Objective:To observe the effects of warming triple needling plus Chinese medication on inflammatory responses and daily functioning ability in patients with knee osteoarthritis(KOA)due to wind-cold-dampness Bi-impediment. Methods:A total of 101 patients with KOA due to wind-cold-dampness Bi-impediment were divided into an acupuncture-medication group and a Chinese medication group using the random number table method.Fifty cases in the Chinese medication group took oral Fang Feng Xi Bi Tang for treatment,and 51 cases in the acupuncture-medication group received additional warming triple needling therapy.The symptom score of traditional Chinese medicine(TCM),inflammatory factor levels,and motor function of the knee joint were compared before and after treatment.The clinical efficacy was also compared between the two groups after treatment. Results:Three cases in the acupuncture-medication group and 2 cases in the Chinese medication group dropped out during the study,and the two groups each had 48 cases being included in statistical analysis ultimately.The total effective rate was 95.8%in the acupuncture-medication group,higher than 79.2%in the Chinese medication group,and the between-group difference was statistically significant(P<0.05).After treatment,the TCM symptom score dropped in both groups(P<0.05)and was lower in the acupuncture-medication group than in the Chinese medication group(P<0.05).The levels of interleukin(IL)-6,tumor necrosis factor(TNF)-α,and IL-1β dropped after the intervention in both groups(P<0.05)and were lower in the acupuncture-medication group than in the Chinese medication group(P<0.05).The scores of knee pain intensity,knee joint stiffness,and diurnal functioning decreased after treatment in the two groups(P<0.05)and were lower in the acupuncture-medication group than in the Chinese medication group(P<0.05). Conclusion:Warming triple needling plus Fang Feng Xi Bi Tang can reduce inflammatory responses,improve daily functioning ability,and enhance the quality of life in patients with KOA due to wind-cold-dampness Bi-impediment.

Objective: To investigate the value of serum hepcidin in assessment of liver inflammation activity among patients with chronic hepatitis B ( CHB ), so as to provide insights into the assessment of liver inflammation activity among CHB patients. Methods: A total of 79 CHB patients who were admitted to the Affiliated Hospital of Hangzhou Normal University were selected as the experimental group, while 40 healthy volunteers were randomly sampled as controls. Subjects'demographic data, liver function tests and iron metabolism parameters were collected from medical records, and serum hepcidin was measured using enzyme-linked immunosorbent assay ( ELISA ). In addition, ultrasound-guided liver biopsy was performed in CHB patients, and mild and moderate-to-severe CHB were classified according to liver inflammation activity and degree of liver fibrosis. Serum hepcidin levels were compared between the experimental and control groups and between patients with mild and moderate-to-severe CHB. The value of serum hepcidin in assessment of liver inflammation activity was examined among CHB patients using the receiver operating characteristic ( ROC ) curve analysis. Results: Subjects in the experimental group included 54 men ( 68.35% ) and had a mean age of ( 39.06±10.67 ) years, while the controls included 24 men (60.00%) and had a mean age of ( 42.43±11.44 ) years. Lower hepcidin levels were measured in the experimental group than in the control group [( 11.70±5.64 ) vs. ( 17.82±3.63 ) μg/L; P<0.05 ]. There were 54 patients with mild CHB ( 68.35% ) and 25 cases with moderate-to-severe CHB ( 31.65% ), and lower hepcidin levels were detected in patients with moderate-to-severe CHB than in those with mild CHB [ ( 6.92±2.21 ) vs. ( 13.95±5.36 ) μg/L; P<0.05 ]. The area under the ROC curve, optimal cut-off, sensitivity and specificity of serum hepcidin were 0.903 ( P<0.05 ), 10.365 μg/L, 100.0% and 72.2% for assessment of moderate-to-severe CHB, respectively. Conclusion Serum hepcidin is feasible to evaluate the liver inflammatory activity among patients with CHB.

Objective To investigate the relationship between the white matter fiber connectivity of the anterior commissure (AC) and schizophrenia, and to explore the role of AC connectivity in cognitive functions in first-episode schizophrenia. Methods Twenty-four patients with first-episode schizophrenia and 29 healthy controls underwent diffu-sion tensor imaging (DTI) to measure fractional anisotropy (FA). Fiber tracking was then used to reconstruct the white matter fiber connectivity of AC to examine the white matter integrity. We also analyzed the relationship between AC integ-rity and cognitive function. Results Compared to healthy controls, patients with first-episode schizophrenia had a signifi-cant reduction in mean FA of AC tracts [(0.48±0.07) vs. (0.54±0.05),P=0.002],longer completion time in trail making test(TMT)[TMT_A: (55.19 ± 19.15) vs. (36.61 ± 11.72), P<0.001;TMT_B: (88.84 ± 38.92) vs. (53.75 ± 23.41), P<0.001] and worse performance in logical memory test [immediate logical memory score:(6.12±3.85) vs. (11.69±3.68), P<0.001;delay logical memory score:(3.33±3.16) vs. (9.83±4.15), P<0.001]. In addition, there was negatively correlation of mean FA of AC tracts with TMT_A completion time (r=-0.458, P=0.037) or TMT_B completion time (r=-0.541, P=0.011) in patients with schizophrenia, but not in controls. Conclusion This study supports the disconnection hypothesis of schizo-phrenia. The deficit of AC microstructure integrity may be partly responsible for impaired executive functions in schizo-phrenia, suggesting that the integrity of white matter fiber is an important endophenotype of schizophrenia.

In order to improve the resolution, contrast and frame rate of ultrasound imaging, it is necessary to design an adaptive beamforming method for plane wave ultrasound imaging. An optimized minimum variance algorithm that suits plane wave ultrasound imaging was proposed, based on the traditional minimum variance algorithm that combines with the subband beamforming as well as the forward-backward spatial smoothing method in the frequency domain. To verify the effectiveness of the improved algorithm, the matlab software was used. Simulation results showed that full width at half maximum and peak side-lobe level of Optimized MV, Conventional MV, DAS boxcar, and Linear scan methods were 0.08, 0.36, 0.92, 1.42 dB, and -41.1, - 37.3, -16.9, - 34.1 dB, respectively. The improved algorithm can significantly improve the image resolution and contrast, particularly applicable to plane wave ultrasound imaging, compared with the conventional minimum variance algorithm and traditional delay-and-sum method.
Algorithms ; Contrast Media ; Image Enhancement ; Image Processing, Computer-Assisted ; methods ; Microbubbles ; Phantoms, Imaging ; Ultrasonography ; instrumentation ; methods

Objective To explore the influencing factors of job burnout among nurses in level 2 and level 3 hospitals in Guangdong province. Methods A total of 2 066 first line nurses from 133 medical, surgical and intensive care units (ICU) of 23 level 2 and level 3 hospitals in Guangdong province were surveyed employing the questionnaire Hospital Nursing Human Resources Research during December 2013 to August 2014. Results In the multivariate logistic regression models, each additional doctor per nurse was associated with 1.34 times increase in the likelihood of high level of emotional exhaustion(EE). Nurses had a 57.4%higher risk of high level of EE when they worked overtime. Every one point increase in ancillary service score, and every one more year working as a nurse was associated with 5.4%, 2.3%increase in the likelihood of high level of EE, respectively. Nurses were 42.1%,40.9%more likely to exhibit high level of depersonalization(DP) when they worked in medical units or hospitals of level 3, compared with nurses of surgical units and hospitals of level 2. Nurses had a 29.5%higher risk of high level of DP when they worked overtime. Nurses holding higher positions had a lower likelihood(37.7%) of high level of reduced personal accomplishment(PA) compared with nurses holding lower positions. Nurses in medical units or ICUs had a 31.2%, 51.6%higher risk of high level of PA than nurses in surgical units, respectively. Conclusions Job burnout of nurses is at a quite high level in level 2 and level 3 hospitals in Guangdong province. The probability of the occurrence of burnout is related to the hospital, unit and nurse characteristics and nursing workloads.

Objective To investigate the difference in cognitive functions between first-episode schizophrenia pa-tients with and without family history. Methods One hundred twenty-seven patients with first-episode schizophrenia were recruited, including 40 patients with family history and 87 sporadic patients. Ninety-six matched normal subjects served as controls. Seven subscales of the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC) were used to assess the cognitive functions of all subjects. Positive and Negative Symptom Scale (PANSS) was used to assess patients ’ symptoms. The relationship between clinical symptoms and cognitive deficits was analyzed. Results There was no signifi-cant difference in the PANSS scores between familial patients and sporadic patients [(91.51±14.07) vs. (87.23±16.37), P>0.05]. The scores of full intelligence quotient (IQ), verbal IQ and operation IQ were lower in patient groups than in con-trol group (all P<0.05). The score of operation IQ was lower in sporadic patients than in familial patients (P<0.05). The scores of PANSS (r=-0.43, P=0.01), positive symptoms (r=-0.32, P=0.04) and negative symptoms (r=-0.38, P=0.02) were negatively correlated with operation IQ, and the scores of PANSS(r=-0.41,P=0.01) and positive symptoms(r=-0.54, P<0.01) were negatively correlated with block rectification scores in sporadic patient group but not in the familial patient group (all P>0.05). Conclusion The patients with schizophrenia have significant intelligence deficits in the early stages. Cognitive deficits are associated with the disease severity in sporadic patients while are independent of clinical symptoms in familial patients.

OBJECTIVETo assess the association of impairment of surface area of first-episode schizophrenia(SZ) with polymorphisms of COMT gene, and the difference in the impaired patterns between familial patients with schizophrenia(FPS) and sporadic patients with schizophrenia(SPS).

METHODSNinety-eight patients with first-episode SZ(FPS=40, SPS=58) and 78 healthy controls were recruited. COMT gene was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Participants were scanned for 3.0T magnetic resonance images. Freesurfer software was used to analyze the difference in brain surface area between SZ and controls, its association with COMT genotypes, and the difference between SPS, FPS and control groups. Multiple tests were corrected using a Monte Carlo simulation at P<0.05.

RESULTSCompared with controls, SZ showed decreased surface area in right occipital cortex and left prefrontal cortex. No association was found between COMT polymorphisms and whole brain area difference. Among the three subgroups, SPS showed smaller left prefrontal area compared with both FPS and control groups. Patients with SPS also showed significant area reduction in right occipital lobe compared with controls.

CONCLUSIONSurface area impairment can be found in those with first-episode SZ, but without association with COMT gene polymorphisms. The SPS have more severe area impairment than FPS, indicating that SPS and FPS may be attributed to different etiological mechanisms.

Adult ; Brain ; diagnostic imaging ; Catechol O-Methyltransferase ; genetics ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Polymorphism, Restriction Fragment Length ; Radiography ; Schizophrenia ; diagnostic imaging ; enzymology ; genetics ; Young Adult

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

【Objective】 To evaluate the differential miRNA expression of breast milk exosome in premature and full-term groups, and to analyze the regulatory pathways by bioinformatics, so as to provide guidance and scientific basis for the growth and development of premature infants and the prevention and treatment of related diseases. 【Methods】 From August 2020 to June 2021, breast milk samples from 13 premature (premate group) and 9 full-term infants(full-term group) in the Department of Child Health Care of the Second Affiliated Hospital of Nanjing Medical University were collected to extract exosomes. The miRNAs of two groups of breast milk exosomes were sequenced by high-throughput sequencing. According to the sequencing results, miRNA expression profiles of milk exosome were analyzed. Biological function software was used to carry out GO and KEGG pathway analysis of differential miRNA. 【Results】 The expression of miRNA in human milk exosomes was rich, especially hsa-miR-148a-3p,hsa-let-7b-5p, hsa-let-7g-5p, hsa-miR-22-3p, hsa-miR-99a-5p, hsa-miR-200, hsa-miR-146b-5p and hsa-miR-26a-5p were relatively high expressed in preterm group and full-term group. Differential expression analysis showed that compared with full-term infant breast milk, 7 miRNAs were up-regulated(log2|fold change|=2.803, 2.714, 1.632, 2.360, 1.350, 3.387, 2.137, respectively), and 5 miRNAs were down-regulated(log2|fold change|=-2.553, -2.197, -2.771, -1.395, -1.136, respectively)(|fold change>2|, P<0.05) in breast milk for preterm infants. In these differential expressed miRNAs, down-regulated miR-29b(P=0.001) and up-regulated miR-133a-3p(P=0.004) were associated with inflammation, and up-regulated miR-126-5p(P=0.021) and miR-126-3p(P=0.041) were associated with lipid metabolism. The fatty acid biosynthesis pathway was obviously enriched in preterm group. MiR-7-5p, miR-29b-3p and miR-100-5p played a role in the fatty acid synthesis pathway. 【Conclusions】 Exosomal miRNAs are rich in breast milk, and have significant differences between preterm and full-term infants′ mothers. The differentially expressed miRNA in preterm infants treast milk may be related to inflammation and promote the growth and development of preterm infants through the fatty acid biosynthesis pathway.

Substantial evidence supports the neurodevelopmental hypothesis of schizophrenia. Meanwhile, progressive neurodegenerative processes have also been reported, leading to the hypothesis that neurodegeneration is a characteristic component in the neuropathology of schizophrenia. However, a major challenge for the neurodegenerative hypothesis is that antipsychotic drugs used by patients have profound impact on brain structures. To clarify this potential confounding factor, we measured the cortical thickness across the whole brain using high-resolution T1-weighted magnetic resonance imaging in 145 first-episode and treatment-naïve patients with schizophrenia and 147 healthy controls. The results showed that, in the patient group, the frontal, temporal, parietal, and cingulate gyri displayed a significant age-related reduction of cortical thickness. In the control group, age-related cortical thickness reduction was mostly located in the frontal, temporal, and cingulate gyri, albeit to a lesser extent. Importantly, relative to healthy controls, patients exhibited a significantly smaller age-related cortical thickness in the anterior cingulate, inferior temporal, and insular gyri in the right hemisphere. These results provide evidence supporting the existence of neurodegenerative processes in schizophrenia and suggest that these processes already occur in the early stage of the illness.