Objective: This study aimed to explore the psychiatric symptoms and associated risk and protective factors among religious adolescents after 2-month home confinement against coronavirus disease-2019 (COVID-19) in China. Methods: 11,603 Chinese adolescents in grades 7–9 were recruited in this survey. An online survey was designed to collect the data. Participants were measured using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 Scale. Results: Religious adolescents showed significantly more severe depressive and anxiety symptoms compared to non-religious. 249 (2.2%) reported COVID-19 exposure. Logistic regression analysis revealed that religiosity was a risk factor for the symptoms of depression (p=0.001) and anxiety (p<0.001). Moreover, among those adolescents with religious beliefs, psychological resilience was protective in preventing depressive and anxiety symptoms. At the same time, emotional abuse, emotional neglect, and a poor parent-child relationship were risk factors. Conclusion Our finding indicates that religious adolescents easily develop depressive and anxiety symptoms, compared to non-religious adolescents. Moreover, those with emotional abuse, emotional abuse, and poor parent-child relationships are more likely to suffer from mental distress and should pay more attention to cope with their mental health.

ObjectiveTo study the characteristics of animal models of acute lung injury caused by non-physical factors， so as to provide a reference for the standardization of the preparation of such animal models and lay a foundation for the research on the pathogenesis and the diagnosis and treatment of acute lung injury. MethodThe articles about the animal experiments of acute lung injury published in the last decade were retrieved from China National Knowledge Infrastructure （CNKI）， Wanfang， SinoMed， VIP， and PubMed with the theme terms of "acute lung injury" and "animal model". The animal species， drugs used in modeling， modeling period， methods used in molding， model standards， and model evaluation indicators were summarized， and Excel was used for the frequency analysis. ResultA total of 338 articles were included in this study. The results of the frequency analysis showed that SD rats/C57BL/6 mice were mainly used to establish the animal models of acute lung injury. Male mice were mostly used for modeling， and the commonly used modeling agent was lipopolysaccharides （LPS）. In most cases， the modeling lasted for 6 h after drug administration. Hematoxylin-eosin staining was mainly used for the observation of histological changes in the lungs， which were taken as the criteria for modeling. The established models were mainly evaluated based on lung dry/wet weight ratio， lung index， morphological changes in the lung tissue， myeloperoxidase （MPO）， superoxide dismutase （SOD）， and levels of inflammatory cytokines in the serum and bronchoalveolar lavage fluid （BALF）. ConclusionThe models of acute lung injury were mostly prepared by intraperitoneal injection of LPS （5 mg·kg^-1） in SD rats and tracheal instillation of LPS （5 mg·kg^-1） in C57BL/6 mice， which were praised for the simple operation， high success rate， and consistent with the pathogenesis of acute lung injury. This study provides a reference for the basic research on acute lung injury by animal experiments.

Clinical data of 655 patients with acute ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) in Luoyang Central Hospital during January 2017 to March 2020 were analyzed retrospectively. There were 425 cases who first visited PCI-capable hospital (PCI hospital group) and 230 cases who were transferred to PCI-capable hospital (transfer group). Compared with PCI hospital group, STEMI patients in the transfer group had a shorter first diagnosis time [2.0 (0.8, 4.2)h vs. 2.5(1.2, 4.1)h, Z=3.66, P<0.01], longer time from first medical contact to the balloon through (FMC2B) [175 (113, 344) min vs. 75 (57, 112) min, Z=-8.92, P<0.01], longer total ischemic time [5.4 (3.5, 9.8) h vs. 3.9 (2.4, 6.0) h, Z=-5.43, P<0.01]. There was no significant difference in the time from PCI hospital entry to balloon passage (DTB) between the two groups [43(29, 103) min vs. 46 (61, 94) min, Z=-0.56, P=0.573]. The compliance rate of FMC2B time<120 min in the transfer group was only 25.9% (50/193). However, the different first-visit hospital had no significant effect on the risk of heart failure ( OR=0.54, 95 %CI:0.16-1.79, P=0.311) and risk of death ( OR=1.14, 95 %CI:0.20-6.36, P=0.885). The results suggest that STEMI patients referred to PCI hospitals have considerable time delay, and the rate of compliance with FMC2B time<120 min is low.

This paper reviews the currently research on competency of practitioners in the field of nutrition and food hygiene at home and abroad. Through literature review, it's found that the there are few researches on competency in China at present. Furthermore, compared with foreign countries, there are several issues in China, such as the methods and index system setting. However, due to different national conditions, there are significant differences in the demand for nutrition and food hygiene practitioners, related disciplines and characteristics between China and abroad. Therefore, when drawing lessons from foreign models, we should appropriately make adjustments according to China's national conditions. This review will provide references for further research on establishing a set of scientific and standardized competency evaluation indexes for practitioners in the field of nutrition and food hygiene with Chinese characteristics.

Objective:To observe any effect of repeated unilateral high frequency transcranial magnetic stimulation (rTMS) on the swallowing function and functional magnetic resonance images of dysphagic stroke survivors.Methods:Twenty stroke survivors with dysphagia were randomly divided into a treatment group ( n=10) and a control group ( n=10). Both groups received traditional swallowing rehabilitation training, while the treatment group was additionally provided with high frequency rTMS over the cortical area of the suprahyoid muscle group of the healthy contralateral cerebral hemisphere. The stimulation frequency was 5Hz and the stimulation intensity was 80% of the resting movement threshold. During the 20-minute treatment, there was a 20-second interval between each 2-second dose of stimulation. Before and after the treatment, both groups were evaluated using the Eating Assessment Tool-10 (EAT-10), a swallowing functional communication measurement (FCM) and the modified Mann Assessment of Swallowing Ability (MMASA). In addition, functional magnetic resonance imaging was used to observe any changes in the relevant brain regions. Results:After the treatment the average EAT-10, FCM and MMASA scores of both groups were significantly better than those before the treatment, with the treatment group′s averages significantly superior to those of the control group. After the treatment, the activation range of the parietal lobe, the superior parietal lobule, the BA7 region and the BA40 area in the treatment group was significantly larger than before the treatment and larger than the control group′s ranges.Conclusions:Repeated high-frequency transcranial magnetic stimulation of the cortical area of the suprahyoid muscles in the contralateral cerebral hemisphere can improve dysphagia and promote the activation of brain areas related to swallowing after a stroke.

Objective:To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) for treatment of duodenal lesions.Methods:A retrospective analysis was performed on the data of 45 patients with 46 duodenal lesions who underwent ESD at the Second Xiangya Hospital of Central South University from January 2011 to May 2019. The lesion features, en bloc resection rate, complete resection rate, complications, postoperative pathology and recurrence were assessed.Results:Among the 45 patients, 20 were males and 25 were females, with age of 52.0±11.8 years. Of the 46 lesions, 31 (67.4%) were located in the duodenal bulb, 12 (26.1%) in the descending part, and 3 (6.5%) at the junction of bulb and descending part. The diameter of the lesions was 2.4±1.9 cm. There were 14 (30.4%) lesions originated from mucosal layer, 29 (63.1%) from submucosal layer, and 3 (6.5%) from muscularis propria.Postoperative pathology showed 11 (23.9%) cases of Brunner gland tumors, 9 (19.6%) neuroendocrine tumors, 5 (10.9%) ectopic pancreas, 5 (10.9%) lipomas, and 16 (34.8%) other pathological patterns. All 45 patients with 46 lesions underwent ESD successfully, and the en bloc resection rate was 100.0% (46/46), complete resection rate was 91.3% (42/46). Intraoperative bleeding occurred in 1 case (2.2%), which was successfully treated by endoscopy. One (2.2%) delayed perforation occurred and was treated by surgical intervention. Electrocoagulation syndrome occurred in 1 case (2.2%), which was relieved after conservative medical therapy. Two cases received further surgery after ESD. The mean hospital stay was 6.2 days (ranged 2-21 days) and no death occurred. Forty-one cases were followed up for 1-78 months, with mean time of 30 months. During the follow-up period, local recurrence occurred in 1 patient (2.4%).Conclusion:ESD is an effective and safe treatment for duodenal lesions and has a good clinical practical value.

Objective To investigate the influence of the microscale attractive interaction on the elastic properties of DNA film in multivalent ion solutions. Methods Kornyshev's electrostatic zipper model was employed to describe the interaction energy between the DNA strands. The thought experiment method and macroscopic continuum bar model were combined to predict the stress-strain relationship, prestress, and elastic modulus of the DNA biofilm.Results Given the packing conditions, the DNA film exhibited a tensile prestress and negative elastic modulus. The prestress of the DNA biofilm ranged from -1.52 MPa to 1.17 MPa, and its elastic modulus ranged from -4.2 MPa to 64 MPa. Conclusions In contrast with monovalent solutions, the microscopic attractive interactions in multivalent solutions caused the elastic properties of the DNA film to exhibit a non-monotonous relationship with the variation in the packing density and salt concentration. The tensile elastic properties were significantly different from the compressive ones, and the tensile/compressive prestress as well as the positive/negative elastic modulus transformed each other. These results can contribute to understanding the mechanism of viral replication and provide references for gene detection and gene therapy.

Objective: To explore the relationship between genotype and phenotype of ABCB11 deficiency. Methods: Clinical data of two siblings with ABCB11 deficiency were retrospectively analyzed. Related literature from PubMed, CNKI and Wangfang databases was reviewed to date (up to August 2017) with 'ABCB11 gene’ or 'bile salt export pump’, 'cholestasis’ and 'child’ as key words. Results: The patients were siblings. Both of them presented as jaundice, pruritus and hepatosplenomegaly since 3 days after birth. Significant laboratory findings on admission of the older sister included high total bilirubin, 170 µmol/L;conjugated bilirubin, 115.8 µmol/L;alanine aminotransferase, 168 U/L;total bile acid 186.3 µmol/L and normal gamma-glutamyl transpeptidase. While routine laboratory data of the younger brother were as follows: total bilirubin, 148.8 µmol/L;conjugated bilirubin, 96.3 µmol/L;alanine aminotransferase, 232.8 U/L;total bile acid 226 µmol/L, and normal gamma-glutamyl transpeptidase.Both received ursodeoxycholic acid and fat-soluble vitamins. Liver pathology of the younger brother showed giant hepatocytes with ballooning degeneration, focal necrosis and intrahepatic cholestasis. Both the patients harbor the same compound heterozygous mutations in ABCB11 gene, c.145C>T (p.Q49X) and c.1510G>A (p.E504K). The sister is 9 years old now, with normal liver function. Jaundice faded around 3 months after birth, pruritus relieved at age 5, and medications was stopped since then. The brother progressed to liver failure after an operation on perianal abscess when he was 8-month-old, and received living-related liver transplantation when he was 9 month and 20 days old (from his mother). Now he is 1 year and 5 months old, with normal liver function. Both are under our follow-up. Literature review revealed 18 ABCB11 deficiency patients from 7 families who had apparent different prognoses, within each family the siblings had the same ABCB11 gene mutation. Seven cases relieved after ursodeoxycholic acid therapy and/or partial external biliary diversion, 5 received orthotopic liver transplantation, 2 developed hepatocellular carcinoma and 4 cases died in childhood. Conclusions The clinical manifestations of ABCB11 deficiency may vary greatly in patients carrying the same genotype, even in siblings. Patients should be managed in individualized maner.

Objective To investigate the expression of human epididymal protein 4 (HE4) in chronic kidney disease (CKD) and its clinical value.Methods From April 2014 to December 2015,Serum samples of 92 non-cancer patients diagnosed as CKD and 84 healthy controls were collected in Nantong University Hospital.HE4,BUN,Scr,Cys C and β2MG were detected.The difference of HE4 expression in different stages of CKD and the correlation of HE4 with Urea,Scr,Cys C and β2MG were analysized,respectively.ROC curve was used to evaluate the auxiliary diagnostic value of HE4,BUN,Scr,Cys C and β2MG.Results The serum HE4 expression in patients with impaired renal function was 388.2 (130.1～1 659.5)mIu/ L,(F=16.237,P=0.001).Which was significantly higher than that in the control group [38.1 (32.77 ～ 48.17)mIu/L].The serum HE4 expression was increased by the stage of renal damage and the difference was existed among different groups (P＜0.05).HE4 expression was positive related with Cys C and β2MG.The AUC of HE4,BUN,Scr,Cys C and β2MG were 0.878,0.785,0.816,0.874 and 0.819,respectively.Conlusion It needs to consider the exsits of impaired renal function when the HE4 was detected.The HE4 might be a novel early diagnostic indication for CKD.

Objective To evaluate the common traditional Chinese medicine syndrome types, therapies and formulas of the wind of four fossae. This will provide reference for the formulation of the guideline for the diagnosis and treatment of traditional Chinese medicine in the wind of four fossae. Methods Delphi method using questionnaires were developed based on literature about TCM syndromes and treatment of the wind of four fossae. The questionnaire were sent to 25 experts nationwide for 2 rounds. The database of the collected data was established. The mean, full score ratio, rank sum and coefficient of variation were described and by SAS 6.12 statistical software. Results A total of 21 valid questionnaires were recovered in the first round and 23 valid questionnaires in the second round. The active coefficient of the experts was 84% and 92%, respectively. The results showed that syndromes of newborn heat, damp heat retention, spleen deficiency and blood dryness, wind dampness accumulating skin, blood deficiency and wind dryness demonstrated high concensus. The consistency scores' mean of 5 syndromes were 1.67, 1.90, 1.83, 1.71 and 1.90. The sum of degrees of 5 syndromes were 37, 40, 42, 36 and 40. The ratio of full scores of 5 syndromes were 0.81, 0.90, 0.87, 0.71 and 0.90. The coefficient of variations of 5 syndromes were 0.32, 0.16, 0.27, 0.27 and 0.16. The therapy of syndrome of newborn heat was clearing away the heart-fire and inducing diuresis by the sanxin daochi decoction; The therapy of syndrome of damp heat retention was clearing heat and removing dampness by longdan xiegan decoction; The therapy of syndrome of wind dampness accumulating skin was dispelling wind and eliminating dampness by xiaofeng san; The therapy of syndrome of spleen deficiency and blood dryness was enriching blood and moistening dryness by danggui decoction; The therapy of syndrome of blood deficiency and wind dryness was replenishing qi to invigorate the spleen and enriching blood to calm endogenous wind by shenling baizhu power and danggui decoction. Conclusion Questionnaire survey could quantify the opinions of experts, and provide reference for the establishment of guideline for the diagnosis and treatment of traditional Chinese medicine in the wind of four fossae.