Objective:To use inductively coupled plasma mass spectrometry(ICP-MS)to screen biomarkers of element omics of thyroid cancer,and to establish a risk assessment model of element omics of thyroid cancer,so as to provide a basis for the diagnosis and treatment of thyroid cancer.Methods:A total of 200 patients with thyroid cancer who admitted to Beijing Tongren Hospital from February to November 2020 were selected as the thyroid cancer group,and 50 healthy volunteers who underwent physical examinations at hospital during the same period were selected as the healthy control group.The total amount of 28 trace elements,including iodine(I),calcium(Ca),iron(Fe),nickel(Ni),copper(Cu),zinc(Zn),selenium(Se),antimony(Sb),etc.,in their serum were determined by ICP-MS.The content of trace element,thyroid function,free triiodothyronine(FT3),free tetraiodothyronine(FT4),triiodothyronine(T3),tetraiodothyronine(T4),and thyroid volume of ultrasound examination of were analyzed,and then,a risk assessment model of elemental omics of thyroid diseases was established.Results:There were statistically significant differences in the contents of eight trace elements,including I,Ca,Fe,Ni,Cu,Zn,Se and Sb between the thyroid cancer group and the healthy control group(U=2.601,1.972,2.607,2.611,2.603,2.605,2.601,2.605,P<0.05),respectively.The I,Cr and Mn levels of female patients with thyroid cancer appeared increase,while there were significant differences in I,Mn,Fe,Ni,Cu,Zn,Se and Sb contents of male patients between the thyroid cancer group and the health control group(U=2.601,2.608,2.603,2.602,1.973,2.603,2.601,2.602,P<0.05),respectively.In thyroid cancer group,the FT3,FT4,T3,T4 correlated with I content(r=06209,0.5116,0.557,0.5923,P<0.05),respectively.There were correlations in the concentrations between Fe and Zn,between Cr and Mn,between Ca and Zn,between Se and Fe,and between Zn and Se in the thyroid cancer group(r=0.5523,0.5528,0.7158,0.5699,0.6371,0.5420,P<0.05),respectively.High concentrations of I and Mn were risk factors for thyroid cancer.The specificity and sensitivity of the risk assessment model of elemental omics of thyroid cancer were all larger than 95%.Conclusion:In patients with thyroid cancer,both of the serum Ca of female patients and serum Fe of male patients play important role besides cobalt(Co),Ni,Cu,Zn,Se and Sb play role,which can provide basis for the diagnosis and treatment of thyroid cancer.The risk assessment model based on elemental omics of thyroid cancer has favorable diagnostic performance.

Artificial intelligence (AI) is widely used as an auxiliary device to diagnosis and treat mental illness, and the scope of its use is gradually expanding. It is widely used as a tool to assist diagnosis in various fields such as radiology and ophthalmology. Meanwhile, in psychiatry, the use of AI has been limited so far due to the lack of a specific objective test for diagnosis and the reliability of medical records for sensitive records such as suicide attempts. However, AI can detect people’s behavior and facial expressions changes more sensitively and more accurately find the correlation between quantitative neurophysiological test results and behavior and emotions. Nowadays, AI is useful as an auxiliary tool in diagnosing not only pediatric and adolescent mental disorders such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), but also affective disorders and psychotic disorders. AI is also actively used to treat insomnia, ASD, ADHD, cognitive dysfunction, depression, anxiety disorders, substance use disorders, and schizophrenia. Many psychiatrists are still cautious about the use of AI. There are concerns that AI cannot replace the doctorpatient relationship, which is the most important element of traditional psychotherapy. Nevertheless, AI can diagnose psychiatric disorders more accurately and can also be useful in improving patients’ symptoms and quality of life through AI or digital treatments. I hope that psychiatrists to contribute to the treatment of human mental illness by becoming users, supervisors, and monitors of AI.

Little is known of the lung cellular immunophenotypes in patients with non-tuberculous mycobacterial lung disease (NTM-LD). Flow-cytometric analyses for the major myeloid and lymphoid cell subsets were performed in less- and more-diseased areas of surgically resected lungs from six patients with NTM-LD and two with Pseudomonas aeruginosa lung disease (PsA-LD). Lymphocytes, comprised mainly of NK cells, CD4 + and CD8 + T cells, and B cells, accounted for ~60% of all leukocytes, with greater prevalence of T and B cells in morediseased areas. In contrast, fewer neutrophils were found with decreased number in morediseased areas. Compared to NTM-LD, lung tissues from patients with PsA-LD demonstrated relatively lower numbers of T and B lymphocytes but similar numbers of NK cells. While this study demonstrated a large influx of lymphocytes into the lungs of patients with chronic NTM-LD, further analyses of their phenotypes are necessary to determine the significance of these findings.

Objective:To summarize the development of a patient with complex regional pain syndrome (CRPS) after distal radius fracture and the effect of repetitive transcranial magnetic stimulation (rTMS) combined with conventional rehabilitation on it. Methods:One patient with CRPS after left distal radius fracture was treated with rTMS combined with conventional rehabilitation for three weeks. The pain degree was evaluated with Visual Analogue Score (VAS), the edema was assessed with volume of hand and circumference of finger, and motion of joint was measured with passive range of motion. The activities of daily living was assessed with modified Barthel Index (MBS). Results:Before treatment, the VAS score was 8, the volume of left hand was 330 ml, the temperature of skin was 36.8 ℃. The activity of flexion and extension of left elbow joint, pronation and supination of left forearm, the flexion, extension, ulnar deviation and temporal deviation of left wrist, and metacarpophalangeal joints (MCP), proximal interphalangeal joint (PIP) and distal interphalangeal joint (DIP) of left hand were all limited. The circumference of left finger was larger than right finger, and the score of MBI was 85. After three weeks of treatment, the VAS score was 2, the volume of the left hand was 310 ml, the temperature of the skin was 33.8 ℃. The activities of left elbow joint, left wrist joint and left MCP, PIP, and DIP were better than before. The score of MBI was 100. Conclusion:rTMS combined with conventional rehabilitation is effective on CRPS after distal radius fracture, in the range of motion and edema of upper extremity, and activities of daily living.

Advances in medical sciences and evidence-based medicine have led to momentous changes in classification and management of thyroid neoplasms. Much progress has been made toward avoiding overdiagnosis and overtreatment of thyroid cancers. The new 2017 World Health Organization (WHO) classification of thyroid neoplasms updated the diagnostic criteria and molecular and genetic characteristics reflecting the biology and behavior of the tumors, and newly introduced the category of borderline malignancy or uncertain malignant potential. Some neoplasms were subclassified, renamed, or redefined as a specific entity. This review introduces changes in the fourth edition WHO classification of thyroid tumors and updates the contemporary diagnosis and classification of thyroid tumors. We also discuss several challenges with the proposal of new diagnostic entities, since they have unique histopathologic and molecular features and clinical relevance.

Objective　Pulmonary function testing is a commonly used indicator for clinical evaluation of the degree of pulmonary fibrosis in patients. This paper aims to investigate the dynamic changes of lung function in mice with pulmonary fibrosis and to establish a range of reference values for lung function parameters in normal Kunming mice.　Methods　Twenty-eight SPF Kunming mice were randomly divided into normal control group (n=14) and model group (n=14). After anesthesia with 10% chloral hydrate, the normal control group only underwent tracheal puncture. The model group received intratracheal puncture and injection of bleomycin (BLM) (5 mg/kg body weight), and the lung function indicators of all mice were detected in the same order on the 1st, 2nd, 3rd and 4th weekends after modeling: Ti, Te, PIF, PEF, TV, EV, RT, MV, f, Penh and EF50.　Results　After intratracheal BLM injection, mice in the model group showed decreased hair softness and smoothness, hair loss and decreased activity after the 2nd week. Compared with the control group, Ti, Te and RT values in the model group significantly increased at week 4 (P<0.05), while the values of PEF, RT, MV, f and EF50 decreased significantly at the same week (P<0.05). Compared with the model group at week 1, the differences in Ti, Te, RT and f values at week 2, 3 and 4 were statistically significant (P<0.05); the differences in MV and EF50 values at week 3 and 4 were statistically significant (P<0.05); while the PIF values only showed differences at week 4 (P<0.001). Compared with the Penh values in the control group at week 2, 3 and 4 (0.553±0.189, 0.662±0.164, 0.712±0.189), the differences of the model group (0.820±0.205, 0.936±0.188, 1.053±0.236) showed statistical significance (P<0.001). Compared with the model group at week 1, the differences of Penh values in the model group only showed statistical significance at week 3 and 4 (P<0.05). Through four-week lung function test, various parameters were obtained, among which the normal range of the main index Penh value was 0.27-0.88.　Conclusion　The lung function detected by the non-invasive whole body plethysmography system was stable and reliable with good effects; the lung function in mice with the BLM-induced pulmonary fibrosis continued to decrease within four weeks. Penh, which reflects airway resistance, can be used for overall screening of the lung function among the test mice after two weeks of modeling.

Objective We aimed to elucidate the prevalence and the antibiotic resistance spectrum of nasal coagulase-negative staphylococci (CoNS) colonization among HIV infectors in Guangzhou. Method After isolation and identification, all CoNS isolates were tested for the antibiotic susceptibility, and the antibiotic resistance genes. Result Among the 1 001 HIV infectors, the prevalence of CoNS and MRCoNS were 57.44% and 48.15%, respectively. The three predominant resistant antibiotics of MRCoNS isolates were penicillin, erythromycin and trimethoprim-sulfame thoxazole, while predominant detection rates of genes were Aac(6’)-aph(2’)、ermC and linA genes. The multidrug resistance rate of MRCoNS isolates were significantly higher than methicillin-susceptible coagulase-negative staphylococci (MSCoNS) isolates (80.69% versus 39.66%, P<0.001, OR=6.36). Conclusions The prevalence and multidrug resistant rates of nasal colonization CoNS and MRCoNS are high among HIV infectors in Guangzhou. MRCoNS isolates were 6.36 times more likely to be of multidrug resistance than MSCoNS isolates.

Asian Continental Ancestry Group ; Child, Preschool ; Electroencephalography ; Female ; GTPase-Activating Proteins ; genetics ; Humans ; Magnetic Resonance Imaging ; Mutation ; genetics ; Spasms, Infantile ; diagnostic imaging ; genetics

Objectives: To explore the modulating effects and related mechanisms of p53-miR-34a-SIRT1 feedback loop in the process of replication senescence of vascular endothelial progenitor cells (EPC). Methods: EPC derived from umbilical cord blood were cultured and identified. Differences on senescence, cell apoptosis, cell cycle and blood tube formation were observed in EPC of 3rdand 6thgeneration. Protein expression of p53, Acetyl-p53, and SIRT1 was also detected by Western blotting in EPC of 3rdand 6thgeneration. The miR-34a inhibitor lentiviral vector was constructed and used to identify whether miR-34a inhibitor can protect 6thgeneration EPC from apoptosis. Results: EPC derived from umbilical cord blood were successfully cultured. The cells senescence rate and apoptosis rate of the 6thgeneration EPC were significantly higher than those of the 3rdgeneration EPC. The cell cycle of 6thgeneration EPC was mainly arrested at G0/G1 phase. The protein expression level of p53 was significantly higher, while the protein expression of acetyl-p53 and SIRT1 was significantly lower in the 6thgeneration EPC than in the 3rdgeneration EPC, all P<0.05. The senescence was significantly attenuated, and late apoptotic cells were significantly reduced, while angiogenesis ability was significantly enhanced in the 6thgeneration EPC transfected with lentiviral vector carrying miR-34a inhibitor. Conclusions: p53-miR-34a-SIRT1 is an important feedback mechanism in the process of EPC replication senescence. The miR-34a inhibitor may be the potential target of delaying EPC senescence.

Many studies have linked cigarette smoke (CS) exposure and tuberculosis (TB) infection and disease although much fewer have studied second-hand smoke (SHS) exposure. Our goal is to review the epidemiologic link between SHS and TB as well as to summarize the effects SHS and direct CS on various immune cells relevant for TB. PubMed searches were performed using the key words “tuberculosis” with “cigarette,”“tobacco,” or “second-hand smoke.” The bibliography of relevant papers were examined for additional relevant publications. Relatively few studies associate SHS exposure with TB infection and active disease. Both SHS and direct CS can alter various components of host immunity resulting in increased vulnerability to TB. While the epidemiologic link of these 2 health maladies is robust, more definitive, mechanistic studies are required to prove that SHS and direct CS actually cause increased susceptibility to TB.
Mycobacterium tuberculosis ; Smoke* ; Smoking ; Tobacco Products ; Tobacco Smoke Pollution ; Tuberculosis*