Objective To study the early diagnostic predictors and key follow-up parameters for girls with rapidly progressive central precocious puberty (RP-CPP). Methods A total of 260 girls with CPP participated in a prospective, nonrandomized, multi-center, nested case control study. After follow-up six months without any therapy, 114 girls were divided into RP-CPP (n=70) and slowly progressive CPP (SP-CPP) (n=44) groups. Results The basal serum LH and insulin-like growth factor Ⅰstandard deviation score (IGF-ⅠSDS) were the important risk factors of RP-CPP (OR 4.04, 1.578), especially the former. The receiver operating characteristic (ROC) curve revealed that the areas under the ROC curve of basal LH and IGF-ⅠSDS were 0.83 and 0.807, respectively. The levels of basal LH and IGF-ⅠSDS were at 0.52 mIU/ml and 0.35 respectively for the accuracy diagnosis of RP-CPP with the maximum Youden indexs. After follow-up for six months, the change levels of height, breast stages, bone age/chronological age ratio, serum LH, uterine and ovarian volume in RP-CPP group were significantly higher than those in SP-CPP group (all P<0.05). Conclusions The level of basal serum LH and IGF-ⅠSDS may be used as the risk predictors for early diagnosis for girls with RP-CPP. The change levels of basal LH, progress rates of gonad and sex character, height, and impaired growth potential seem to be the key follow-up parameters for CPP progress.

Objective To investigate the clinical characteristics of upper respiratory tract infection in hospita-lized children with mental disorders,and to analyze the risk factors for nosocomial infection,so as to provide reference for clinical treatment and prevention and control of nosocomial infection(NI). Methods The NI of 1 587 hospitalized children at the Second Affiliated Hospital of xinxiang Medical University from January to December 2016 was investiga-ted and a retrospective study was conducted on 78 hospitalized children with nosocomial upper respiratory tract infec-tion. In a ratio of 1: 2,the patients with mental disorders during the same time at hospital,without the occurrence of hospital infection,with same gender and same age group,were selected as the control group,then the univariate regres-sion analysis and multivariate conditional Logistic regression analysis were carried out. Results Of the 1 587 cases,86 cases were NI,and the incidence of NI infection was 5. 42%. Among them,the upper respiratory tract infection accoun-ted for 83. 87%(78 cases). Univariate conditional Logistic regression analysis indicated that the type of disease,hospi-talization days,insight,rehabilitation activities,hand hygiene habits,self -support ability,eating habits,management mode,seasonal and environmental conditions were the risk factors for upper respiratory tract infection in hospitalized children with mental disorders(all P<0. 05). Multivariate analysis showed that the odds ratio( OR)of autumn and winter,poor self-support ability,no insight,poor hand hygiene habits,longer hospitalization days( over 14 d),severe mental illness were 19. 627( 5. 391 -23. 518 ),12. 835( 3. 436 -18. 715 ),5. 427( 1. 879 -16. 921 ),3. 752 (1. 743-16. 864),3. 618( 1. 659 -12. 671 ),3. 361( 1. 478 -10. 527 ),respectively,which were significantly associated with the occurrence of upper respiratory infection,and the differences were statistically significant( all P<0. 05). Conclusions The season,self-support ability,insight,hand hygiene habits,days hospitalization,and disease type are the independent risk factors for upper respiratory infection in hospitalized children with mental disorders,posi-tively controlling and eliminating of independent risk factors for upper respiratory tract may reduce its incidence in the inpationt children.

Objective To analyze the willingness and influencing factors for usage of pre-exposure prophylaxis(PrEP) among male students who have sex with men (MSM) in universities of Guangxi. Meth-ods 295 MSM students in universities were recruited by Snow-balling methods. Questionnaires were self-administered to collect social demographic information,AIDS related risky sexual behaviors and willingness for usage of PrEP. Logistic regression was employed for univariate and multivariate analysis. Results Of the 295 MSM,58(19.7%)had ever heard PrEP,265(89.8%) said that they would like to use PrEP. Multivari-ate logistic regression analysis showed that those who had found partners through friends ( OR=11.419,95%CI:1.363~95.641), those who would advise his friend to use PrEP ( OR=87.946,95%CI:13.660-566. 222),those who concerned the convenience to gain the medicine ( OR=119.652,95%CI:3.765-3802.184) and those who said that they could take medicine every day ( OR=88.245,95%CI:10.237-760.696) were more likely to accept PrEP. The subjects whose partners would be angry if they stick to use condoms( OR=0.106,95%CI:0.019-0.606),and those who suspected the effectiveness of drugs( OR=0.010,95%CI:0. 001-0.112) were less likely to accept PrEP. Conclusion The acceptability of PrEP is high in university students'MSM. The safety of drugs and the convenience to gain the medicine are the main influencing factors for usage of PrEP.Using of PrEP should be strengthened to the MSM.

Objective: To analyze serum HBV-RNA levels in patients with chronic hepatitis B whose serum HBV-DNA has dropped to undetected levels after treatment with entecavir, and to explore the correlation between HBV-RNA level and liver biochemical parameters, which lay the research foundation for the clinical significance of new serological marker HBV-RNA. Methods: HBeAg negatively detected 107 cases with chronic hepatitis B whose serum HBV-DNA test results were lower than detection level for six consecutive months after receiving standard nucleoside therapy for more than 12 months were included. HBV-RNA level was detected by Perkin-Elmer reagent. HBV-DNA level was detected by Roche Cobas. Hitachi automatic biochemical analyzer was used to detect ALT and AST. Architect chemiluminescence analyzer was used to detect HBsAg, HBeAg, anti-HBe and anti-HBc. RStudio software was performed to analyze the correlation between HBV-RNA level and liver biochemical parameters. Logistic regression was used to analyze the independent factors influencing HBV-RNA level. Results: The positive detection rate of serum HBV-RNA in patients with chronic hepatitis B whose serum HBV-DNA had dropped to undetected levels after ETV treatment was 22.43%. HBsAg, ALT and AST levels in HBV-RNA positive group were slightly higher than HBV-RNA negative group, while anti-HBc levels were slightly higher in HBV-RNA negative group. There was no difference in the level of anti-HBe between the HBV-RNA negative and the positive group. Logistic regression analysis showed that anti-HBc was an independent factor influencing the level of HBV-RNA detection (P = 0.021). Conclusion HBV-RNA can be detected in some patients with chronic hepatitis B whose serum HBV-DNA level has dropped to undetected levels after ETV treatment. Serum HBV-RNA only comes from the direct transcription of cccDNA, so it is better than HBV-DNA and HBsAg to reflect cccDNA level or activity. Anti-HBc, as an independent factor influencing the level of HBV-RNA, may be used in combination as a new marker to predict the efficacy of antiviral therapy.

Objective:To investigate the clinical application of salvianolate for injection in Tongde Hospital of Zhejiang Province and evaluate its rationality of injection.Methods:From March 2018 to November 2018, 560 patients treated with salvianolate for injection in Tongde Hospital of Zhejiang Province were selected by random sampling method.The indications, usage and dosage, route of administration, choice of vehicle, concentration of vehicle, course of treatment, compatibility, contraindications and adverse reactions of salvianolate for injection were analyzed retrospectively.Results:Totally 560 inpatients received salvianolate for injection were collected, about 26.96%(151/560) was consistent with the indication, 99.82%(559/560) with a correct administration dosage and frequency, 100.00%(560/560) with right administration route, 95.00%(532/560) with a right solvent selection, 67.86%(380/560) with correct solvent concentration, 61.07%(342/560) with a correct treatment course, 100.00%(560/560) with a right medicine combination, about 94.46%(529/560) was consistent with coagulation function contraindication, about 90.18%(505/560) was consistent with liver function contraindication.The incidence of adverse reactions was 1.61%(9/560).Conclusion:In the clinical application of salvianolate for injection, a high rate of unreasonable usage is found in indication, treatment course and solvent selection.Because of the serious problems in the use of salvianolate injection, it should be used strictly to ensure clinical medication safety.

OBJECTIVETo assess the methodological quality and reporting quality on Meta-analysis being published in the Chinese Journal of Gastrointestinal Surgery.

METHODSComputerized literature searching was carried out in Wanfang Medical Online to collect articles that Meta-analysis was used in the Chinese Journal of Gastrointestinal Surgery since it was founded till July, 2014. Manual retrieval was also conducted. Two researchers independently screened for literature and extracted data. Qualities on methodologies or on the processes of reporting and reviewing were evaluated by both AMSTAR and PRISMA scales.

RESULTSForty-two papers on meta-analyses were included in this study. Results on the quality of methodology evaluation showed that the lowest and highest scores were 6 and 9 respectively, the median score was 7. Two articles (4.8%) were rated as high, 40 articles (95.2%) as moderate and 0 articles (0%) as low. Although the quality of methodology was above the average, however, there were still some problems seen in some papers as the conflict of interest was not stated, the list of studies (included and excluded) was not provided, a comprehensive literature search was not performed, the likelihood of publication bias was not assessed, etc. Results on the quality of reporting evaluation showed that the lowest and highest scores were 14 and 22 respectively, the average score was 18.43 ± 2.03, 3 articles (7.1%) scored less than 15 points, 35 articles (83.3%) scored 15.5-21 points, and 4 articles (9.6%) scored 21.5-27 points. The included reviews had high quality on the titles of the report, inclusion criteria, rationale of introduction, synthesis of results, results of individual. However, the abstract, objectives of introduction, scheme and registered, inclusion criteria, research screening, additional analysis, conclusion limitations, funding support etc. were lack of comprehensive reports.

CONCLUSIONSArticles on Meta-analysis published in the Chinese Journal of Gastrointestinal Surgery are of high quality. The Chinese Journal of Gastrointestinal Surgery can provide better evidence for clinical decision to gastrointestinal surgeons. However, both of qualities on methodology and reports sill call for continuous improvement.

Objective To explore the value of pelvic CT angiography(CTA)digital three-dimensional reconstruction model(abbreviated as"three-dimensional model")in the diagnosis of female pelvic mass.Methods A total of 98 patients with pelvic mass who were hospitalized and operated in Xi'an People's Hos-pital(Xi'an Fourth Hospital)from January 2021 to April 2023 were selected.All patients underwent B-ultra-sound and CTA examination before operation,and the original data of CTA were collected.The digital three-dimensional model of pelvic mass was established by three-dimensional reconstruction software,and the source of pelvic mass was judged according to the blood supply of pelvic mass.Taking postoperative pathological di-agnosis as the gold standard,the coincidence rate between different preoperative diagnosis methods(B-ultra-sound,CTA examination and three-dimensional model)was compared.The receiver operating characteristic(ROC)curve was plotted to evaluate the efficacy of different preoperative diagnostic methods in judging the ovarian origin of pelvic tumors.Results A total of 130 pelvic masses were included in 98 patients,and the average maximum diameter of the mass was(71.61±3.03)mm,including 83 ovarian masses and 47 non-ovarian masses.Taking postoperative pathological diagnosis as the gold standard,the diagnostic coincidence rate of the preoperative three-dimensional model was 72.31％,which was higher than that of B-ultrasound(58.46％)and CTA(52.31％),and the differences were statistically significant(P＜0.001).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,Kappa value,and area under the ROC curve were 79.51％,91.49％,94.29％,71.67％,83.85％,0.67 and 0.855,respectively,when the three-dimensional model showed that the blood supply of the mass originated from ovarian artery or uterine artery-ovarian branch.Conclusion The three-dimensional model of pelvic CTA can directly display the blood supply source,characteristics of mass,and the relationship between mass and adjacent organs,which can guide the clinical treatment.It has certain clinical value to judge the ovarian origin of pelvic mass by using ovarian artery and uterine artery-ovarian branch.

Objective:To summarize and evaluate the domestic and foreign evidence on the intervention and management of neuropathic pain in patients with spinal cord injury, so as to provide evidence-based basis for clinical nursing staff.Methods:According to "6S" evidence model of evidence pyramid, computer evidence retrieval was carried out. Expert consensus and evidence summary quality assessment used the corresponding evaluation criteria of JBI evidence-based Health Care Centers (2016), while evidence-based guidelines quality used AGREE Ⅱinstrument, and high quality evidence was extracted.Results:A total of 6 articles, including 5 guidelines and 1 expert consensus, were included in this study. A total of 22 pieces of evidence were extracted, including the assessment, intervention measures, feedback, education and nursing model of neuropathic pain in patients with spinal cord injury.Conclusion:This study summarizes the evidence for the intervention and management of pathologic pain in spinal cord injury, which can provide scientific basis for clinical nursing staff. As the evidence summarized in this study comes from many countries, sufficient evaluation of clinical environment and other related factors should be conducted before application to promote the quality of nursing.

Objective:To evaluate the reporting quality of clinical practice guidelines in medical imaging.Methods:Medical imaging guidelines were searched in CNKI, Wanfang data, CBM, Web of Science, PubMed, and other guideline-related websites. The search period is from January 1, 2017 to February 26, 2022. According to the reporting items for practice guidelines in healthcare (RIGHT) checklist, two researchers separately extracted information from the included guidelines and evaluated the reporting quality, and cross-checked them.Results:Eighteen guidelines in Chinese were included. The average reporting rate was (56.2±14.3) %. The reporting rate of basic information in Domain 1 (75.9%, 82/108) and other information in Domain 7 (68.5%, 37/54) were the highest, while funding and declaration and management of interests in Domain 6 (25.0%, 18/72) had the lowest reporting rate. The included guidelines had a lower reporting rate in item 2 (executive summary of recommendations, 27.8%, 5/18), item 11a (type of systematic review on which the guideline is based, 5.6%, 1/18), item 14a (patient preferences and values, 22.2%, 4/18), item 15 (evidence to decision processes recommendations, 22.2%, 4/18), and item 16 (external review, 16.7%, 3/18).Conclusions:The overall reporting quality of medical imaging guidelines needs to be improved. It is recommended that future guideline developers master the guideline research and evaluation tools, such as the RIGHT statement, and fully report the details and key information to improve the transparency and comprehensiveness of the guidelines.

Objective:Based on UPLC-Q-TOF/MS, to screen a panel of plasma metabolite biomarkers for TB diagnosis and evaluate its diagnostic efficacy.Methods:102 active TB patients [49 males, 53 females, age 40.0(24.0, 48.5) years] from Shanghai Pulmonary Hospital and Shanghai East Hospital from January 2017 to January 2018, 100 TB-IGRA positive patients [55 males, 45 females, age 44.0(37.0, 52.0) years] and 96 healthy controls [55 males, 41 females, age 43.0(32.2, 52.8) years] from Shanghai East Hospital were randomly enrolled. UPLC-Q-TOF/MS technology was used to detect small molecule metabolites in plasma. Combined with multivariate statistical methods VIP and univariate statistic analysis Student's t-test, the main differential metabolites in the plasma of patients with active tuberculosis were filtered. The ROC curve was analyzed for the differential metabolites, and the AUC value, specificity, and sensitivity for diagnosis were used to screen metabolic biomarkers with diagnostic potential. Results:All the samples examined resulted in 10 266 variables, and 1 153 substances were identified by qualitative retrieval through the human metabolome database. After pairwise comparison of samples from the three groups, differential metabolites that simultaneously satisfied VIP > 1 and P<0.05 were plotted into a Venn diagram, and the resulting intersection set contained 38 major differential metabolites. The ROC curve analysis of 38 major metabolites showed that the area under the curve of lactic acid, dopamine, 9-pentadecenoic acid, and 12,13-dihydroxy octadecadienoic acid in the diagnosis of active tuberculosis were 0.92, 0.98, 0.94, and 0.94, respectively, the specificity was both more than 90% and the sensitivity was both more than 80%. The specificity and sensitivity of four metabolites in the combined diagnosis of active tuberculosis were both 94%. Conclusion:Lactic acid, dopamine, 9-pentadecenoic acid, and 12, 13-dihydroxy octadecadienoic acid can be used as potential metabolic biomarkers for tuberculosis diagnosis.