Objective To analyze the prevalence and clinical features of cytomegalovirus (CMV)infection in patients with systemic lupus erythematosus (SLE).Methods Patients with SLE in Peking University Third Hospital from 2013 to 2015 and age and sex matched healthy controls were enrolled.All patients were detected for CMV antibody,CMV DNA and CMV PP65 in the blood.The prevalence of CMV infection and the clinical characteristics were analyzed using Chi-square test.Results Altogether 349 SLE patients and 209 healthy controls were enrolled.In SLE group,the positive rate of CMV IgG was 90.3％ (315/349),which was similar to that of the control group,while the positive rate of CMV IgM was 8.0％ (28/349),which wassignificantly higher than controls 1.4％(3/209) (x2=10.811,P=0.001),and the active CMV infection rate was 69.1％(241/349).Those in the active phase of SLE were more likely to have active CMV infection when compared with those in remission [75.4％(93/256) vs 51.6％(48/93),x2=18.049,P＜0.01].The percentage [43.2％(104/241)] of severe patients in those with active CMV infection was much higher than that in those without CMV infection 9.2％(10/108) (x2=38.953,P＜0.01).Those SLE patients had active CMV infection were clinically more severe and the most common clinical manifestation were proteinuria/hemoturia,cytopenia and fever.Conclusion In SLE patients,the positive rate of CMV IgM is significantly higher than healthy control and the prevalence of active CMV infection is high,especially in those at active disease.Those with active CMV infection are clinically more severe but have no features of active CMV infection,which indicates that the CMV infection might be a trigger of SLE activity.

Objective To evaluate the effects of folic acid supplement on subjects with different 5, 10-methylenetet-rahydrofolate reductase (MTHFR) genotypes. Methods One hundred and eleven healthy women were divided into CC, CT and TT groups according to their MTHFR C677T genotypes. In each group subjects were randomly sub-divided into interven-tion (400 μg/d folic acid supplement) and control (usual diet) groups. The plasma folate, red blood cell (RBC) folate and plasma homocysteine (Hcy) concentration were measured at baseline and two months after intervention. Results The plasma folate was lower and the plasma Hcy was higher in the TT genotype than those in CC or CT genotypes (P＜0.05 or P＜0.01). After two months of intervention, the levels of plasma folate, RBC folate concentration increased while the plasma Hcy concen-tration decreased in all three intervention groups. Although the plasma folate concentration increased the most obvious in TT genotype than that of CC and CT genotypes, P＜0.05), the plasma Hcy concentration decreased the most obvious in TT geno-type than that of CT genotype, P＜0.05). Logistic regression analysis showed that the MTHFR TT genotype was a risk factor of high Hcy concentration, which was 8.078 times compared with that of CC genotype (P＜0.05). Conclusion Folic acid sup-plement can significantly increase plasma folate and red cell folate concentration, and reduce plasma Hcy concentration in all MTHFR genotypes. TT genotype was the most dangerous in disorder of folic metabolic and high Hcy concentration. However, low-dose folic acid supplement cannot reduce the risk of high Hcy concentration.

Objective:To evaluate the effects of dexmedetomidine on the enhancement of fear memory by propofol in rats with post-traumatic stress disorder (PTSD).Methods:Two hundred and twenty clean-grade healthy male Sprague-Dawley rats, weighing 300-400 g, aged 12-16 weeks, underwent conditioned fear memory training, and PTSD model was developed.One hundred and twenty rats were divided into 6 groups ( n=20 each) by a random number table method: control group (C group), PTSD group, propofol group (P1 group), and propofol + different doses of dexmedetomidine groups (P1+ DEX10 group, P1+ DEX20 group and P1+ DEX40 group). In group C, only sound was played and no electric shock was given during conditioned fear memory training.After conditioned fear memory training, sesame oil 1 ml/kg was intraperitoneally injected in PTSD group, propofol 1 ml/kg was intraperitoneally injected in group P1, and dexmedetomidine 10, 20 and 40 μg/kg were intraperitoneally injected in P1+ DEX10, P1+ DEX20 and P1+ DEX40 groups, respectively.After drug administration, conditioned fear memory test was performed to record the time of rigid behavior within 90 s, and the percentage of time of rigid behavior was calculated.The development of SpO 2<90% was recorded during administration.One hundred Sprague-Dawley rats were divided into 5 groups ( n=20 each) by the random number table method: propofol group (P2 group), and propofol+ dexmedetomidine given at different timings groups (P2+ DEX T0 group, P2+ DEX T30 group, P2+ DEX T60 group and P2+ DEX T90 group). After the conditioned fear memory training, propofol 1 ml/kg was intraperitoneally injected in 5 groups, an then dexmedetomidine 20 μg/kg was intraperitoneally injected at 0, 30, 60 and 90 min after propofol administration in P2+ DEX T0, P2+ DEX T30, P2+ DEX T60 and P2+ DEX T90 groups, respectively.Conditioned fear memory test was performed after drug administration to record the time of rigid behavior within 90 s, and the percentage of time of rigid behavior was calculated. Results:Only 6 rats developed SpO 2<90% during the administration period in P1+ DEX40 group.Compared with C group, the percentage of time of rigid behavior was significantly increased in PTSD group ( P<0.05). Compared with PTSD group, the percentage of time of rigid behavior was significantly increased in P1 group ( P<0.05). Compared with P1 group, the percentage of time of rigid behavior was significantly decreased in P1+ DEX20 and P1+ DEX40 groups ( P<0.05), and no significant change was found in the percentage of time of rigid behavior in P1+ DEX10 group ( P>0.05). Compared with P2 group, the percentage of time of rigid behavior was significantly decreased in P2+ DEX T0 and P2+ DEX T30 groups ( P<0.05), and no significant change was found in the percentage of time of rigid behavior in P2+ DEX T60 and P2+ DEX T90 groups ( P>0.05). Conclusions:Dexmedetomidine can attenuate propofol-induced enhancement of fear memory in a rat model of PTSD, and the best effect is achieved in early administration of moderate dose (20 μg/kg, within 30 min after propofol administration).

Objective:To screen the risk factors for post-traumatic stress disorder (PTSD) after emergency trauma surgery in the patients.Methods:The medical records of emergency surgical trauma patients (traffic accident, fall, engineering accident, etc.) were retrospectively collected.The general condition and perioperative clinical indicators of the patients were recorded.The patients were divided into PTSD group and non-PTSD group according to whether PTSD occurred within 1 month after surgery.Multivariate logistic regression analysis was used to screen the risk factors for PTSD.Results:A total of 312 patients were enrolled, and the incidence of PTSD at 1 month after surgery was 19.9%.There were significant differences in preoperative VAS score, ratio of gender, intraoperative use of propofol, intraoperative use of dexmedetomidine, and postoperative ICU transfer rate between PTSD group and non-PTSD group ( P<0.05). The results of logistic regression analysis showed that intraoperative use of propofol, preoperative high VAS score and postoperative admission to ICU were independent risk factors for PTSD, and intraoperative use of dexmedetomidine was a protective factor for the prevention of PTSD ( P<0.05). Conclusions:Intraoperative use of propofol, preoperative high VAS score and postoperative transfer to ICU are independent risk factors for postoperative PTSD in the patients with emergency trauma, and intraoperative use of dexmedetomidine is a protective factor for the prevention of PTSD.

Objective To explore the prevalence and epidemic characteristics of overweight, obesity, and central obesity in Shanghai Pudong New Area. Methods Multi-stage stratified random sampling method was conducted in Pudong New Area in 2013. Residents over 15 years old were randomly selected from 13 communities and participated in the cross-sectional study. A structured questionnaire was used to collect the information and physical examination, biochemical assays were also conducted. SPSS 20. 0 was used to analyze the results. Results The averagebodymassindexofparticipantswas(25.04±3.79)kg/m2andtheaveragewaistcircumferencewas(82.44± 9. 51) cm. The prevalences of overweight, obesity, and central obesity were 41. 67%, 17. 70%, and 31. 32%respectively. Standardized prevalences of overweight, obesity, and central obesity were 34. 39%, 16. 96%, and 25. 66% respectively, according to 2010 national age composition of population. Statistically significant sex differences were found among the prevalence of overweight, obesity, and central obesity groups(all P<0. 05). The prevalence of central obesity in female was raised by increasing age. Residents with hypertension, hyperglycemia, dyslipidemia, and metabolic disorders had higher prevalences in overweight, obesity, and central obesity ( all P<0. 05). Conclusion The prevalences of overweight, obesity, and central obesity among the residents in Shanghai Pudong New Area were relatively high. Relevant risk factors should be explored to promote health education that may enhance people′s awareness of weight management.

Objective:To explore the difference of gray matter volume between anxious depression(AD)and non anxious depression(NAD) patients, and its correlation with clinical characteristics.Methods:One hundred and fifty patients with depression were included from September 2014 to October 2018, meanwhile 62 healthy controls with matching demographic characteristic were recruited. The severity of the patients was assessed by Hamilton depression scale-17(HAMD-17). Patients were divided into anxious depression group(AD group, n=80)and non-anxious depression group (NAD group, n=70) according to whether anxiety/somatization factor scored 7. All subjects were scanned with 3.0 T underwent structural MRI scan. The structural magnetic resonance data were preprocessed by voxel-based morphometry (VBM). The rest toolkit was used to calculate the difference of gray matter volume among the three groups. By SPSS 19.0, post-hoc t test was used for pairwise comparison and Pearson correlation analysis was performed between gray matter volume and clinical factors in patients with anxious depression. Results:Compared to the NAD group, the gray matter volume of the right middle frontal gyrus(MNI: x=28.5, y=21.0, z=48.0, t=-4.83, Bonferroni multiple comparison adjustment, P<0.05/3) and left dorsolateral superior frontal gyrus(MNI: x=-18.0, y=27.0, z=43.5, t=-6.08, Bonferroni multiple comparison correction, P<0.05/3)were significantly decreased in AD group. Correlation analysis found that the gray matter volume of the right middle frontal gyrus in patients with anxious depression was negatively correlated with the insight of anxiety/somatization factor score ( r=-0.36, P=0.001). Conclusion:The volume of prefrontal lobe in patients with anxiety depression is lower than that in patients with non anxiety depression, which may be related to the serious clinical symptoms in patients with anxiety depression.The decrease of right middle frontal gyrus volume can be used as a potential biological marker for the severity of impaired insight.

Bone graft materials have mixed effects of bone repair in the field of oral maxillofacial surgery. The qualitative analyses performed by previous studies imply that autogenous odontogenic materials and autogenous bone have similar effects on bone repair in clinical jaw bone transplantation. This retrospective systematic assessment and network metaanalysis aimed to analyze the best effect of clinical application of autogenous odontogenic materials and autogenous, allogeneic, and xenogeneic bone grafts in bone defect repair. A systematic review was performed by searching the PubMed, Cochrane Library, and other journal databases using selected keywords and Medical Subject Headings search terms. 10 Papers (n = 466) that met the inclusion criteria were selected. The assessment of heterogeneity did not reveal any overall statistical difference or heterogeneity (P = 0.051 [ 0.05), whereas the comparison between autogenous and allogeneic bone grafts revealed local heterogeneity (P = 0.071 0.1). Risk of bias revealed nine unclear studies and one high-risk study. The overall consistency was good (P = 0.065 [ 0.05), and the local inconsistency test did not reveal any inconsistency. The publication bias was good. The confidence regarding the ranking of bone graft materials after GRADE classification was moderate. The effects on bone repair in the descending order were as follows: autogenous odontogenic materials, xenogeneic bone, autogenous bone, and allogeneic bone. This result indicates that the autogenous odontogenic materials displayed stronger effects on bone repair compared to other bone graft materials. Autogenous odontogenic materials have broad development prospects in oral maxillofacial surgery.

Objective:To investigate the regional homogeneity (ReHo) among the major depressive disorder patients without mixed features (MDD noMF), major depressive disorder with mixed features (MMF), bipolar disorder with mixed features (BMF) and bipolar disorder patients without mixed features (BD noMF) patients, and to explore the brain activity and functional connectivity patterns of the MMF and BMF patients. Methods:This was a cross-sectional study. The MDD noMF patients (MDD noMF group), MMF patients (MMF group), BMF patients (BMF group), BD noMF patients (BD noMF group), and age-and gender-matched healthy controls (HC group) were recruited from Beijing Anding Hospital, Capital Medical University between April, 2021 and June, 2022. All the participants underwent resting-state functional MRI scanning. The ReHo values was computed with the DPABI software based on the MATLAB. Firstly, the difference in ReHo among the patients with MDD noMF, MMF, BMF, BD noMF and HC group were estimated by the analysis of covariance and the post-hoc method (LSD or Games-Howell). And then, the brain regions with significant different ReHo values were selected as the seeds to calculate the functional connectivity with the whole brain. Results:A total of 29 cases in the MDD noMF group, 24 cases in the MMF group, 26 cases in the BMF group, 29 cases in the BD noMF group, and 42 in the HC group were included. The differences in ReHo values in the left fusiform and the left precuneus of the 5 groups were statistically significant ( P<0.05). Among of them, the ReHo values of the left fusiform were lower in the MMF, BMF and BD noMF groups compared with the HC group ( P<0.05), while the ReHo values of the left precuneus in MDD noMF, MMF, BMF and BD noMF groups were higher than that in the HC group ( P<0.05). The ReHo value of the left fusiform was lower in the MMF group compared with the MDD noMF group ( P=0.001); the ReHo value of the left fusiform was lower in the BMF group compared with the MDD noMF and BD noMF groups ( P<0.05). The functional connectivity between the left fusiform and vermis, left insula, right putamen, and left medial superior frontal gyrus, and functional connectivity between the left precuneus and right superior frontal gyrus (dorsolateral) showed significant difference among the MDD noMF, MMF, BMF, BD noMF and HC groups ( P<0.05). Compared with HC group, MDD noMF, MMF, BD noMF groups showed higher functional connectivity between the left fusiform and the vermis, and MDD noMF, MMF, BMF, BD noMF group showed higher functional connectivityy between the the left fusiform and the left insula, left medial superior frontal gyrus and right putamen ( P<0.05). Compared with the MDD noMF group, the MMF, BMF and BD noMF groups showed higher functional connectivity between the left fusiform and the left insula ( P<0.05). Compared with the MDD noMF group, the BMF and BD noMF groups had higher functional connectivity between the left fusiform and the left medial superior frontal gyrus ( P<0.05). The BMF group showed higher functional connectivity of the left fusiform with the right putamen than the MDD noMF and BD noMF groups. Additonally, the BMF and BD noMF groups showed higher functional connectivity between the left precuneus and the right superior frontal gyrus (dorsolateral) than HC, MDD noMF and MMF groups ( P<0.05). Conclusions:MMF and BMF patients have local abnormalities of functional activity synchronization in the left fusiform and precuneus and abnormal functional connectivity patterns with multiple brain regions. MMF and BMF patients have specific neuroimaging features compared to MDD noMF or BD noMF patients and also share similar neuroimaging pathogenesis.

Pump thrombosis after ventricular assist device implantation is a major limiting factor in its long-term clinical application. Early identification and timely intervention for pump thrombosis complications are great important for the curative effect after ventricular assist device implantation. This paper summarizes the predictive factors and risk factors of pump thrombosis after ventricular assist device implantation, and discusses the monitoring of pump thrombosis.