Objective:To investigate the use of simple pooling and bivariate model in meta-analyses of diagnostic test accuracy (DTA) published in Chinese journals (January to November, 2014), compare the differences of results from these two models, and explore the impact of between-study variability of sensitivity and specificity on the differences. Methods:DTA meta-analyses were searched through Chi-nese Biomedical Literature Database (January to November, 2014). Details in models and data for four-fold table were extracted. Descriptive analysis was conducted to investigate the prevalence of the use of simple pooling method and bivariate model in the included literature. Data were re-analyzed with the two models respectively. Differences in the results were examined by Wilcoxon signed rank test. How the re-sults differences were affected by between-study variability of sensitivity and specificity, expressed by I2 , was explored. Results:The 55 systematic reviews, containing 58 DTA meta-analyses, were included and 25 DTA meta-analyses were eligible for re-analysis. Simple pooling was used in 50 (90. 9%) systematic reviews and bivariate model in 1 (1. 8%). The remaining 4 (7. 3%) articles used other models pooling sensitivity and specificity or pooled neither of them. Of the reviews simply pooling sensitivity and specificity, 41(82. 0%) were at the risk of wrongly using Meta-disc software. The differences in medians of sensitivity and specificity between two models were both 0. 011( P<0. 001, P=0. 031 respectively). Greater differences could be found as I2 of sensitivity or specificity became larger, especially when I2 >75%. Conclusion:Most DTA meta-analyses published in Chinese journals(January to November, 2014) combine the sensitivity and specificity by simple pooling. Meta-disc software can pool the sensitivity and specificity only through fixed-effect model, but a high proportion of authors think it can implement random-effect model. Simple pooling tends to underestimate the results compared with bivariate model. The greater the between-study variance is, the more likely the simple pooling has larger deviation. It is necessary to increase the knowledge level of statistical methods and software for meta-analyses of DTA data.

Sleep takes an important role in maintaining typical development, neural plasticity, and language development. Not only poorer performance in memory and cognitive functions, but also obvious delayed language development are seen in children and adolescents with sleep problem. Previous research found that sleep duration affects children and adolescents' ability in comprehensive vocabulary, expressive vocabulary, and vocabulary retention. Children and adolescents with poor sleep quality usually show language developmental delay, however, there is no integrated evaluation tool for sleep and language, and a consistent conclusion is therefore not reached. Daytime naps are beneficial to consolidate vocabulary learning in infants, and it’s also relevant to vocabulary retention and generalization in children and adolescents. Children with sleep related breathing disorders show lower ability in receptive language comprehension and lower lexical level, and with the increase of their age, the severity of their language disorder becomes higher. Besides, sleep can promote language learning in children with neuro-developmental disorder.The neuro-physiological mechanism underlying sleep and language remains unknown, and one of the possible explanations is that sleep problem harms the information processing in frontal lobe and hippocampus, and interferes with neural plasticity. The injury includes memory, attention, executive function, auditory processing, and so on, and finally language development is damaged. Further research is necessary to clarify the relation and mechanism between these two elements, this will be helpful in finding out an effective way to promote language function in children with language retardation and/or combined with neuro-developmental disorder.

Objective:To assess the association between particulate air pollution and hospital admissions for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing, and to eva-luate the differences of association among different subgroups.Methods: Hospital admissions to intertiary hospitals for AECOPD from January 1,2014, through December 31, 2015 were obtained from the electronic hospitalization summary reports (HSRs).We obtained the data on air pollution during the study period from the national air pollution monitoring system.The data on meteorological variables were obtained from the Chinese meteorological bureau.A poison generalized additive model was used to assess the effects of particulate pollution on AECOPD with adjustment for the long term trend, day of week, holiday effect and meteorological variables.Subgroup analyses were also conducted by age and gender, which would help identify higher-risk groups.Results: A total of 7 884 hospitalizations from 15 tertiary hospitals were recorded during the study period, and 69.3% were male patients, 37.1% were ≥80 years of age, 45.5% were 65-79 years of age, and 17.4% were younger than 65.The mean (SD) daily concentrations of PM2.5, PM10 were 77.1 (66.6) μg/m3, 111.9 (75.8) μg/m3.Every 10 μg/m3 increase in particulate pollution concentration for a lag of 4 d was associated with an increase in hospital admissions for AECOPD as follows: 0.53% (95% CI: 0.01%-1.06%, P=0.0478) of PM2.5, 0.53% (95% CI: 0.07%-1.00%, P=0.0250) of PM10, respectively.We found differences in risk for AECOPD admissions among the different subgroups.For every 10 μg/m3 increase in PM2.5, PM10 exposure in the female group there was a 1.13% (95% CI: 0.19%-2.07%, P=0.018 3) increase, 1.06% (95% CI: 0.22%-1.91%, P=0.013 6) increase in admissions, respectively, while in the male group, the association was non-significant.The patients of 80 years of age and older demonstrated a hi-gher risk of AECOPD, 1.25% (95% CI: 0.40%-2.11%, P=0.004 0) increase of PM2.5, 1.18% (95% CI: 0.42%-1.95%, P=0.002 4) increase of PM10, respectively, while other subgroups didn't find significant association.Conclusion: Our findings showed that particulate air pollution was significantly associated with hospital admissions for AECOPD in Beijing.The susceptibility to particulate pollution varied by gender and age.

Abstract The increasing fragile and vulnerable adolescents mental health determines the increasing demand for psychological health services among teenagers, which indicates the inadequacy of traditional mental health service models. This article summarizes the necessity of digital mental health services for adolescents, and then lists the application examples of digital mental health services across the world, aiming to provide reference for digital mental health services among Chinese adolescents.

Objective:To investigate the correlations between perfused lung volumes, visual scores (using perfusion SPECT/CT) and right-heart catheter (RHC) hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 51 consecutive CTEPH patients (17 males, 34 females, age (59±12) years) in the First Affiliated Hospital of Guangzhou Medical University between March 2015 and July 2019 were retrospectively analyzed. All patients underwent lung perfusion SPECT/CT imaging and RHC examinations. Perfused lung volumes were determined using threshold-based (15%-85%) segmentation. Visual semiquantitative scoring in each lung segment was performed using Begic method. RHC hemodynamic parameters including pulmonary artery systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure (mPAP), pulmonary arteriolar wedge pressure (PAWP), pulmonary vessel resistance (PVR), cardiac output (CO), cardiac index (CI) were recorded. Spearman correlation analysis was used to evaluate the correlations between perfused lung volumes, visual scores and hemodynamic parameters.Results:There were significant correlations between perfused lung volumes (30%-70% threshold) and mPAP ( rs values: from -0.414 to -0.302, all P<0.05). Among them, perfused lung volumes under the threshold of 40% and 45% were moderately correlated with mPAP ( rs values: -0.414, -0.412, both P<0.05). Perfused lung volume (40% threshold) was moderately negatively correlated with PASP, PADP ( rs values: -0.402, -0.440, both P<0.05), and slightly negatively correlated with PVR ( rs=-0.352, P<0.05). Visual scores were slightly positively correlated with the PADP ( rs=0.311, P<0.05), while there was no correlation between visual scores and other RHC hemodynamic parameters ( rs values: from -0.201 to 0.275, all P>0.05). Conclusion:Perfused lung volumes based on threshold-based segmentation in lung perfusion SPECT/CT imaging can accurately reflect hemodynamic status and may provide useful information for severity assessment of CTEPH.

Objective:To evaluate the cognitive information processes in children with autism spectrum disorder(ASD)based on the Das-Naglieri Cognitive Assessment System(DN: CAS)and to explore the characteristics of these cognitive processes.Methods:Thirty-two children with ASD and thirty-two healthy controls matched 1∶1 by gender and age were enrolled in this study.The cognition of all individuals was evaluated by the DN: CAS.SPSS 26.0 software was used for statistical analysis and Mann-Whitney U test was conducted to analyze the data. Results:Compared with the healthy control group, children with ASD had significantly lower scores in planning subtest of DN: CAS(23.50(19.00, 25.00) vs 30.50(27.00, 35.75), Z=-5.014, P<0.01), attention subtest of DN: CAS(25.50(20.25, 27.75) vs 33.00(28.00, 36.00), Z=-4.317, P<0.01), and the DN: CAS total score(115.00(106.00, 132.25) vs 139.00(127.00, 143.00), Z=-3.849, P<0.01). And there were significant differences in matching numbers(9.00(6.25, 10.00) vs 12.00(10.00, 13.75), Z=-4.317, P<0.01), planned codes(7.00(5.25, 8.00) vs 9.00(7.00, 11.00), Z=-3.404, P<0.01), planned connections(7.00(4.25, 9.75) vs 10.00(9.00, 12.00), Z=-4.383, P<0.01)in planning and expressive attention(8.00(6.25, 10.75) vs 11.50(8.25, 13.75), Z=-3.251, P<0.01), number detection(8.00(6.25, 10.00) vs 10.00(9.00, 12.00), Z=-3.628, P<0.01), receptive attention(8.00(6.00, 9.00) vs 10.00(9.00, 13.00), Z=-3.351, P<0.01)in attention between ASD children and healthy controls. Conclusion:ASD children have the planning and attention deficits.

Objective To investigate the effect of day chemotherapy on medical expenses of breast cancer patients.Methods The medical expenses of breast cancer patients in the First Affiliated Hospital of Guangxi Medical Universtiy from January 2019 to September 2023 were retrospectively investigated.Interrupted time series analysis was used to analyze the changes and trend of medical expenses and expenses structure of breast cancer before and after the implementation of day chemotherapy.Results The number of 8066 cases with breast cancer were included in this study.After day chemotherapy,the total expenses and each expense detail decreased significantly(P＜0.001).The total expenses,medicine expense,examination expenses and other expenses showed an upward trend before implementation of day chemotherapy(P＜0.05),the laboratory expenses showed a downward trend before implementation of day chemotherapy(P＜0.001).The total medical expenses decreased by 7306.34 yuan immediately after the implementation of day chemotherapy.The expenses of laboratory test,treatment,examination,nursing,medicine,health materials and other expenses were decreased by 599.59 yuan,1674.34 yuan,1470.66 yuan,91.37 yuan,3473.91 yuan,231.51 yuan and 436.73 yuan,respectively.Conclusion The implementation of day chemotherapy for breast cancer has significantly reduced all kinds of costs,which is conductive to reducing disease burden of patients.

Objective:To explore the influence of tomoxetine hydrochloride on the cognitive processing of children with attention deficit hyperactivity disorder (ADHD).Methods:From January 2018 to July 2021, 62 ADHD children who were treated with tomoxetine hydrochloride for the first time for(8±4) weeks were selected as the ADHD group.And 62 healthy children matched with age and sex were selected as the healthy control group.Pre-test and post-test by the Das-Naglieri: Cognitive Assessment System(DN: CAS) were performed to evaluate the cognitive function of all individuals.The differences of cognitive processing in pre-treatment and post-treatment of ADHD group were compared with those in healthy control group.The difference between before and after treatment of ADHD group was also compared.SPSS 26.0 statistical software was adopted for statistical analysis.The scores of ADHD group pre-treatment and post-treatment were compared by paired sample t-test, and the scores of ADHD group pre-treatment and post-treatment were compared with those of healthy control group by independent sample t-test. Results:Compared with healthy control group, there were lower of planning score((18.77±5.92) vs (28.56±5.55)), attention score((22.24±5.93) vs (29.56±6.16)), simultaneous processing ((34.21±7.75) vs (37.61±6.29)), successive processing((30.37±7.12) vs (33.74±5.43)), and the total scores((105.60±21.29) vs (134.84±22.87)) in ADHD group before treatment, and there were significant differences( t=9.49, 6.74, 2.68, 2.96, 7.36, all P<0.05). Compared with healthy control group, there were lower of planning score ((22.13±5.99)s), attention score((25.26±7.11) with significant difference( t=6.20, 3.60, both P<0.05) in ADHD group after treatment.And there was no significant difference in the simultaneous processing test and the successive processing test after treatment compared with the healthy control group(both P>0.05). In ADHD group, the scores of planning, simultaneous processing, attention, successive processing and the total score were significantly higher after treatment than those before treatment and there were significant differences( t=-6.03, -4.13, -4.77, -5.48, -8.59, all P<0.05). (2) Compared with the healthy control group, there were lower of matching number score and other 8 sub-test scales in DN: CAS test in ADHD group before treatment, and the differences were statistically significant (all P<0.05). Meanwhile, there were still lower of matching number score and other 4 sub-test scales in DN: CAS test in ADHD group after treatment, and the differences were statistically significant (all P<0.05). The matching number score and other 10 sub-test scales in DN: CAS test in ADHD group after treatment were all higher than those of before treatment(all P<0.05). Conclusion:The planning, attention, simultaneous processing, successive processing and total cognitive function of ADHD children were significantly improved after treatment with tomoxetine hydrochloride, special for simultaneous processing and successive processing.

Objective:The aim of this study is to analyze the distribution features of patients with solitary plasmacytoma and calculate the prevalence of solitary plasmacytoma in China in the year 2016.Methods:This study was based on China’s urban employees’ basic medical insurance and the urban residences’ basic medical insurance from 21 provinces from January 1, 2016 to December 31, 2016. Patients with solitary plasmacytoma were identified by disease names and codes. Subgroup analyses were carried out by sex, region, and age. Furthermore, sensitivity analyses were performed to test the robustness of the results. Age-adjusted prevalence was calculated based on the 2010 Chinese census data, the 2013 Revised European Standard Population, the 2010 US population, and the 2011 Australian population.Results:In 2016, the prevalence of solitary plasmacytoma in China was 1.18 per 100 000 population (95% CI, 1.06-1.31) , with 1.26 per 100 000 population (95% CI, 1.10-1.43) and 1.10 per 100 000 population (95% CI, 0.93-1.29) for males and females, respectively. The age-adjusted prevalence based on the 2010 Chinese census data was 0.85 per 100 000 population (95% CI, 0.82-0.88) . Conclusion:This study estimated the prevalence of solitary plasmacytoma in China on the basis of the national urban medical insurance, which can provide clues for the enactment of solitary plasmacytoma-related medical policies and basic studies about solitary plasmacytoma.

Objective:To investigate the clinical features of 17q12 microdeletion cases before and after delivery, and provide a reference for prenatal diagnosis and genetic counseling.Methods:A retrospective analysis was conducted on five fetuses diagnosed with 17q12 microdeletion by single nucleotide polymorphism array in Quanzhou Women's and Children's Hospital between April 2020 and June 2023. Clinical data including prenatal ultrasonography findings, genetic causes, parental clinical features, and postnatal outcomes were summarized and analyzed using descriptive statistical analysis.Results:The five fetuses had normal results of karyotype analysis of amniotic fluid, but carried a microdeletion of 1.4 to 1.8 Mb in the 17q12 region of the chromosome, involving 20 genes listed in the Online Mendelian Inheritance in Man database. Pedigree verification was performed on all five cases and the results indicated one maternally inherited case with the mother having polycystic kidneys complicated by left hydronephrosis, one de novo case, and three paternally inherited cases with one father having multiple cysts in both kidneys and two fathers showing no abnormalities. Multiple abnormalities were found in the five fetuses by prenatal ultrasonography, including enhanced renal parenchymal echogenicity in four cases and pyelectasis in one case. Two cases chose to terminate the pregnancies, while the other three continued the pregnancies to full term. Postnatal follow-ups showed that one case was normal in growth and development with no abnormalities by renal ultrasound; one case developed polycystic kidney; one case with normal renal ultrasound findings had a speech disorder and symptoms of suspected autism at the age of three. Conclusions:The main manifestation of 17q12 microdeletion is enhanced renal parenchymal echogenicity in the fetal stage and postnatal polycystic kidney. In prenatally diagnosed cases, pedigree verification is necessary as an objective and scientific genetic counseling is helpful in pregnancy decision-making.