Perimenopausal syndrome （MPS）， a common endocrine system disease， is one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in endocrinology， gynecology， and interdisciplinary fields of both Western and Chinese medicine to discuss the advantages and challenges of diagnosing and treating MPS with Western medicine， TCM， and integrative medicine. Experts at the conference believe that MPS is initiated by estrogen decline and rooted in deficiency， with the pathogenesis being imbalance between Yin and Yang in the kidney. The hormone replacement therapy in Western medicine for menopause can rapidly alleviate related symptoms by quickly restoring the estrogen level and timely detect and delay complications of menopause， whereas such a therapy has certain risks， necessitating close monitoring of adverse reactions. Moreover， the various contraindications and precautions limit the clinical application of the hormone replacement therapy. TCM has advantages in synergistically alleviating symptoms such as hot flashes， sweating， sleep disorders， and emotional abnormalities of MPS without causing obvious adverse reactions. However， its efficacy is slower than the hormone replacement therapy， and the TCM evidence for preventing and treating complications of menopause remains unclear. Three suggestions were proposed for the future development of both Western and TCM for ameliorating MPS. First， an integrated diagnosis and treatment system for MPS with both Western and Chinese medicine should be established. Second， high-quality evidence-based interventions for MPS should be developed with TCM alone or in combination with Western medicine. Third， efforts should be made to promote the new TCM drug development and the interdisciplinary cooperation for treating MPS.

Objective:To explore the value of salivary gland imaging based on deep learning and Delta radiomics in assessing salivary gland injury after 131I treatment in post-thyroidectomy thyroid cancer patients. Methods:A retrospective analysis on 223 patients (46 males, 177 females, age(47.7±14.0) years ) with papillary thyroid cancer, who underwent total thyroidectomy and 131I treatment in Affiliated Hospital of Guilin Medical University between December 2019 and January 2022, was conducted. All patients underwent salivary gland 99Tc mO 4- imaging before and after 131I therapy. The patients were categorized according to salivary gland function based on 99Tc mO 4- imaging results (normal salivary gland vs salivary gland injury), and divided into training and test sets in a ratio of 7∶3. A ResNet-34 neural network model was trained using images at the time of maximum salivary gland radioactivity and those based on background radioactivity counts for structured image feature data. The Delta radiomics approach was then used to subtract the image feature values of the two periods, followed by feature selection through t-test, correlation analysis, and the least absolute shrinkage and selection operator( LASSO) algorithm, to develop logistic regression (LR), support vector machine (SVM), and K-nearest neighbor (KNN) predictive models. The diagnostic performance of 3 models for salivary gland function on the test set was compared with that of the manual interpretation. The AUCs of the 3 models on the test set were compared (Delong test). Results:Among the 67 cases of the test set, the diagnostic accuracy of 3 physicians were 89.6%(60/67), 83.6%(56/67), and 82.1%(55/67) respectively, with the time required for diagnosis of 56, 74 and 55 min, respectively. The accuracies of LR, SVM, and KNN models were 91.0%(61/67), 86.6%(58/67), and 82.1%(55/67), with the required times of 12.5, 15.3 and 17.9 s, respectively. All 3 radiomics models demonstrated good classification and predictive capabilities, with AUC values for the training set of 0.972, 0.965, and 0.943, and for the test set of 0.954, 0.913, and 0.791, respectively. There were no significant differences among the AUC values for the test set ( z values: 0.72, 1.18, 1.82, all P>0.05). Conclusion:The models based on deep learning and Delta radiomics possess high predictive value in assessing salivary gland injury following 131I treatment after surgery in patients with thyroid cancer.

Objective This study aimed to investigate the potential relationship between urinary metals copper (Cu), arsenic (As), strontium (Sr), barium (Ba), iron (Fe), lead (Pb) and manganese (Mn) and grip strength. Methods We used linear regression models, quantile g-computation and Bayesian kernel machine regression (BKMR) to assess the relationship between metals and grip strength.Results In the multimetal linear regression, Cu (β=-2.119), As (β=-1.318), Sr (β=-2.480), Ba (β=0.781), Fe (β= 1.130) and Mn (β=-0.404) were significantly correlated with grip strength (P < 0.05). The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was -1.007 (95％ confidence interval:-1.362, -0.652; P < 0.001) when each quartile of the mixture of the seven metals was increased. Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength, with Cu, As and Sr being negatively associated with grip strength levels. In the total population, potential interactions were observed between As and Mn and between Cu and Mn (Pinteractions of 0.003 and 0.018, respectively).Conclusion In summary, this study suggests that combined exposure to metal mixtures is negatively associated with grip strength. Cu, Sr and As were negatively correlated with grip strength levels, and there were potential interactions between As and Mn and between Cu and Mn.

Objective: To investigate the etiology, complications, and prognostic factors of stage 5 chronic kidney disease (CKD5) in children. Methods: A case series study was conducted to retrospectively analyze the general situation, clinical manifestations, laboratory tests, genetic testing, and follow-up data (until October 2022) of 174 children with CKD5 who were diagnosed and hospitalized at the Children's Hospital of Chongqing Medical University from April 2012 to April 2021. The characteristics of complications in the children were compared based on age, gender, and etiology. Based on the presence or absence of left ventricular hypertrophy (LVH), patients were divided into LVH group and non LVH group for analyzing the influencing factors of cardiovascular disease. Patients were also divided into death group and survival group, peritoneal dialysis group and hemodialysis group based on the follow-up data for analyzing the prognostic factors. The chi-square test, independent sample t-test, Fisher exact probability test, Mann-Whitney U test and Kruskal Wallis test were used to analyze data among different groups. Multivariate Logistic regression analysis was used to identify the prognostic factors. Results: A total of 174 children with CKD5 were enrolled in the study (96 boys and 78 girls), aged 11.2 (8.2, 13.0) years. Congenital kidney and urinary tract malformations (CAKUT) were the most common causes of the CKD5 (84 cases, 48.3%), followed by glomerular diseases (83 cases, 47.7%), and among which 28 cases (16.1%) were hereditary glomerular diseases. The common complications of CKD5 included anemia (98.2%, 165/168), mineral and bone disorder in chronic kidney disease (CKD-MBD) (97.7%, 170/174), lipid metabolism disorders (87.5%, 63/72), hypertension (81.4%, 127/156) and LVH (57.6%,57/99). The incidences of hypertension in primary glomerular disease were higher than that in CAKUT(93.8%(30/32) vs.73.7%(56/76),χ²=5.59,P<0.05). The incidences of hypertension in secondary glomerular disease were higher than that in CAKUT and that in hereditary kidney disease (100.0%(20/20) vs. 73.7%(56/76), 68.2%(15/22), both P<0.05). The incidence of hypocalcemia in CAKUT, primary glomerular disease, and hereditary kidney disease was higher than that in secondary glomerular disease (82.1%(69/84), 88.2%(30/34), 89.3%(25/28) vs. 47.6%(10/21), χ²=10.21, 10.75, 10.80, all P=0.001); the incidence of secondary hyperparathyroidism in women was higher than that in men (80.0%(64/80) vs. 95.0%(57/60), χ²=6.58, P=0.010). The incidence of LVH in children aged 6-<12 was higher than that in children aged 12-18 (73.5%(25/34) vs. 43.1%(22/51), χ²=7.62, P=0.006). Among 113 follow-up children, the mortality rate was 39.8% (45/113). Compared to the survival group, the children in the death group had lower hemoglobin, higher blood pressure, lower albumin, lower alkaline phosphatase and higher left ventricular mass index ((67±19) vs. (75±20) g/L, 142 (126, 154) vs. 128(113, 145) mmHg(1 mmHg=0.133 kPa), (91±21) vs. (82±22) mmHg, 32 (26, 41) vs. 40 (31, 43) g/L, 151 (82, 214) vs. 215 (129, 37) U/L, 48 (38, 66) vs. 38(32, 50) g/m^2.7,t=2.03, Z=2.89, t=2.70, Z=2.49, 2.79, 2.29,all P<0.05), but no independent risk factors were identified (all P>0.05). The peritoneal dialysis group had better alleviation for anemia, low calcium, and high phosphorus than the hemodialysis group ((87±22) vs. (72±16) g/L, (1.9±0.5) vs. (1.7±0.4) mmol/L, (2.2±0.7) vs. (2.8±0.9) mmol/L, t=2.92, 2.29, 2.82, all P<0.05), and the survival rate of the peritoneal dialysis group was significantly higher than that of the hemodialysis group (77.8% (28/36) vs. 48.4% (30/62), χ²=8.14, P=0.004). Conclusions: CAKUT is the most common etiology in children with CKD 5, and anemia is the most common complication. The incidence of complications in children with CKD 5 varies with age, gender and etiology. Anemia, hypertension, hypoalbuminemia, reduced alkaline phosphatase and elevated LVMI may be the prognostic factors in children with CKD5. Peritoneal dialysis may be more beneficial for improving the long-term survival rate.
Male ; Humans ; Child ; Female ; Retrospective Studies ; Alkaline Phosphatase ; Kidney Failure, Chronic/therapy* ; Renal Insufficiency, Chronic/therapy* ; Hypertension ; Risk Factors ; Hypertrophy, Left Ventricular/etiology* ; Anemia/etiology*

At present, the prevention and control of new coronavirus has entered a critical period. However, the use of quantitative real-time PCR (qRT-PCR)assays for the detection of viral nucleic acid, as a crucial diagnostic approach, has been doubted in clinical practice. Herein, we have reviewed the current status of epidemic prevention and control, latest development of detection technologies, disease characteristics, clinical sampling and transport. It has also discussed the factors that may affect the performance of viral nucleic acid detection, and suggested some effective methods to improve the detection performance of the assays.

At present, the prevention and control of new coronavirus has entered a critical period. However, the use of quantitative real-time PCR (qRT-PCR) assays for the detection of viral nucleic acid, as a crucial diagnostic approach, has been doubted in clinical practice. Herein, we have reviewed the current status of epidemic prevention and control, latest development of detection technologies, disease characteristics, clinical sampling and transport. We have also discussed the factors that may affect the performance of viral nucleic acid detection, and suggested some effective methods to improve the detection performance of the assays.

Objective To discuss the relationship between anxiety and nutriture of postoperative patients with laryngeal carcinoma.Methods SAS was used to investigate and analyze 150 patients 24-48 hours after laryngectomy of their anxiety,and 78 cases were chosen for further study and divided into the mile group,moderate group and severe group according to their anxiety degree.NRS2002 was used to evaluate their nutriture a day before and 10 days after operation,and lymphocyte count,stitches removal time,extubation time and hospitalization time after surgery were compared.Results There were statistically significant differences of BMI,ALB,lymphocyte count 10 days after surgery,stitches removal time,extubation time and hospitalization time after surgery among three groups (F =58.540,88.062,61.581,113.31,23.77,37.10,respectively; P ＜ 0.01).Patients with higher degree of anxiety had worse nutriture and worse prognosis.Conclusions There is close relationship between anxiety and nutriture in postoperative patient with laryngeal carcinoma.Patients with higher level of anxiety had worse nutriture,worse wound healing and longer hospitalization time,alleviating their anxiety can help improve their nutriture,and psychological intervention can improve their prognosis.

Objective To identify the differentially expressed genes of osteoblasts under the stimulation of mechano growth factor E peptide( MGF-Ct24E) and mechanical stress by microarray analysis. Methods Primary osteoblasts were cultured in vitro, which were subjected to mechanical stimulation(with the mechanical strain of 12% and frequency of 0.5 Hz) and MGF-Ct24E treatment(50 mg/L), respectively. The gene expression profiles were analysed by cDNA microarrys and quantitative PCR was used to validate the microarray data. ResultsCompared with the control group, 1 866 genes were found to have differentially expressed in the mechanical loading group, in which 1 113 genes were up-regulated, while 753 genes were down-regulated. 1 178 genes were found to have differentially expressed in the MGF-Ct24E group, in which 796 genes were up-regulated and 382 genes were down-regulated. GO analysis suggested that the gene expression profile of MGF-Ct24E group was consistent with that of the mechanical loading group and differentially expressed genes were mainly involved in cell proliferation and differentiation, response to mechanical stress and mechaotransduction. ConclusionsThe microarray analysis showed that MGF-Ct24E treatment had similar effects with the mechanical loading on the gene expression of osteoblasts, which might provide a novel approach to study the usage of MGF-Ct24E for treating bone repair in the absence of mechanical stimulation.

Objective To study the needing of different payments of inpatients for nursing operation inform and to provide theoretical guidance for clinical nursing operation inform,so as to meet patients' personalities and diversification needs.Methods Totals of 774 inpatients in four hospitals of Guilin city were investigated with self-designed questionnaire from January to March in 2011,then the results were analyzed.Results Inpatients' needs for nursing operation inform were high both in four groups public expense,selfexpense,basic medical insurance of city,new type of rural cooperative medical care insurance,and especially 85％ inpatients needed most was 11 items of needs.Most of patients selected nurses to be the informer and they were willing to informed in oral way.There were significant difference on the needing of 12 items nursing operations among inpatients with different payments ( P ＜ 0.05 or P ＜ 0.01 ).Conclusions It is necessary to sufficiently assess the needing of different payments inpatients for inform in order to meet their infromed needs of nursing operations.Nurses as important informers,we should pay attention to their role.

OBJECTIVETo explore the effective therapy for maintenance hemodialysis patients in dificiency syndrome in end-stage renal disease.

METHODSNinety-seven cases were divided into an observation group (51 cases) and a control group (46 cases) randomly, and routine western medicine was used in both of them. On this base, moxibustion was used in Zusanli (ST 36) and Sanyinjiao (SP 6) in paper-tube-moxibustion equipment in the observation group. Evaluate the therapeutic effect on symptoms by comparing the symptom scores in two groups before and after treatment.

RESULTSAll the symptom scores in the observation group were improved after treatment, and the differences were significant (all P < 0.05). Among all symptoms, the most improved ones included lassitude and fatigue, short breath and aversion to talk, poor appetite, soreness and softness of waist and knees, aversion to cold, cold extremities and so on. In the aspect of therapeutic effect on symptoms, the total effective rate in observation group (64.7%, 33/51) was higher than that in control group (23.9%, 11/46), and the difference was significant (P < 0.05).

CONCLUSIONMoxibustion can improve the clinical symptoms of maintenance hemodialysis patients in end-stage renal disease, and can generate some therapeutic effect to the dificiency syndrome of this disease.

Acupuncture Points ; Adult ; Aged ; Female ; Humans ; Kidney Failure, Chronic ; therapy ; Male ; Middle Aged ; Moxibustion ; Renal Dialysis ; Young Adult