ObjectiveTo understand the seropositivity of neutralizing antibodies (NAb) and low-level NAb against SARS-CoV-2 infection in the community residents, and to explore the impact of COVID-19 vaccination and SARS-CoV-2 infection on the levels of NAb in human serum. MethodsOn the ground of surveillance cohort for acute infectious diseases in community populations in Shanghai, a proportional stratified sampling method was used to enroll the subjects at a 20% proportion for each age group (0‒14, 15‒24, 25‒59, and ≥60 years old). Blood samples collection and serum SARS-CoV-2 NAb concentration testing were conducted from March to April 2023. Low-level NAb were defined as below the 25^th percentile of NAb. ResultsA total of 2 230 participants were included, the positive rate of NAb was 97.58%, and the proportion of low-level NAb was 25.02% (558/2 230). Multivariate logistic regression analysis indicated that age, infection history and vaccination status were correlated with low-level NAb (all P<0.05). Individuals aged 60 years and above had the highest risk of low-level NAb. There was a statistically significant interaction between booster vaccination and one single infection (aOR=0.38, 95%CI: 0.19‒0.77). Compared to individuals without vaccination, among individuals infected with SARS-CoV-2 once, both primary immunization (aOR=0.23, 95%CI: 0.16‒0.35) and booster immunization (aOR=0.12, 95%CI: 0.08‒0.17) significantly reduced the risk of low-level NAb; among individuals without infections, only booster immunization (aOR=0.28, 95%CI: 0.14‒0.52) showed a negative correlation with the risk of low-level NAb. ConclusionsThe population aged 60 and above had the highest risk of low-level NAb. Regardless of infection history, a booster immunization could reduce the risk of low-level NAb. It is recommended that eligible individuals , especially the elderly, should get vaccinated in a timely manner to exert the protective role of NAb.

Background::Coronavirus disease 2019 (COVID-19) has potential risks for both clinically worsening pulmonary hypertension (PH) and increasing mortality. However, the data regarding the protective role of vaccination in this population are still lacking. This study aimed to assess the safety of approved vaccination for patients with PH.Methods::In this national prospective cohort study, patients diagnosed with PH (World Health Organization [WHO] groups 1 and 4) were enrolled from October 2021 to April 2022. The primary outcome was the composite of PH-related major adverse events. We used an inverse probability weighting (IPW) approach to control for possible confounding factors in the baseline characteristics of patients.Results::In total, 706 patients with PH participated in this study (mean age, 40.3 years; mean duration after diagnosis of PH, 8.2 years). All patients received standardized treatment for PH in accordance with guidelines for the diagnosis and treatment of PH in China. Among them, 278 patients did not receive vaccination, whereas 428 patients completed the vaccination series. None of the participants were infected with COVID-19 during our study period. Overall, 398 patients received inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine, whereas 30 received recombinant protein subunit vaccine. After adjusting for baseline covariates using the IPW approach, the odds of any adverse events due to PH in the vaccinated group did not statistically significantly increase (27/428 [6.3%] vs. 24/278 [8.6%], odds ratio = 0.72, P = 0.302). Approximately half of the vaccinated patients reported at least one post-vaccination side effects, most of which were mild, including pain at the injection site (159/428, 37.1%), fever (11/428, 2.6%), and fatigue (26/428, 6.1%). Conclusions::COVID-19 vaccination did not significantly augment the PH-related major adverse events for patients with WHO groups 1 and 4 PH, although there were some tolerable side effects. A large-scale randomized controlled trial is warranted to confirm this finding. The final approval of the COVID-19 vaccination for patients with PH as a public health strategy is promising.

Objective:To systematically retrieve, analyze and evaluate risk prediction models of postoperative urinary retention, so as to provide a basis for the application and optimization of the model.Methods:The research on the risk prediction model of postoperative urinary retention was electronically retrieved in PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP, China Biology Medicine disc and other databases. The language of the literature was Chinese or English. The search period was from database establishment to February 20, 2023. Two researchers independently conducted literature screening and data extraction, and independently evaluated the bias risk and applicability of the included literature using the Prediction Model Risk of Bias Assessment Tool.Results:A total of 10 articles were included, including 17 risk prediction models for postoperative urinary retention. The areas under the receiver operating characteristic curve of 17 models were 0.700 to 0.920. The five most common predictors included in the model were age, gender, postoperative analgesia, diabetes, and operation time. The applicability of the model was good among the 10 studies, but there was some bias, mainly due to insufficient sample size, neglect of missing data and processing methods, overfitting issues, conversion of continuous variables into binary variables, and use of single factor screening for predictive factors.Conclusions:The risk prediction model of postoperative urinary retention has good prediction performance, but there is a certain risk of bias. The clinical value of the model needs further verification. External validation and continuous optimization are required for existing prediction models. Prospective research should also be carried out to develop a universal prediction model with good prediction performance, so as to provide an accurate and practical tool for clinical evaluation of postoperative urinary retention.

Objective To summarize changes in antibiotic resistance of Salmonella typhimurium enteritis in children in our hospital and analyze its treatment.Methods A total of 186 children with Salmonella typhimurium enteritis in the pediatrics department of our hospital were selected.The drug resistance of common antibiotics against Salmonella typhimurium for children was analyzed,and the annual and pre-/post-treatment changes of multi-drug resistant bacteria were also analyzed.Based on the initial treatment of antibiotics and the first drug sensitivity test results,patients were divided into the initial sensitive group(121 cases)and the initial insensitive group(65 cases).The hospital stay and fecal culture negative conversion time were compared between the two groups of children.Results Among the Salmonella typhimurium isolated from 186 children,the resistance rate of Salmonella typhimurium to commonly used cephalosporin antibiotics in pediatrics demonstrated an overall upward tendency.Among them,the resistance rates of ceftriaxone(43.6%)and cefotaxime(35.5%)were relatively high.From 2017 to 2019,the proportion of multi-drug resistant bacteria presented a gradual upward trend,while from 2020 to 2023,the proportion declined.The incidence of multi-drug resistant bacteria exhibited an increasing trend after treatment(P＜0.05).After 1 week of treatment,there were no significant differences in the above three types of drug resistance changes.The hospital stay and the time for fecal culture to turn negative were both shorter in the initial sensitive group than those in the initial insensitive group(P＜0.05).Conclusion The problem of bacterial resistance in Salmonella typhimurium enteritis in children is severe.Initial empirical treatment with sensitive antibiotics and a reasonable course of anti-infective treatment can help reduce the bacterial drug resistance rate and shorten the hospital stay.

Objective To optimize the extraction process of naphthoquinone from Walnut green husk with ethanol volume fraction,solid-liquid ratio and extraction temperature as the influencing factors on the basis of a single factor test,and study the in vitro antioxidant activity of the extract.Methods The alcohol extraction method was used to extract naphthoquinone from Walnut green husk,and extraction process was optimized by Box-Behnken design-response surface methodology and back propagation neural network simulation.The scavenging capacity of naphthoquinone from Walnut green husk on hydroxyl radical(HO·),superoxide anion radical(O2·)and 1,1-diphenyl-2-trinitrophenylhydrazine radical(DPPH·)were determined.Results The optimal extraction condition was as follows:ethanol volume fraction of 40％,solid-liquid ratio of 1∶30(g/mL),extraction temperature of 70 ℃,extraction time of 2 h,and the extraction amount of naphthoquinone obtained was(20.182±1.851)mg/g.The scavenging rates of 0.1 g/L naphthoquinone extract on HO·,O2-·and DPPH were 16.09％,67.28％and 73.00％,respectively.Conclusion The extraction process of naphthoquinone from Walnut green husk is stable and feasible.The naphthoquinone extract from Walnut green husk exhibits good antioxidant activity.

Acute myocarditis(AM)may rapidly progress to fulminant myocarditis(FM),but lacks special clinical presentation.Multimodal echocardiography combined conventional transthoracic echocardiography,two-dimensional and three-dimensional speckle tracking imaging,myocardial contrast echocardiography and so on is helpful to detecting AM in early stage and assessing the severity,being of great value for clinical decision-making and prognostic evaluation.The research progresses of multimodal echocardiography in AM were reviewed in this article.

Objective To observe the effects of gastrodin combined with multisensory stimulation on the neurological function and serum levels of CXC chemokine ligand 16 (CXCL16) and vascular endothelial growth factor (VEGF) in patients with post-stroke cognitive impairment. Methods A total of 130 patients with post-stroke cognitive impairment admitted from June 2019 to June 2022 were selected as study subjects and divided into monotherapy group and combination therapy group, with 65 patients in each group. The monotherapy group received gastrodin treatment, while the combination therapy group received both gastrodin and multisensory stimulation therapy. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate neurological function, the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA) scores were used to assess cognitive function, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of CXCL16 and VEGF. The total effective rate of treatment and the occurrence of adverse reactions were compared between the two groups. Results After treatment, both the monotherapy and combination therapy groups showed lower NIHSS scores than before treatment, with the combination therapy group showing lower NIHSS scores than the monotherapy group (P < 0.05). After treatment, both groups had higher MMSE and MOCA scores than before treatment, with the combination therapy group revealing higher scores than the monotherapy group (P < 0.05). Additionally, serum CXCL16 levels were lower and VEGF levels were higher in both groups after treatment compared to treatment before, with the combination therapy group showing lower CXCL16 levels and higher VEGF levels than the monotherapy group (P < 0.05). The total effective rate of treatment was higher in the combination therapy group than in the monotherapy group (P < 0.05). Conclusion Gastrodin combined with multisensory stimulation can reduce serum CXCL16 levels and increase serum VEGF levels in patients, thereby improving neurological function in patients with post-stroke cognitive impairment.

Purpose: This study aimed to identify the risk factors and sonographic variables that could be integrated into a predictive model for endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) in women with abnormal uterine bleeding (AUB). Materials and Methods: This retrospective study included 1837 patients who presented with AUB and underwent endometrial sampling. Multivariable logistic regression was developed based on clinical and sonographic covariates [endometrial thickness (ET), resistance index (RI) of the endometrial vasculature] assessed for their association with EC/AEH in the development group (n=1369), and a predictive nomogram was proposed. The model was validated in 468 patients. Results: Histological examination revealed 167 patients (12.2%) with EC or AEH in the development group. Using multivariable logistic regression, the following variables were incorporated in the prediction of endometrial malignancy: metabolic diseases [odds ratio (OR)=7.764, 95% confidence intervals (CI) 5.042–11.955], family history (OR=3.555, 95% CI 1.055–11.971), age ≥40 years (OR=3.195, 95% CI 1.878–5.435), RI ≤0.5 (OR=8.733, 95% CI 4.311–17.692), and ET ≥10 mm (OR=8.479, 95% CI 5.440–13.216). :A nomogram was created using these five variables with an area under the curve of 0.837 (95% CI 0.800–0.874). The calibration curve showed good agreement between the observed and predicted occurrences. For the validation group, the model provided acceptable discrimination and calibration. Conclusion The proposed nomogram model showed moderate prediction accuracy in the differentiation between benign and malignant endometrial lesions among women with AUB.

Most information used to evaluate diabetic statuses is collected at a special time-point, such as taking fasting plasma glucose test and providing a limited view of individual's health and disease risk. As a new parameter for continuously evaluating personal clinical statuses, the newly developed technique "continuous glucose monitoring" (CGM) can characterize glucose dynamics. By calculating the complexity of glucose time series index (CGI) with refined composite multi-scale entropy analysis of the CGM data, the study showed for the first time that the complexity of glucose time series in subjects decreased gradually from normal glucose tolerance to impaired glucose regulation and then to type 2 diabetes (P for trend < 0.01). Furthermore, CGI was significantly associated with various parameters such as insulin sensitivity/secretion (all P < 0.01), and multiple linear stepwise regression showed that the disposition index, which reflects β-cell function after adjusting for insulin sensitivity, was the only independent factor correlated with CGI (P < 0.01). Our findings indicate that the CGI derived from the CGM data may serve as a novel marker to evaluate glucose homeostasis.
Humans ; Glucose ; Blood Glucose ; Insulin Resistance/physiology* ; Diabetes Mellitus, Type 2/diagnosis* ; Blood Glucose Self-Monitoring ; Time Factors ; Insulin

Tuina (Chinese massage) is an important part of Traditional Chinese Medicine. It is a simple and inexpensive technique, and has shown effectiveness for muscle and bone diseases, visceral diseases, gynecological diseases, and common diseases in children. This paper aims to analyze the factors influencing the effects of Tuina. The factors included the aspects of diagnosis, treatment, prognosis, patient factors and doctor-patient communication. During the treatment of Tuina, doctors should carry out good doctor-patient communication, properly evaluate and exam patients, and clarify diagnosis, take appropriate Tuina techniques according to the patients' constitution, health condition, and comorbidity. Only in such way, could Tuina achieve effectiveness and safety.