Objective: To conduct network analysis of biased constitution to provide theoretical basis for daily health management. Methods: Purposive sampling and snowball sampling methods were used to collect the required data via a web-based questionnaire from February 3rd, 2022 to January 21st, 2023. The tendency scores of 8 biased constitutions (qi-deficiency type, yang-deficiency type, yin-deficiency type, phlegm-dampness type, damp-heat type, blood-stasis type, qi-depression type, and special diathesis type) were evaluated by 30-Item Short Version of Constitution in Chinese Medicine Questionnaire. Data analysis was conducted in R. The qgraph package was used to construct network analysis models and calculate the edge weight, namely regularised partial correlation coefficients (r) and centrality coefficients (including strength, closeness, betweenness and expected influence), while mgm was used to calculate the predictability of each node within the network. The ggplot2 package was used to visualize network analysis result, and bootnet was applied to assess the structural reliability and robustness of the network, including the r accuracy assessment, the stability assessment of the centrality coefficients, and the difference test result of node centrality coefficients. Results: A total of 3, 691 valid samples were obtained from the survey. The result of the network analysis showed that: (1) the strength of the association between phlegm dampness type and damp-heat type (r=0.370), qi-deficiency type and qi-depression type (r =0.315), qi-deficiency type and special diathesis type (r=0.260), qi-deficiency type and phlegm-dampness type (r=0.247), and the phlegm-dampness type and qi-depression type (r=0.247) was high. (2) The centrality of phlegm-dampness type and qi-deficiency type was the strongest, and the differences between the centrality coefficients of phlegm-dampness type and qi-deficiency type were not significant. There were no other nodes where all 4 centrality coefficients were not significantly different from qi-deficiency type and phlegm-dampness type, and the predictability of phlegm-dampness type and qi-deficiency type was the highest. (3)The result of the r accuracy assessment showed that the r of this network did not differ significantly from the average of multiple samples, so the r accuracy of this network was high. (4) Correlation stability(CS) coefficient of the four centrality indicators were CS Strength=0.59, CS Closeness=0.75, CS Betweenness=0.75, and CS Expected influence=0.75. This indicated that the stability of the centrality indicators of this network was very good. Conclusion Complex connections exist between various biased constitutions, and phlegm-dampness type and qi-deficiency type are the two key biased constitutions in the entire biased constitution.

Objective To study and analyze the CT and MRI findings of hepatic eosinophilic infiltration. Methods Twenty nine patients of hepatic eosinophilic infiltration who were confirmed by biopsy or clinical diagnosis were retrospectively analyzed. All the patients underwent CT and/or MRI scan. Twenty seven cases underwent upper abdominal CT plain scan and three phase enhanced scan, and 5 cases underwent upper abdominal MR plain scan and three phase enhanced scan, of which 3 cases underwent CT and MRI scan. Evaluations were made regarding to the numbers of lesion, distribution, size, shape, margin, density or signal characteristic, enhancement parttern and other special features. Pearson correlation analysis was used to analyze the correlation between the number of hepatic lesions and the number of eosinophils in peripheral blood. Results A total of 108 lesions of eosinophilic hepatic infiltration were observed in 29 cases, including 2 cases with single lesion and 27 cases with multiple lesions. Ninety five of the lesions were located in subcapsular parenchyma or surrounding the portal vein. Most subcapsular lesions were wedge-shaped(n=28). Lesions surrounding portal vein were round-shaped(n=32), while the hepatic parenchymal lesions were irregular or round-shaped(n=13). The mean size of lesion was 34 mm, ranging from 3 to 61 mm. The margin of all the lesions were obscure. The lesions showed slightly low density or isodensity on CT pre-contrast images. On MR pre-contrast images, lesions showed slightly low signal or isointense on T1WI, and hyperintense on T2WI. Branches of portal vein were found infilrated by all lesions. Tueleve cases showed“stripe sign”along the portal vein branches, 16 cases showed“halo ring sign”around the portal vein. Pearson analysis indicated a significant correlation between the number of eosinophilic hepatic infiltrated lesions and the increase of eosinophils in peripheral blood (r=0.783, P<0.05). Conclusion The imaging features of EHI had certain characteristics, especially in the three phase dynamic enhanced scanning, from which we can mainly find“progressive enhancement”,“portal vein sign”,“stripe sign”and“halo ring sign”.

Objective To evaluate the diagnostic value of combined detection of serum autoantibodies against against p53 and Bmi-1 in lung cancer (LC).Methods Serum levels of autoantibodies against p53 and Bmi-1 were measured by enzyme-linked immunosorbent assay (ELISA) in 92 patients with LC and 80 normal controls.The combined diagnostic value was evaluated with the receiver operating characteristic (ROC) curve.Results The serum levels of autoantibodies against p53 and Bmi-1 were significantly higher in LC than in normal controls (0.438 ±0.705 vs 0.045 ±0.035,Z =-7.667,P ＜0.01;0.117±0.061 vs 0.068 ±0.031,Z =-7.179,P ＜0.01).The levels of autoantibodies against p53 and Bmi-1 were not related to age,gender,pathological classification,lymph node status or tumor-node-metastasis (TNM) stage (P ＞ 0.05).The combined detection of two autoantibodies provided an enhanced sensitivity of 63.0％,a specificity of 91.2％ and an area under curve (AUC) of 0.881,which showed better diagnostic efficiency compared to individual autoantibodies.Conclusions Combined detection of autoantibodies against p53 and Bmi-1 shows good diagnostic value,which may aid diagnosis of LC.

Objective: To investigate the association of sleep quality, depressive symptoms and their interaction with non suicidal self injury (NSSI) among rural middle school students, so as to provide a reference for early prevention and control of NSSI among rural middle school students. Methods: A multi stage cluster sampling method was used to randomly select four rural middle schools in Xuzhou, Jiangsu Province. A total of 1 723 middle school students were investigated according to the principle of grade stratification and class random selection. Paper questionnaires (including demographic factors, Non Suicidal Self Injury Short Scale, Pittsburgh Sleep Quality Index, Patient Health Questionnare-9) were used to conduct the questionnaire survey. Logistic regression model was used to analyze the association of sleep quality, depressive symptoms and their interaction with NSSI among rural middle school students. Results: Totally 30.5% of middle school students had NSSI. Univariate results showed that girls (33.0%) had a higher incidence of NSSI than boys(27.3%), and those with sleep disorders and depressive symptoms had a higher incidence of NSSI, which was 46.8%, 43.6%. The results of multivariate Logistic regression showed that the risk of NSSI in students with sleep disorder was 1.80 times that in those without sleep disorder( OR 95%CI=1.42-2.28, P <0.01). The risk of NSSI in students with depressive symptoms was 3.32 times higher than that in those without depressive symptoms( OR 95%CI=2.60-4.24, P <0.01). The interaction results showed that there was additive interaction between sleep disturbance and depressive symptoms on the occurrence of NSSI behavior in rural middle school students, and the relative excess risk, attributable proportion and synergy index were 1.80, 0.30 and 1.57, respectively. Conclusion Sleep disorder and depressive symptoms are risk factors for NSSI among rural middle school students, and there is additive interaction between them.

Objective:To analyze the online learning behaviors and learning results of students under different teaching modes with different learning motivations, and to provide a reference for optimizing the development of online teaching.Methods:Samples of students taking the physiology small private online course (SPOC) in 2019 and 2020, and students taking the massive open online courses (MOOC) in the same year were selected in the study to discuss the differences in learning behaviors of students under different teaching modes and learning effects on students with different learning motivations. The online learning behaviors of students were analyzed based on their learning engagement, interactive behavior and learning motivation. SPSS 25.0 was used to analyze the data with statistical methods such as function calculation, frequency statistics, regression analysis, rank sum test, correlation test and chi-square test.Results:The learning participation level ( z=14.36, P<0.001), and the human-machine and interpersonal learning interaction level ( z=-11.70, -16.18, both P<0.001) of SPOC learners in 2020 were higher than those in 2019. The overall interactive level was moderately correlated with performances of students ( r=0.42, 0.52, both P<0.001), and the correlation between interpersonal behavior and grades was much more stronger ( r=0.60, 0.55, both P<0.001). The performance composition of SPOC and MOOC learners in 2019 was completely different ( χ2=857.45, P<0.001). The learning effect of externally motivated students was significantly better than that of internally motivated students ( z=-28.42, P<0.001). Conclusion:The teaching mode adopted by the school can affect the learning effect by influencing the students' online learning engagement and interactive behavior. Besides, students' own learning motivation also plays a key role in their academic performance.

Objective:To study the characteristics of breath sound spectroscopy in chronic obstructive pulmonary disease(COPD) patients with different lung function grades, to preliminarily determine the characteristic parameters and indicators of breath sound spectrograms with different lung function grades of COPD, and to explore the visualization and measurability of the differences in respiratory auscultation in patients with different lung function grades.Methods:Patients diagnosed and treated in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Chongming Branch from October 2018 to December 2020 were selected. Fifty-two patients with COPD (22 patients with moderate to moderate obstructive ventilation dysfunction (mild to moderate group), 30 patients with severe obstructive ventilation dysfunction (severe group)) and 36 normal controls (control group) were selected. The respiratory sounds were sampled with an electronic stethoscope and transmitted to the audit audio software to calculate the relevant data of respiratory sound pressure level (SPL) and the ratio to minute ventilation (VE) of samples with different lung function grades. A retrospective case-control study was used. The data with normal distribution were analyzed by one-way ANOVA, and the pairwise comparison was performed by SNK- q test. Results:The breathing audio frequency of mild-moderate, severe COPD patients and the control group has a sound pressure difference of (-0.5±2.2) dB and (-1.6±6.1) dB, (0.7±4.0) dB, and there was significant difference between each group ( F=2.64, P=0.038). The sound pressure level per minute ventilation (SPL 50-200/VE) of respiratory sound inspiratory phase in COPD patients with mild to moderate and severe obstructive ventilation dysfunction and the control group were (5.7±1.8) dB/L, (6.1±2.3) dB/L and (5.4±0.9) dB/L, respectively. The expiratory SPL 50-200/VE were (5.8±1.7), (6.3±2.2) and (5.3±1.2) respectively. There was significant difference among the three groups ( Finhalation=3.26, P=0.048; Frespiration=2.44, P=0.045). ROC curve results showed that SPL 50-200/VE in the inspiratory phase, SPL 50-200/VE in the expiratory phase, and sound pressure difference to assess different grades of obstructive ventilatory dysfunction had diagnostic value (AUC values were 0.697, 0.725 and 0.686, respectively; and P values were 0.015, 0.005 and 0.022, respectively). In some patients with COPD, abnormally high energy levels may appear in the time-frequency diagram of breath sounds. Conclusion:There are significant differences in respiratory audio spectrum analysis between patients with different degrees of obstructive ventilation dysfunction and those with normal ventilation function, which can provide a basis for auxiliary judgment of obstructive ventilation dysfunction.

Objective: To investigate the effects of terlipressin (TP) on blood pressure and survival in septic mice following trauma and its mechanism. Methods: ① Survival experiment: 120 male C57BL/6 mice aged 6-8 weeks were enrolled, the posttraumatic sepsis mice model was reproduced by traumatic hemorrhage (bilateral femoral fracture + 45% of total blood loss) followed by cecal ligation and puncture (CLP) after 8 hours. Intraperitoneal injection of TP was used for intervention. Sixty model mice were used to observe the effect of 0.05 μg/g TP at different intervention times (the drug was given immediately after traumatic hemorrhage + the administration was repeated after 6 hours, the drug was given immediately after traumatic hemorrhage + the administration was repeated every 6 hours until the end of the experiment, the drug was given at 4 hours after CLP + the administration was repeated every 6 hours until the end of the experiment) on 48-hour cumulative survival rate of mice with posttraumatic sepsis for finding the best intervention time of TP. The other 60 model mice were used to observe the effect of different TP intervention doses (0.01, 0.05, 0.25 μg/g) at the best intervention time on the 48-hour cumulative survival rate of mice with posttraumatic sepsis for finding the best intervention dose of TP. ② Intervention experiment: the other 45 mice were enrolled, and they were randomly divided into traumatic hemorrhage + sham group (TH+sham group, only laparotomy without CLP), TH+CLP group, and TH+CLP+TP group (the best intervention time and dose of TP shown by survival experiment were used), with 15 mice in each group. Mean arterial pressure (MAP) of mice was monitored continuously. The orbital whole blood was collected at 2 hours after successful reproduction of the model, and the lung tissues were harvested at 12 hours and 24 hours, respectively. The pathological changes in lung tissue were observed with light microscope. The contents of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in serum and lung tissue were determined by enzyme linked immunosorbent assay (ELISA). The expressions of IL-1β and TNF-α mRNA in lung tissue were determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-qPCR). The expressions of nuclear factor-κB p65 (NF-κB p65) in the nucleus and cytoplasm of lung tissue were determined by Western Blot. Results: ① Survival experiment results showed that the 48-hour cumulative survival rate of mice was highest with TP intervention by 0.05 μg/g administration immediately after traumatic hemorrhage and repeated every 6 hours, which was the best intervention method of TP. ② Intervention experiment results showed that the pulmonary alveolar wall fracture accompanied by inflammatory cell infiltration was found at 12 hours after the successful reproduction of traumatic sepsis model, and the pathological damage was gradually increased with time prolongation. MAP was decreased sharply after traumatic hemorrhage, and it was continued to decrease after two-hit of CLP. The contents of IL-1β and TNF-α in serum and lung tissue, the expressions of IL-1β and TNF-α mRNA in lung tissue, and expressions of NF-κB p65 protein in cytoplasm and nucleus of TH+CLP group were significantly higher than those in TH+sham group. Compared with TH+CLP group, the pathological changes in lung tissue were improved significantly, and the MAP was decreased gently after TP intervention, the levels of inflammatory mediators in serum were significantly decreased [IL-1β (pg/L): 164.32±25.25 vs. 233.11±23.02, TNF-α (pg/L): 155.56±31.47 vs. 596.38±91.50, both P < 0.05], and their expressions in lung tissue [IL-1β content (ng/mg): 262.68±16.56 vs. 408.15±17.85, IL-1β mRNA (2^-ΔΔCt): 2.63±0.68 vs. 6.22±0.74; TNF-α content (ng/mg): 311.07±17.35 vs. 405.04±24.83, TNF-α mRNA (2^-ΔΔCt): 2.04±0.62 vs. 5.32±0.55, all P < 0.01], and NF-κB p65 protein expressions were significantly down-regulated (gray value: 0.47±0.01 vs. 1.28±0.05 in cytoplasm, 0.45±0.02 vs. 1.95±0.06 in nucleus, both P < 0.01]. Conclusions The continuous intervention with TP 0.05 μg/g administration immediately after traumatic hemorrhage and repeated every 6 hours could improve the MAP of mice with traumatic sepsis, and improve the prognosis. The mechanism may be related to alleviating the inflammatory response and inhibiting the activation of the NF-κB signaling pathway in the lung tissue.

Objective: To explore the network structure characteristics and core items of rural middle school students suffering from campus bullying and anxiety symptoms, so as to provide a reference basis for the precise prevention and intervention of the comorbidity of campus bullying and anxiety symptoms. Methods: From September 2021 to March 2022, a multi stage random cluster sampling method was used to select 1 920 rural middle school students from Xuzhou. The Chinese version of the Olweus Bully/Victim Questionnaire was used to investigate the situation of campus bullying, and the Chinese version of the Generalized Anxiety Disorder (GAD-7) was used to assess anxiety symptoms. The network analysis method was used to construct the network between suffering from campus bullying and anxiety symptoms of rural middle school students to evaluate the centrality, bridge strength, stability and accuracy of each item. Results: The total score of suffering from campus bullying symptoms of rural middle school students was (10.42±3.26) points, and the total score of anxiety symptoms was (11.47±4.93) points. The symptom with the highest strength and expected influence was "unable to stop or control one s worry emotions", and the node strength and expected influence value was 1.041 7. The nodes "feel nervous, anxious or irritable" and "unable to stop or control one s worry emotions" were most closely related. The symptoms with the highest bridge strength were "others give me ugly nicknames to scold me or make fun of and satirize me" and "unable to stop or control one s worry emotions". Conclusions Rural middle school students suffering from campus bullying is related to anxiety symptoms. Accurate intervention according to the intervention targets may minimize the negative impact of suffering from campus bullying and anxiety symptoms on rural middle school students.

OBJECTIVE: To investigate the effects of terlipressin (TP) on blood pressure and survival in septic mice following trauma and its mechanism. METHODS: (1) Survival experiment: 120 male C57BL/6 mice aged 6-8 weeks were enrolled, the posttraumatic sepsis mice model was reproduced by traumatic hemorrhage (bilateral femoral fracture + 45% of total blood loss) followed by cecal ligation and puncture (CLP) after 8 hours. Intraperitoneal injection of TP was used for intervention. Sixty model mice were used to observe the effect of 0.05 μg/g TP at different intervention times (the drug was given immediately after traumatic hemorrhage + the administration was repeated after 6 hours, the drug was given immediately after traumatic hemorrhage + the administration was repeated every 6 hours until the end of the experiment, the drug was given at 4 hours after CLP + the administration was repeated every 6 hours until the end of the experiment) on 48-hour cumulative survival rate of mice with posttraumatic sepsis for finding the best intervention time of TP. The other 60 model mice were used to observe the effect of different TP intervention doses (0.01, 0.05, 0.25 μg/g) at the best intervention time on the 48-hour cumulative survival rate of mice with posttraumatic sepsis for finding the best intervention dose of TP. (2) Intervention experiment: the other 45 mice were enrolled, and they were randomly divided into traumatic hemorrhage + sham group (TH+sham group, only laparotomy without CLP), TH+CLP group, and TH+CLP+TP group (the best intervention time and dose of TP shown by survival experiment were used), with 15 mice in each group. Mean arterial pressure (MAP) of mice was monitored continuously. The orbital whole blood was collected at 2 hours after successful reproduction of the model, and the lung tissues were harvested at 12 hours and 24 hours, respectively. The pathological changes in lung tissue were observed with light microscope. The contents of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in serum and lung tissue were determined by enzyme linked immunosorbent assay (ELISA). The expressions of IL-1β and TNF-α mRNA in lung tissue were determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-qPCR). The expressions of nuclear factor-κB p65 (NF-κB p65) in the nucleus and cytoplasm of lung tissue were determined by Western Blot. RESULTS: (1) Survival experiment results showed that the 48-hour cumulative survival rate of mice was highest with TP intervention by 0.05 μg/g administration immediately after traumatic hemorrhage and repeated every 6 hours, which was the best intervention method of TP. (2) Intervention experiment results showed that the pulmonary alveolar wall fracture accompanied by inflammatory cell infiltration was found at 12 hours after the successful reproduction of traumatic sepsis model, and the pathological damage was gradually increased with time prolongation. MAP was decreased sharply after traumatic hemorrhage, and it was continued to decrease after two-hit of CLP. The contents of IL-1β and TNF-α in serum and lung tissue, the expressions of IL-1β and TNF-α mRNA in lung tissue, and expressions of NF-κB p65 protein in cytoplasm and nucleus of TH+CLP group were significantly higher than those in TH+sham group. Compared with TH+CLP group, the pathological changes in lung tissue were improved significantly, and the MAP was decreased gently after TP intervention, the levels of inflammatory mediators in serum were significantly decreased [IL-1β (pg/L): 164.32±25.25 vs. 233.11±23.02, TNF-α (pg/L): 155.56±31.47 vs. 596.38±91.50, both P < 0.05], and their expressions in lung tissue [IL-1β content (ng/mg): 262.68±16.56 vs. 408.15±17.85, IL-1β mRNA (2^{-Δ ΔCt}): 2.63±0.68 vs. 6.22±0.74; TNF-α content (ng/mg): 311.07±17.35 vs. 405.04±24.83, TNF-α mRNA (2^{-Δ ΔCt}): 2.04±0.62 vs. 5.32±0.55, all P < 0.01], and NF-κB p65 protein expressions were significantly down-regulated (gray value: 0.47±0.01 vs. 1.28±0.05 in cytoplasm, 0.45±0.02 vs. 1.95±0.06 in nucleus, both P < 0.01]. CONCLUSIONS The continuous intervention with TP 0.05 μg/g administration immediately after traumatic hemorrhage and repeated every 6 hours could improve the MAP of mice with traumatic sepsis, and improve the prognosis. The mechanism may be related to alleviating the inflammatory response and inhibiting the activation of the NF-κB signaling pathway in the lung tissue.
Animals ; Blood Pressure ; Interleukin-1beta ; Lypressin/analogs & derivatives* ; Male ; Mice ; Mice, Inbred C57BL ; Sepsis ; Terlipressin ; Tumor Necrosis Factor-alpha

Intrahepatic cholangiocarcinoma （ICC） is a special type of liver cancer with atypical clinical symptoms in the early stage， and most patients are already in the advanced stage at the time of initial diagnosis. Due to a lack of effective molecular markers and treatment options， ICC patients tend to have an extremely low five-year survival rate. Exosomes are vesicles secreted by cells that contain proteins， RNA， and lipids， and they are important carriers of intercellular communication. Recent studies have shown that exosomes play a crucial role in the development and progression of ICC， and this article reviews the role and mechanism of exosomes in the diagnosis and treatment of ICC and looks into the future treatment prospect and potential clinical application of exosomes.