Objective To investigate the articulation acoustic characteristics of children with spastic cerebral palsy and their correlation with articulation intelligibility.Methods A total of 17 children with cerebral palsy and 17 ordinary children aged 6-12 years were included in the study,and the articulation acoustics and articulation intelligi-bility performance of the two types of children were compared by using three kinds of corpus:monophthong,single word and sentence,and the correlation between them was studied.Results The articulation intelligibility of the monophthong,single word and sentence corpus of children with spastic cerebral palsy was lower than that of ordina-ry children(P＜0.01),as follows:monophthong＞single word＞sentence.In the monophthong corpus,only mandibular distance and tongue distance were significantly lower than that of ordinary children(P＜0.05),and only mandibular distance and vowel space area(VSA)were significantly correlated with articulation intelligibility(P＜0.05).In the single word corpus,mandibular distance,tongue distance and VSA were significantly lower than that of ordinary children,while vowel ellipse area(VEA)was significantly higher than that of ordinary children(P＜0.05).All other indexes except VSA and formant centralization ratio(FCR)were significantly correlated with artic-ulation intelligibility(P＜0.05).In the sentence corpus,all the other indexes except mandibular distance were sig-nificantly worse than those of ordinary children(P＜0.05),and all the acoustic indexes were significantly correlated with articulation intelligibility(P＜0.05).Conclusion Children with cerebral palsy have poor articulation acoustic cha-racteristics and articulation intelligibility,and the corpus complexity will affect the degree of correlation between the two.

Objective To investigate the articulation acoustic characteristics of children with spastic cerebral palsy and their correlation with articulation intelligibility.Methods A total of 17 children with cerebral palsy and 17 ordinary children aged 6-12 years were included in the study,and the articulation acoustics and articulation intelligi-bility performance of the two types of children were compared by using three kinds of corpus:monophthong,single word and sentence,and the correlation between them was studied.Results The articulation intelligibility of the monophthong,single word and sentence corpus of children with spastic cerebral palsy was lower than that of ordina-ry children(P＜0.01),as follows:monophthong＞single word＞sentence.In the monophthong corpus,only mandibular distance and tongue distance were significantly lower than that of ordinary children(P＜0.05),and only mandibular distance and vowel space area(VSA)were significantly correlated with articulation intelligibility(P＜0.05).In the single word corpus,mandibular distance,tongue distance and VSA were significantly lower than that of ordinary children,while vowel ellipse area(VEA)was significantly higher than that of ordinary children(P＜0.05).All other indexes except VSA and formant centralization ratio(FCR)were significantly correlated with artic-ulation intelligibility(P＜0.05).In the sentence corpus,all the other indexes except mandibular distance were sig-nificantly worse than those of ordinary children(P＜0.05),and all the acoustic indexes were significantly correlated with articulation intelligibility(P＜0.05).Conclusion Children with cerebral palsy have poor articulation acoustic cha-racteristics and articulation intelligibility,and the corpus complexity will affect the degree of correlation between the two.

Objective:To explore the effect of inflammatory cell levels on the anticoagulant efficacy in patients with liver cirrhosis complicated with portal vein thrombosis (PVT).Methods:A total of 106 patients with liver cirrhosis complicated with PVT who visited the Zhongshan Hospital, Fudan University from 2017 to 2022 were prospectively included. The PVT grade and recanalization were evaluated by imaging. Cox regression was used to analyze the predictive factors of anticoagulation efficacy. The time-dependent receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value of inflammatory cells for predicting anticoagulation efficacy. The Kaplan-Meier method was used to compare the 1-year PVT recanalization rate of patients with different levels of inflammatory cells.Results:Univariate analysis showed that Child-Pugh score ( HR=1.41), D-dimer ( HR=0.98), platelet ( HR=0.98), C-reactive protein to lymphocyte ratio ( HR=1.01), monocyte ( HR=0.21), lymphocyte ( HR=0.34), and prothrombin time( HR=1.32) was related to the improvement of PVT (all P<0.05). Multivariate analysis confirmed that lymphocytes ( HR: 0.41, 95% CI: 0.20-0.85, P=0.016) and prothrombin time ( HR: 1.23, 95% CI: 1.01-1.50, P=0.036) were independent predictors of anticoagulant efficacy. Grouped according to the ROC cutoff value, the 1-year recanalization rate of PVT in the high-level lymphocyte group (4.55% vs 32.84%, P=0.012) and the high-level monocyte group (5.56% vs 31.4%, P=0.028) was significantly lower than that in the low-level group. After excluding patients undergoing splenectomy, the recurrence rate in the high-level lymphocyte group was still lower than that in the low-level group (6.25% vs 33.77%, P=0.038). Conclusions:Among patients with liver cirrhosis accompanied by PVT, high levels of lymphocytes and monocytes are the key factors for the poor efficacy of anticoagulation therapy. For PVT patients with poor anticoagulation efficacy, the therapeutic strategy of anti-inflammatory combined with anticoagulation can be considered for exploration in the future.

Objective:To explore the effect of inflammatory cell levels on the anticoagulant efficacy in patients with liver cirrhosis complicated with portal vein thrombosis (PVT).Methods:A total of 106 patients with liver cirrhosis complicated with PVT who visited the Zhongshan Hospital, Fudan University from 2017 to 2022 were prospectively included. The PVT grade and recanalization were evaluated by imaging. Cox regression was used to analyze the predictive factors of anticoagulation efficacy. The time-dependent receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value of inflammatory cells for predicting anticoagulation efficacy. The Kaplan-Meier method was used to compare the 1-year PVT recanalization rate of patients with different levels of inflammatory cells.Results:Univariate analysis showed that Child-Pugh score ( HR=1.41), D-dimer ( HR=0.98), platelet ( HR=0.98), C-reactive protein to lymphocyte ratio ( HR=1.01), monocyte ( HR=0.21), lymphocyte ( HR=0.34), and prothrombin time( HR=1.32) was related to the improvement of PVT (all P<0.05). Multivariate analysis confirmed that lymphocytes ( HR: 0.41, 95% CI: 0.20-0.85, P=0.016) and prothrombin time ( HR: 1.23, 95% CI: 1.01-1.50, P=0.036) were independent predictors of anticoagulant efficacy. Grouped according to the ROC cutoff value, the 1-year recanalization rate of PVT in the high-level lymphocyte group (4.55% vs 32.84%, P=0.012) and the high-level monocyte group (5.56% vs 31.4%, P=0.028) was significantly lower than that in the low-level group. After excluding patients undergoing splenectomy, the recurrence rate in the high-level lymphocyte group was still lower than that in the low-level group (6.25% vs 33.77%, P=0.038). Conclusions:Among patients with liver cirrhosis accompanied by PVT, high levels of lymphocytes and monocytes are the key factors for the poor efficacy of anticoagulation therapy. For PVT patients with poor anticoagulation efficacy, the therapeutic strategy of anti-inflammatory combined with anticoagulation can be considered for exploration in the future.

Aim To investigate the shared transcriptional characteristics of non-alcoholic fatty liver disease(NAFLD)and atherosclerosis(As)using bioinformatics techniques.The goal is to identify potential mechanisms and key targets of As that are linked to NAFLD through gene crosstalk analysis of both diseases.Additionally,the study will validate the expression levels of these key targets in animal tissues and human serum samples.Methods The gene ex-pression profiles of NAFLD(dataset GSE89632)and As(dataset GSE43292)were obtained from GEO database.Differ-ential gene analysis and weighted gene co-expression network analysis were conducted to identify common genes between the two diseases.These shared genes were further analyzed using the String database for protein interaction analysis and R software.Core genes were identified through calculations in Cytoscape software,validation with external datasets(GSE100927),and machine learning techniques(LASSO regression).Finally,key core genes were determined by crea-ting nonalcoholic fatty liver and As mouse models on a high-fat diet and collecting peripheral serum samples from patients with NAFLD and coronary heart disease(CHD).Results Seventy-five shared genes were identified between the two diseases,with major enrichment pathways including cytokine-cytokine receptor interaction,IL-17 signaling pathway,lipid and atherosclerosis,and NF-κB signaling pathway.Through integration of multiple bioinformatics methods,two core genes(MMP-9 and CCL3)were identified.Subsequent animal experiments demonstrated a significant increase in MMP-9 and CCL3 levels in the liver and aortic sinus of mice fed with high-fat diet,MMP-9 and CCL3 levels in the liver tissue of high-fat diet-fed mice were 2.43 times(P＜0.001)and 1.35 times(P＜0.01)higher than the control group,in the aortic sinus tissue,MMP-9 and CCL3 levels were 2.10 times(P＜0.001)and 1.58 times(P＜0.01)higher.Human serum sample verification further supported these findings,showing MMP-9 and CCL3 levels in patients with both NAFLD and CHD to be 1.21 times(P＜0.01)and 1.29 times(P＜0.01)higher than in patients with CHD alone.Conclusion This study identified MMP-9 and CCL3 may play key roles in NAFLD-related As,providing potential targets for the study of NAFLD-related As.

Objective To investigate the dietary patterns of rural residents in the high-incidence areas of esophageal cancer (EC), and to explore the clustering and influencing factors of risk factors associated with high-incidence characteristics. Methods A special structured questionnaire was applied to conduct a face-to-face survey on the dietary patterns of rural residents in Yanting county of Sichuan Province from July to August 2021. Univariate and multivariate logistic regression models were used to analyze the influencing factors of risk factor clustering for EC. Results There were 838 valid questionnaires in this study. A total of 90.8% of rural residents used clean water such as tap water. In the past one year, the people who ate fruits and vegetables, soybean products, onions and garlic in high frequency accounted for 69.5%, 32.8% and 74.5%, respectively; the people who ate kimchi, pickled vegetables, sauerkraut, barbecue, hot food and mildew food in low frequency accounted for 59.2%, 79.6%, 68.2%, 90.3%, 80.9% and 90.3%, respectively. The clustering of risk factors for EC was found in 73.3% of residents, and the aggregation of two risk factors was the most common mode (28.2%), among which tumor history and preserved food was the main clustering pattern (4.6%). The logistic regression model revealed that the gender, age, marital status and occupation were independent influencing factors for the risk factors clustering of EC (P<0.05). Conclusion A majority of rural residents in high-incidence areas of EC in Yanting county have good eating habits, but the clustering of some risk factors is still at a high level. Gender, age, marital status, and occupation are influencing factors of the risk factors clustering of EC.

Objective: To investigate the characteristics of rabies-exposed population in Wenzhou City, Zhejiang Province from 2014 to 2023, so as to provide insights into the prevention and control of rabies. Methods: Data of rabies-exposed population in Wenzhou City from 2014 to 2023 were collected through Wenzhou Rabies-Exposed Population Summary Sheet reported by dog injury clinics. The species of animals causing injuries, exposure time, exposure grade, exposure site, and post-exposure treatment were descriptively analyzed. Results: Totally 709 900 patients were admitted to dog injury clinics in Wenzhou City from 2014 to 2023, and the exposure rate showed an increasing trend (Z=7.238, P<0.001), with an average annual exposure rate of 750.75/105. The number of cases with exposure to rabies peaked in July (79 230 cases, 11.16%) and August (78 570 cases, 11.07%). Dogs were predominant animals causing injuries (448 900 cases, 63.23%), and the exposure rate showed a downward trend (Z=-5.921, P<0.001); cats were the second (175 142 cases, 24.67%), and the exposure rate showed an upward trend (Z=23.314, P<0.001). The upper (379 695 cases, 53.49%) and lower limbs (287 521 cases, 40.50%) were the main exposure sites. There were 21 034 cases (2.96%) exposed to head and face, and the exposure rate of head and face showed an upward trend (Z=3.549, P<0.001). Grade II exposure was the most common (403 881 cases, 56.89%), and the exposure rate showed an upward trend (Z=8.769, P<0.001). The proportion of using human rabies immune globulin was 23.13% in Grade III exposed population, showing a downward trend (Z=-12.848, P<0.001). Conclusions The exposure rate of rabies in Wenzhou City showed an upward trend from 2014 to 2023, with July and August as the peak months of exposure. Injuries mainly caused by dogs, while the exposure rate of cat bites showed an upward trend. The proportion of using human rabies immune globulin needs to be improved.

Objective To compare the efficacy and safety of endoscopic ligation treatment and endoscopic tissue glue injection for secondary prevention of gastric variceal bleeding.Methods Patients with cirrhosis and esophagogastric variceal bleeding treated with gastric variceal ligation in Zhongshan Hospital,Fudan University,from January 2017 to December 2019 were screened(ligation group).And during the same period,patients underwent endoscopic cyanoacrylate treatment were also screened(tissue glue group).59 patients were included in the two groups after propensity score matching.Univariate and multivariate Cox proportional hazard regression models were used to anslyze risk factors for re-bleeding.Kaplan-Meier curves were plotted to analyze re-bleeding rate and mortality of the two treatment groups.Results There was no statistically significant difference in the eradication rate of esophagogastric varices between the ligation group and the tissue glue group(83.05％vs 79.66％,P=0.778);the ligation group required fewer median endoscopic treatments for variceal eradication(2 vs 3,P=0.017)and a lower average dosage of cyanoacrylate(0.70 mL vs 2.67 mL,P＜0.001).Multivariate Cox regression analysis showed that portal shunt was a risk factor for esophagogastric varices re-bleeding(HR=3.14,95％CI 1.02-9.68,P=0.046),endoscopic variceal ligation was a protective factor against re-bleeding(HR=0.25,95％CI 0.08-0.71,P=0.010).Compared with endoscopic cyanoacrylate injection,endoscopic ligation treatment did not significantly increase the 2-year risk of esophagogastric variceal re-bleeding(18.69％vs 36.29％,P=0.067)or risk of death(1.69％vs 3.39％,P=1.000);patients with GOV1 type had a significantly lower risk of re-bleeding after endoscopic ligation treatment(0 vs 40.27％,P=0.012)and there was a trend towards a lower re-bleeding risk in patients with GOV2 type after endoscopic ligation treatment(13.27％vs 34.16％,P=0.056).Conclusions Endoscopic ligation treatment has higher eradication rate for esophagogastric varices,and does not increase the risk of re-bleeding,death,or other adverse events.Therefore,it can be considered an effective secondary prevention way for patients with gastric varices.

Objective:A cohort of patients with oxaliplatin-associated portal hypertension was established and compared with patients with hepatitis B or schistosomiasis-associated cirrhotic portal hypertension to explore the course, disease features and prognosis of endoscopic treatment.Methods:From January 1, 2014 to December 31, 2021, patients diagnosed with portal hypertension and gastroesophageal varices after oxaliplatin chemotherapy at Zhongshan Hospital of Fudan University were selected (oxaliplatin general group). The patients who received endoscopic treatment for the first time because of esophagogastric variceal bleeding in the oxaliplatin general group were included in the oxaliplatin group. From January 1, 2014 to December 31, 2016, patients who initially received endoscopic treatment for the first time because of esophagogastric variceal bleeding due to hepatitis B or schistosomiasis-associated cirrhotic portal hypertension at Zhongshan Hospital of Fudan University were enrolled (hepatitis B group and schistosomiasis group). The history of oncology and chemotherapy, laboratory results, imaging and pathological findings were collected, and the clinical features were analyzed. Clinical data were collected, and the clinical features, 3-year cumulative non-bleeding rate and survival rate after endoscopic treatment of the 3 groups including oxaliplatin group, hepatitis B group and schistosomiasis group were compared. Kaplan-Meier survival curve was drawn to estimate treatment effects, and log-rank method was performed to test the differences in survival curves. Chi-square test and Mann-Whitney U test were used for statistical analysis. Results:There were 93 patients in oxaliplatin general group, with a median chemotherapy course of 8 (ranged from 6 to 10) cycles, and the median time from the end of chemotherapy to the diagnosis of gastroesophageal varices was 4 (ranged from 2 to 6) years. There were 55 patients in oxaliplatin group, 191 cases in hepatitis B group and 96 cases in schistosomiasis group. There were 78.5% (73/93) of patients in the oxaliplatin group classified as Child-Pugh grade A, and 33 patients (35.5%) with portal vein thrombosis. The abdominal imaging showed no obvious liver cirrhosis such as liver shrinkage and uneven surface. The pathology of 11 patients with liver biopsy in the oxaliplatin general group showed mainly vascular injury and fibrous deposition in the confluent area with lymphocytic infiltration, mild hepatocellular injury, and no pseudolobule formation. In terms of baseline characteristics, direct bilirubin, alanine transaminase, and aspartate transaminase levels of patients in the oxaliplatin group were all lower than those of the hepatitis B group and schistosomiasis group (4.8 (3.9, 6.5) μmol/L vs. 6.4 (4.7, 9.0) and 6.5 (4.4, 9.4) μmol/L; 17 (13, 22) U/L vs. 22 (15, 31) and 19 (15, 27) U/L; 22 (19, 25) U/L vs. 28 (22, 39) and 29 (22, 42) U/L), while albumin and prealbumin levels and the proportion of patients with Child-Pugh grade A were all higher than those of the hepatitis B group and schistosomiasis group (39.0 (35.0, 42.5) g/L vs. 34.0 (30.0, 38.3) and 33.8 (29.5, 36.0) g/L; 0.160 (0.130, 0.197) g/L vs. 0.120 (0.090, 0.150) and 0.110 (0.080, 0.140) g/L; 74.5% (41/55) vs. 55.5% (106/191) and 42.7% (41/96)), and the differences were all statistically significant ( U=3 298.50, 2 749.00, 2 159.00, 7 759.00, 5 822.50, χ2=6.92 and U=1 622.00, 1 878.50, 1 305.50, 3 989.00, 3 264.50, χ2=16.36; all P<0.05). The 3-year rebleeding risk in the oxaliplatin group was higher than that in the hepatitis B group ( HR=1.80, 95% confidence interval 1.07 to 3.02, P=0.026), but the difference was not statistically significant compared with that of the schistosomiasis group ( HR=1.04, 95% confidence interval 0.61 to 1.78, P=0.874). There were no statistically significant differences in the 3-year cumulative survival rate between the oxaliplatin group and the hepatitis B group and schistosomiasis group (96.4% (53/55) vs. 94.8% (181/191) and 95.8% (92/96), both P>0.05). Conclusions:The pathology of liver injury in patients with oxaliplatin-associated portal hypertension are mainly vascular injury and fibrous deposition in the confluent area. The efficacy of endoscopic treatment to prevent rebleeding in patients with oxaliplatin-associated portal hypertension is significantly inferior to that in patients with hepatitis B-associated portal hypertension, but comparable to that in patients with schistosomiasis-associated portal hypertension.

Objective:A cohort of patients with oxaliplatin-associated portal hypertension was established and compared with patients with hepatitis B or schistosomiasis-associated cirrhotic portal hypertension to explore the course, disease features and prognosis of endoscopic treatment.Methods:From January 1, 2014 to December 31, 2021, patients diagnosed with portal hypertension and gastroesophageal varices after oxaliplatin chemotherapy at Zhongshan Hospital of Fudan University were selected (oxaliplatin general group). The patients who received endoscopic treatment for the first time because of esophagogastric variceal bleeding in the oxaliplatin general group were included in the oxaliplatin group. From January 1, 2014 to December 31, 2016, patients who initially received endoscopic treatment for the first time because of esophagogastric variceal bleeding due to hepatitis B or schistosomiasis-associated cirrhotic portal hypertension at Zhongshan Hospital of Fudan University were enrolled (hepatitis B group and schistosomiasis group). The history of oncology and chemotherapy, laboratory results, imaging and pathological findings were collected, and the clinical features were analyzed. Clinical data were collected, and the clinical features, 3-year cumulative non-bleeding rate and survival rate after endoscopic treatment of the 3 groups including oxaliplatin group, hepatitis B group and schistosomiasis group were compared. Kaplan-Meier survival curve was drawn to estimate treatment effects, and log-rank method was performed to test the differences in survival curves. Chi-square test and Mann-Whitney U test were used for statistical analysis. Results:There were 93 patients in oxaliplatin general group, with a median chemotherapy course of 8 (ranged from 6 to 10) cycles, and the median time from the end of chemotherapy to the diagnosis of gastroesophageal varices was 4 (ranged from 2 to 6) years. There were 55 patients in oxaliplatin group, 191 cases in hepatitis B group and 96 cases in schistosomiasis group. There were 78.5% (73/93) of patients in the oxaliplatin group classified as Child-Pugh grade A, and 33 patients (35.5%) with portal vein thrombosis. The abdominal imaging showed no obvious liver cirrhosis such as liver shrinkage and uneven surface. The pathology of 11 patients with liver biopsy in the oxaliplatin general group showed mainly vascular injury and fibrous deposition in the confluent area with lymphocytic infiltration, mild hepatocellular injury, and no pseudolobule formation. In terms of baseline characteristics, direct bilirubin, alanine transaminase, and aspartate transaminase levels of patients in the oxaliplatin group were all lower than those of the hepatitis B group and schistosomiasis group (4.8 (3.9, 6.5) μmol/L vs. 6.4 (4.7, 9.0) and 6.5 (4.4, 9.4) μmol/L; 17 (13, 22) U/L vs. 22 (15, 31) and 19 (15, 27) U/L; 22 (19, 25) U/L vs. 28 (22, 39) and 29 (22, 42) U/L), while albumin and prealbumin levels and the proportion of patients with Child-Pugh grade A were all higher than those of the hepatitis B group and schistosomiasis group (39.0 (35.0, 42.5) g/L vs. 34.0 (30.0, 38.3) and 33.8 (29.5, 36.0) g/L; 0.160 (0.130, 0.197) g/L vs. 0.120 (0.090, 0.150) and 0.110 (0.080, 0.140) g/L; 74.5% (41/55) vs. 55.5% (106/191) and 42.7% (41/96)), and the differences were all statistically significant ( U=3 298.50, 2 749.00, 2 159.00, 7 759.00, 5 822.50, χ2=6.92 and U=1 622.00, 1 878.50, 1 305.50, 3 989.00, 3 264.50, χ2=16.36; all P<0.05). The 3-year rebleeding risk in the oxaliplatin group was higher than that in the hepatitis B group ( HR=1.80, 95% confidence interval 1.07 to 3.02, P=0.026), but the difference was not statistically significant compared with that of the schistosomiasis group ( HR=1.04, 95% confidence interval 0.61 to 1.78, P=0.874). There were no statistically significant differences in the 3-year cumulative survival rate between the oxaliplatin group and the hepatitis B group and schistosomiasis group (96.4% (53/55) vs. 94.8% (181/191) and 95.8% (92/96), both P>0.05). Conclusions:The pathology of liver injury in patients with oxaliplatin-associated portal hypertension are mainly vascular injury and fibrous deposition in the confluent area. The efficacy of endoscopic treatment to prevent rebleeding in patients with oxaliplatin-associated portal hypertension is significantly inferior to that in patients with hepatitis B-associated portal hypertension, but comparable to that in patients with schistosomiasis-associated portal hypertension.