Objective To explore the advantages and disadvantages of da Vinci robotic-assisted thoracoscopic resection of pediatric posterior mediastinal tumors compared to traditional thoracoscopic surgery.Methods A total of 79 pediatric patients who underwent posterior mediastinal tumor resection at Union Hospital,Tongji Medical College,Huazhong University of Sci-ence and Technology,between January 2018 and October 2021 were included.Among them,47 patients underwent da Vinci ro-botic-assisted thoracoscopic surgery(Group A),and 32 patients underwent traditional thoracoscopic surgery(Group B).The pa-tients'age,gender,weight,tumor type,size,surgical time,intraoperative and postoperative complications,and other factors were compared and analyzed.Results There were 44 male and 35 female patients,with an average age of 4.5 years[(4.7±2.4)vs.(4.4±1.8),P=0.19]and an average weight of 21.7 kg[(23.6±7.5)vs.(20.9±6.1),P=0.10].Tumor sizes were(5.2±3.1)cm vs.(4.5±2.3)cm(P=0.07).All surgeries were completed safely with no intraoperative deaths.Pathological re-sults showed 25 cases of ganglioneuroma,19 cases of ganglioneuroblastoma,16 cases of neuroblastoma,10 cases of lymphangio-ma,8 cases of foregut cyst,and 1 case of lipoblastoma.One patient required conversion to thoracotomy due to intraoperative bleeding.The average anesthesia time[(127±25)vs.(124±30)min,P=0.42]and the operative time[(84±17)vs.(102±27)min,P=0.02)were significantly different.Estimated intraoperative blood loss[(14.6±4.4)vs.(15.4±5.3)mL,P=0.38]and the chest drainage time[(3.7±2.5)vs.(4.1±3.0)days,P=0.09]varied between groups.The average lengths of hospital stay were different[(7.2±1.9)vs.(7.4±2.3)days,P=0.40].Postoperative complications included 1 case of chylo-thorax,3 cases of pneumothorax,and 1 case of Horner's syndrome in Group A.There were 1 case of hemothorax,4 cases of pneumothorax,and 1 case of Horner's syndrome in Group B.Patients with ganglioneuroblastoma and neuroblastoma received postoperative chemotherapy.Follow-up for 2 to 5 years showed that all children recovered well,with no recurrence.Conclusion Both da Vinci robotic-assisted surgery and traditional thoracoscopic surgery are safe and feasible for pediatric mediastinal tumor surgery.The optimized instruments of the da Vinci robotic surgical system offer advantages in surgeries involving larger tumors or complex anatomical structures.

Objective To explore the correlation between high-sensitivity C-reactive protein(hs-CRP)-to-lymphocyte ratio(CLR)and the severity of coronary heart disease,as well as the degree of coronary artery lesions.Methods A total of 603 patients who underwent coronary angiography in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to November 2023 were conducted on the retrospective analysis.All patients were divided into non-coronary heart disease group,stable an-gina pectoris(SAP)group,and acute coronary syndrome(ACS)group according to clinical classification.Basing on the Gensini score for coronary arteries,the extent of stenosis in patients'coronary arteries was classified into mild(0-31 points),moderate(31-61 points),and severe(≥61 points)groups.Differences in CLR and neutrophil-to-lymphocyte ratio(NLR)among groups were com-pared.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of CLR,NLR,and troponin Ⅰ for ACS.Spearman correlation analysis was used to evaluate the correlation between CLR,NLR and the degree of coronary stenosis.Results The CLR in the ACS group was higher than that in the SAP group,which was in turn higher than that in the non-coronary heart disease group,the differences were statistically significant(P＜0.05).The troponin Ⅰ and NLR in the ACS group were significantly higher than those in the SAP group(P＜0.05),but there was no statistical significance between the SAP group and non-coronary heart disease group(P＞0.05);the area under the curve(AUC)of CLR,NLR and troponin Ⅰ in predicting ACS were 0.787,0.730 and 0.837,re-spectively(P＜0.001).At the optimal cut-off value,the sensitivity and specificity of CLR were 75.5％and 71.6％.In the mild,moderate,and severe coronary lesion groups,with the degree of coronary stenosis worsened,levels of NLR and CLR increased correspond-ingly,and the differences were statistically significant(P＜0.05);Spearman correlation analysis demonstrated a positive correlation be-tween CLR,NLR and the degree of coronary stenosis in coronary heart disease patients(rCLR=0.308,rNLR=0.247,P＜0.001).Conclusion Levels of CLR have a positive correlation with the severity of disease and the degree of coronary artery lesions in coronary heart disease patients.Compared with NLR and troponin Ⅰ,it can better reflect the differences between stable-phase coronary heart dis-ease patients and non-coronary heart disease patients,and has a higher sensitivity in predicting ACS patients,providing clinical value for early diagnosis and condition evaluation in coronary heart disease patients.

Objective To explore the correlation between high-sensitivity C-reactive protein(hs-CRP)-to-lymphocyte ratio(CLR)and the severity of coronary heart disease,as well as the degree of coronary artery lesions.Methods A total of 603 patients who underwent coronary angiography in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to November 2023 were conducted on the retrospective analysis.All patients were divided into non-coronary heart disease group,stable an-gina pectoris(SAP)group,and acute coronary syndrome(ACS)group according to clinical classification.Basing on the Gensini score for coronary arteries,the extent of stenosis in patients'coronary arteries was classified into mild(0-31 points),moderate(31-61 points),and severe(≥61 points)groups.Differences in CLR and neutrophil-to-lymphocyte ratio(NLR)among groups were com-pared.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of CLR,NLR,and troponin Ⅰ for ACS.Spearman correlation analysis was used to evaluate the correlation between CLR,NLR and the degree of coronary stenosis.Results The CLR in the ACS group was higher than that in the SAP group,which was in turn higher than that in the non-coronary heart disease group,the differences were statistically significant(P＜0.05).The troponin Ⅰ and NLR in the ACS group were significantly higher than those in the SAP group(P＜0.05),but there was no statistical significance between the SAP group and non-coronary heart disease group(P＞0.05);the area under the curve(AUC)of CLR,NLR and troponin Ⅰ in predicting ACS were 0.787,0.730 and 0.837,re-spectively(P＜0.001).At the optimal cut-off value,the sensitivity and specificity of CLR were 75.5％and 71.6％.In the mild,moderate,and severe coronary lesion groups,with the degree of coronary stenosis worsened,levels of NLR and CLR increased correspond-ingly,and the differences were statistically significant(P＜0.05);Spearman correlation analysis demonstrated a positive correlation be-tween CLR,NLR and the degree of coronary stenosis in coronary heart disease patients(rCLR=0.308,rNLR=0.247,P＜0.001).Conclusion Levels of CLR have a positive correlation with the severity of disease and the degree of coronary artery lesions in coronary heart disease patients.Compared with NLR and troponin Ⅰ,it can better reflect the differences between stable-phase coronary heart dis-ease patients and non-coronary heart disease patients,and has a higher sensitivity in predicting ACS patients,providing clinical value for early diagnosis and condition evaluation in coronary heart disease patients.

Objective To explore the advantages and disadvantages of da Vinci robotic-assisted thoracoscopic resection of pediatric posterior mediastinal tumors compared to traditional thoracoscopic surgery.Methods A total of 79 pediatric patients who underwent posterior mediastinal tumor resection at Union Hospital,Tongji Medical College,Huazhong University of Sci-ence and Technology,between January 2018 and October 2021 were included.Among them,47 patients underwent da Vinci ro-botic-assisted thoracoscopic surgery(Group A),and 32 patients underwent traditional thoracoscopic surgery(Group B).The pa-tients'age,gender,weight,tumor type,size,surgical time,intraoperative and postoperative complications,and other factors were compared and analyzed.Results There were 44 male and 35 female patients,with an average age of 4.5 years[(4.7±2.4)vs.(4.4±1.8),P=0.19]and an average weight of 21.7 kg[(23.6±7.5)vs.(20.9±6.1),P=0.10].Tumor sizes were(5.2±3.1)cm vs.(4.5±2.3)cm(P=0.07).All surgeries were completed safely with no intraoperative deaths.Pathological re-sults showed 25 cases of ganglioneuroma,19 cases of ganglioneuroblastoma,16 cases of neuroblastoma,10 cases of lymphangio-ma,8 cases of foregut cyst,and 1 case of lipoblastoma.One patient required conversion to thoracotomy due to intraoperative bleeding.The average anesthesia time[(127±25)vs.(124±30)min,P=0.42]and the operative time[(84±17)vs.(102±27)min,P=0.02)were significantly different.Estimated intraoperative blood loss[(14.6±4.4)vs.(15.4±5.3)mL,P=0.38]and the chest drainage time[(3.7±2.5)vs.(4.1±3.0)days,P=0.09]varied between groups.The average lengths of hospital stay were different[(7.2±1.9)vs.(7.4±2.3)days,P=0.40].Postoperative complications included 1 case of chylo-thorax,3 cases of pneumothorax,and 1 case of Horner's syndrome in Group A.There were 1 case of hemothorax,4 cases of pneumothorax,and 1 case of Horner's syndrome in Group B.Patients with ganglioneuroblastoma and neuroblastoma received postoperative chemotherapy.Follow-up for 2 to 5 years showed that all children recovered well,with no recurrence.Conclusion Both da Vinci robotic-assisted surgery and traditional thoracoscopic surgery are safe and feasible for pediatric mediastinal tumor surgery.The optimized instruments of the da Vinci robotic surgical system offer advantages in surgeries involving larger tumors or complex anatomical structures.

Objective: Social media addiction and internet gaming disorder may cause mental health problems among a minority of university students. The Bergen Social Media Addiction Scale (BSMAS) and the 9-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF) are commonly used worldwide. However, they have not been translated or validated into Indonesian. The present study aimed to translate and validate the BSMAS and IGDS9-SF in an Indonesian context among young adults. Methods: A multi-center, web-based cross-sectional study was conducted among 458 university students (74% female; mean age 22.5 years) in Indonesia from June to December 2021. The BSMAS and IGDS9-SF were translated into Indonesian. Internal consistency (using Cronbach’s α and McDonald’s ω) and factor structure (using confirmatory factor analysis) of the two instruments were examined. Concurrent validity of BSMAS and IGDS9-SF was examined using their correlations with two external concepts: nomophobia and psychological distress. Results: Internal consistency of the Indonesian BSMAS and IGDS9-SF were both acceptable (Cronbach’s α=0.80 and 0.90; McDonald’s ω=0.86 and 0.92). Both instruments were unidimensional with good factor loadings (0.54–0.78 for BSMAS; 0.63–0.79 for IGDS9-SF). Moreover, BSMAS and IGDS9-SF had stronger associations with nomophobia (r=0.58 and 0.12; p<0.001) than with psychological distress (r=0.43 and 0.15; p<0.001). Conclusion The Indonesian versions of the BSMAS and IGDS9-SF had good psychometric properties in terms of linguistic validity, unidimensionality, and reliability. The findings indicate the tools are appropriate for assessing the risk of social media addiction and internet gaming disorder among university students in Indonesia.

BACKGROUND/OBJECTIVES: This study aimed to examine the food security status of urban poor adolescents and its association with diet quality. SUBJECTS/METHODS: A cross-sectional survey was conducted among 188 adolescents aged 13–18 yrs living in Kuala Lumpur, Malaysia. Household food insecurity and dietary intake data were collected using the Radimer/Cornell hunger and food insecurity instrument and 2-day 24-h dietary recalls, respectively. Diet quality was determined using the Malaysian Healthy Eating Index (HEI). Weight and height were measured and body mass index-for-age, as well as height-for-age z scores were calculated. RESULTS: The present study revealed that 47.9% of the adolescents experienced household food insecurity, 24.5% experienced individual food insecurity, 18.6% household food security, and 9.0% child hunger. The mean score of diet quality was 56.83 ± 10.09, with a significantly lower HEI score among food insecure adolescents (household food insecure, individual food insecure, and child hunger) than household food secure adolescents (P = 0.001). The differences between food secure and food insecure households were found to be significant for energy (P = 0.001) and nutrients including proteins (P = 0.006), carbohydrates (P = 0.005), dietary fiber (P = 0.001), folate (P < 0.001), and vitamin C (P = 0.006). The multiple linear regression showed that adolescents who experienced food insecurity (β = −0.328; P = 0.003) were found to be significantly associated with poor diet quality (F = 2.726; P < 0.01), wherein 13.3% of the variation in the diet quality was explained by the food security status. CONCLUSIONS Experiencing food insecurity contributed to poor diet quality among urban poor adolescents. Further longitudinal studies are needed to comprehensively understand this association to improve food insecurity and diet quality among urban poor communities.

Gastrointestinal Tract/pathology* ; Humans ; Immunoblastic Lymphadenopathy/pathology* ; Lymphoma, T-Cell, Peripheral/pathology*

Objective: To observe the effects of herb-partitioned moxibustion and ginger-partitioned moxibustion on the growth of colon tumors in rats with colitis-associated colon cancer (CACC), and explore the mechanism of moxibustion intervening CACC through the purinergic receptor P2X ligand-gated ion channel 7 (P2X7R)/signal transducer and activator of transcription 3 (STAT3)/vascular endothelial growth factor (VEGF) pathway. Methods: A total of 26 male Sprague-Dawley rats were selected. According to the random number table method, 6 rats were selected as the normal group. The remaining 20 rats were injected intraperitoneally with azoxymethane (AOM) combined with oral dextran sodium sulfate (DSS) to prepare the CACC model. After the model was successfully established, 2 rats were randomly selected for model identification. The remaining 18 rats which were successfully modeled were randomly divided into a model group, a herb-partitioned moxibustion group and a ginger-partitioned moxibustion group, with 6 rats in each group. Moxibustion intervention was performed in the herb-partitioned moxibustion group and the ginger-partitioned moxibustion group at Qihai (CV 6) and bilateral Tianshu (ST 25). Moxibustion was performed twice at each point each time, once a day, at a 1-day interval after 6 consecutive interventions, for a total of 30 interventions. After intervention, the colon tumor load, pathological change and histopathological score were observed. Immunohistochemistry was used to detect the expressions of VEGF, P2X7R, phospho-STAT3 (p-STAT3), and nuclear factor-kappa B p65 (NF-κB p65) proteins in rat colon tissue. Western blot was used to detect the levels of p-STAT3 and NF-κB p65 proteins in rat colon tissue. Results: Compared with the normal group, the colon tumor load and histopathological score in the model group were significantly increased (both P<0.001), and different grades of dysplasia were observed in colon tissue from the model group, reaching the degree of adenocarcinoma; the expression level of P2X7R protein in colon tissue was significantly decreased (P<0.001), and the expression levels of p-STAT3, NF-κB p65 and VEGF proteins were significantly increased (all P<0.001) in the model group. Compared with the model group, the colon tumor load, colon histopathological score and the levels of p-STAT3, NF-κB p65 and VEGF proteins in colon tissue were significantly decreased (all P<0.05) in the herb-partitioned moxibustion group and the ginger-partitioned moxibustion group while the expression levels of P2X7R protein in colon tissue were significantly increased (both P<0.05). Conclusion: Both herb-partitioned moxibustion and ginger-partitioned moxibustion can reduce the colon tumor load in CACC rats and delay the progression of colon adenomas. The mechanism may be mediated by the P2X7R/STAT3 pathway to inhibit STAT3 phosphorylation, thereby reducing VEGF protein expression.

OBJECTIVE: To observe the clinical efficacy of acupuncture method for mild cognitive impairment in the elderly. METHODS: A total of 96 patients were randomly divided into an observation group, a control group and a waiting group, 32 cases in each group. The patients in the observation group were treated with acupuncture at Baihui (GV 20), Shenting (GV 24), Yintang (GV 29) and Sishencong (EX-HN 1), etc, while the patients in the control group were treated with nonpenetrating sham acupuncture at the same acupoints as the observation group. The treatment was given once every other day, three times a week for 8 weeks. The patients in the waiting group only received health guidance for 8 weeks. Montreal cognitive assessment scale (MoCA) and mini-mental state examination (MMSE) were used before and after 8-week treatment in all three groups. The observation group and the control group were followed up for 2 months and evaluated with MoCA and MMSE. RESULTS: The MoCA scores in the observation group after treatment and during follow-up were higher than before treatment (<0.01), but there was no significant difference between follow-up and after treatment (>0.05). The MoCA scores in the control group after treatment and during follow-up were higher than before treatment (<0.01, <0.05), and the MoCA score during follow-up was lower than after treatment (<0.01). There was no significant difference before and after treatment in the waiting group (>0.05). The difference before and after treatment in the observation group was higher than the control group and waiting group (<0.01), while that in the control group was higher than the waiting group (<0.01). The difference between follow-up and before treatment in the observation group was higher than the control group (<0.01), and the improving between follow-up and after treatment was superior to the control group (<0.01). The MMSE scores after treatment and during follow-up were higher than before treatment in the observation group (<0.01), but there was no significant difference between the follow-up and after treatment (>0.05). The MMSE scores after treatment and during follow-up were higher than before treatment in the control group (<0.01), and the MMSE score during follow-up was lower than after treatment (<0.01). There was no significant difference before and after treatment in the waiting group (>0.05). The difference before and after treatment the observation group and control group was not significant (>0.05), and those in the two groups were higher than the waiting group (<0.01). The difference between follow-up and before treatment in the observation group was higher than the control group (<0.01), and the difference between follow-up and after treatment was lower than the control group (<0.01). CONCLUSION acupuncture method could improve cognitive impairment in elderly patients with mild cognitive impairment.
Acupuncture Points ; Acupuncture Therapy ; Aged ; Cognitive Dysfunction ; therapy ; Female ; Humans ; Male ; Mental Status and Dementia Tests ; Treatment Outcome

Objective To investigate the effect of matrine on the cardiac function and left ventricular remodeling in rats with isoproterenol (ISO) -induced cardiac hypertrophy.Methods Seventy-two adult male SD rats were randomly divided into six groups as follows:normal group,model group,control group (matrine 200 mg · kg-1 · d-1),large-,medium-and small-dose experimental groups(matrine 200,100,50 rng · kg-1 · d-1),and there were 12 rats in each group.The 5 mg · kg-1 · d-1 isoproterenol (ISO) was subcutaneously injected to establish the model of chronic pathological left ventricular hypertrophy in model group and experimental groups.The 0.9％ NaCl was administrated to rats in normal group and control group.The aforementioned medications were offered once daily to 12 rats of each group for 7 successive days.On day 8,cardiac function was evaluated by the biological function experiment system.The hematoxylin-eosin staining was used to observe pathological morphology changes of the left ventricular tissues.Insulin-like growth factor-1 (IGF-1) and transforming growth factor-β1(TGF-β1)levels in serum were determined by ELISA.Expression levels of IGF-1and TGF-β1 genes in myocardial tissues were detected by real time fluorescence quantitative PCR method.Results After drug-concerned treatment,serum IGF-1 levels in normal group,model group,control group,large-,medium-and small-dose experimental groups were separately (2.04 ± 0.52),(3.66 ± 0.97),(2.08±0.95),(1.98 ± 0.98),(1.93 ±0.78) and (1.59 ± 0.48)ng · mL-1;moreover,serum TGF-β1 levels in those groups were (94.11 ±10.63),(139.98 ± 37.64),(90.36 ± 30.02),(84.55 ± 45.70),(74.74 ± 42.18) and (72.84 ± 21.43) pg · mL-1.In contrast with model group,the serum IGF-1 or TGF-β1 levels were lowered in other groups (P ＜ 0.05).Similarly,expression levels of cardiac IGF-1 genes in normal group,model group,control group,large-,medium-and small-dose experimental groups were sequentially 3.34 ± 3.27,10.91 ± 7.44,3.09 ± 1.86,0.62 ± 0.44,0.64 ± 0.26,1.00 ± 0.35;furthermore,expression levels of cardiac TGF-β1 genes were successively 0.70 ± 0.67,10.97 ± 9.86,0.63 ± 0.32,1.25 ± 0.98,1.76 ± 2.40,0.86 ± 0.46;and hence the TGF-β1 gene levels in model group were much higher than those of other groups (P ＜ 0.01).Conclusion Matrine significantly improved the cardiac function in rats with ISO-induced left ventricular hypertrophy and simultaneously regulated the cardiac hypertrophy-causing cytokines.