OBJECTIVETo investigate the mechanisms of pressure intervention, and to explore the most effective regime for pressure therapy.

METHODSSeveral trials were carried out to study the efficacy and mechanism of pressure therapy, and the development and application efficacy of a smart pressure monitored suit (SPMS) for scar management. (1) Effectiveness of pressure therapy. Forty-five patients suffered burn on extremities were divided into pressure treatment group (n = 36) and control group (n = 9) according to the random number table. Patients in pressure treatment group were prescribed with a regime of wearing custom pressure garment (10% strain rate of pressure + 9 mm thick local pressure padding) more than 23 hours per day, while no active intervention was conducted on patients in control group. Scar conditions were assessed using the Vancouver Scar Scale (VSS), spectrocolorimeter, and tissue palpation ultrasound system. Data were processed with t test or paired t test. (2) Changes in fibroblasts growth rate under pressure. Fibroblasts extracted from scar tissue excised during surgery were loaded with 0, 1.1, 2.8, 5.6 mm Hg (1 mm Hg = 0.133 kPa) pressure respectively to observe the growth rate of fibroblasts. Data were processed with Fisher LSD post-hoc analysis. (3) Scar thickness upon pressure. The changes in scar thickness upon 0, 5, 15, 25, 35 mm Hg pressure were measured at early stage (1 - 6 months), mid-stage (7 - 12 months), and late stage (more than 12 months) using the high frequency ultrasound imaging system. Data were processed with correlation analysis and regression analysis. (4) Study on application of SPMS. Thirty-six patients with hypertrophic scars once treated with the conventional garment were recruited and they were prescribed with the regime of wearing SPMS for one month. Feedback from all participants in rating conventional garment and SPMS was obtained using self-reported questionnaire. The interface pressure of pressure garment was measured using the Pliance X system. Data were processed with Wilcoxon Sign-Ranks test.

RESULTS(1) Scar thickness, color, and VSS score were significantly improved in pressure treatment group after two-month of pressure intervention. VSS score of the scars in pressure treatment group was lower than that in control group two months after treatment. (2) The growth rate of scar fibroblasts under 5.6 mm Hg pressure was obviously lower than that under 0 mm Hg pressure 2 days after pressure loading (mean deviation = 0.086, P = 0.001). Growth rates of fibroblasts under 2.8 and 5.6 mm Hg pressure were obviously lower than that under 0 mm Hg pressure 3 days after pressure loading (with mean deviation respectively 0.060 and 0.118, P = 0.003, P < 0.001). (3) Scar thickness was significantly reduced upon pressure, and a negative relationship between scar thickness and pressure level was observed (r = -0.96, P < 0.01). (4) The results of SPMS study showed a reduction in both static pressure (19.5%) and dynamic pressure (11.9%) after one month of usage; while there was nearly 50.0% reduction in pressure in conventional garment. SPMS was rated significantly higher than conventional garment in terms of comfort, permeability and clinical efficacy (P ≤ 0.001).

CONCLUSIONSPressure therapy can effectively inhibit the growth of hypertrophic scar, while its exact mechanism needs further study for verification. SPMS is convenient to apply for patients. It takes less time to fabricate and adjust when compared to the conventional garment. Its clinical effect is positive and it may expand its application to other medical conditions.

Primary blast-induced traumatic brain injury (bTBI) has been observed at the boundary of brain tissue and cerebrospinal fluid (CSF). Such injury can hardly be explained by using the theory of compressive wave propagation, since both the solid and fuid materials have similar compressibility and thus the intracranial pressure (ICP) has a continuous distribution across the boundary. Since they have completely different shear properties, it is hypothesized the injury at the interface is caused by shear wave. In the present study, a preliminary combined numerical and theoretical analysis was conducted based on the theory of shear wave propagation/reflection. Simulation results show that higher lateral acceleration of brain tissue particles is concentrated in the boundary region. Based on this fnding, a new biomechanical vector, termed as strain gradient, was suggested for primary bTBI. The subsequent simple theoretical analysis reveals that this parameter is proportional to the value of lateral acceleration. At the boundary of lateral ventricles, high spatial strain gradient implies that the brain tissue in this area (where neuron cells may be contained) undergo significantly different strains and large velocity discontinuity, which may result in mechanical damage of the neuron cells.
Biomechanical Phenomena ; Blast Injuries ; etiology ; physiopathology ; Brain Injuries, Traumatic ; etiology ; physiopathology ; Compressive Strength ; Computer Simulation ; Finite Element Analysis ; Humans

Objective To clarify the necessity of therapeutic drug monitoring (TDM ) of voriconazole ,and give relevant clinical tips ,by comparing the plasma concentration of different clinical specialties before and after adjustment of dose .Methods This is a retrospective study of voriconazole TDM data .It involves 435 cases voriconazole plasma trough concentration meas-urement results of 154 inpatients to make a preliminary assessment .Results 4 .3% plasma concentration were higher than 5 .5 μg/ml ,26 .5% plasma concentration were less than 1 .0 μg/ml in renal transplantation department ;while 52 .3% plasma concentration were higher than 5 .5 μg/ml ,no less than 1 .0 μg/ml in infectious disease department .Conclusions Therapeutic drug monitoring is necessary for rational use of voriconazole .The majority of plasma concentrations in renal transplantation pa-tients were <1 .0 μg/ml ,lower than recommended treatment concentration range ;while most infectious disease patients have> 5 .5 μg/ml ,higher than recommended treatment concentration range .Clinical pharmacists can be more closely involved in the clinical use of voriconazole based on the results of the therapeutic drug monitoring .

To determine cancer pathway activities in nine types of primary tumors and NCI60 cell lines, we applied an in silico approach by examining gene signatures reflective of consequent pathway activation using gene expression data. Supervised learning approaches predicted that the Ras pathway is active in ～70% of lung adenocarcinomas but inactive in most squamous cell carcinomas, pulmonary carcinoids, and small cell lung carcinomas. In contrast, the TGF-β, TNF-α, Src, Myc, E2F3, and β-catenin pathways are inactive in lung adenocarcinomas. We predicted an active Ras, Myc, Src, and/or E2F3 pathway in significant percentages of breast cancer, colorectal carcinoma, and gliomas. Our results also suggest that Ras may be the most prevailing oncogenic pathway. Additionally, many NCI60 cell lines exhibited a gene signature indicative of an active Ras, Myc, and/or Src, but not E2F3, β-catenin, TNF-α, or TGF-β pathway. To our knowledge, this is the first comprehensive survey of cancer pathway activities in nine major tumor types and the most widely used NCI60 cell lines. The "gene expression pathway signatures" we have defined could facilitate the understanding of molecular mechanisms in cancer development and provide guidance to the selection of appropriate cell lines for cancer research and pharmaceutical compound screening.

Objective: To understand the prevalence of attention deficit and hyperactivity disorder (ADHD) in children in China and provide scientific basis for early prevention and treatment of ADHD in children. Methods: A systematic literature retrieval was conducted by using CNKI, Wanfang data, CBM and VIP databases for the information about the prevalence of ADHD in children in China published from 1979 to 2017. Pubmed database was used to retrieve the literatures about ADHD prevalence in children in China published from 1946 to 2017. The quality of literature was evaluated based on the cross-sectional study criteria according to STROBE statement. Stata 12.0 was used for combined prevalence and subgroup analyses, including gender, regions, publication year, diagnostic criteria, sampling methods, and so on. Egger testing and the evaluation of funnel graph were used to evaluate the publication bias of these literatures, and sensitivity analysis was done by using different models and eliminating the influence of any one of these articles on combined effect value. Results: Twenty articles were included. The total sample size was 88 755, including 46 216 boys and 42 539 girls. The prevalence of ADHD in children in China was 5.6% (95%CI: 5.0%-6.3%). The prevalence was 7.7% (95%CI: 6.7%-8.8%) in boys and 3.4% (95%CI: 3.0%-3.8%) in girls, the difference was statistically significant (P<0.05). No statistically significance difference in the ADHD prevalence was observed between different regions publication years, diagnostic criteria and sampling methods. Conclusions: The prevalence of ADHD in children in China was high, and boys tended to have a higher prevalence compared with girls. Appropriate screening methods for early detection and intervention conduction of ADHD should be taken among children in China.
Attention Deficit Disorder with Hyperactivity/epidemiology* ; Child ; China/epidemiology* ; Female ; Humans ; Male ; Prevalence ; Sex Distribution

Objective: To investigate the effect of heterogeneous nuclear ribonucleoprotein K (hnRNP K) and its interaction with human papillomavirus 16 (HPV16) on cervical intraepithelial neoplasia (CIN). Methods: The participants included 67 women with normal cervix (NC), 69 women with CINⅠ and 68 women with CINⅡ/Ⅲ in a community cohort of pathologically diagnosed women established in Jiexiu of Shanxi province, from June 2014 to June 2015. A structured questionnaire was used to collect the demographic data of the subjects and the related factors of cervical lesions. Cervical exfoliated cells and cervical tissues from biopsy or surgery were selected. The infection status of HPV16 was detected by flow-through hybridization. The protein expression levels of hnRNP K were evaluated by Western blot. SPSS 23.0 software was used to collate and analyze the data. To study the differences in demographic characteristics, related factors, hnRNP K protein and HPV16 infection among NC, CINⅠand CINⅡ/Ⅲgroups, χ(2) test, trend χ(2) test, and Kruskal-Wallis H test were conducted. Multiple comparisons of hnRNP K protein in three groups were completed by using the Bonferroni method. The OR and its 95%CI of hnRNP K, HPV16 and CIN were calculated by using the unconditional logistic regression models. Two-way interactions between hnRNP K protein and HPV16 infection on CIN were analyzed by using additive model and related indicators. Results: HPV16 infection rates were 10.4% in women with normal cervix, 14.5% in women with CINⅠ and 41.2% in women with CINⅡ/Ⅲ, respectively. The differences among three groups were significant (P<0.001). Moreover, the infection rates of HPV16 gradually increased with the increasing severity of CIN (trend χ(2)=18.512, P<0.001). The differences in protein expression of hnRNP K among three groups were significant (H=48.138, P<0.001) and the expressionincreased with the development of cervical lesionss (trend χ(2)=21.765, P<0.001). Results from the interaction analysis indicated that there were additive effects between high expression of hnRNP K protein and HPV16 in CINⅡ/Ⅲ group compared with normal group (API=0.639, 95%CI: 0.083-1.196). In contrast, no such additive effect was found in CINⅠ group. Conclusions: HPV16 infection and over-expression of hnRNP K protein were associated with the increased risk of cervical intraepithelial neoplasia. There might be interaction between hnRNP K protein overexpression and HPV16 infection existed on the progress of CINⅡ/Ⅲ.
Case-Control Studies ; Disease Progression ; Female ; Gene Expression Regulation, Neoplastic ; Heterogeneous-Nuclear Ribonucleoprotein K/metabolism* ; Human papillomavirus 16 ; Humans ; Papillomavirus Infections ; Uterine Cervical Neoplasms/virology* ; Uterine Cervical Dysplasia/virology*

Objective: To compare the time and spatial distribution of hepatitis C and HIV/AIDS cases and its correlation, in China from 2012 to 2017. Methods: Data on reported hepatitis C and HIV/AIDS cases was gathered from the Direct Reporting System of Infectious Diseases Information Network in China, 2012 to 2017 while annually collected provincial data was based on the date of review and current address. Correlation of the data was analyzed, using both simple correlation and linear regression methods. Results: The number of reported cases of hepatitis C remained stable in China, in 2012-2017, with the number of annual reported cases as 201 622, 203 155, 202 803, 207 897, 206 832 and 214 023, respectively. The number of reported cases on HIV/AIDS showed a steady growing trend, from 82 434, 90 119, 103 501, 115 465, 124 555 to 134 512. However, the numbers of hepatitis C and HIV/AIDS cases were in the same, top six provinces: Henan, Guangdong, Xinjiang, Guangxi, Hunan and Yunnan. Results from the simple correlation analysis indicated that there was a positive correlation (r>0.5, P<0.01) existed between the above-said two kinds of cases at the provincial level in China, in 2012-2017. Again, results from the linear regression analysis also showed that the correlation coefficient r(s) and year was strongly correlated (r=0.966) while r(s) had been linearly increasing with time. Conclusions: Our data showed that there were temporal and spatial correlations existed between the reported cases of hepatitis C and HIV/AIDS at the provincial level, suggesting that relevant prevention and control programs be carried out in areas with serious epidemics. Combination of the two strategies should be encouraged, especially on prevention and treatment measures related to blood transmission.
Age Distribution ; China/epidemiology* ; Epidemics ; HIV ; HIV Infections/ethnology* ; Hepatitis C/ethnology* ; Humans ; Linear Models ; Spatial Analysis ; Spatio-Temporal Analysis ; Young Adult

The zinc finger transcription factor Egr-1 is critical for coupling extracellular signals to changes in cellular gene expression. In the hippocampus and amygdala, two major central regions for memory formation and storage, Egr-1 is up-regulated by long-term potentiation (LTP) and learning paradigms. Using Egr-1 knockout mice, we showed that Egr-1 was selectively required for late auditory fear memory while short term, trace and contextual memory were not affected. Additionally, synaptic potentiation induced by theta burst stimulation in the amygdala and auditory cortex was significantly reduced or blocked in Egr-1 knockout mice. Our study suggests that the transcription factor Egr-1 plays a selective role in late auditory fear memory.

Background/Aims: To determine the value of salivary pepsin in discriminating sub-types of gastroesophageal reflux disease (GERD) and GERD-related disorders. Methods: Overall, 322 patients with different sub-types of GERD and 45 healthy controls (HC) were studied. All patients took Gastroesophageal Reflux Disease Questionnaire (GerdQ) and underwent endoscopy and 24-hour esophageal pH monitoring and manometry. Salivary pepsin concentration (SPC) was detected by using colloidal gold double-antibody immunological sandwich assay. Oral esomeprazole treatment was administrated in the patients with non-erosive reflux disease (NERD) and extra-esophageal symptoms (EES). Results: Compared to HC, patients with erosive esophagitis, NERD, EES, EES plus typical GERD symptoms, or Barrett’s esophagus had a higher prevalence of saliva and SPC (all P < 0.001). There was no significant difference in the positive rate for pepsin in patients with functional heartburn or GERD with anxiety and depression, compared to HC. After esomeprazole treatment, the positive rate and SPC were significantly reduced in NERD (both P < 0.001) and in EES (P = 0.001 and P = 0.002, respectively). Of the 64 NERD patients, 71.9% (n = 46) were positive for salivary pepsin, which was significantly higher than the rate (43.8%, n = 28) of pathological acid reflux as detected by 24-hour esophageal pH monitoring (P = 0.002). Conclusions Salivary pepsin has an important significance for the diagnosis of GERD and GERD-related disorders. Salivary pepsin and 24-hour esophageal pH monitoring may complement with each other to improve the diagnostic efficiency.

COPD refers to a group of chronic respiratory diseases which seriously influence the people's health and life quality. The national COPD surveillance in China has been implemented since 2014 with the goal of monitoring the prevalence and trend of COPD and related risk factors in China. The paper summarizes the item and method of national COPD surveillance in China.
Aged ; China/epidemiology* ; Chronic Disease/psychology* ; Female ; Humans ; Male ; Middle Aged ; Population Surveillance/methods* ; Prevalence ; Pulmonary Disease, Chronic Obstructive/psychology* ; Quality of Life ; Risk Factors