Objective: Patients with severe symptomatic aortic stenosis are assessed for coronary artery disease (CAD) prior to transcatheter aortic valve implantation (TAVI) with treatment implications. Invasive coronary angiography (ICA) is the recommended modality but is associated with peri-procedural complications. Integrating machine learning (ML)-based computed tomography-derived fractional flow reserve (CT-FFR) into existing TAVI-planning CT protocol may aid exclusion of significant CAD and thus avoiding ICA in selected patients. Materials and Methods: A single-center, retrospective study was conducted, 41 TAVI candidates with both TAVI-planning CT and ICA performed were analyzed. CT datasets were evaluated by a ML-based CT-FFR software. Beta-blocker and nitroglycerin were not administered in these patients. The primary outcome was to identify significant CAD. The diagnostic performance of CT-FFR was compared against ICA. Results: On per-patient level, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were 89%, 94%, 80%, 97% and 93%, respectively. On per-vessel level, the sensitivity, specificity, PPV, NPV and diagnostic accuracy were 75%, 94%, 67%, 96% and 92%, respectively. The area under the receiver operative characteristics curve per individual coronary vessels yielded overall 0.90 (95% confidence interval 85%–95%). ICA may be avoided in up to 80% of patients if CT-FFR results were negative. Conclusion ML-based CT-FFR can provide accurate screening capabilities for significant CAD thus avoiding ICA. Its integration to existing TAVI-planning CT is feasible with the potential of improving the safety and efficiency of pre-TAVI CAD assessment.

BACKGROUND: The effect of air pollution on annual change rates in grip strength and body composition in the elderly is unknown. OBJECTIVES: This study evaluated the effects of long-term exposure to ambient air pollution on change rates of grip strength and body composition in the elderly. METHODS: In the period 2016-2020, grip strength and body composition were assessed and measured 1-2 times per year in 395 elderly participants living in the Taipei basin. Exposure to ambient fine particulate matters (PM_2.5), nitric dioxide (NO₂), and ozone (O₃) from 2015 to 2019 was estimated using a hybrid Kriging/Land-use regression model. In addition, long-term exposure to carbon monoxide (CO) was estimated using an ordinary Kriging approach. Associations between air pollution exposures and annual changes in health outcomes were analyzed using linear mixed-effects models. RESULTS: An inter-quartile range (4.1 µg/m³) increase in long-term exposure to PM_2.5 was associated with a faster decline rate in grip strength (-0.16 kg per year) and skeletal muscle mass (-0.14 kg per year), but an increase in body fat mass (0.21 kg per year). The effect of PM_2.5 remained robust after adjustment for NO₂, O₃ and CO exposure. In subgroup analysis, the PM_2.5-related decline rate in grip strength was greater in participants with older age (>70 years) or higher protein intake, whereas in skeletal muscle mass, the decline rate was more pronounced in participants having a lower frequency of moderate or strenuous exercise. The PM_2.5-related increase rate in body fat mass was higher in participants having a lower frequency of strenuous exercise or soybean intake. CONCLUSIONS Among the elderly, long-term exposure to ambient PM_2.5 is associated with a faster decline in grip strength and skeletal muscle mass, and an increase in body fat mass. Susceptibility to PM_2.5 may be influenced by age, physical activity, and dietary protein intake; however, these modifying effects vary across different health outcomes, and further research is needed to clarify their mechanisms and consistency.
Humans ; Hand Strength ; Aged ; Male ; Female ; Environmental Exposure/adverse effects* ; Follow-Up Studies ; Taiwan ; Air Pollution/adverse effects* ; Particulate Matter/adverse effects* ; Muscle, Skeletal/drug effects* ; Air Pollutants/adverse effects* ; Ozone/adverse effects* ; Aged, 80 and over ; Adipose Tissue/drug effects* ; Body Composition/drug effects* ; Nitrogen Dioxide/adverse effects*

Fusarium head blight (FHB), caused by Fusarium graminearum, not only leads to severe yield losses but also poses a threat to food safety due to the mycotoxins produced by the pathogen. Since this disease is preventable but not curable, the current control mainly relies on chemical fungicides, the long-term use of which may lead to pathogen resistance and environmental pollution. To develop green control methods, we screened 13 biocontrol strains from the rhizosphere soil of wheat, among which strain No. 12 (identified as Pythium aphanidermatum) showed significant antifungal effects. In the plate confrontation test, this strain reduced the colony diameter of the pathogen by 69.2% (1.47 mm vs. 4.78 mm in the control group), with an inhibition rate of 77% (P < 0.01). Microscopic observation revealed obvious deformations in the pathogen hyphae, suggesting a lysing effect. The coleoptile experiment further confirmed that the pre-treatment with this strain reduced the incidence rate to 0. These findings provide new candidate strains for the biocontrol of FHB and offer a scientific basis for reducing the use of chemical fungicides and promoting sustainable agricultural development.
Triticum/growth & development* ; Fusarium/growth & development* ; Plant Diseases/prevention & control* ; Soil Microbiology ; Pest Control, Biological/methods* ; Pythium/physiology* ; Biological Control Agents ; Rhizosphere ; Fungicides, Industrial

Objective:To investigate the acute gastrointestinal injury (AGI) in patients with extracorporeal membrane oxygenation (ECMO) at the early stage of operation and its influencing factors.Methods:A total of 70 patients with ECMO who were hospitalized in the Emergency Care Unit of Guangxi Zhuang Autonomous Region People's Hospital from September 2020 to December 2021 were retrospectively analyzed, and a total of 70 patients with ECMO who were hospitalized in the emergency care unit of Guangxi Zhuang Autonomous Region People's Hospital from September 2020 to December 2021 were retrospectively analyzed. According to the 2012 guidelines of the European Society of Intensive Care Medicine on the classification of acute gastrointestinal injury in critically ill patients, the patients were divided into AGI group and non-AGI group. The incidence of acute gastrointestinal injury in the early stage was statistically analyzed, and the results of blood gas analysis during ECMO loading and ECMO parameters, hemodynamic indexes and biochemical indexes after ECMO transfer were statistically analyzed. To explore the influencing factors and independent risk factors of AGI in the early stage. In addition, 70 patients were divided into successful group and non-successful group according to whether they were successfully withdrawn. The occurrence of acute gastrointestinal injury between the two groups was compared, and the effect of acute gastrointestinal injury on ECMO patients was analyzed.Results:Among the 70 ECMO patients, the incidence of early AGI was 71.43% (50 cases), and the components of AGI Ⅰ, Ⅱ, Ⅲ and Ⅳ were 18.57% (13 cases), 41.43% (29 cases), 11.43% (8 cases) and 0% (0 cases), respectively. ① Univariate analysis showed that systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), vasoactive drug index (VIS), pH, lactic acid and BMI were significantly different between AGI group and non-AGI group when ECMO was used ( P < 0.05). Logistic binary regression analysis showed that BMI was an independent risk factor for early AGI in ECMO patients (ROC area 0.657, 95% confidence interval 0.522-0.791 ( P < 0.05), and Yoden index 0.15). (3) The AGI composition ratio of the unsuccessful group was higher than that of the unsuccessful group ( P < 0.05). Conclusions:Patients with ECMO have a high incidence of AGI in the early stage, mainly occurring in grade I and Ⅱ. Systolic blood pressure, diastolic blood pressure, MAP, VIS, pH, lactic acid and BMI when ECMO is put on are influential factors for the early development of AGI in ECMO patients, among which BMI is an independent risk factor for the early development of AGI in ECMO patients. The occurrence of AGI reduces the probability of successful withdrawal in ECMO patients.

ObjectiveTo investigate the genetic polymorphism and structure of 47 autosomal microhaplotypes in the Han population in Changshu City, Jiangsu Province, and to evaluate the forensic efficiencies and forensic parameters. MethodsThe DNA library of unrelated individual samples was prepared according to MHSeqTyper47 kit manual and sequenced on the MiSeq FGx platform. Microhaplotype genotyping and sequencing depth statistics were processed using MHTyper. The genetic information of samples was then evaluated. The fixation index and genetic distance between the Jiangsu Changshu population and the reference populations in the 1000 Genomes Project phase 3 (1KG) were calculated, and forensic parameters were evaluated. ResultsThe fixation index and genetic distance between the Han population in Changshu, Jiangsu, and the CHB (Han Chinese in Beijing, China) reference population in 1KG were the lowest. The effective allele number (A_e) of each locus is also the closest between the two populations. The combined matching probability (CMP) of the Changshu Han population is close to the 5 populations of the East Asian reference super-population in 1KG, which is 1.25×10^-36, and the combined probability of exclusion reached 0.999 999 999 964 1. ConclusionThis study reported the genetic polymorphism and allele frequency of 47 microhaplotypes in a Han population in Changshu City, Jiangsu Province. This information provides a data basis for 47 microhaplotypes in forensic applications. In addition, the polymorphism differences between the 1KG reference population and the Han population in Changshu, Jiangsu were compared, and the genetic structure of 47 microhaplotypes in the Han population in Changshu, Jiangsu was revealed. In general, the reference data of the East Asian super-population in 1KG is more in line with the genetic characteristics of Han population in Changshu, Jiangsu.

BACKGROUND:Recent studies have shown that the Notch signaling pathway plays a varying role in osteoporosis,and in-depth research in this field is of great significance to the prevention and treatment of osteoporosis.Traditional Chinese medicine has become the focus of research in today's society due to its obvious multi-faceted,multi-level benefits in alleviating osteoporosis with less adverse effects. OBJECTIVE:To analyze and summarize domestic and international literature to further understand the connection between the Notch signaling pathway and osteoporosis and to elucidate the mechanism by which traditional Chinese medicine prevents and treats osteoporosis via the Notch signaling pathway. METHODS:CNKI,WanFang,and VIP were searched with the keywords of"Notch,osteoporosis,osteoblasts,osteoclasts,bone marrow mesenchymal stem cells,signaling pathway,traditional Chinese medicine,pill,experiment"in Chinese.PubMed,Nature,and Embase were retrieved using the keywords of"Notch,osteoporosis,osteoblasts,osteoclasts,mesenchymal stem cells,signal pathway,traditional Chinese medicine,pill,experiment"in English.The search time was from database inception to October 2022. RESULTS AND CONCLUSION:The Notch signaling pathway plays a role in the development and progression of osteoporosis to varying degrees by regulating the differentiation and proliferation of mesenchymal stem cells,osteoblasts and osteoclasts.The Notch signaling pathway regulates the proliferation and differentiation of mesenchymal stem cells,osteoblasts and osteoclasts by directly or indirectly regulating key cytokines such as Notch1,Jagged1,Hes,Hey,macrophage colony-stimulating factor and nuclear factor-κB receptor-activating factor ligand,which in turn promotes or inhibits bone formation and ultimately has a certain effect on the prevention and treatment of osteoporosis.The active ingredients of Chinese herbs are mostly extracted from herbs for kidney tonifying,such as Epimedium,Cortex Eucommiae,Malaytea Scurfpea Fruit,Eleutherococcus Senticosus,Ligustrum Lucidum.Moreover,herbal compounds and preparations have the effect of tonifying kidney and strengthening bone,which provides more herbal options and directions for the subsequent study of Notch signaling pathway toward the prevention and treatment of osteoporosis.Current studies on traditional Chinese medicine mainly focus on active ingredients and single herbal extracts,with relatively few clinical trials on Chinese herbal compounds and preparations.Fewer studies have been conducted on the regulation of Notch signaling pathways by acupuncture,manipulation,and integrated Chinese and Western medicine to prevent and treat osteoporosis.Therefore,there is a need to explore the mechanisms by which traditional Chinese medicine technology-based therapies and integrated Chinese and Western medicine regulate the Notch signaling pathway to treat osteoporosis.

BACKGROUND:The nuclear factor-κB signaling pathway plays an important role in the pathogenesis of osteoporosis.In recent years,increasing studies have shown that terpenoid herbal monomer compounds can inhibit the activity of bone resorbing cells and promote the differentiation of bone forming cells via the nuclear factor-κB signaling pathway,thus reducing bone resorption and increasing bone formation,which has certain preventive and therapeutic effects on osteoporosis. OBJECTIVE:By analyzing and summarizing the domestic and international literature,to investigate the relationship between nuclear factor-κB signaling pathway and osteoporosis in depth,elucidate the mechanism of terpenoid monomer compounds in regulating the nuclear factor-κB signaling pathway to prevent osteoporosis,and systematically summarize the terpenoid monomer compounds targeting to regulate the nuclear factor-κB signaling pathway to prevent osteoporosis. METHODS:According to the proposed inclusion and exclusion criteria,two researchers searched for relevant articles published from database inception to December 2022 in CNKI and PubMed using the search terms"NF-κB,osteoporosis,osteoblasts,osteoclasts,angiogenesis,traditional Chinese medicine,terpenoid"in Chinese and English,respectively.A third researcher summarized and organized the literature and 75 articles were finally included for a systematic review. RESULTS AND CONCLUSION:The nuclear factor-κB signaling pathway mediates the onset and progression of osteoporosis by regulating the differentiation and proliferation of osteoblasts and osteoclasts,as well as angiogenesis.Activation of the nuclear factor-κB signaling pathway negatively regulates the proliferation and differentiation of osteoblasts.Activation of the nuclear factor-κB signaling pathway enhances osteoclast activity and inhibits osteoblast growth,thereby inhibiting compensatory bone production to maintain bone homeostasis.However,over-activation of the nuclear factor-κB signaling pathway can lead to osteoporosis.The nuclear factor-κB signaling pathway is involved in the"angiogenesis-osteogenesis"coupling by upregulating the expression levels of cytokines such as angiopoietin-1,platelet-derived growth factor BB and vascular endothelial growth factor,which promote the growth of blood vessels in bone.The terpenoid herbal monomer compounds are used in the field of tissue engineering to promote the proliferation and differentiation of bone cells,thereby promoting the growth and repair of bone tissue.Terpenoid herbal monomer compounds can prevent and treat osteoporosis by inhibiting the degradation of nuclear factor-κB inhibitor,blocking nuclear factor-κB/p65 phosphorylation and nuclear translocation,thereby weakening the nuclear factor-κB signaling pathway,promoting osteoblast differentiation and inhibiting osteoclast formation.Currently,research on the regulation of nuclear factor-κB signaling pathway by monomeric compounds of terpenoids to prevent osteoporosis is mainly based on in vitro cellular experiments and animal models,and there is a lack of research on the complex physiological and pathological processes in humans.In the future,more clinical trials and studies are needed to further clarify the mechanism of action and efficacy of the nuclear factor-κB signaling pathway involved in the intervention of osteoporosis.

Objective:To explore the application and diagnostic value of low-dose scan technique of chest computed tomography(CT)combined with three dimensional(3D)reconstruction for ribs in chest trauma.Methods:A total of 118 patients with highly suspected rib fracture who admitted to the 904th Hospital of People's Liberation Army Joint Service Support Force were selected,and all cases underwent low-dose scan technique of chest CT combined with 3D reconstruction for ribs.The image qualities of chest CT scans with different low-doses combined with 3D reconstruction for ribs were analyzed,and the diagnostic accuracies among low dose scan technique of chest CT,3D reconstruction for ribs and the combination of them for chest trauma were compared.Results:Both the sharpness and clarity of the edges of the bronchi,blood vessels,lung parenchyma,interlobular septum,mediastinum and ribs were poorer,and the artifacts of soft tissue were more and the noise were more when the tube current of CT scan was 50 Ma.Both the sharpness and clarity of the edges of the bronchi,blood vessels,lung parenchyma,interlobular septum,mediastinum and ribs were general,and a part of soft tissues existed artifacts and the noise amounts were less when the tube current of CT scan was 70 Ma,which did not affect the diagnosis.The radiation dose as 50 mA was significantly higher than that as 70 mA,with a statistically significant difference(t=10.969,P<0.05).In 118 patients with chest trauma,the examination of low-dose scan technique of chest CT combined with 3D reconstruction for ribs indicated that there were 112 cases of rib fractures and 7 cases of costal cartilage fractures.In the examined 388 fractures of rib and costal cartilage,355 fractures(91.49%)were rib fractures and 33 fractures(8.51%)were costal cartilage fractures.In 118 patients with chest trauma,76 cases(64.41%)complicated with pulmonary contusions and lacerations,and 41 cases(35.75%)complicated with pleural effusion,and 10 cases(8.47%)complicated with thoracic vertebral fractures,and 6 cases(5.08%)complicated with splenic contusions and lacerations,and 5 cases(4.24%)complicated with mediastinal and subcutaneous emphysemas.The most direct imaging sign of rib fracture was visible and transparent low-density shadow.Chest CT scan can generally better display dislocation of the fractured end.The 3D reconstruction image showed a visibly line-like shadow on one side of rib if only one side of ribs fractured and the other side was intact.A total of 395 rib and costal cartilage fractures were confirmed by 3D reconstruction,which included 363 rib fractures(91.90%)and 32 costal cartilage fractures(8.10%).A total of 410 rib and costal cartilage fractures were confirmed by low-dose scan technique of chest CT combined with 3D reconstruction for ribs,which included 375 rib fractures(91.46%)and 35 costal cartilage fractures(8.54%).In the comparison of 418 rib injuries that were confirmed during surgery,the accuracy of low-dose scan technique of chest CT was 92.82%(388/418)in diagnosing rib and costal cartilage fractures,and the accuracy of 3D reconstruction for ribs was 94.50%(395/418)in diagnosing that,and the accuracy of low-dose scan technique of chest CT combined with 3D reconstruction for ribs was 95.69%(410/418)in diagnosing that.There was a significant difference in accuracy among the three types of examinations(x2=13.062,P<0.05).Conclusion:Low dose scan technique of chest CT combines with 3D reconstruction for ribs can be used in the diagnosis of chest trauma,which has higher accuracy and can provide reliable imaging information for clinical diagnosis and treatment.

Objective:To analyze the research hot points and trend of general practice in China.Methods:It was a bibliometric analysis. Research papers presentated on Chinese Society of General Practice from 2014 to 2022 were collected. The distribution and its trend were analysed in terms of titles, submission time, research topics, methods and contents as well as authors′ affilation.Results:A total of 944 research papers were included in the analysis. The results showed a general increasing trend in number of research papers presented on annual conferences from 2014 to 2022 with some fluctuation. The papers covered 28 research dimensions; the highest number of papers was on the development of general practice system, the training and education system for general practitioners, and the construction of information technology (576 papers, 61.0%). The most common topic was on primary health services (230 papers, 24.4%), followed by education and training (225, 23.8%) and chronic disease management (212, 22.5%); while fewer papers were dealing with community-based care (39, 4.1%) and rational medication (7, 0.7%). In terms of the affiliation of the first author, 437 papers (46.3%) were from affiliated hospitals of medical universities/colleges, 223 (23.6%) from community health service institutions, 132 (14.0%) from higher education institutions, 118 (12.5%) from non-affiliated hospitals, and 35 (3.7%) were from administration institutions. In terms of regions, it covered all provinces (municipalities/autonomous regions) (including Hong Kong and Taiwan) with few overseas. Shanghai and Beijing contributed more papers than other regions. In terms of research methodology, most papers used quantitative studies (882, 93.7%), less used qualitative studies (39, 4.1%) or mixed studies (23, 2.4%).Conclusion:The analysis indicates that a wide range of contents are involved in general practice research in China, and more high-quality studies are from medical colleges/universities and their affiliated general hospitals, and most papers use quantitative studies.

Objective To investigate the association between auditory processing and problem behaviors in preschool children,as well as the mediating role of executive function.Methods A total of 2 342 preschool children were selected from 7 kindergartens in Nanjing,China from June to August 2021.They were evaluated using Preschool Auditory Processing Assessment Scale,Conners Parent Symptom Questionnaire,and Behavior Rating Inventory of Executive Functioning-Preschool version.Children with different demographic features were compared in the scores and the abnormality rates of auditory processing,problem behaviors,and executive function.The influencing factors of the total scores of auditory processing,problem behaviors,and executive function were evaluated using multiple linear regression analysis.Whether executive function was a mediating factor between auditory processing and executive function was examined.Results Sex and grade were the main influencing factors for the total score of auditory processing(P<0.05),and sex,grade,parental education level,and family economic status were the main influencing factors for the total scores of problem behaviors and executive function(P<0.05).The auditory processing score(rs= 0.458,P<0.05)and problem behavior score(rs=0.185,P<0.05)were significantly positively correlated with the executive function score,and the auditory processing score was significantly positively correlated with the problem behavior score(rs=0.423,P<0.05).Executive function played a partial mediating role between auditory processing and problem behaviors,and the mediating effect accounted for 33.44% of the total effect.Conclusions Auditory processing can directly affect the problem behaviors of preschool children and indirectly affect problem behaviors through executive function.[Chinese Journal of Contemporary Pediatrics,2024,26(2):174-180]