Objective:To explore the characteristics of depression,anxiety,and stress symptoms among Chinese men who have sex with men(MSM),to determine the links of psychological resilience with these symptoms at the symptom level,and to provide insights for tailoring mental health intervention measures for MSM.Methods:A cross-sectional survey was conducted in southwestern China(Chongqing and Sichuan)from May to August 2022.The Depression,Anxiety,and Stress Scale-21 was used to assess mental health-related symptoms in MSM.Psychological resilience was evaluated using the brief version of the Connor-Davidson Resilience Scale.A regularized partial correlation network was constructed,and then a Bayesian network was established to identify potential causal rela-tionships in symptoms.A flow network was used to explore the link between psychological resilience and symptoms of anxiety,depres-sion,and stress.Results:A total of 938 MSM were included in the analysis.The proportion of MSM with depression,anxiety,and stress was 29.74%."Panic","scared","no relax",and"down-hearted"showed high expected influence.Bridging symptoms were"panic","down-hearted",and"agitated".Central and bridging symptoms also appeared at the top of the Bayesian network.Psychological resil-ience was negatively correlated with"no initiative","down-hearted","meaningless","panic",and"no relax".Conclusion:Central symptoms"panic","scared","no relax",and"down-hearted",as well as bridging symptoms"panic","down-hearted",and"agi-tated"are identified through network analysis.The potential causal priority of these symptoms is prominent.Interventions tailored to central and bridging symptoms may be effective,and interventions for enhancing psychological resilience may alleviate negative emotion-related symptoms,especially depressive symptoms in the MSM population.

OBJECTIVE To evaluate the efficacy of oral and facial muscle functional training in treating adult obstructive sleep apnea(OSA)and to identify clinical indicators influencing treatment outcomes.METHODS Through a prospective cohort study,patients diagnosed with OSA in the study unit were recruited to undergo a 3-month myofunctional therapy,including soft palate-related muscles,tongue muscles,buccal muscles,and labial muscles in multiple muscle groups,once a day,five times a week,with the use of offline clinic guidance,and the APP program video follow up training for effective training.Data were collected on multiple dimensions including physical signs,sleep breathing monitoring parameters,and airway measurements from imaging studies.Treatment efficacy was assessed by comparing subjective and objective sleep indicators before and after training.Patients were categorized into effective and ineffective groups based on treatment outcomes.Differences in baseline clinical indicators between these groups were analyzed using univariate and multivariate regression analyses.RESULTS The study finally included 58 people,51 males and 7 females,age(38.36±8.96)years,BMI(27.14±3.68)kg/m2,AHI of the enrolled patients was reduced from(31.27±22.28)times/h pre-training to(26.27±21.38)times/h post-training,the minimum oxygen saturation was increased from(78.43±10.07)%to(80.50±10.06)%,snoring index decreased from(62.80±75.20)times/h to(36.40±43.19)times/h,and ESS score decreased from 7.00±5.31 pre-training to 5.50±3.17.By comparing the effective and ineffective groups,it was found that there was a statistically significant difference in the tongue position and ESS scores between the two groups(both P<0.05),while no significant differences were found in gender,age,neck circumference,posterior soft palate area,uvula area,posterior tongue area,or posterior epiglottic area(all P>0.05).Univariate logistic regression analysis indicated that tongue position,AHI,and ESS scores were factors affecting the efficacy of oral and facial muscle function training.Multivariate regression analysis revealed that AHI was an independent prognostic factor for this training in OSA patients.CONCLUSION Oral and facial muscle function training can improve both subjective and objective sleep breathing indices in OSA patients.Tongue position,AHI,and ESS scores may serve as prognostic factors for OSA treatment,aiding in guiding subsequent individualized intervention therapies.

Objective:To investigate the relationship between the Palatopharyngeal Arch Staging System（PASS） and the severity of Obstructive Sleep Apnea（OSA）, as well as the patterns of airway collapse, while further assessing its clinical applicability. Methods:A total of 98 patients diagnosed with OSA at the Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen University Affiliated Shenzhen Hospital, were recruited for this study. Data collected included basic demographic information, oropharyngeal laryngoscopy videos, results from awake laryngoscopy Muller tests, and indicators from sleep respiratory monitoring. The distribution of each PASS stage among patients with varying severities of OSA was compared. Additionally, both objective and subjective sleep indicators along with occurrences of airway collapse in OSA patients across different PASS stages were analyzed. Results:In total, 98 patients participated in this study. Statistically significant differences were observed in neck circumference, weight, Body Mass Index（BMI）, tongue position, and PASS stage when comparing mild-to-moderate OSA patients to those with severe OSA（P<0.05）. Furthermore, there were statistically significant variations in Apnea-Hypopnea Index（AHI）, minimum blood oxygen saturation levels, average blood oxygen saturation levels, oxygen desaturation index values, and total oxygen desaturation indices among OSA patients categorized by different PASS stages. Multiple comparisons revealed statistically significant differences in AHI as well as minimum and average blood oxygen saturation levels between patients at PASS 1 versus those at PASS 3（P<0.05）. Additionally, notable differences regarding oropharyngeal collapse rates among OSA patients across various PASS stages were identified; specifically between those at PASS stage 1 and those at PASS stage 3. Conclusion:The proportion of PASS stages for OSA varies across different severity levels. The severity of OSA and the degree of airway collapse in patients with varying PASS stages also exhibit significant differences. Patients classified as PASS 3 demonstrate a more severe form of OSA compared to those at PASS 1, with stage 3 being more susceptible to oropharyngeal collapse than its stage 1 counterpart. This assessment system is anticipated to address the current limitations in evaluating the lateral pharyngeal wall within the oropharynx.
Humans ; Sleep Apnea, Obstructive/pathology* ; Male ; Severity of Illness Index ; Female ; Middle Aged ; Polysomnography ; Adult ; Pharynx/physiopathology* ; Aged

Objective To investigate the mechanism of action of Guizhi Fuling pill in treating chro-nic prostatitis(CP)using network pharmacology and molecular docking techniques.Methods Compo-nents of Guizhi Fuling pill were collected from the Traditional Chinese Medicines Systems Pharmacolo-gy Platform(TCMSP),and target information was obtained from the SwissTarget database.Targets for chronic prostatitis were screened from the GeneCards,OMIM,CTD,and DisGeNET disease data-bases.A protein-protein interaction(PPI)network was established and analyzed.Gene ontology(GO)functional annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway en-richment analysis were performed using the DAVID database.The Cytoscape software was employed to construct an association network linking the components of Guizhi Fuling Pill,their targets,and the targets of chronic prostatitis.Molecular docking was conducted using AutoDock Vina software to verify the binding stability between the components of Guizhi Fuling pill and their targets.Results After screening and deduplication in the TCMSP database,76 components of Guizhi Fuling Pill were iden-tified,and 655 component targets were retrieved from the SwissTarget database.There were 190 intersecting targets between GuizhiFuling Pill and chronic prostatitis.GO analysis indicated that Guizhi Fuling Pill may treat chronic prostatitis by participating in processes such asapoptosis,ATP binding,and signal transduction.KEGG analysis suggested that Guizhi Fuling Pill can regulate pathways such as phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)and mitogen-acti-vated protein kinase(MAPK)to intervene in chronic prostatitis.Molecular docking data demonstra-ted that the components of Guizhi Fuling pill exhibited stable conformations with their targets.Con-clusion The components of Guizhi Fuling Pill can stably bind to their targets and exert therapeutic effects on chronic prostatitis through multiple targets and pathways.

Objective:To investigate the value of routine echocardiography and two-dimensional speckle tracking echocardiography in evaluating the left ventricular function of patients with gestational diabetes mellitus (GDM) prenatal and postpartum.Methods:Twenty-two patients with clinically confirmed GDM in Xiamen Zhongshan Hospital from October 2019 to December 2020 were chosed as the case group, and 22 healthy pregnant women were chosed as the control group. Routine echocardiography and two-dimensional speckle tracking echocardiography were performed in the third trimester and about 3 months postpartum. Routine echocardiographic parameters and longitudinal strain (LS), circumfirential strain (CS) were obtained. The correlation between global longitudinal strain(GLS) and other cardiac function parameters was analyzed. The relationship between clinical parameters of pregnant women and GLS was analyzed by multiple linear regression.Results:In comparison with the control group, the interventricular septal diameter at disatole, left ventricular posterior wall diameter at diastole, Tei index were increased, e′ was decreased in GDM group(all P<0.05); the GLS, each layer LS of GDM group were lower than the control group(all P<0.05), the GLS, each layer LS and torsion parameters were improved at 3 months postpartum(all P<0.05). There was a negative correlation between GLS and Tei( r=-0.224, P=0.036). GLS and HbA 1c was linearly correlated with the regression equation: GLS=-27.458+ 1.534×HbA 1c( R2=0.115). Conclusions:The left heart function of pregnant women with GDM in the third trimester are significantly impaired, but the cardiac function recovers to a certain extent about 3 months after delivery. Two-dimentional speckle-tracking echocardiography is a more accurate and sensitive technique to evaluate the early damage of cardiac function in pregnant women with GDM.

Adventitia ; Atherosclerosis/genetics* ; Cell Communication ; Humans ; Hyperhomocysteinemia/genetics* ; Sequence Analysis, RNA

Objective:To explore the value of enhancement rate of aneurysm wall by high-resolution magnetic resonance vessel wall imaging (HR-VWI) in assessing the risk of intracranial aneurysm rupture.Methods:Seventy patients with 80 intracranial aneurysms, admitted to our hospital from January 2016 to December 2019, were chosen in our study; morphological parameters (shape, neck width, height, diameter) of the intracranial aneurysms, and signal intensity and enhancement rate of aneurysm wall were collected from HR-VWI. These patients were divided into a high-risk rupture group (PHASES scores>3) and a low-risk rupture group (PHASES scores≤3) according to PHASES scores. Univariate analysis was used to compare the differences of clinical data (age, gender, blood pressure, blood lipids, and smoking history) and aneurysm imaging data between the two groups of patients. Multivariable Logistic regression was used to determine the independent influencing factors for aneurysm rupture, and receiver-operating characteristic (ROC) curve of enhancement rate of aneurysm wall in predicting aneurysm rupture was drew to determine the best diagnostic value.Results:Univariate analysis showed that the percentages of patients with hypertension, multiple aneurysms and irregular aneurysm morphology, aneurysm height, aneurysm diameter and aneurysm wall enhancement rate were significantly different between the high-risk rupture group and low-risk rupture group ( P<0.05). Multivariate Logistic regression analysis showed that aneurysm diameter ( OR=1.647, 95%CI: 1.177-2.306, P=0.004) and aneurysm wall enhancement rate ( OR=5.317, 95%CI: 1.527-18.512, P=0.009) were independent influencing factors for rupture of intracranial aneurysms. The area of ROC curve was 0.735, the optimal cut-off value was 0.583; the sensitivity of predicting rupture of intracranial aneurysms was 72.7% and the specificity was 70.2%. Conclusion:The aneurysm wall enhancement rate is significantly correlated with risk of aneurysm rupture; when the PHASES scores>3 and aneurysm wall enhancement rate>58.3%, clinical intervention should be vigilant.

With the development of imaging technology, high-resolution magnetic resonance vascular wall imaging technology has been gradually applied to the risk assessment of intracranial aneurysms rupture. It has provided more comprehensive information for clinicians to assess the stability of intracranial aneurysms. This article summarizes the indicators used for assessing the risk of intracranial aneurysms rupture in recent years with high-resolution magnetic resonance vascular wall imaging.

Acute gangrenous cholecystitis is a histologic diagnosis,mostly diagnosed by intraoperative or postoperative pathology.In China,as the aging population increases,the incidence of the disease increases steadily.AGC is still an indication of surgical treatment for acute cholecystitis(AC),but the diagnosis and treatment of AGC remains a challenge for clinical surgeons.However,preoperative clinical data such as age, gender,hypertension,diabetes,coronary heart disease,cholelithiasis disease history,laboratory examination and radiographic results are helpful in early diagnosis and reasonable surgical timing selection.

Objective To analyze the impact of detrusor underactivity (DU) on the outcomes of transurethral resection of prostate (TURP) in patients with benign prostatic obstruction (BPO).Methods A retrospective study was conducted in 157 BPO patients who underwent TURP from January 2013 to December 2016.Their ages ranged from 48 to 86 years with a mean age of 70 years.All patients underwent urodynamic study before surgery,bladder contraction index(BCI) ranged from 49.3 to 208.6,with a mean of 120.1.The patients were divided into two groups according to BCI.DU group (BCI ＜ 100) consisted of 47 patients,non-DU group (BCI ≥ 100) 110patients.Before surgery,there were no significant differences in International Prostate Symptom Score (IPSS),storage and voiding symptom scores of IPSS (IPSS-S,IPSS-V),quality of life (QOL),maximum free flow rate (fQmax),post-voided residual urine volume (PVR) between the two groups[(21.5 ±7.0)vs.(21.5 ±6.2),(9.5 ±3.6)vs.(9.8 ±3.5),(12.0 ± 4.9)vs.(11.8±4.2),(5.1 ±0.8)vs.(5.3 ±0.7),(6.5±3.5)ml/s vs.(7.6±5.0)ml/s,(137.4± 146.2)ml vs.(105.2 ± 135.9)ml] (P ＞ 0.05 for each).The outcomes of TURP were assessed by the above mentioned parameters at 3 months postoperatively;IPSS、IPSS-S、IPSS-V were regarded as successful if they improved more than 50％,QOL was successful if it was improved more than 3,fQmax successful if it was improved 5ml/s.The change and successful improvement rates of the above mentioned parameters were compared between DU and non-DU group.Through receiver operating characteristic curve(ROC) analysis,patients were categorized into mild DU and severe DU group and compared the successful improvement rates between the two groups.Results Both DU group and non-DU group improved significantly in IPSS,IPSS-S,IPSS-V,QOL,fQmax,PVR at 3 months postoperatively (P ＜ 0.05)and the two groups differed significantly in those parameters [(8.6 ± 7.3) vs.(4.4 ±4.5),(5.0 ± 3.5) vs.(3.6 ±2.8),(3.6 ±5.1)vs.(0.9 ± 2.3),(2.3 ±1.5) vs.(1.5 ± 1.0),(11.5 ±6.9) ml/s vs.(16.3 ± 6.9) ml/s,(48.4 ± 65.6) ml vs.(23.6 ± 25.6) ml] (P ＜ 0.05 for each).In regard to the successful improvement rates of IPSS,IPSS-S,IPSS-V,QOL,fQ DU group was less successful than non-DU group [70.2％ (33/47)vs.90.9％ (100/110),51.1％ (24/47)vs.73.6％ (81/110),74.5％ (35/47)vs.93.6％ (103/110),59.6％ (28/47)vs.83.6％ (92/110),42.6％ (20/47)vs.81.8％ (90/110),P ＜0.05 for each].Youden index was maximum when BCI equaled to 82.There were significant differences in the successful improvement rates of IPSS and IPSS-V between mild DU (82 ≤ BCI ＜ 100) and severe DU (BCI ＜ 82) group [82.8％ (24/29) vs.50.0％ (9/18),86.2％ (25/29) vs.55.6％ (10/18),P ＜ 0.05 for each),no significant differences in IPSS-S and fQmax [58.6％ (17/29) vs.38.9％ (7/18),48.3％ (14/29) vs.33.3％ (6/18),P ＞ 0.05 for each].Conclusions Benign prostatic obstruction patients with DU can achieve improvement in both subjective and objective parameters after TURP,but patients without DU can get more improvement.BPO patients with severe DU patients show a worse improvement of the voiding symptom.Surgeons should have adequate communication with the patients and inform them of appropriate expectations.