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 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 To evaluate the efficacy of the traditional Chinese medicine NAOAN capsule in primary prevention of stroke in high?risk populations. Methods A multicenter, randomized controlled study was performed in community setting, involving 1 088 individuals at high risk of stroke, with cerebrovascular function scores<75 and 10?year Framingham stroke risk ≥6%. Subjects were recruited in communities at Beijing, Shanghai, Changsha, and Chengdu communities, through resident committees or the village unit. A total of 559 subjects were randomized into a group treated with the NAOAN capsule, and 529 subjects in an aspirin treatment group. Follow?up was performed every 2 months for 2 years. At the mid?point and end of the intervention, we compared cerebrovascular function differences between the 2 groups. Results During the 2?year community trial, 531 subjects in the NAOAN capsule group and 465 in the aspirin group followed the protocol. Cerebrovascular function scores increased from 45.2±19.7 at baseline to 61.7±26.5 after the 2?year trial (t=－12.931, P<0.001) in the NAOAN capsule group, and from 47.2±18.9 at baseline to 53.7 ± 25.1 (t=－5.058, P<0.001) in the aspirin group; greater increases in cerebrovascular function scores were found in the NAOAN capsule group than that in the aspirin group (t=4.906, P<0.001). Conclusions Cerebrovascular function in individuals at high risk of stroke was improved by taking NAOAN capsule. Cerebrovascular function scores improved more with NAOAN capsules than with aspirin.