Objective To explore the necessity of colonoscopy in young patients with chronic constipation.Methods Data of patients aged 18-50 underwent colonoscopy at Tianjin Medical University General Hospital with chronic constipation as the sole indication between April 2003 and May 2014 were analyzed.Endoscopic and pathologic reports were analyzed.Results During the study period,a total of 563 patients were included,who were aged 18-50 with chronic constipation as the sole indication,of which 260 patients were aged 18-35,and 303 patients were aged 36-50.No lesion was found during colonoscopy in 167 (29.7％) patients,whereas in other 396 (70.3 ％) patients positive findings were reported,including polyps in 45 patients (of which 13 were with multiple polyps),adenomas in 20(17 in distal colon,3 in proximal colon).In patients aged 18-35,3 cases of adenomas(3/260,1.2％) were found,of which 1 patient (1/260,0.4％)had advanced adenoma.In patients aged 36-50,17 cases of adenomas(17/303,5.6％) were found,of which 4 (4/303,1.3％) were advanced ones.Colorectal cancers were found in 2 patients (0.7％,2/303),both in patients aged 36-50.The detection rate for colorectal neoplasms (including adenoma and cancer) in patients with chronic constipation aged 18-35 was significantly lower than that in patients aged 36-50[1.2％(3/260) VS 6.3％(19/303),P=0.002,95％CI:0.05-0.60].Conclusion The detection rate for colorectal neoplasms in patients aged 18-35 years with chronic constipation is relatively low,and colonoscopy is not recommended for them.

Objective To evaluate necessity of colonoscopy in symptomatic subjects with colorectal neoplasia screening score.Methods Data of consecutive patients who underwent routine colonoscopy between October 2015 and December 2015 were prospectively collected.APCS score and HKCS score were used to evaluate the detection rate of colorectal tumors in groups of different risks and to predict the necessity of colonoscopy in symptomatic subjects.Results There were 815 subjects with mean age of 51.2± 14.8 years.Colorectal neoplasia and advanced neoplasia were identified in 170 (20.9％) and 43 (5.3％) cases.APCS score was classified as average risk (AR),moderate risk (MR) and high risk (HR),which included 234,400 and 161 cases,respectively.The detection rates of colorectal neoplasia in AR,MR and HR groups were 9.5％,20.0％ and 41.0％,respectively,and those of advanced neoplasia were 0％,5.5％ and 13.0％,respectively.Detection rate of colorectal neoplasia in the HR group showed 6.7 times of that in the AR group (95％CI:3.9-11.2).HKCS score was classified as AR and HR,which included 633 and 182 cases in the present study.The detection rates of colorectal neoplasia in these groups were 16.3％ and 36.8％,and those of advanced neoplasia were 3.2％ and 12.6％.Detection rate of colorectal neoplasia in HR group was 3.0 times of that in AR group (95％CI:2.1-4.3).Conclusion APCS score and HKCS score are both suitable for evaluating the necessity of colonoscopy in symptomatic subjects.It is necessary for HR patients to undergo colonoscopy to detect colorectal neoplasia,however,AR patients evaluated by APCS score can delay colonoscopy to economize medical resources and avoid unnecessary complications.

Objective:To investigate the relationship between median sagittal corpus callosum area and neural behavior in children with autism spectrum disorder (ASD).Methods:From January 2017 to December 2018, in Anhui Provincial Children's Hospital, 38 children with ASD were selected as the study group, and 35 matched children with normal development were selected as the control group.The autism behavior checklist (ABC) scale was used to evaluate the neurological behavior of children with ASD.All children were examined by cranial MRI.The total and partition area of the corpus callosum were measured at the median sagittal position, and the difference between the two groups was analyzed, as well as the relationship between the area of the corpus callosum and the abnormal neurological behavior of ASD.Results:The total and panition area size of corpus callosum in the study group were smaller than those in the control group[area 1: (182.63±30.99)mm 2 vs.(213.82±26.01)mm 2, area 2: (54.78±10.77)mm 2 vs.(63.75±12.53)mm 2, area 3: (45.16±6.52)mm 2 vs.(54.04±10.56)mm 2, area 4: (35.82±8.05)mm 2 vs.(49.93±14.47)mm 2, area 5 (127.63±26.50)mm 2 vs.(154.32±30.18)mm 2, total area: (445.31±64.91)mm 2 vs.(533.57±60.50)mm 2], and the differences were statistically significant ( t=-4.189, -2.982, -3.230, -4.363, -3.649, -5.543, all P<0.05). The differences between the two groups were mainly concentrated in the area of the knee, the area of the isthmus and the total area of the corpus callosum.The total area of corpus callosum was negatively correlated with 5 neurobehavioral dysfunction scores of ASD.The total area of corpus callosum was significantly correlated with communication disorder and language disorder ( r=-0.439, -0.544, all P<0.01). Conclusion:There are abnormalities in the development of the corpus callosum in children with ASD.The smaller the area of the corpus callosum, the more severe the clinical abnormal behavioral symptoms is.The measurement of corpus callosum area in children with ASD can provide support for diagnosis and disease assessment.

Objective:To explore the risk factors for the occurrence of thrombocytopenia (TCP) within 2 weeks after pediatric liver transplantation (LT) and examine the relationship between the occurrence of TCP and prognosis.Methods:From January 2021 to November 2021, clinical data were retrospectively reviewed for 162 pediatric LT recipients aged under 4 years at Organ Transplantation Center of Tianjin First Central Hospital.Based upon the lowest value of platelet count at Week 2 post-operation, they were assigned into two groups of TCP (n=90) and non-TCP (n=72). General preoperative profiles, intraoperative findings, postoperative complications, types of commonly used antibiotics, anticoagulant dosing and prognosis of two groups were compared.Univariate and multivariate analyses were utilized for examining the independent risk factors for TCP.Receiver operating characteristic (ROC) curve was plotted for examining the cut-off value of independent risk factors for diagnosing TCP.Results:Among them, 90 (55.56%) developed TCP within 2 weeks post-operation and 25(15.43%) developed TCP at Day 1 post-operation.The median preoperative platelet count was 178×10 9/L and the lowest value was 65×10 9/L at Day 3(1-4) post-operation with a declining rate of 63.5% and platelet count of recipient normalized at Day 6(4-7.25) post-operation.The results of univariate analysis showed statistically significant inter-group differences in operative duration[(574.43±80.53)min vs.(526.75±72.42)min], intraoperative blood loss[400(300, 550)ml vs.320(300, 400)ml], red blood cell transfusion[2(2, 3)U vs.2(1.5, 2.0)U], preoperative platelet count[178.5(141.75, 242.5)×10 9/L vs.257 (209.75, 357)×10 9/L], postoperative infection rate[27.8%(25/90)vs.13.9%(10/72)] and dosing rates of piperacillin sodium and tazobactam sodium[8.9%(8/90)vs.25.0%(18/72)] ( P<0.05). Multivariate Logistic regression analysis revealed statistically significant inter-group differences in operative duration( P=0.008), red blood cell transfusion( P=0.01), preoperative platelet count( P<0.01) and postoperative infection rate ( P=0.02). The results of ROC curve analysis showed that the cut-off values of operative duration, red blood cell transfusion and preoperative platelet count were 535 min, 2.75 U and 183.5×10 9/L respectively.Length of ICU stay was higher in TCP group than that in non-TCP group, and the difference was statistically significant [4(3, 5) vs.3(3, 4) day, P=0.006]. Conclusions:LT children aged under 4 years with intraoperative red blood cell transfusion>2.75 U, operative duration>535 min and preoperative platelet count<183.5×10 9/L are more likely to develop post-transplantation TCP.And occurrence of TCP prolongs the length of ICU stay in pediatric recipients.

Objective To probe into the total number and development status of respiratory physicians in China, and to analyze existing problems, for reference in making strategy and policy decisions in professional development of respiratory physicians in the country. Methods The basic information of China′s healthcare institutions and healthcare manpower in 2015 were provided by the Statistics Center of the National Health Commission. The number of respiratory specialists and their profile, drawn from such basic information, were subject to descriptive statistics. Results In 2015, there were 2.729 million medical practitioners ( including assistant doctors ) nationwide, 30.3 thousand among whom being respiratory physicians, accounting for 1.11% of the total. Among these respiratory physicians, practicing respiratory physicians account for 87.1% , respiratory physicians with a master degree and above account for only 19.7% , respiratory physicians with over 10 years of working experience account for 65.8% , respiratory physicians with senior titles account for only 21.4% , and 89.4% of the respiratory physicians work in general hospitals. Conclusions By the criteria of specializing in respiratory specialty over five years and being attending or above, the number approximates 14. 6 thousand nationwide. If practicing ( assistant) physicians specializing in respiratory specialty are also included, the number may hit 30. 3 thousand. Such a number, compared with other specialties, may be sufficient, yet their competence is far from satisfactory. Therefore it is imperative to build a standardized pulmonary medicine fellowship training system for their competence improvement.

Background Parabens, a widely used class of preservatives, are suspected to be potential obesogens as emerging endocrine disrupting chemicals with reproductive and developmental toxicity. Objective To analyze five urinary parabens (PBs) and estimate the associations of exposure to PBs with adiposity measures in 10-year-old school-age children. Methods A total of 471 school-age children aged 10 years from the Sheyang Mini Birth Cohort were enrolled in this study. A questionnaire survey was conducted to collect socio-demographic information, physical activity, and dietary intake. Weight, height, and waist circumference of children were measured, and age- and sex-adjusted body mass index (BMI-Z score) was calculated. Spot urine samples were collected during the follow-up visits. Urinary concentrations of five PBs including methyl-paraben (MeP), ethyl-paraben (EtP), propyl-paraben (PrP), butyl-paraben (BuP), and benzyl-paraben (BzP) were detected by gas chromatography-tandem mass spectrometry (GC-MS/MS). Generalized linear models (GLMs) and Bayesian kernel machine regression (BKMR) models were applied to estimate associations of individual/overall urinary PBs concentrations with BMI Z-score and waist circumference. Results The positive rates of selected five urinary PBs were in the range from 78.98% to 98.94%. The urinary PBs concentrations (geometric mean) were in the range of 0.31-5.43 μg·L⁻¹. The children's BMI Z-score and waist circumference (mean ± standard deviation) were (0.56±1.40) and (67.62±10.07) cm respectively. The GLMs results showed that the urinary BzP concentration was negatively associated with waist circumference (b=−0.08, 95%CI: −0.14, −0.02; P=0.01). In sex-stratified analysis, the urinary concentration of BzP was negatively associated with BMI-Z score (b=−0.59, 95%CI: −0.88, −0.30; P<0.001) and waist circumference (b=−0.80, 95%CI: −1.23, −0.37; P<0.001) in boys, but not in girls. The BKMR results also found significant negative correlations of urinary BzP concentrations with BMI-Z score and waist circumference, which were consistent with the GLM results. Conclusion The selected 10-year-old children are extensively exposed to PBs in the study area. Furthermore, childhood PBs exposure may have potential impacts on childhood adiposity measures with sex-specific effects.

Objective: To determine the changed expression levels, biological roles and underlying mechanism of LncSox4 in non-small cell lung cancer (NSCLC), providing novel biomarkers for NSCLC diagnosis and therapy. Methods: QRT-PCR was used to detect the expression of LncSox4 in the tumor tissues of NSCLC patients. Colony formation, cell growth curve, Transwell migration and invasion assays were used to determine the effects of LncSox4 knockdown on A549 cell function, respectively. Flow cytometry was used to determine the effects of LncSox4 on the progression of A549 cell cycle. QRT-PCR and western blot were used to explore the expressions of genes and proteins in epithelial-mesenchymal transition (EMT). Results: The expression of LncSox4 was upregulated significantly in carcinoma tissues of NSCLC compared to the para-carcinoma tissues (t=7.109，P＜0.01). The growth rate of A549 cells slowed down in LncSox4 knockdown group and the number of formed cell colonies was less than that in control group(P＜0.01). LncSox4 knockdown reduced the migration and invasion abilities of A549 cells (P＜0.01) and induced cell cycle arrest at G1 phase(P＜0.01). LncSox4 knockdown downregulated the protein expressions of Cyclin D1, c-Myc, N-cadherin, and Vimentin, while upregulated the expression of E-cadherin in A549 cells. LncSox4 knockdown also decreased the expressions of EMT-related transcription factors including snail, slug and twist. Conclusion The high expression of LncSox4 in NSCLC may promote malignant progression of NSCLC by enhancing cell proliferation, migration and invasion, suggesting that it should be a promising target for diagnosis and therapy of NSCLC.

The proteolysis targeting chimeras (PROTACs) technology has been rapidly developed since its birth in 2001, attracting rapidly growing attention of scientific institutes and pharmaceutical companies. At present, a variety of small molecule PROTACs have entered the clinical trial. However, as small molecule PROTACs flourish, non-small molecule PROTACs (NSM-PROTACs) such as peptide PROTACs, nucleic acid PROTACs and antibody PROTACs have also advanced considerably over recent years, exhibiting the unique characters beyond the small molecule PROTACs. Here, we briefly introduce the types of NSM-PROTACs, describe the advantages of NSM-PROTACs, and summarize the development of NSM-PROTACs so far in detail. We hope this article could not only provide useful insights into NSM-PROTACs, but also expand the research interest of NSM-PROTACs.

Objective: To investigate the expression change, biological role and action mechanism of long non-coding RNA (lncRNA) LINC00978 in non-small cell lung cancer (NSCLC). Methods: The expression levels of LINC00978 in tumor tissues and serum samples of NSCLC patients were detected by the qRT-PCR. The effects of knockdown and overexpression of LINC00978 on the biological function of A549 cells were determined by the CCK-8, colony formation, Transwell migration and invasion assays. The action mechanisms of LINC00978 in NSCLC were investigated by the flow cytometry, qRT-PCR and western blot, respectively. Results: The expression levels of LINC00978 in the tissues ( t =2.465, P ＜0.05) and serum samples ( t =8.781, P ＜0.01) of NSCLC patients increased. The knockdown of LINC00978 inhibited the proliferation, migration and invasion of A549 cells ( P ＜0.01) and induced cell cycle arrest at G1 phase and apoptosis of A549 cells ( P ＜0.01). The knockdown of LINC00978 downregulated the expression of Cyclin D1 and Bcl-2 , and upregulated the expression of Bax ( P ＜0.05). In addition, the knockdown of LINC00978 inhibited the expression of N-cadherin, Vimentin, Snail, Slug and Twist, and promoted the expression of E-cadherin ( P ＜0.05). The overexpression of LINC00978 had the opposite effect. Conclusion LINC00978 is highly expressed in NSCLC and can promote the occurrence and progression of NSCLC, which may serve as a potential target for the diagnosis and therapy of NSCLC.