Objective: To explore the association between executive function and emotional and behavioral problems in first-grade elementary school students, so as to provide a reference for promoting children s mental health. Methods: From March to May 2024, 423 first-grade elementary school students from 6 primary schools aged 6-7 were selected by using stratified cluster random sampling in Shanxi, Shanghai, Shandong, Guangxi, Xinjiang, and Jiangxi. Data were collected by using the Executive Function Assessment Scale and the Strengths and Difficulties Questionnaire. An independent samples t-test was used to analyze differences in executive function of different genders and differences in emotional and behavioral problems among first-grade school students with varying executive function levels; a linear regression model was employed to analyze the association between children s executive function and emotional and behavioral problems. Results: A total of 42 first-grade elementary school students (9.9%) were identified as having executive function deficits. Students in the executive function deficit group scored higher on internalizing behavior (7.50±0.52), externalizing behavior (11.26±0.52), and total difficulties (18.52± 0.93 ) were significantly higher than those of children without deficits (4.37±0.14, 6.69±0.17, 10.64±0.27) ( t =5.79, 8.50, 9.23, all P <0.05). Results of linear regression analysis showed that, after controlling for relevant covariates such as gender, age, family economic status, being an only child, and body mass index, the factor scores, dimensional scores, and total scores of executive function were all positively correlated with scores for externalizing problems, internalizing problems, and total difficulties ( β =0.07-0.32, all P <0.05). Conclusions Children s executive function is closely associated with emotional and behavioral problems, and those with poorer executive function exhibit more pronounced emotional and behavioral problems. Improving children s executive function may help promote their mental health.

Kleine-Levin syndrome (KLS) is a rare, recurrent-remitting sleep disorder characterized by periodic hypersomnia, hyperphagia, and hypersexuality, accompanied by cognitive dysfunction, perceptual disturbances, mood changes, or psychiatric abnormalities. Patients typically experience recurrent episodes, with hypersomnic periods lasting from several days to weeks. Most KLS patients exhibit normal functions during the intermission period, while early-onset KLS cases in adolescents are rare, often presenting with frequent episodes and complex symptoms, which can easily lead to misdiagnosis. Therefore, this case report analyzed the detailed medical history, laboratory findings, differential diagnosis, and treatment of a teenage patient with KLS, along with a review of the literature. This case aims to provide a deeper understanding of the complex symptoms and diagnostic challenges associated with early-onset KLS in adolescents.

Kleine-Levin syndrome (KLS) is a rare, recurrent-remitting sleep disorder characterized by periodic hypersomnia, hyperphagia, and hypersexuality, accompanied by cognitive dysfunction, perceptual disturbances, mood changes, or psychiatric abnormalities. Patients typically experience recurrent episodes, with hypersomnic periods lasting from several days to weeks. Most KLS patients exhibit normal functions during the intermission period, while early-onset KLS cases in adolescents are rare, often presenting with frequent episodes and complex symptoms, which can easily lead to misdiagnosis. Therefore, this case report analyzed the detailed medical history, laboratory findings, differential diagnosis, and treatment of a teenage patient with KLS, along with a review of the literature. This case aims to provide a deeper understanding of the complex symptoms and diagnostic challenges associated with early-onset KLS in adolescents.

Objective:To explore the clinical efficacy and influence on quality of life of Compound Kunshen Injection combined with SOX regimen (Tigio + Oxaliplatin) in the treatment of elderly patients with advanced gastric cancer.Methods:A total of 76 elderly patients with advanced gastric cancer admitted to Caidian District People's Hospital of Wuhan from May 2017 to December 2021 were retrospectively analyzed. Patients were divided into study group ( n=38) and control group ( n=38) according to different treatment methods. The study group was treated with Compound Kunshen Injection combined with SOX regimen, and the control group was treated with SOX regimen. All patients received at least 2 cycles of chemotherapy. The disease control rate (DCR) , the changes of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) before and after treatment of the two groups were compared. The occurrence of adverse reactions to chemotherapy and the improvement of quality of life related indicators before and after treatment were observed in the two groups. Results:The DCR of the study group was 84.2% (32/38) and that of the control group was 63.2% (24/38) , with a statistically significant difference ( χ2=4.34, P=0.037) . After treatment, CEA levels in both study group and control group were decreased compared with those before treatment [7.92 (5.00, 50.23) ng/ml vs. 40.08 (6.37, 68.18) ng/ml, Z=3.53, P<0.001; 40.24 (20.12, 53.69) ng/ml vs. 41.32 (11.50, 63.90) ng/ml, Z=2.06, P=0.044], and CEA level in the study group was decreased more significantly than that in the control group ( Z=1.99, P=0.048) . After treatment, CA199 levels in both study group and control group were decreased compared with those before treatment [20.23 (17.34, 71.31) U/ml vs. 70.14 (12.75, 96.95) U/ml, Z=2.70, P=0.007; 54.25 (30.54, 76.75) U/ml vs. 62.28 (23.00, 84.80) U/ml, Z=2.37, P=0.018], with no statistically significant difference in the reduction level of CA199 between the two groups ( Z=0.73, P=0.463) . Most of the adverse reactions in the two groups during chemotherapy were grade 1-2, which disappeared after symptomatic treatment. Compared with the control group, the study group had lower incidence of gastrointestinal reaction [26.3% (10/38) vs. 52.6% (20/38) , χ2=5.50, P=0.019], myelosuppression [18.4% (7/38) vs. 44.7% (17/38) , χ2=6.09, P=0.014] and peripheral neurotoxicity [21.1% (8/38) vs. 44.7% (17/38) , χ2=4.83, P=0.028]. The improvements of QOL score [78.9% (30/38) vs. 55.3% (21/38) , χ2=4.83, P=0.028], Karnofsky performance status score [71.1% (27/38) vs. 47.4% (18/38) , χ2=4.41, P=0.036], hemoglobin [73.7% (28/38) vs. 50.0% (19/38) , χ2=4.52, P=0.034] and pain control [65.8% (25/38) vs. 24.1% (16/38) , χ2=4.29, P=0.038] of the study group were better than those of the control group, with statistically significant differences. Conclusion:Compound Kunshen Injection combined with SOX regimen in the treatment of elderly patients with advanced gastric cancer can not only improve the DCR of patients, but also reduce the serum levels of tumor markers CEA and CA199, among which the CEA decline is more obvious, reduce the incidence of adverse reactions of chemotherapy and improve the quality of life of patients.

Objective:To investigate the diagnosis, treatment and aeromedical assessment of military flying personnel with cerebral cavernous malformations (CCM).Methods:The clinical data and aeromedical assessment conclusions of military flying personnel with CCM in Air Force Medical Center from 2015 to 2021 were collected and analyzed based on reviewing the relevant aeromedical assessment cases and literatures at home and abroad.Results:A total of 10 flying personnel, all male, 20-41 years old, with an average age of 28.3 years, including 8 pilots, 2 air combat/technical personnel, with the flying hours of 110-4 000 h and the average flying hours of 1 102.0 h. The sizes of lesions were 3-12 mm, including 2 cases were smaller than 5 mm, 6 cases were 5-10 mm and 2 cases were bigger than 10 mm. All lesions were located under the cortex, including a case of occipital lobe, 4 cases of frontal lobe, 2 cases of temporal lobe and 3 cases of cerebellar hemisphere. Among the 10 flying personnel, only a case presented intracranial haemorrhage (right cerebellar hemisphere) as first symptom and was treated surgically. Three cases were temporarily grounded due to they were under the grounding observation. Other 7 flying personnel had been followed up for more than 6 months. Their reexaminations of MRI showed no change in lesions and EEG examination showed no abnormalities. Two air combat/technical personnel were qualified for flight and 1 helicopter pilot was limited to be a co-pilot, and 2 dual-seat fighter pilots were qualified (limited to dual-seat fighter) and flight-qualified respectively. Two fighter pilots were qualified for lower performance aircraft (limited to bomber, transporter or helicopter).Conclusions:For CCM military flying personnel, the aeromedical assessment conclusion should be made according to the symptoms, lesion location and size, inflight incapacitation possibility assessment, treatment effect, ground observation and follow-up results, as well as the aircraft type and occupation.

Objective:To investigate the diagnosis, treatment and aeromedical assessment of military flying personnel with cerebral cavernous malformations (CCM).Methods:The clinical data and aeromedical assessment conclusions of military flying personnel with CCM in Air Force Medical Center from 2015 to 2021 were collected and analyzed based on reviewing the relevant aeromedical assessment cases and literatures at home and abroad.Results:A total of 10 flying personnel, all male, 20-41 years old, with an average age of 28.3 years, including 8 pilots, 2 air combat/technical personnel, with the flying hours of 110-4 000 h and the average flying hours of 1 102.0 h. The sizes of lesions were 3-12 mm, including 2 cases were smaller than 5 mm, 6 cases were 5-10 mm and 2 cases were bigger than 10 mm. All lesions were located under the cortex, including a case of occipital lobe, 4 cases of frontal lobe, 2 cases of temporal lobe and 3 cases of cerebellar hemisphere. Among the 10 flying personnel, only a case presented intracranial haemorrhage (right cerebellar hemisphere) as first symptom and was treated surgically. Three cases were temporarily grounded due to they were under the grounding observation. Other 7 flying personnel had been followed up for more than 6 months. Their reexaminations of MRI showed no change in lesions and EEG examination showed no abnormalities. Two air combat/technical personnel were qualified for flight and 1 helicopter pilot was limited to be a co-pilot, and 2 dual-seat fighter pilots were qualified (limited to dual-seat fighter) and flight-qualified respectively. Two fighter pilots were qualified for lower performance aircraft (limited to bomber, transporter or helicopter).Conclusions:For CCM military flying personnel, the aeromedical assessment conclusion should be made according to the symptoms, lesion location and size, inflight incapacitation possibility assessment, treatment effect, ground observation and follow-up results, as well as the aircraft type and occupation.

In this study, voltage was used as a disturbance factor to investigate the relationship between microbial community and methane (CH₄) production flux in a microbial electrolytic cell coupled anaerobic digestion (MEC-AD). Metabolic flux analysis (MFA) was used to explore the relationship between the CH₄ metabolic flux produced and the microbes. The results showed that both methane production flux and hydrogen production flux changed significantly upon voltage disturbance, while the voltage disturbance had little effect on acetic acid production flux. The maximum CH₄ production flux under 0.6 V disturbance was 0.522±0.051, which increased by 77% and 32%, respectively, compared with that of the control group under 1.0 V (0.295±0.013) and under 1.4 V (0.395±0.029). In addition, an average of 15.7%±2.9% of H₂ (flux) was used to reduce CO₂ to produce CH₄ and acetic acid, and an average of 27.7%±6.9% of acetic acid (flux) was converted to CH₄. Moreover, the abundance of Lachnospiraceae significantly affected the flux of acetic acid. The flux of CH₄ production is positively correlated with the abundances of Petrimonas, Syntrophomonas, Blvii28, and Acinetobacter, and negatively correlated with the abundances of Tuzzerella and Sphaerochaeta. The species that affected the flux of H₂ and CH₄ were similar, mostly belonging to Bacteroides, Clostridium, Pseudomonas and Firmicutes. Furthermore, the interspecies interaction is also an important factor affecting the MEC-AD methanogenesis flux.
Acetates ; Anaerobiosis ; Bioreactors ; Electrolysis ; Methane

OBJECTIVE: To investigate the clinical outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH) after surgeries in Yunnan Province. METHODS: We retrospectively analyzed the demographic features, vascular risk factors, severity at admission, and aneurysm locations in 85 patients with aSAH receiving surgical interventions in Yunnan Province. All the patients were treated by aneurysm clipping or coiling and followed up for clinical outcomes and recovery of daily activities evaluated by modified Rankin Scale (mRS) and Activities of Daily Living (ADL) scale, respectively. RESULTS: Thirty-four of the patients (40.0%) underwent aneurysm clipping and 51 (60.0%) underwent aneurysm coiling. During a median follow- up period of 66.23 months (IOR, 12.03 months), 84.7% of the patients had low mRS scores, and 78.8% lived independently. The WFNS grade at admission was significantly correlated with the follow-up mRS scores (95%: 1.48-19.09, =0.011) and ADL (95%: 2.55-28.77, < 0.001). Multivariate analysis showed that age (95%: 1.02-1.23, =0.017; 95%: 1.00-1.15, =0.038) and a high WFNS grade at admission (95%: 2.19-141.48, =0.007; 95%: 2.84-82.61, =0.002) were independent predictors of both mRS and ADL scores at follow-up. There was no significant difference in clinical outcomes or the length of hospital stay between the two treatment strategies ( > 0.05), but the cost of hospitalization was significantly higher in coiling group than in the clipping group ( < 0.001). CONCLUSIONS Both aging and a high WFNS grade at admission are associated with a poor prognosis of aSAH, for which aneurysm clipping and coiling have similar long- term outcomes, but for patients with a high WFNS score, aneurysm clipping is favored over coiling in terms of health economics.

Objective:To explore feasible aeromedical evaluation methods and principles of obstructive sleep apnea (OSA) for Air Force by analyzing the diagnosis, treatment and assessment of cases of the military flying personnel at home and abroad.Literature resource and selection:Based on the journal papers and scientific reports published at home and abroad, we analyzed the evaluation methods and management of sleep disorders in United States Air Force (USAF) and the current situation of Chinese military flying personnel.Literature quotation:Forty-four related literatures, including 37 published articles, 2 medical standards, 3 monographs, 1 scientific report, 1 electric announcement, were cited.Literature synthesis:OSA related flight safety risk that induced by daytime sleepiness, cognitive impairment and emotional abnormalities is the importance of Aviation medicine concern. USAF’s diagnosis of OSA follows the criteria recommended by the American Academy of Sleep Medicine and is carried out by accredited professional sleep lab. Its treatment is conducted in conjunction with military deployment. The well-treated aircrew could be waivered but the special assessment and close follow-up of the treatment compliance are required. There are corresponding requirements in the medical selection of high-performance fighter pilots and armed helicopter pilots in China, but no provisions in physical standards for flying personnel. Inconsistencies exist among clinical diagnosis, treatment and medical assessment.Conclusions:It is necessary to formulate relevant physical examination standards of OSA for military flying personnel, improve the awareness of support departments at all levels, supplement OSA screening in regular physical examination, and assign accredited sleep health centers to undertake the diagnosis, treatment and medical assessment of OSA. Waiver could be considered to the flying personnel with good treatment compliance.

Objective:To explore feasible aeromedical evaluation methods and principles of obstructive sleep apnea (OSA) for Air Force by analyzing the diagnosis, treatment and assessment of cases of the military flying personnel at home and abroad.Literature resource and selection:Based on the journal papers and scientific reports published at home and abroad, we analyzed the evaluation methods and management of sleep disorders in United States Air Force (USAF) and the current situation of Chinese military flying personnel.Literature quotation:Forty-four related literatures, including 37 published articles, 2 medical standards, 3 monographs, 1 scientific report, 1 electric announcement, were cited.Literature synthesis:OSA related flight safety risk that induced by daytime sleepiness, cognitive impairment and emotional abnormalities is the importance of Aviation medicine concern. USAF’s diagnosis of OSA follows the criteria recommended by the American Academy of Sleep Medicine and is carried out by accredited professional sleep lab. Its treatment is conducted in conjunction with military deployment. The well-treated aircrew could be waivered but the special assessment and close follow-up of the treatment compliance are required. There are corresponding requirements in the medical selection of high-performance fighter pilots and armed helicopter pilots in China, but no provisions in physical standards for flying personnel. Inconsistencies exist among clinical diagnosis, treatment and medical assessment.Conclusions:It is necessary to formulate relevant physical examination standards of OSA for military flying personnel, improve the awareness of support departments at all levels, supplement OSA screening in regular physical examination, and assign accredited sleep health centers to undertake the diagnosis, treatment and medical assessment of OSA. Waiver could be considered to the flying personnel with good treatment compliance.