Objective To investigate the risk factors of electrocoagulation syndrome after endoscopic submucosal dissection (ESD) in patients with colorectal lesions.Methods Clinical data of 145 patients with colorectal mucosal lesions undergoing ESD in People's Hospital of Wuhan University between September 2010 and September 2015 were retrospectively studied.Results Among 45 patients,post endoscopic submucosal dissection electrocoagulation syndrome (PEECS) was developed in 32 cases (22％).The median age in PEECS group was higher (t =-5.783,P =0.000),the median lesion size was larger(t =-5.590,P =0.000),the median length of hospital stay was longer (t =-6.841,P =0.000) than those in non-PEECS group.Univariate regression analysis showed PEECS was associated with the age,lesion size,lesion location,length of hospital stay,malignant tumor,polyps type,resection modality.Multivariable logistic regression analysis showed that the independent risk factors for the development of electrocoagulation syndrome were age ＞65 year (OR =1.123,95％ CI:1.013-1.244,P =0.027),lesion size ＞ 3.5 cm (OR =1.173,95％ CI:1.015-1.357,P =0.031),malignant tumor (OR =3.498,95 ％ CI:1.460-8.379,P =0.005),hospital stay ＞ 10 d (OR =2.480,95％ CI:1.346-4.569,P =0.004),non-rectal lesions (OR =12.612,95％ CI:3.446-46.157,P =0.000).Conclusion Attention should be paid for colorectal lesion patients with high risk of PEECS,when endoscopic submucosal dissection is performed.

Objective:To investigate the effect of Xuanbai Chengqi Decoction (XBCQT) on lung-gut injury and intestinal function, and analyze its effect on intestinal flora in sepsis mice.Methods:C57 male mice were randomly divided into three groups with 12 mice in each group: control group, model group and treatment group. The sepsis model was prepared by intra-peritoneal injection of lipopolysaccharide (LPS) 5 mg/kg. XBCQT was administered by gavage 24 h before, 0.5 h after and 12 h after modeling. The lung, colon and blood samples were collected at 24 h after modeling. The pulmonary and intestinal inflammatory cytokine content of interleukin-1β (IL-1β), IL-6, tumor necrosis factor α (TNF-α) and monocyte chemoattractant protein (MCP-1) was measured by real-time fluorescence quantitative PCR. HE staining was used to evaluate the structural damage and changes of lung and gut, and Western blot and Immunohistochemistry methods were used to analyze the expression of occludin and claudin-1 in intestinal epithelium. Finally, the plasma endotoxin content of each group was tested by Limulus test kit. Fecal DNA of mice was extracted and the changes of intestinal flora in sepsis mice were detected by 16S rDNA quantitative PCR. The measurement data among the three groups were compared by one-way analysis of variance.Results:(1) XBCQT significantly reduced the pulmonary inflammatory cytokine IL-1β, IL-6, TNF-α and MCP-1 expression (all P<0.05), and attenuated lung injury. (2) Compared to the model group, the treatment group exhibited a reduction in intestinal damage and a decrease in the intestinal inflammatory cytokines (all P<0.05). XBCQT increased the expression of epithelial tight junction and mucin of colon, and improved the intestinal epithelium barrier function. (3) XBCQT treatment decreased the content of endotoxin in plasma of sepsis mice ( P<0.05), promoted the growth of beneficial bacteria Akkermansia muciniphila and reduced the expression of Enterococcus in the intestine of sepsis mice (all P<0.05). Conclusions:XBCQT can significantly improve the intestinal inflammatory injury, regulate the intestine epithelium barrier and improve the intestinal function in sepsis mice.

Objective:To investigate the relationship between serum free triiodothyronine (FT 3) and the severity and prognosis of elderly patients with coronavirus disease 2019 (COVID-19). Methods:Clinical data of the elderly patients aged≥65 years old with COVID-19 who were admitted to the Ninth People′s Hospital of Wuxi from December 27, 2022 to January 18, 2023 were collected. The laboratory examinations of the non-severe and the severe/critical groups were compared. Patients were divided into group T1 (FT 3<2.51 pmol/L), group T2 (FT 3=2.51 to 2.95 pmol/L, ), and group T3 (FT 3>2.95 pmol/L) according to the FT 3 level. Independent sample t test was used for comparison between groups. Logistic regression analysis was performed to evaluate the risk factors for severe/critical disease, and to analyze the risk of severe/critical COVID-19 in elderly patients with different FT 3 levels. The receiver operator characteristic (ROC) curve was drawn to analyze the predictive value of FT 3 on the occurrence of severe/critical disease in patients. Kaplan-Meier survival curve and log-rank test were used to analyze the 30-day survival rate of elderly COVID-19 patients. Results:Among the 190 patients, the FT 3 level in the severe/critical group was (2.54±0.30) pmol/L, which was significantly lower than that in the non-severe group ((2.91±0.69) pmol/L), and the difference was statistically significant ( t=-3.42, P=0.001). Elevated serum FT 3 level was a protective factor for severe/critical disease in elderly COVID-19 patients (odds ratio ( OR)=0.139, 95% confidence interval ( CI) 0.034 to 0.577, P=0.007). There were 66 patients in the T1 group, 61 in the T2 group and 63 in the T3 group, respectively. After adjusted for sex, age, history of lung diseases, history of cardiac diseases, history of hypertension, history of diabetes mellitus, history of cerebral infarction, white blood cell count, lactate dehydrogenase, D-dimer, free thyroxine and thyrotropin, the risk of developing severe/critical disease in group T1 and group T2 were 10.982 folds and 3.695 folds of that in group T3, respectively (both P<0.05). The area under ROC curve of FT 3 of predicting severe/critical COVID-19 in the elderly patients was 0.731. The sensitivity and specificity were 0.733 and 0.659, respectively. The cut-off value was 2.53 pmol/L. The 30-day survival rate in patients with FT 3<2.53 pmol/L was significantly lower than that in patients with FT 3≥2.53 pmol/L ( χ2=13.49, P<0.001). Conclusions:The elevated level of FT 3 is a protective factor for progression to severe/critical disease in elderly patients with COVID-19. The evaluation of serum FT 3 could predict the severity and prognosis of elderly COVID-19 patients.

OBJECTIVETo investigate the stages of health-related behaviors, family and peer support situation about adolescent in Wuhan, and to provide evidence for health intervention and health promotion.

METHODSBased on the principle of multi-stage stratified cluster sampling, extracted two junior middle school and two high school in two cities in Wuhan from March 2012 to May. A total of 1 200 students, which were part of the first and second grade class in middle school and high school, toke as the investigation object. The study surveyed following content, including the demographic situation, adolescent health-related behavior (physical activity, sedentary behavior, high-fat diet behavior, fruit and vegetable intaking behavior), stages of adolescent health related behavior (precontemplation, contemplation, preparation, action, maintenance) and adolescent support got from family and peer. The questionnaire was distributed in 1 200 copies, the valid questionnaires were 1 052 and the effective rate was 87.67%. Using χ² test to compare the different stages of change in health related behavior, t test was used to compare different groups of social support and using analysis of variance and post test to analyze social support of the four types behavior.

RESULTSIn 1 052 students, there was 555 (52.8%) middle school students, 497 (47.2%) high school students, and 553 (52.6%) boys, 499 (47.4%) girls. In physical exercise and sedentary behavior, numbers of precontemplation was respectively accounting for 42.2% (444/1 200) and 28.4% (299/1 200). In high-fat diet behavior, the stages of preparation and maintain was occupied 46.7% (492/1 200). In fruit and vegetable intake behavior, there was 32.9% (346/1200) students in contemplation. Numbers in action stage was both less in the above four behavior, accounting for 6.2% (65/1 200), 8.9% (94/1 200), 14.0% (147/1 200) and 6.3% (66/1 200) separately. Adolescent peer support score respectively (2.9 ± 0.7), (2.8 ± 0.8) and (2.9 ± 0.9), which was higher than the family support scores ((2.7 ± 1.1), (2.5 ± 1.2) and (2.9 ± 1.2)) (t values were -8.72, -11.22 and -2.59, respectively. All P values were < 0.001) in physical exercise, sedentary behavior and high fat diet, but in the intake of fruits and vegetables behavior, family support score was higher than peer support (score was respectively (3.3 ± 0.9) and (3.5 ± 1.2); t < 9.97, P < 0.001). ANOVA and post hoc comparison showed that the score of family and peer support in the after-action stage was significantly higher than that the before-action stage in physical exercise, high-fat diet and fruit and vegetable intake behavior, while the differences in sedentary behavior was not significant.

CONCLUSIONYouth health-related behaviors remained in its infancy, there was a certain impact on its stages which showed that the higher social support the more advanced stages of behavior.

Adolescent ; Adolescent Behavior ; Diet, High-Fat ; Exercise ; Family ; Feeding Behavior ; Female ; Fruit ; Health Behavior ; Humans ; Male ; Peer Group ; Schools ; Social Support ; Students ; Surveys and Questionnaires ; Vegetables

OBJECTIVETo learn the dietary fat intake behavior status and influencing psychological factors in teenagers.

METHODSAccording to the multi-stage stratified cluster sampling method, students were recruited from middle and high schools in Hangzhou, Wuhan and Xi'an from March to May, 2012. Chinese version of adolescent dietary fat intake behavior of psychological measurement scales was utilized in field investigations with 3 448 effective questionnaires. Under the transtheoretical model, the status quo of teenagers fat intake behavior was analyzed and it shows the relationship between stages and psychological variables, including strategy of change, decision balance and self-efficacy.

RESULTSIn the 3 448 participants, the proportion of girls were 52.4% (1 806/3 448) and boys were 47.6% (1 642/3 448), while the mean age was (14.85 ± 1.46). There are significant differences among distributed stages of behavior change, grouped by gender, grade and region (χ(2) values were 33.59, 20.53, 27.92, P < 0.001). In different gender groups, the number of boys in precontemplation came to the first and accounted for 24.2% (438/1 806), and the number of girls were more in contemplation and preparation stage, which accounted for 49.5% (813/1 642), and it was the least both in the action stage with the ratio 12.1% (218/1 806) and 14.7% (241/1 642) respectively; in different grade groups, the numbers of student in middle school and high school were the largest in contemplation and precontemplation stage, accounted for 24.9% (494/1 986) and 23.4% (343/1 462); and among different regions, the proportion in precontemplation, contemplation and preparation stage was not a few, and this ratio in Hangzhou, Wuhan, Xi'an area was 70.6% (801/1 135), 61.7% (649/1 052) and 68.8% (867/1 261), respectively. The number in action stage was the least of all, which were 144, 147, 168, respectively. Ordinal logistic mode showed that the four variables, including the scores of process of change, decision balance (pros), decision balance (cons) and self-efficacy, were factors which significantly affected the stages of behavior change, which showed a significant difference (F values were 155.12, 19.86, 44.59, 94.27, P < 0.001) in different stages. From precontemplation stage to action stage, the score of the process of change, decision balance (pros) and self-efficacy showed an upward trend, and achieved the highest score in the action stage (from 32.6 ± 12.8, 8.4 ± 2.9, 19.7 ± 6.9 to 48.4 ± 12.6, 10.1 ± 2.5, 25.9 ± 6.9, respectively); contrarily, the decision balance (cons) decreased with the development of behavioral stage (from 14.7 ± 4.4 to 12.2 ± 3.9). Post hoc comparison also found that the score of process of change, decision balance (pros) and self-efficacy after action stages were higher than those before action, while the score of decisional balance (cons) in the precontemplation stage was higher than that in the other 4 stages.

CONCLUSIONFat intake behavior in teenagers showed different stages, whose psychological factors had significant influences, with decision balance (pros) hindered the progress of stages of behavior change, while other three factors played a positive role.

Adolescent ; Adolescent Behavior ; Decision Making ; Dietary Fats ; Female ; Humans ; Male ; Models, Theoretical ; Self Efficacy ; Students ; Surveys and Questionnaires

OBJECTIVETo develop a suitable fat intake behavior of psychological measurement scales for the Chinese adolescents and evaluate its validity and reliability.

METHODSAccording to the multi-stage stratified cluster sampling principle, a total of 3 600 junior students were recruited from the classes in 12 selected high schools in Hangzhou, Wuhan and Xi'an from March to May, 2012. Based on introducing and translating the original scale abroad, Chinese version of adolescent fat intake behavior of psychological measurement scales was utilized in field investigations. The reliability was assessed, using Cronbach's α and split-half reliability; while exploratory factor analysis used to test its validity, with entries-dimension correlation coefficient (IIC), correlation coefficient between the scores and the dimension, and the dimension of correlation coefficient test content validity.

RESULTSThe valid subject of the study was 3 448(of whom males were 52.4% (1 806/3 448) and female were 47.6% (1 642/3 448)), while the mean age was (14.85 ± 1.46) years old. The internal consistency reliability (Cronbach's α) for total scale score and four domains were 0.922,0.933, 0.660, 0.773 and 0.869 respectively, whose split-efficacy reliability were separately 0.927, 0.933, 0.790, 0.624 and 0.889. Data from the exploratory factor analysis revealed the following dimensions:the entries were all inclusive, with the cumulative contribution rate at 59.453%, 56.062% and 52.668%, respectively. The results of IIC showed that in the four dimensions, the contained entries between Spearman correlation coefficient have statistically significant, with the r value range of 0.584-0.793, 0.665-0.818, 0.654-0.765 and 0.622-0.747 severely, while other dimensions from weak to moderate relationships, the r value ranged from -0.028 to 0.614.

CONCLUSIONThe reliability and validity of the adolescent fat intake behavior of psychological measurement scales (Chinese version) were good, and could be used to measure the fat intake behavior of psychological conditions in Chinese adolescents.

Adolescent ; Dietary Fats ; Eating ; psychology ; Feeding Behavior ; Female ; Humans ; Male ; Psychological Tests ; Students ; psychology ; Surveys and Questionnaires

OBJECTIVE: To explore the genetic etiology for a fetus with congenital orofacial cleft. METHODS: Single nucleotide polymorphism microarray (SNP array) was carried out on skin tissues sampled from the fetus following induced abortion for the detection of copy number variation (CNVs). Pathogenicity of the candidate gene was validated through experiment. RESULTS: SNP array revealed that the fetus has carried a hemizygous 9.23Mb deletion at Xq21.31-q22.1(91 063 807-100 293 555), which was inherited from its mother. The region contained 13 OMIM genes and 1 ncRNA coding gene(MIR548M). Inhibiting of the expression of the MIR548M gene in oral epithelial celllines has resulted in up-regulation of the expression of SUMO1 gene which was known to involve in the pathogenesis of orofacial cleft. CONCLUSION Dosage insufficiency of the MIR548M gene may underlie the etiology of orofacial cleft in this fetus.
Cleft Lip/genetics* ; Cleft Palate/genetics* ; DNA Copy Number Variations/genetics* ; Female ; Fetus ; Humans ; MicroRNAs/genetics* ; Polymorphism, Single Nucleotide ; Pregnancy ; SUMO-1 Protein

AIM:To observe the effect of acupuncture on adenosine A1 receptor(A1R)in the caudate puta-men(CPu)of complete Freund's adjuvant(CFA)rats,and to explore the potential mechanism of acupuncture in treat-ment of inflammatory pain.METHODS:Sixty-four 6～8-week-old male Wistar rats were randomly divided into saline group,model group(CFA group),CFA+manual acupuncture(MA)group,CFA+solvent dimethyl sulfoxide(DMSO)group,CFA+A1R agonist 2-chloro-N6-cyclopentyladenosine(CCPA)group,CFA+A1R antagonist 8-cyclopentyl-1,3-di-propylxanthine(DPCPX)group,CFA+MA+DMSO group and CFA+MA+DPCPX group.In MA groups,on the 2nd day af-ter modeling,the rats were needled at Zusanli points on both sides,30 min at a time,once per day,for 7 d.Pain threshold of plantar thermal radiation was used to observe the pain response of the rats.The content of cyclic adenosine monophos-phate(cAMP)in the CPu was detected by ELISA.The protein expression and phosphorylation levels of protein kinase A(PKA)and cAMP response element-binding protein(CREB)were detected by Western blot.The expression of A1R in the CPu was detected by immunofluorescence staining.RESULTS:Compared with saline group,CFA modeling signifi-cantly lowered the thermal pain threshold of the rats(P<0.01).Compared with CFA group,the thermal pain threshold of the rats in CFA+MA group and CFA+CCPA group was significantly increased(P<0.05 or P<0.01).Compared with CFA+ MA+DMSO group,the thermal pain threshold of the rats in CFA+MA+DPCPX group was decreased(P<0.05).Compared with CFA group,A1R protein relative expression level and positive cells in the CPu of the rats in CFA+MA group were in-creased(P<0.05 or P<0.01).Compared with saline group,cAMP content and p-CREB protein level in the CPu of the rats in CFA+MA group were decreased(P<0.05).Compared with CFA+DMSO group,cAMP content and p-CREB pro-tein level in CFA+MA+DMSO and CFA+CCPA groups were significantly decreased(P<0.01).Compared with CFA+MA+ DMSO group,the levels of cAMP,p-PKA and p-CREB in CFA+MA+DPCPX group were significantly increased(P<0.05 or P<0.01).CONCLUSION:Acupuncture on bilateral Zusanli can relieve inflammatory pain in CFA rats,and its mech-anism may be related to A1R/cAMP/p-CREB signaling pathway.

OBJECTIVETo study the situation of sports and its influencing factors among students in order to improve health related education and promotion programs.

METHODSA multistage random sampling method was used on 3 600 students from three cities to understand their physical exercise behavior. Both t and χ(2) test were used to measure the scale of psychology and to describe the time spent on exercise. Single variance factor was used to measure the levels of change on behavior of physical activities, psychological and physical exercise behaviors.

RESULTSThe weekly exercise time for students was 2.66 ± 1.801 days, with 81.4% of the students less than four days. Data showed that 37.3%, 23.6%, 20.5% of the high school students were in pre-contemplation stage, in contemplation stage, or in preparation stage respectively, with only 18.6 percent of the high school students in the action phase and maintaining phase. Students in the stages of change increase the amount of physical exercises. Scores with statistically significant differences were seen in the following areas: between five stages of behavior change on strategies (F = 77.442, P < 0.001), forward effects on the balance of decision-making (F = 29.498, P < 0.001), having negative effects (F = 14.784, P < 0.001)and self-efficacy (F = 135.544, P < 0.001). Changing strategy on the intention stage of front maintenance phase, positive effects on decision-making balance and self-efficacy scores were increasing along with the increasing stages of changing. The effect of balancing the negative effects increased when the change of phase decreased.

CONCLUSIONStudents were in lack of physical exercise per week. The differences related to the behavior on physical exercise did exist but most of the high school students were in the primary stage. Psychological factors played important role in the different stages of changing, suggesting that high school students should receive different health education and psychological intervention measures to enhance the effectiveness of physical exercise.

Adolescent ; Exercise ; psychology ; Female ; Health Behavior ; Humans ; Male ; Students ; psychology