Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

Patients with severe or critical coronavirus disease 2019 (COVID-19) are at high risk of death primarily due to respiratory failure caused by the cytokine storm in pulmonary tissues. The treatment response of these patients remains limited. Recently, low-dose radiation therapy (LDRT) has been clinically adopted to treat severe or critical COVID-19 patients in multiple medical centers abroad, indicating high feasibility and effectiveness. However, the mechanism and optimal radiation dose are still incompletely clear. This paper reviews the radiobiological mechanism, effectiveness, adverse reactions, and radiotherapy dose of LDRT in the treatment of severe or critical COVID-19 patients, aiming to better understand the clinical benefits and adverse reactions of LDRT.

Objective:To compare the postoperative efficacy and complications of frontalis suspension and levator resection in the treatment of blepharoptosis.Methods:According to the Cochrane systematic review method, we searched PubMed, Medline, Cochrane Library, Wanfang database, VIP Database, and China Knowledge Network database. The randomized and non-randomized controlled trials for comparing frontalis suspension and levator resection in the treatment of blepharoptosis were included. Revman 5.3 Meta analysis software was used.Results:A total of 13 clinical trials were involved in this study, including 1308 patients. Frontalis suspension was performed in the experimental group and levator resection was performed in the control group. The OR value of postoperative efficacy between the 2 groups was 2.91, 95% CI (1.57-5.39), P<0.01, the difference was statistically significant. Postoperative lagophthalmos after frontalis suspension was better [ MD=-1.05, 95% CI (-1.43--0.68), P<0.01], the difference was statistically significant. The OR value of undercorrection between the 2 groups was 0.24, 95% CI(0.16-0.36), P<0.01, the difference was statistically significant. Conclusions:The postoperative efficacy after frontalis suspension is higher. Postoperative complications after frontalis suspension are less.

Ulcerative colitis(UC)is a chronic inflammatory bowel disease caused by many factors including colonic inflammation and microbiota dysbiosis.Previous studies have indicated that celastrol(CSR)has strong anti-inflammatory and immune-inhibitory effects.Here,we investigated the effects of CSR on colonic inflammation and mucosal immunity in an experimental colitis model,and addressed the mechanism by which CSR exerts the protective effects.We characterized the ther-apeutic effects and the potential mechanism of CSR on treating UC using histological staining,intestinal permeability assay,cytokine assay,flow cytometry,fecal microbiota transplantation(FMT),16S rRNA sequencing,untargeted metabolomics,and cell differentiation.CSR administra-tion significantly ameliorated the dextran sodium sulfate(DSS)-induced colitis in mice,which was evidenced by the recovered body weight and colon length as well as the decreased disease activity index(DAI)score and intestinal permeability.Meanwhile,CSR down-regulated the production of pro-inflammatory cytokines and up-regulated the amount of anti-inflammatory mediators at both mRNA and protein levels,and improved the balances of Treg/Thl and Treg/Th1 7 to maintain the colonic immune homeostasis.Notably,all the therapeutic effects were exerted in a gut microbiota-dependent manner.Furthermore,CSR treatment increased the gut microbiota diversity and changed the compositions of the gut microbiota and metabolites,which is probably associated with the gut microbiota-mediated protective effects.In conclusion,this study provides the strong evidence that CSR may be a promising therapeutic drug for UC.

Objective:To investigate the resistance of adult Aedes albopictus to commonly used insecticides, in order to scientifically select and use insecticides. Methods:In Siming, Jimei and Haicang districts of Xiamen City in September 2018, and in Siming, Jimei and Xiang'an districts of Xiamen City in August 2019, larvae and egg blocks of Aedes albopictus in the field were collected by ladle method, and then raised to adult mosquitoes in the laboratory. The resistance of adult Aedes albopictus to 7 commonly used insecticides was determined by the contact tube method, and the knockdown rate of 1 h and mortality rate of 24 h recovery were calculated. The resistance level was determined according to the mortality rate: ≥98% was the sensitive group (S); 80% - < 98% was potential resistant group (M); < 80% was resistant group (R). Results:In 2018 and 2019, adult Aedes albopictus were exposed to 0.1% deltamethrin, 0.4% beta-cypermethrin, 0.5% lambda-cyhalothrin, 1.4% alpha-cypermethrin, 3% permethrin, 0.5% malathion and 0.05% propoxur, the knockdown rates of 1 h were 95.1% (117/123), 98.3% (115/117), 100.0% (116/116), 99.2% (120/121), 98.4% (123/125), 97.5% (119/122), 100.0% (127/127) and 96.7% (118/122), 98.6% (143/145), 100.0% (139/139), 100.0% (149/149), 98.0% (146/149), 96.8% (121/125), and 100.0% (126/126), respectively. In 2018, the mortality rates of 24 h recovery were 91.1% (112/123), 78.6% (92/117), 75.0% (87/116), 88.4% (107/121), 96.0% (120/125), 99.2% (121/122), and 100.0% (127/127), respectively. In 2019, the adjusted mortality rates of 24 h recovery were 74.9%, 76.9%, 79.5%, 91.4%, 92.3%, 100.0%, and 100.0%, respectively. Conclusions:Adult Aedes albopictus in Xiamen City is sensitive to malathion and propoxur, and it has a high resistance to pyrethroids insecticides such as deltamethrin, beta-cypermethrin and lambda-cyhalothrin. Therefore, it is necessary to strengthen resistance monitoring and use different insecticides in turn to reduce and delay the development of resistance.

Objective To evaluate the application value of polymerase chain reaction (PCR)-fluorescence probe method in identifying genotypes of hepatitis C virus (HCV).Methods One hundred and sixty six serum samples from patients with chronic HCV infection were collected nationwide from March to June 2016.HCV Core-E1 gene region was amplified and sequenced by nested reverse transcription-PCR (RT nested-PCR)and genetic subtypes were analyzed by phylogenetic tree,meanwhile HCV genotypes were also determined by PCR-fluorescent probe method.Kappa test was used to compare the consistency of two methods.Results Among 166 samples detected by RT nested-PCR,the genotype of 66 samples (39.8%) was 1 b,34 (20.5%)was 2a,16 (9.6%)was 3a,27 was 3b (16.2%),23 (13.9%)was 6a.Two samples with 3b genotype detected by RT nested-PCR were identified as 1 b by PCR-fluorescent probe.The consistency rate of two methods was 98.7% (164 /166),there was no significant difference between two methods (χ2 =0.0492,P >0.05).Conclusion PCR-fluorescence probe method can accurately identify HCV genotypes and can be used in clinic.

ObjectiveTo observe the effect of auricular point sticking plus acupressure on blood pressure and lipid in hypertension patients with a dampness-phlegm constitution.MethodThe eligible subjects were randomized into antreatment group of 38 cases and a control group of 40 cases. The control group was intervened by conventional medication, while thetreatment group was additionally intervened by auricular point sticking plus acupressure. Before and after intervention, the blood pressure and lipid levels [total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL)] were detected. ResultAfter intervention, the blood pressure, TC and TG levels were decreased in thetreatmentgroup (P<0.05,P<0.01), while the changes of HDL and LDL were statistically insignificant (P>0.05).ConclusionAuricular point sticking plus acupressure can somehow improve the blood pressure, TC and TG of hypertension patients with a dampness-phlegm constitution.

This study examined the association of a common polymorphic allele (25G) of the low-density lipoprotein receptor-related protein1 (LRP1) gene with myocardial infarction (MI). The genotypes of LRP1 25CG (rs35282763) were determined in 347 MI patients and 347 age- and sex-frequency-matched controls from an unrelated Chinese Han population. Factor VIII (FVIII) levels were measured in the MI patients and controls by chromogenic assay and enzyme-linked immunosorbent assay (ELISA). The results showed that LRP1 25CG (rs35282763) genotype distribution did not differ significantly between patients (n=206 for 25CC, n=122 for 25CG) and controls (n=191 for 25CC, n=126 for 25CG; P>0.05). The 25G allele was not associated with a reduced risk of MI (P>0.05). Further stratifications for age, sex, and other cardiovascular risk factors did not affect the negative findings. It was concluded that the presence of the G allele at the 25CG (rs35282763) polymorphism of the LRP1 is not associated with a reduced risk of MI, and genotyping for LRP1 25CG (rs35282763) polymorphism is not useful in assessing the individual risk of MI.

This study examined the association of a common polymorphic allele (25G) of the low-density lipoprotein receptor-related proteinl (LRP1) gene with myocardial infarction (MI).The genotypes of LRP1 25CG (rs35282763) were determined in 347 MI patients and 347 age-and sex-frequency-matched controls from an unrelated Chinese Han population.Factor Ⅷ (FⅧ) levels were measured in the MI patients and controls by chromogenic assay and enzyme-linked immunosorbent assay (ELISA).The results showed that LRP1 25CG (rs35282763) genotype distribution did not differ significantly between patients (n=206 for 25CC,n=122 for 25CG) and controls (n=191 for 25CC,n=126 for 25CG;P＞0.05).The 25G allele was not associated with a reduced risk of MI (P ＞0.05).Further stratifications for age,sex,and other cardiovascular risk factors did not affect the negative findings.It was concluded that the presence of the G allele at the 25CG (rs35282763) polymorphism of the LRP1is not associated with a reduced risk of MI,and genotyping for LRP1 25CG (rs35282763) polymorphism is not useful in assessing the individual risk of MI.

Objective To compare the efficacy of different rehabilitation models on acalculia after acquired brain injury. Methods 113 cases were randomly assigned to 3 groups: control group(n=37), computer-assisted training group(n=38) and face-to-face training group(n=38). The control group just received cognitive dysfunction evaluation. The training groups received cognitive rehabilitation training 5 days a week and 30 minutes a day which sustained for 6 weeks. And 33 patients were selected to prolong for 12 weeks. They were evaluated with Revised EC301Calculation and Number Processing Battery in Chinese version (EC301-CR) at the beginning, the 6th week point and the 12th week point respectively. Results 6-week after treatment, The performance of both the computer-assisted training group and face-to-face training group significantly improved(P<0.001); It showed that computer-assisted group>face-to-face group>control group(P<0.001) both 6 weeks and 12 weeks latter. Significant negative correlation was found between age and performance of EC301-CR(P<0.05).Conclusion The effect of computer-assisted training on acalculia is superior to face-to-face training; The first 6 weeks of training is the best period for rehabilitation; The younger the patient is, the better results are.