T was genotyped by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)in all the patients.Results The occurrence of CR in this population was 23.3%(70/300).There was CYP3A4 894C/T polymorphism in the study population.The frequencies of the three kinds of genotypes(CC,CT,TT)in CR group and non-CR(NCR)group were 45.7%,50.0%,4.3% and 63.5%,31.7%,4.8%,respectively.The frequency of TT genotype was significantly higher in NCR group than that in CR group(OR=2.06,95% CI:1.201-3.547,P=0.020).C allele carriers were more likely to develop clopidogrel resistance compared with that of T allele carriers(OR=1.59,95% CI:1.037-2.442,P=0.023).Conclusion CYP3A4 gene 894C/T polymorphism is associated with the risk of CR,and C allele carriers may be a possible genetic susceptibility factor for patients with CR.

Objective To evaluate the short-term efficacy of lamivudine versus entecavir for patients with HBeAg-negative acute-on-chronic liver failure (ACLF) with different pretreatment liver failure degrees.MethodsA total of patients with HBeAg-negative ACLF were enrolled into this retrospective study.Seventy-two cases were treated with lamivudine 100 mg daily,while 93 cases were treated with entecavir 0.5 mg daily.Biochemical items,model for end-stage liver disease (MELD)score,hepatitis B virus (HBV) DNA level and mortality were observed.The efficacies of the two drugs were analyzed in patients with different degrees of liver failure.The comparison of rates was done using chi-square test and the measurement data were compared by t test.ResultsAmong the patients with pretreatment MELD scores above 30,the post-treatment HBV DNA levels in lamivudine group and entecavir group were (3.6 ± 1.1) lg copy/mL and (3.7 ± 1.4) lg copy/mL,respectively (t=0.181,P=0.859) and the mortalities were 92.0％ and 91.8％,respectively (χ2 =0.002,P=0.680).For the patients with pretreatment MELD scores from 23 to 30,the post-treatment HBV DNA levels in two groups were (3.2± 1.1) lg copy/mL and (3.2±2.3) lg copy/mL,respectively (t=0.760,P=0.455) and the mortalities were 42.9％,54.1％,respectively (χ2 =0.799,P=0.455).In patients with pretreatment MELD scores below 23,the post-treatment HBV DNA levels in two groups were (3.1±1.0) lg copy/mL and (2.8±1.5) lg copy/mL,respectively (t=-0.740,P=0.464) and the mortalities were 3/19 and 6.3％,respectively (χ2=1.227,P=0.455).In lamivudine group,the mortalities were significantly different among patients with three different ranges of pretreatment MELD scores (χ2 =26.967,P =0.000).The similar differences were also found in entecavir group (χ2 =41.260,P=0.000).ConclusionsAmong treatment na?ve patients with HBeAg-negative ACLF,the short-term efficacy of lamivudine versus entecavir is equal if the degree of pretreatment liver failure is similar.Meanwhile,the degrees of pretreatment liver failure significantly affects the outcome of the treatment.

Objective:To standardize the naming of organ at risk (OAR) and target area during cervical cancer radiotherapy based on AAPM TG-263.Methods:After self-programming of Matlab software to implement the reading and resolution of radiotherapy structure files, the naming of each substructure was automatically output, recorded and restored. After naming all substructures, the structure names were classified by keywords. According to TG-263, a standard naming conversion table of OAR and target area was developed, and the classified structure names were standardized through procedures. Finally, the standardized named radiotherapy structure files were output and imported into the treatment planning system (TPS).Results:The radiation structure of 144 patients with cervical cancer was successfully transformed and displayed correctly in TPS. Before the transformation, the naming of OAR and target area lacked of uniform norms and standards, and the naming of the same structure significantly differed. After the transformation, 43 naming methods of OAR and 74 naming methods of the target area were unified into 20 and 8 naming methods, which were more convenient for staff understanding and communication.Conclusion:The standardization of cervical cancer radiotherapy structure naming can reduce the inconsistency of naming and provide reference for the standardized naming of pelvic tumors.

Objective To investigate the hearing outcome efficiency of tympanostomy tubes and when combined with adenoidectomy for otitis media with effusion treatment. Methods A systematic literature review of tympanostomy tubes and tympanostomy tubes combined with adenoidectomy were performed using PubMed, EMBASE,the Cochrane Library,MEDLINE,all of the included studies were randomized controlled trial. The quality of included studies was evaluated according to the Risk of Bias Table of the Cochrane Handbook. Data were analyzed with Review Manager 5.02 software. Heterogeneity was examined,and forest plot was drawn. Results All of the included 4 studies were randomized controlled trials. At 6 month follow-up patients,the tym-panostomy tubes and tympanostomy tubes combined with adenoidectomy had no difference in hearing improvement (WMD = 1.06,95%CI-0.18 ~ 2.29,P = 0.09). At 12 month follow-up patients,the tympanostomy tubes com-bined with adenoidectomy were better than tympanostomy tubes alone(WMD = 3.03,95%CI 0.91 ~ 5.14,P =0.005). Conclusions The meta analysis result reveals that tympanostomy tubes combined with adenoidectomy have an advantage in long term follow up time for hearing improvement in children's otitis media with effusion treatment.

Abstract In recent years, the prevention and treatment of eye diseases in children has become one of the worldwide recognized public health issues. Both genetic and environmental factors can influence the development of offspring visual systems, leading to abnormal vision acuity such as refractive errors, strabismus, and nystagmus. With the aim of elucidating the influencing factors and mechanisms of early life adverse exposures on offspring vision outcomes, the article summarizes the research on exposure in early life and visual acuity in offspring from different perspectives, including tobacco exposure during pregnancy, exposure to microelements, gestational diabetes, gestational hypertension, and drug abuse during pregnancy, so as to provide scientific evidence for the development of more effective strategies to prevent and control eye diseases in children and adolescents.

Population based health data collection and analysis are important in epidemiological research. In recent years, with the rapid development of big data, Internet and cloud computing, artificial intelligence has gradually attracted attention of epidemiological researchers. More and more researchers are trying to use artificial intelligence algorithms for genome sequencing and medical image data mining, and for disease diagnosis, risk prediction and others. In recent years, machine learning, a branch of artificial intelligence, has been widely used in epidemiological research. This paper summarizes the key fields and progress in the application of machine learning in epidemiology, reviews the development history of machine learning, analyzes the classic cases and current challenges in its application in epidemiological research, and introduces the current application scenarios and future development trends of machine learning and artificial intelligence algorithms for the better exploration of the epidemiological research value of massive medical health data in China.

Objective:To analyze the current research status, hotspots, and trends in the field of cancer symptom management in recent 10 years, and to provide a reference for further research.Methods:Articles published from January 2010 to December 2019 were retrieved with "cancer OR tumor OR neoplasm" and "symptom management" as the subject terms from the core collection of Web of Science database. CiteSpace 5.7.R1 was used for analysis and visualization of researchers, countries, institutions, journals, documents, keywords and other content.Results:The number of papers published in the field of cancer symptom management was basically on the rise, but the number of co-authored papers by multiple authors and institutions was insufficient. The United States, the United Kingdom, Canada, and Australia were the main countries in the field of cancer symptom management. They occupied a key position in this field and cooperated closely with each other. China's number of publications ranked the fifth, but it did not take a central place, and it had less international cooperation. Journal of Clinical Oncology, Journal of Pain and Symptom Management, and Supportive Care in Cancer were the core journals in this field. The related articles published on them reflected the foundation of this field, and provided important reference for this field. Cancer, symptoms, intervention measures, self-care, remote management, etc. have been research hotspots in recent years. Conclusions:This study provides a perspective for understanding the related research in cancer symptom management, and supplies valuable information for researchers to identify potential collaborators and cooperative institutions, core journals, hot topics, and research frontiers. In the future, researchers may focus on such hotspots and frontiers as symptoms, interventions, self-care, and remote management.

Objective:To systematically evaluate the effect of umbilical therapy in adult ulcerative colitis.Methods:The clinical randomized controlled trials (RCT) related to the effect of umbilical therapy in ulcerative colitis in the Chinese and English databases were systematically searched, and their citations were traced. The search time limit was from the establishment of each database to December 30, 2020. Two researchers screened and evaluated the articles according to the inclusion and exclusion criteria, and extracted article information and data. RevMan5.3 was used for meta-analysis.Results:A total of 13 Chinese articles were included, with 898 patients. The results of meta-analysis showed that there was no statistically significant difference in the general symptom relief rate [ RR=0.70, 95% CI (0.12, 4.19), P=0.70]and effective rate [ RR=0.93, 95% CI (0.54, 1.59), P=0.86]between conventional therapy and umbilical therapy alone. Umbilical therapy combined with conventional therapy can improve the effective rate of treatment [ RR=1.26, 95% CI (1.18, 1.35), P<0.000 01], general symptom relief rate [ RR=1.94, 95% CI (1.44, 2.61), P<0.000 1], abdominal pain relief rate [ RR=1.90, 95% CI (1.42, 2.54), P<0.000 1], diarrhea relief rate [ RR=1.32, 95% CI (1.07, 1.64), P=0.01], remission rate of pus and blood stool [ RR=1.22, 95% CI (1.03, 1.44), P=0.02]and reduced disease activity [ MD=-1.79, 95% CI (-3.37, -0.21), P=0.03]. In terms of adverse reactions, the difference between the two groups was not statistically significant [ RR=0.33, 95% CI (0.08, 0.80), P=0.13]. Conclusions:The efficacy of umbilical therapy alone is equivalent to that of conventional therapy, but umbilical therapy combined with conventional therapy is more effective in improving the treatment effective rate, general symptom relief rate and clinical symptoms. Due to the limitation of the number and quality of the included studies, long-term follow-up, large sample and rigorous RCT studies are needed to prove it.

Objective:Based on the AAPM TG-263, a Content-Based Standardizing Nomenclatures (CBSN) was proposed to explore the feasibility of its standardization verification for organs at risk (OAR) of nasopharyngeal carcinoma (NPC).Methods:The radiotherapy structure files of 855 patients with nasopharyngeal carcinoma (NPC) receiving intensity-modulated radiotherapy (IMRT) from 2017 to 2019(15 of whom showed clinical anomalous structures) were retrospectively collected and processed. The Matlab self-developed software was used to obtain the image position, geometric features, first-order gray histogram, and the Gray-level Co-occurrence Matrix′s texture features of the OAR contour outlined by the doctor to establish the CBSN Location Verification model and CBSN Knowledge Library. Fisher discriminant analysis was employed to establish a CBSN OAR classification model, which was evaluated using self-validation, cross-validation, and external validation, respectively.Results:99%(69/70) of the simulated anomalous structures were outside the 90% reference range of the CBSN Knowledge Library and the characteristic parameters significantly differed among different OARs (all P<0.001). The accuracy rates of self-validation, cross-validation and external verification of the CBSN OAR classification model were 92.1%, 92.0% and 91.8%, respectively. Fourteen cases of clinical abnormal structures were successfully detected by CBSN with an accuracy rate of 93%(14/15). In the simulation test, the accuracy of the left and right location verification reached 100%, such as detecting the right eye lens named Len_L. Conclusion:CBSN can be used for OAR verification of NPC, providing reference for multi-center cooperation and standardized radiotherapy of NPC patients.