiang Province were recruited using a multi-stage stratified cluster random sampling method. Demographic information, disease history, smoking, alcohol consumption, physical activity and sleep quality were collected by questionnaire surveys, and blood pressure, fasting blood glucose and glycosylated hemoglobin were collected through physical examination and laboratory testing. The incidence of poor sleep quality symptoms (snoring/asphyxia/suffocation, difficulty falling asleep, night awakening, taking sleeping pills and early morning awakening) in patients with diabetes and hypertension was descriptively analyzed, and sleep quality was evaluated. Results: A total of 1 539 patients with hypertension and diabetes were surveyed, including 715 males (46.46%) and 824 females (53.54%). The patients had a mean age of (68.68±7.62) years. The proportions of night awakening, early morning awakening, snoring/asphyxia/suffocation, difficulty falling asleep and taking sleeping pills were 29.82%, 28.53%, 20.73%, 15.79% and 4.29%, respectively. The proportion of poor sleep quality was 66.54%. Employment status, smoking status, moderate/high intensity physical activity and blood pressure control were related to poor sleep quality (all P<0.05). Conclusion Poor sleep quality is common in patients with hypertension and diabetes, with the main symptoms being night awakening, early morning awakening, difficulty falling asleep and snoring/asphyxia/suffocation.

Objective To investigate the features of parental attachment in children with attention deficit hyperactivity disorder(ADHD).Methods Experience in Close Relationship Scale Revised(ECR-R),Relationship Questionnaire(RQ) and Homemade General Situation Table was conducted among 164 parents of ADHD and 328 parents of normal children.Results The attachment repretation in fathers of children with ADHD showed that autonomous(43.9％ ) was lower than those of the control group (52.4％),dismissing type (41.5％ ) was higher than the normal group (34.1％),preoccupied( 12.2％ ) was higher than those in the control group (8.0％),unresolved type (2.4％) was lower than those of the control group (5.5％),the difference was not statistically significant (P ＞ 0.05 ).The attachment repretation in mothers of children with ADHD showed that autonomous (40.2％) was lower than those of the control group (50.0％),dismissing type (30.5％) belowed the normal group (32.3％),preoccupied type ( 20.7％ ) higher than those in the control group ( 10.4％ ),unresolved type (8.5％) higher than those in the control group (7.3％),the difference was not statistically significant (P ＞0.05).Two groups had no statistical differences in paternal attachment anxiety,paternal attachment avoidance、maternal attachment anxiety and maternal attachment avoidance dimensions ( ( 3.44 + 0.97 ) vs ( 3.37 + 0.82 ),(3.70+0.57)vs(3.72 +0.57),(3.37+0.87) vs(3.36 +0.83),(3.74+0.68)vs(3.64±0.59),allP＞0.05).Conclusion There is no significant differences in the features of parental attachment between children with ADHD and normal children.

Objective: To investigate the situation of road traffic injuries (RTIs) among middle school students in Shaoxing City, Zhejiang Province, so as to provide the basis for implementation of interventions against RTIs among students. Methods: From 2021 to 2023, a multi-stage stratified cluster sampling method was used to select 82 junior high school classes and 89 senior high school classes in Shaoxing City as the survey population. Data on basic information, commuting travel, road safety behaviors and road safety knowledge awareness were collected through questionnaires, and the prevalence of RTIs in the past year was analyzed. Results: A total of 6 287 middle school students were surveyed, and 971 cases of RTIs were reported, with a reporting rate of 15.44%. The reporting rate of RTIs was higher in males than in females (17.68% vs. 13.34%, P<0.05). The reporting rate of RTIs was higher in high school students than in junior high school students (17.70% vs. 12.66%, P<0.05). The students who mainly walked to school (18.00%), walked 5 days a week (17.82%) and traveled with classmates (17.58%) had higher reporting rates of RTIs. Among those who walked for ≥20 minutes, the reporting rate of RTIs was higher in males than in females (P<0.05). Among different road safety behaviors, the reporting rate of RTIs was higher in males than in females who used electronic devices (P<0.05). The reporting rates of RTIs were relatively high among students who played for ≥10 minutes on the way (32.92%), crossed traffic lights directly when being late for school (41.54%) and crossed traffic barriers directly (30.67%). The reporting rate of RTIs among middle school students decreased with the increase of road safety knowledge scores (P<0.05). Conclusions Male students, high school students, students with road risky behaviors and with low awareness of road safety knowledge have higher reporting rates of RTIs. It is necessary to strengthen road safety knowledge education for students.

Student evaluation is an important part of the teaching process.The Children's Hos-pital of Chongqing Medical University focused on the characteristics of individual child's growth and overall development according to the own condition and integrated formative assessment and summa-tive evaluation in the classroom teaching and clinical internship process. All the measures mentioned above not only help promote students' learning interests,master of knowledge and clinical skills but also exert positive effect on the improvement of teaching level.

Objective To assess the value of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) in differential diagnosis of neuroendocrine carcinoma of the uterine cervix (NECUC) from other tumors.Methods A total of 12 NECUCs,39 cervical squamous cell carcinomas (SCC) and 21 cervical adenocarcinomas (CA) confirmed by pathology were analyzed retrospectively.All the patients underwent conventional MRI and DWI.The ADC values were measured and compared among NECUC,SCC and CA.Diagnostic performance of ADC was compared using receiver operating characteristic curves (ROC).Results The mean ADC values of NECUC,SCC and CA were (0.66 ± 0.11) ×10-3 mm2/s,(0.86 ± 0.11) × 10-3 mm2/s and (1.04 ± 0.17) × 10-3 mm2 / s,with statistical differences between any two groups (P ＜0.001).The optimal cutoff values of ADC for differentiating NECUC and SCC was 0.681 ×10-3mm2/s with a sensitivity of 94.9％,specificity of 75.0％ and accuracy of 90.2％.The optimal cutoff values of ADC for differentiating NECUC and CA was 0.824× 10-3mm2/s with a sensitivity of 95.2％,specificity of 91.7％ and accuracy of 98.9％.Conclusion The differences of the mean ADC value are helpful for the differential diagnosis of NECUC,SCC and CA.

Objective To study interleukin-23 (IL-23) levels in serum and dendritic cells of acute-on-chronic liver failure (ACLF) patients with chronic hepatitis B (CHB) and to explore its relationship with the prognosis.Methods Peripheral blood mononuclear cells and serum were collected from 40 ACLF patients with CHB (including survival group 27 cases and non-survival group 13 cases) and 26 healthy controls.Monocytes were induced to immature dendritic cell in vitro and TNF-α was added to induce dendritic cell maturation.IL-23 mRNA of dendritic cells was detected by real time polymerase chain reaction (PCR), and serum IL-23 level was measured by enzyme-linked immuno sorbent assay (ELISA).Differences among the parameters with normal distribution were compared using t test, those with non-normal distribution were compared using non-parametric Mann-Whitney U-test, and the relationship between two variables was assessed by Spearman′s rank correlation.Results International normalized rate (INR) and model for end-stage liver disense (MELD) scores in non-survival group of ACLF were higher than those in survival group (INR: 2.32 vs 1.64, U=69.00, P=0.002 2;MELD:36 vs 30, U=64.50, P=0.001 4).However, there were no significant differences between two groups at gender, age, alanin aminotransferase (ALT), aspartate aminotrans ferase (AST), bilirubin, creatinine, hepatitis B virus (HBV) DNA, hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and serum IL-23.IL-23 mRNA level in dendritic cells at baseline in non-survival group of ACLF was significantly higher than that in survival group (76 vs 43, U=71.50, P=0.002 8).After treatment, serum IL-23 was significantly declined in survival group ([160±75] ng/L vs [91±49] ng/L, t=4.012, P=0.000 2), but not in non-survival group.Significant positive correlation was observed between IL-23 mRNA level in dendritic cells and MELD score at baseline (r=0.7198,P<0.01).Conclusions Persistent high serum IL-23 level suggests poor prognosis in ACLF patients with CHB.IL-23 mRNA expression in dendritic cells has good consistency with MELD score and the patients with high IL-23 mRNA expression has poor outcome.

Objective To analyze the prevalence and clinical characteristics of brucellosis in Liuzhou that is a non-pasture area,and to provide a basis for diagnosis and treatment of brucellosis.Methods Time distribution,population distribution,main symptoms,onset time,serum procalcitonin (PCT),C reactive protein (CRP) and blood routine were analyzed in 20 patients with brucellosis at the Fourth Affiliated Hospital of Guangxi Medical University from January 2013 to December 2016,and the results were compared with those of 35 cases of sepsis.Results A total of 20 cases brucellosis was conformed,13 cases (65.0％,13/20) occurred in 2016,and the incidence was increased year by year.Sixteen cases (80.0％,16/20) had a history of exposure to cattle and sheep.The ages of patients in brucellosis group were younger than those in sepsis group [(46.6 + 10.4) years vs (59.4 + 17.0) years,t =-3.49,P ＜ 0.05],the onset time in brucellosis was longer than those in sepsis group [24.5(14.3-39.8) d vs 7.0 (6.0-12.0) d,U =90.00,P ＜ 0.05].Eight cases (100.0％,8/8) of brucellosis showed that the PCT ＜ 0.5 μg/L,while only 3 cases (8.6％,3/35) in sepsis group,the difference was significant statistically between the two groups (x2 =23.99,P ＜ 0.05).Majority of brucellosis showed that white blood cells (70.0％,14/20),neutrophils (85.0％,17/20),lymphocytes (90.0％,18/20),neutrophil ratio (80.0％,16/20) and lymphocyte ratio (55.0％,11/20) were normal.Compared with the sepsis group,the levels of PCT [0.30(0.19-0.38) μg/L vs 4.70 (1.30-18.28) μg/L,U =0.00,P ＜ 0.05],CRP [24.43 (12.78-45.06) mg/L vs 101.60 (62.63-163.58) mg/L,U =100.00,P ＜ 0.05],white blood cells [5.76 (4.76-7.99) × 109/L vs 12.34 (8.50-16.12) × 109/L,U =91.50,P ＜ 0.05] and neutrophils [3.22(2.49-4.65) × 109/L vs 10.40(7.76-14.05) × 109/L,U =58.00,P ＜ 0.05] in brucellosis were lower,while lymphocytes [1.80(1.26-2.69) × 109/L vs 0.91(0.52-1.36) × 109/L,U =121.50,P ＜ 0.05] were higher.Conclusion The number of patients with brucellosis is increased in a non-pasture area these years,and the PCT,CRP and blood routine are different from those in sepsis,so physicians should pay much more attention to the disease in early diagnosis and treatment.

BACKGROUND/AIMS: To investigate the role of selected serum microRNA (miRNA) levels as potential noninvasive biomarkers for differentiating S0–S2 (early fibrosis) from S3–S4 (late fibrosis) in patients with a chronic hepatitis B virus (HBV) infection. METHODS: One hundred twenty-three treatment-naive patients with a chronic HBV infection who underwent a liver biopsy were enrolled in this study. The levels of selected miRNAs were measured using a real-time quantitative polymerase chain reaction assay. A logistic regression analysis was performed to assess factors associated with fibrosis progression. Receiver operating characteristic (ROC) curve and discriminant analyses validated these the ability of these predicted variables to discriminate S0–S2 from S3–S4. RESULTS: Serum miR-29, miR-143, miR-223, miR-21, and miR-374 levels were significantly downregulated as fibrosis progressed from S0–S2 to S3–S4 (p < 0.05), but not miR-16. The multivariate logistic regression analysis identified a panel of three miRNAs and platelets that were associated with a high diagnostic accuracy in discriminating S0–S2 from S3–S4, with an area under the curve of 0.936. CONCLUSIONS: The levels of the studied miRNAs, with the exception of miR-16, varied with fibrosis progression. A panel was identified that was capable of discriminating S0–S2 from S3–S4, indicating that serum miRNA levels could serve as a potential noninvasive biomarker of fibrosis progression.
Biomarkers ; Biopsy ; Early Diagnosis* ; Fibrosis ; Hepatitis B virus ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Liver Cirrhosis* ; Liver* ; Logistic Models ; MicroRNAs* ; Polymerase Chain Reaction ; ROC Curve

Objective:To investigate the abnormalities of gray matter volume (GMV) and the synergistic changes in different cerebral regions in the first-episode and early-onset depression (EOD) patients.Methods:A total of 60 patients with untreated EOD (EOD group) and 64 healthy controls (control group) matched for age, gender, and education underwent high-resolution T 1WI MR scans. Voxel-based morphometry was used to calculate the cerebral GMV. The difference in GMV between the two groups was compared with the t-test. Different brain regions were selected as seeds for structural covariation network (SCN) analysis. Spearman correlation model was used to analyze the correlation between the GMV in different cerebral regions and illness duration as well as the scores of Hamilton rating scale for depression (HAMD) 17 items in EOD group. Results:Compared to control group, the EOD group had significantly increased GMV in the right orbitofrontal cortex, right dorsolateral prefrontal cortex, right inferior parietal lobule, right superior parietal lobule and bilateral precuneus ( P<0.05, corrected by FDR). Based on the right orbitofrontal cortex and dorsolateral prefrontal cortex as seed regions, structural covariance analysis revealed that abnormal cooperative brain regions in EOD group, mainly distributed in the bilateral frontal lobe, parietal lobe, occipital lobe, temporal lobe, paralimbic system and cerebellum ( P<0.05, corrected by FDR). In EOD group, significant negative correlations were observed between the GMV in the right orbitofrontal cortex ( r=-0.314, P=0.015), the left precuneus ( r=-0.283, P=0.029), and illness duration. Significant positive correlations were observed between the GMV in the right dorsolateral prefrontal cortex and the scores of anxiety/somatization factor of HAMD17 ( r=0.331, P=0.010), the left precuneus and weight factor of HAMD17 ( r=0.255, P=0.049), respectively. Conclusions:Abnormal GMV changes are observed in some regions of the prefrontal and parietal lobule in patients with untreated EOD, accompanied by extensive covariant brain regions and additional structural connectivity. In addition, the abnormal GMV changes in some regions are associated with clinical features. Part of the prefrontal and parietal lobule may be the biomarkers to objectively evaluate abnormal brain structure in depression patients in the early stage.