Objective:To investigate the value of synthetic MRI for evaluating lumbar intervertebral disc degeneration.Methods:A total of 414 lumbar intervertebral discs from 85 patients were included prospectively from September 2018 to February 2019 in First Affiliated Hospital of China Medical University. The T 1, T 2 and proton density (PD) mapping were generated from synthetic MRI. Two doctors measured the T 1, T 2 and PD values to evaluate intraobserver agreement by using ICC. For Pfirrmann grade comparisons, the variables with normal distribution were analyzed with the one-way analysis of variance, whereas those with skewed distribution were analyzed with the Kruskal-Wallis H test. Furthermore, the ROC curves were used on significant parameters to evaluate their diagnostic efficacy. The Z test was used to compare the differences of area under the ROC curves (AUC). Results:The color of the quantitative mapping changed along with the increase of the Pfirrmann grade of the intervertebral discs, which corresponded to the decrease of the T 2WI signal intensity. The ICC values of the quantitative values of nucleus pulposus indicated excellent agreement (ICC>0.900), followed by anterior annulus fibrosus (ICC>0.700) and then the posterior annulus fibrosus (ICC>0.600). The results of the adjacent Pfirrmann grade comparisons were as follows: between Pfirrmann grade Ⅰ and Ⅱ, the differences of T 2 and PD values of nucleus pulposus were statistically significant ( P=0.004 and P<0.001, respectively); between Pfirrmann grade Ⅱ and Ⅲ, the differences of T 1, T 2 and PD values of nucleus pulposus were statistically significant (all P<0.001); between Pfirrmann grade Ⅲ to Ⅳ, the T 1, T 2 and PD values of nucleus pulposus (all P<0.001) and the T 1 and PD values of posterior annulus fibrosus ( P=0.025, P<0.001, respectively) had statistically significant differences; between Pfirrmann grade Ⅳ to Ⅴ, the difference of T 2 values of nucleus pulposus were statistically significant ( P=0.031). The AUC of T 2 values of nucleus pulposus between Pfirrmann grade Ⅱ to Ⅲ and grade Ⅳ to V were higher than those of the PD values ( Z=2.443, 3.591 and P=0.015,<0.001). Conclusions:Synthetic MRI can quantitatively evaluate lumbar disc degeneration, in which the T 2 value of nucleus pulposus may be the most effective parameter with high repeatability.

Objective To evaluate the clinical value of fasting blood glucose (FBG) in the diagnosis of multiple organ dysfunction syndrome (MODS) caused by pulmonary infection in elderly patients with diabetes. Methods Patients over 65 years old with diabetic pulmonary infection admitted to Department of Cadres Ward of Bethune International Peace Hospital of PLA from July 2015 to December 2016 were enrolled. According to the patient's highest FBG level during pulmonary infection, all patients were divided in two groups. The cases whose FBG ≥8.83 mmol/L were served as suspicious multiple organ dysfunction syndrome in the elderly (MODSE) group, and those had FBG < 8.83 mmol/L were served as suspicious non-MODSE group. The incidence of MODSE in suspicious MODSE group and suspicious non-MODSE group was compared. The receiver operating characteristic curve (ROC) was drawn, and the clinical value of highest FBG in the diagnosis of MODSE caused by pulmonary infection in elderly patients with diabetes was assessed. Results 119 elderly patients with diabetes and pulmonary infection were enrolled in the analysis. All patients were male, with age of 76-105 years with an average of (89.41±4.16) years. Among 119 patients, 55 of them with suspected MODSE, 64 of them with suspected non-MODSE. The incidence of MODSE in suspicious MODSE group was significantly higher than that in suspicious non-MODSE group (78.2% vs. 12.5%), with statistically significant difference (χ2 = 52.108, P = 0.000). The area under the ROC curve of the highest FBG for diagnosis of MODSE was 0.895, and 95% confidence interval (95%CI) was 0.839-0.951 (P < 0.001). When using FBG ≥ 8.83 mmol/L to diagnose MODSE induced by pulmonary infection in elderly patients with diabetes, the sensitivity was 84.3% and the specificity was 82.4%. Conclusion FBG ≥ 8.83 mmol/L, as an indicator reflecting the changes of metabolic function, have a diagnostic value for MODSE caused by pulmonary infection in elderly patients with diabetes.

Objective To investigate the role of S100B protein in the pathogenesis of patients with Japanese encephalitis (JE).Methods A total of 45 patients were enrolled in the Second Hospital of Hebei Medical University from August 2013 to October 2013,who were diagnosed as JE on the basis of clinical features and positive IgM antibodies against JE virus measured by enzyme-linked immunosorbent assay (ELISA) from the Center of Disease Control of Shijiazhuang.The JE patients were divided into initial phase group,acute phase group and convalescence group based on the course,mild JE group,moderate JE group and severe JE group based on the severity,MRI-no-lesion group and MRI lesions group based on the imaging findings of JE.Twelve cases with no evidence of infection in central nervous system in the meantime were chosen as control.The S100B protein was measured by ELISA.Results The content of S100B protein in cerebrospinal fluid was as follows:522.76 (393.35,620.37) pg/ml in mild JE group (acute phase group:609.77 (549.27,779.71) pg/ml,convalescence group:420.48 (344.36,453.19) pg/ml),792.09 (705.47,1 108.96) pg/ml in moderate JE group (acute phase group:770.19 (646.31,1 069.54) pg/ml,convalescence group:803.45 (602.90,1 396.84) pg/ml),and 1 021.94 (680.84,1 302.15) pg/ml in severe JE group (acute phase group:981.82 (680.84,1 826.28) pg/ml,convalescence group:989.00 (553.62,1 207.67) pg/ml).The S100B protein content was 561.52 (454.36,814.56) pg/ml,803.45 (602.90,1 104.01) pg/ml,762.22 (594.95,1 044.97) pg/ml,581.76 (442.51,1 069.10) pg/ml in MRI-no-lesion group,MRI lesions group,total acute phase group and total convalescence group,respectively.While in control group,the S100B protein content was 266.71 (205.72,390.05) pg/ml.The contents of S100B protein in moderate JE group,severe JE group,total acute phase group,total convalescence group,MRI-no-lesion group,MRI lesions group were higher than that in control group (H =4.864,5.497,5.075,3.918,2.971,4.981,P =0.000,0.000,0.000,0.000,0.009,0.000).The contents of S100B protein in mild JE group was lower than that in moderate JE group and severe JE group (H =-2.786,-3.514,P =0.032,0.003).Conclusions The level of S100B protein in cerebrospinal fluid is related with the severity,duration and imaging presentation of JE patients.The dynamic monitoring of S100B protein levels is of great significance for assessment of the patients' condition and curative effect.

BACKGROUND:Numerous diseases like cardiac hypertrophy and intervertebral disc degeneration are known to be implicated in the changes of mechanical stress acting on surrounding tissues or cells, and autophagy contributes to the pathogenesis of these diseases. OBJECTIVE:To review the effects of mechanical factors on autophagy in different tissues and the underlying molecular mechanisms, thereby providing references for the research of autophagy and the prevention and treatment of related diseases. METHODS:A search of Web of Science and PubMed databases was performed for the literatures addressing the effects of mechanical factors on autophagy using the English keywords ofautophagy, mechanicaland the articles were summarized systematically. Finally, 52 literatures were enrolled according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION:Mechanical factors make great effects on autophagy of various cells, such as myocardial cells, endothelial cells, chondrocytes and skeletal muscle cells. Autophagy is a self-protective reaction, and the mechanical stress of physiological conditions induces autophagy to maintain cellhomeostasis, normal function and survival. The mechanism of autophagy induced by mechanical stress may involve PI3K-AKT-mTOR, oxygen free radical, AKT-FoxO and other pathways, and the definite mechanism needs to be further studied.

Objective To study the current situation of migrant children' s social adaptation and ex?plore its influencing factors. Methods The study population was 1547 children aged 10?16 years recruited from Shijiazhuang city. Social adaptation was collected through social adaptation questionnaire,whereas self?control was measured by children' s self?control investigating questionnaire. The data were statistically ana?lyzed with the ANOVA and stepwise regression analysis. Results ①There was no significant difference on social adaptation scores between migrant children and urban children (3.71±0.65,3.70±0.69, P>0.05). ②Among migrant children,girls scored significantly higher than boys(3.80±0.59,3.63±0.69, P<0.01). And as the grade of the migrant children increased,the social adaptation scores decreased (3.82±0.68,3.72±0.64, 3.58±0.60, P<0.01). ③The poor control system had a significantly negative prediction on migrant children' s social adaptation ( β=-0.299, P<0.01),whereas the good self?control system had a significantly positive prediction on migrant children' s social adaptation ( β=0.243, P<0.01) . Both parent?child relationship and peer relationship significantly positively predicted migrant children ' s social adaptation ( β=0. 179, β=0.092, P<0.01) . There was no significant correlation between the proportion of the migrant children in the classes and migrant children's social adaptation (P>0.05). Conclusion There is no significant difference on social adaptation between migrant children and urban children. Children' s self?control,parent?child rela?tionship and peer relationship have significant influence on social adaptation of migrant children .

Objective:To evaluate the reliability and validity of the Chinese version of the Self-Regulatory Fa-tigue Scale (SRF-S)in Chinese young people.Methods:A sample of 553 young people from a university and a state-owned enterprise was administrated with the SRF-S,the Simplified Coping Style Questionnaire (SCSQ)and the Dual-Mode Self-Control Scale (DMSC-S).Item analysis was conducted to identify valid items and revise the scale.Then the construct validity of the revised scale was tested through confirmatory factor analysis.Finally,a sam-ple of 238 graduate students was retested two weeks later to examine the reliability of the scale.Results:Item analy-sis showed that the SRF-S had satisfactory item discrimination (r >0.38).Confirmatory factor analysis showed that the whole scale had a three-order factor and good construct validity (χ2 /df=5.08,RMSEA =0.09,NFI =0.90, NNFI =0.90,CFI =0.92,IFI =0.92,GFI =0.90)after removing 2 items with factor loadings lower than 0.32,and the range of factor loading was between 0.37 and 0.71.The SRF-S total and subscale scores were positively corre-lated with the scores of negative coping and poor control (r =0.25 -0.58,Ps <0.001),and were negatively associ-ated with the scores of positive coping and good self-Control (r =-0.22 --0.47,Ps <0.001).The Cronbach's αcoefficients were 0.84 for the total scale,and 0.64 to 0.69 for the three subscales,respectively;the test-retest relia-bility coefficients were 0.73 for the total scale,and 0.62 to 0.67 for the three subscales,respectively.Conclusion:It suggests that the Chinese version of SFR-S could be used as an effective and reliable tool for assessing self-regu-latory fatigue state among Chinese young people.

Objective To investigate the effects of adipocyte plasma membrane-associated protein(APMAP)over-expression on glomerular podocyte injury in adriamycin(ADR)nephropathy.Methods The rat model of adriamy-cin nephropathy was constructed by tail vein injection of adriamycin,the expression of APMAP and NF-κB p65 in renal tissue was measured by immunohistochemistry.A mouse glomerular podocytes MPC-5 cell line with APMAP gene over-expression was constructed,then podocyocytes injury model was induced by 0.5 μmol/L ADR and trea-ted with NF-κB signaling pathway activator CU-T12-9.The proliferation of cells was checked by CCK-8.The activity of lactate dehydrogenase(LDH)was determined by ELISA.The apoptosis of podocytes was determined by flow cytometry.Western blot was used to detect protein expressions of NF-κB p65,p-NF-κB p65 and TNF-α.Results APMAP was expressed in kidney tissue of doxorubicin nephropathy rats at a low level,while NF-κB p65 was significantly high expressed(P＜0.05).Over-expression of APMAP increased proliferation of MPC-5 cells and decreased LDH activity,apoptosis rate,and also down-regulated protein expression of NF-κB p65,P-NF-κB p65 and TNF-α under ADR exposure(P＜0.05).However,combined treatment with CU-T12-9 significantly inhibited the ameliorative effect of APMAP over-expression on the damage of MPC-5 cells exposed to ADR.Conclusions The over-expression of APMAP can inhibit ADR-induced glomerular podocyte injury,and its mechanism might be related to the inhibition of NF-κB signaling pathway.

Kawasaki disease is an acute febrile rash disease with systemic vasculitis as the main lesion, which can lead to coronary artery lesion(CAL)in some children.Early diagnosis of Kawasaki disease can effectively prevent CAL.Previous studies on the risk factors of CAL in Kawasaki disease focused on leukocyte, neutrophil percentage, erythrocyte sedimentation rate, C-reactive protein, serum albumin, etc.In recent years, many new biomarkers have been found.This review summarized the newly studied risk factors, aiming to provide reference for timely treatment of Kawasaki disease and prevention of CAL.

Objective:To investigate the effect of laboratory indicators on hair loss in patients with female pattern hair loss (FPHL).Methods:Patients with FPHL who visited the Outpatient Clinic of the Department of Medical Aesthetics in Hangzhou First People’s Hospital from November 2022 to November 2023 were selected as the study group, and healthy women who matched the age of the study group in the physical examination center during the same period were selected as the control group. The general information of the patient was recorded, and was also tested by trichoscopy to rule out other patterns of alopecia. Representative indicators including testosterone, dehydroepiandrosterone sulfate(DHEA-S), thyroid-stimulating hormone, 25-hydroxyvitamin D, and serum ferritin were selected from laboratory tests for further analysis. Otherwise, the proportion of deficiency in vitamin D(<20 ng/ml) was calculated based on 25-hydroxyvitamin D levels (number of deficiency cases/total number of cases in each group×100%). Count data were presented as samples (percentages), and chi-square test was used for comparison between groups. Normally distributed continuous data were presented with Mean±SD, independent samples t-test was used for comparison between groups, M( Q1, Q3) was used for non-normally distributed continuous data, and Wilcoxon rank-sum test was used for comparison between groups. Multivariate logistic regression was used to analyze the influencing factors of FPHL. P<0.05 was statistically significant. Results:A total of 37 patients were selected in both groups. The mean age was (28.8±1.3) years in the study group and (29.6±0.9) years in the control group ( t=0.49, P=0.625). The body mass index was (22.8±0.4) kg/m 2 in the study group, and (23.5±0.3) kg/m 2 in the control group ( t=1.26, P=0.211). The testosterone level was 0.58 (0.49, 0.79) nmol/L in the study group, and 0.54 (0.50, 0.78) nmol/L in the control group( Z=1.42, P=0.157). The level of DHEA-S was 6.21 (5.18, 9.60) μmol/L in the study group, and 6.20 (5.20, 9.34) μmol/L in the control group ( Z=2.75, P=0.006). The level of thyroid-stimulating hormone was 2.56 (1.55, 3.66) mU/L in the study group and 1.49 (1.05, 2.65) mU/L in the control group ( Z=2.51, P=0.012). The level of 25-hydroxyvitamin D was 15.44 (11.80, 21.20) ng/ml in the study group, and the level of 25-hydroxyvitamin D was 20.32 (12.07, 21.20) ng/ml in the control group ( Z=2.30, P=0.021), and the proportion of 25-hydroxyvitamin D deficiency in the study group was 64.9% (24/37), which was higher than that in the control group [40.5% (15/37)] ( χ2=4.39, P=0.036). The serum ferritin level was 64.44 (39.47, 133.45) μg/L in the study group and 67.75 (52.63, 143.83) μg/L in the control group ( Z=0.70, P=0.484). The results of multivariate logistic regression analysis showed that the risk of FPHL was increased by the high level of DHEA-S and thyroid-stimulating hormone, and the low level of 25-hydroxyvitamin D (all P<0.05). Conclusion:Abnormal level of DHEA-S, thyroid-stimulating hormone, and 25-hydroxyvitamin D may be risk factors for FPHL.

Objective:To investigate the effect of laboratory indicators on hair loss in patients with female pattern hair loss (FPHL).Methods:Patients with FPHL who visited the Outpatient Clinic of the Department of Medical Aesthetics in Hangzhou First People’s Hospital from November 2022 to November 2023 were selected as the study group, and healthy women who matched the age of the study group in the physical examination center during the same period were selected as the control group. The general information of the patient was recorded, and was also tested by trichoscopy to rule out other patterns of alopecia. Representative indicators including testosterone, dehydroepiandrosterone sulfate(DHEA-S), thyroid-stimulating hormone, 25-hydroxyvitamin D, and serum ferritin were selected from laboratory tests for further analysis. Otherwise, the proportion of deficiency in vitamin D(<20 ng/ml) was calculated based on 25-hydroxyvitamin D levels (number of deficiency cases/total number of cases in each group×100%). Count data were presented as samples (percentages), and chi-square test was used for comparison between groups. Normally distributed continuous data were presented with Mean±SD, independent samples t-test was used for comparison between groups, M( Q1, Q3) was used for non-normally distributed continuous data, and Wilcoxon rank-sum test was used for comparison between groups. Multivariate logistic regression was used to analyze the influencing factors of FPHL. P<0.05 was statistically significant. Results:A total of 37 patients were selected in both groups. The mean age was (28.8±1.3) years in the study group and (29.6±0.9) years in the control group ( t=0.49, P=0.625). The body mass index was (22.8±0.4) kg/m 2 in the study group, and (23.5±0.3) kg/m 2 in the control group ( t=1.26, P=0.211). The testosterone level was 0.58 (0.49, 0.79) nmol/L in the study group, and 0.54 (0.50, 0.78) nmol/L in the control group( Z=1.42, P=0.157). The level of DHEA-S was 6.21 (5.18, 9.60) μmol/L in the study group, and 6.20 (5.20, 9.34) μmol/L in the control group ( Z=2.75, P=0.006). The level of thyroid-stimulating hormone was 2.56 (1.55, 3.66) mU/L in the study group and 1.49 (1.05, 2.65) mU/L in the control group ( Z=2.51, P=0.012). The level of 25-hydroxyvitamin D was 15.44 (11.80, 21.20) ng/ml in the study group, and the level of 25-hydroxyvitamin D was 20.32 (12.07, 21.20) ng/ml in the control group ( Z=2.30, P=0.021), and the proportion of 25-hydroxyvitamin D deficiency in the study group was 64.9% (24/37), which was higher than that in the control group [40.5% (15/37)] ( χ2=4.39, P=0.036). The serum ferritin level was 64.44 (39.47, 133.45) μg/L in the study group and 67.75 (52.63, 143.83) μg/L in the control group ( Z=0.70, P=0.484). The results of multivariate logistic regression analysis showed that the risk of FPHL was increased by the high level of DHEA-S and thyroid-stimulating hormone, and the low level of 25-hydroxyvitamin D (all P<0.05). Conclusion:Abnormal level of DHEA-S, thyroid-stimulating hormone, and 25-hydroxyvitamin D may be risk factors for FPHL.