Objective To explore the mediating effect of sleep duration on the relationship between qi stagnation constitution and anxiety/depression in junior high school students.Methods From March 20 to March 31,2020,a total of 10,325 students from 6 junior high schools in Henan,Liaoning,Shaanxi,Shandong,and Fujian provinces were sampled by cluster sampling.Firstly,the general conditions(age,gender,grade,hometown,whether they are an only child)and sleep duration were collected,and their qi stagnation constitution,depression and anxiety status were evaluated by using the Qi Stagnation Subscale in the"TCM Constitution Classification and Judgment Scale",the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder(GAD-7).Secondly,Spearman correlation analysis was used to explore the correlation between qi stagnation constitution,sleep duration,and anxiety/depression.Then,linear regression analysis and mediating effect test were used to explore the relationship between qi stagnation constitution and anxiety/depression in junior high school students,and the mediating effect of sleep duration was analyzed,and the results were verified.Results(ⅰ)The detection rate of anxiety in non-only children was higher than that of only children(x2=11.198,P=0.001);The detection rate of anxiety(x2=106.967,P＜0.001)or depression(x2=84.692,P＜0.001)was higher among senior students than those in lower grades,while those of girls with anxiety(x2=100.441,P＜0.001)or depression(x2=71.418,P＜0.001)were higher than those of boys.The detection rates of anxiety(x2=1 092.298,P＜0.001)and depression(x2=866.740,P＜0.001)in qi stagnation constitution students were higher than those of non-qi stagnation constitution students,and the detection rates of anxiety(x2=1 076.716,P＜0.001)and depression(x2=1 099.725,P＜0.001)in students whose sleep duration less than 8 h were higher than those of whose sleep duration more than 8 h,and the shorter the sleep duration,the higher the detection rate.(ⅱ)Qi stagnation constitution positively predicted anxiety/depression(β=0.679,P＜0.001;β=0.718,P＜0.001),and sleep duration had a negative predictive effect on anxiety/depression(β=-0.403,P＜0.001;β=-0.439,P＜0.001).(ⅲ)Sleep duration played a partial mediating role in the relationship between qi stagnation constitution and anxiety/depression in junior high school students,and the mediating effect accounted for 13.40％and 13.79％of the total effect,respectively.Conclusion Although qi stagnation constitution mainly affects anxiety/depression through direct effect,it can still be partially indirectly realized through the mediating variable of sleep duration,that is,the shorter the sleep duration,the higher the risk of anxiety/depression in junior high school students.Therefore,the mental health problems of junior high school students can be prevented and improved by regulating qi stagnation constitution and ensuring adequate sleep duration.

Objective To explore the clinical efficacy and safety of transarterial chemoembolization(TACE)combined with immune checkpoint inhibitor(ICI)and molecular targeted therapy for Child-Pugh grade B hepatocellular carcinoma(HCC).Methods The patients with Child-Pugh grade B HCC,who received TACE combined with ICI and molecular targeted therapy(combination group)or TACE monotherapy(monotherapy group)at the three medical centers including the Affiliated Zhongda Hospital of Southeast University of China between January 2018 and May 2021,were enrolled in this study.The primary outcome was overall survival(OS),and the secondary outcomes included progression-free survival(PFS),objective response rate(ORR),and clinical safety.Results A total of 126 patients were enrolled in this study,including 64 patients in the combination group and 62 patients in the monotherapy group.No statistically significant difference in median OS existed between the combination group and the monotherapy group[17.7 months(95％CI:11.9-29.9 months)vs.13.2 months(95％CI:7.8-19.9 months);P=0.160].In the combination group,the patients having a Child-Pugh score of 7 points obtained a significantly better OS[19.0months(95％CI:13.6-NR)vs.13.2 months(95％CI:8.0-NR),P=0.024].The differences in the median PFS and ORR between the two groups were not statistically significant(P=0.720 and P=0.960 respectively).Grade Ⅲ/Ⅳ adverse events occurred in 19 patients(14.1％)of the combination group and in 6 patients(9.7％)of the monotherapy group.Conclusion In treating patients with Child-Pugh grade B HCC,TACE combined with ICI and molecular targeted therapy does not show a better prognosis than TACE monotherapy,however,the patients having a Child-Pugh score of 7 points in the combination group can have a much better OS.

OBJECTIVE To establish the fingerprints of Ardisia crenata， Sophora tonkinensis and their couplet medicines， and to determine the contents of five components in them. METHODS Using water as solvent， single lyophilized powder of A. crenata and S. tonkinensis and combined lyophilized powder of their couplet medicines were prepared by combining lyophilization technology. The fingerprints of three lyophilized powder samples were established by using high-performance liquid chromatography （HPLC）， and the contents of 5 kinds of components such as gallic acid were determined simultaneously. RESULTS There were 5， 10 and 14 common peaks in the fingerprints for single lyophilized powder of A. crenata and S. tonkinensis and combined lyophilized powder of their couplet medicines； the similarities of them with the control fingerprints were all greater than 0.90. For combined lyophilized powder of couplet medicines， peak 3 Δ 基金项目 国家重点研发计划项目（No.2018YFC1708100）；贵 州省科技计划项目（No.黔科合基础-ZK〔2022〕一般483，No.黔科合成 was identified as gallic acid， peak 4 as matrine， peak 6 as 果〔2021〕一般137）；贵州省教育厅高等学校科学研究项目（青年项目） oxymatrine， peak 8 as bergenin， and peak 14 as trifolirhizin. In single lyophilized powder of A. crenata， the average contents of gallic acid and bergenin were 0.499 3 and 4.962 6 mg/g， respectively. In single lyophilized powder of S.tonkinensis， the average contents of matrine， oxymatrine and trifolirhizin were 3.046 0， 2.336 6 and 0.278 6 mg/g， respectively. In combined lyophilized powder of couplet medicines， the average contents of gallic acid， matrine， oxymatrine， bergenin and trifolirhizin were 0.560 6， 2.548 7， 1.382 2， 5.960 7 and 0.279 1 mg/g， respectively. The transfer rates were 8.87%-513.19%. CONCLUSIONS The established fingerprint and content determination methods are stable and feasible， and can be used for the quality control of A. crenata and S. tonkinensis and their couplet medicines. The average contents of matrine and oxymatrine in combined lyophilized powder of A. crenata-S. tonkinensis couplet medicines are decreased.

Objective To evaluate the clinical efficacy and safety of CT-guided percutaneous osteoplasty(POP)in the treatment of osteolytic metastases of the pelvis.Methods The clinical data of a total of 40 patients with pelvic osteolytic metastases,who received CT-guided POP at the Affiliated Zhongda Hospital of Southeast University between October 2011 and December 2021,were collected.Visual analogue scale(VAS)score was used to evaluate the clinical pain relief degree at one week,one month,3 months,6 months and 12 months after POP,and the joint function and the used dose of analgesic drugs were recorded.The preoperative and the postoperative 3-month,6-month and 12-month extents of the pelvic tumor destruction were compared.Based on the progression of local lesions within 12 months of follow-up,the patients were divided into controlled group and progression group.The proportion of using systemic anti-tumor therapy,the size of lesion,the amount of bone cement injected,and the cement filling ratio were compared between the two groups.Results Successful surgical procedure was accomplished for 57 lesions in 40 patients.The mean amount of bone cement injected was(4.56±2.25)mUpoint.In the 40 patients,the preoperative and the postoperative one-week,one-month and 3-month VAS score were(8.00±0.85)points,(2.05±0.96)points,(2.08±0.94)points and(2.18±0.84)points respectively,the difference in VAS score between preoperative value and postoperative one-week value was statistically significant(P＜0.01).In 37 patients,the postoperative 6-month VAS score was(2.35±0.54)points;and in 28 patients,the postoperative 12-month VAS score was(2.43±0.79)points.The differences in VAS score between postoperative one-week value and postoperative one-month,3-month,6-month,and 12-month values were not statistically significant(all P＞0.05),while the differences in VAS score between preoperative value and postoperative values were statistically significant(F=316.3,P＜0.01).The postoperative 3-month,6-month,and 12-month local control rates were 96.49％,85.19％,and 78.12％respectively,the differences between each other among the above three values were statistically significant(P=0.026).No statistically significant differences in the proportion of using systemic anti-tumor therapy,the lesion size and the amount of bone cement injected existed between the controlled group and the progression group(all P＞0.05).The cement filling ratio in the controlled group and the progression group was(81.26±9.17)％and(68.40±12.98)％respectively,and the difference between the two groups was statistically significant(P＜0.01).Conclusion For the treatment of pelvic metastases,CT-guided POP is clinically safe and effective.The injected bone cement can control the progression of local lesions for a longer time.(J Intervent Radiol,2023,32:1197-1201)

Objective::Coronavirus disease 2019 (COVID-19) exists as a pandemic. Mortality during hospitalization is multifactorial, and there is urgent need for a risk stratification model to predict in-hospital death among COVID-19 patients. Here we aimed to construct a risk score system for early identification of COVID-19 patients at high probability of dying during in-hospital treatment.Methods::In this retrospective analysis, a total of 821 confirmed COVID-19 patients from 3 centers were assigned to developmental ( n = 411, between January 14, 2020 and February 11, 2020) and validation ( n = 410, between February 14, 2020 and March 13, 2020) groups. Based on demographic, symptomatic, and laboratory variables, a new Coronavirus estimation global (CORE-G) score for prediction of in-hospital death was established from the developmental group, and its performance was then evaluated in the validation group. Results::The CORE-G score consisted of 18 variables (5 demographics, 2 symptoms, and 11 laboratory measurements) with a sum of 69.5 points. Goodness-of-fit tests indicated that the model performed well in the developmental group ( H = 3.210, P = 0.880), and it was well validated in the validation group ( H = 6.948, P= 0.542). The areas under the receiver operating characteristic curves were 0.955 in the developmental group (sensitivity, 94.1%; specificity, 83.4%) and 0.937 in the validation group (sensitivity, 87.2%; specificity, 84.2%). The mortality rate was not significantly different between the developmental ( n = 85,20.7%) and validation ( n = 94, 22.9%, P = 0.608) groups. Conclusions::The CORE-G score provides an estimate of the risk of in-hospital death. This is the first step toward the clinical use of the CORE-G score for predicting outcome in COVID-19 patients.

Objective::Coronavirus disease 2019 (COVID-19) exists as a pandemic. Mortality during hospitalization is multifactorial, and there is urgent need for a risk stratification model to predict in-hospital death among COVID-19 patients. Here we aimed to construct a risk score system for early identification of COVID-19 patients at high probability of dying during in-hospital treatment.Methods::In this retrospective analysis, a total of 821 confirmed COVID-19 patients from 3 centers were assigned to developmental ( n = 411, between January 14, 2020 and February 11, 2020) and validation ( n = 410, between February 14, 2020 and March 13, 2020) groups. Based on demographic, symptomatic, and laboratory variables, a new Coronavirus estimation global (CORE-G) score for prediction of in-hospital death was established from the developmental group, and its performance was then evaluated in the validation group. Results::The CORE-G score consisted of 18 variables (5 demographics, 2 symptoms, and 11 laboratory measurements) with a sum of 69.5 points. Goodness-of-fit tests indicated that the model performed well in the developmental group ( H = 3.210, P = 0.880), and it was well validated in the validation group ( H = 6.948, P= 0.542). The areas under the receiver operating characteristic curves were 0.955 in the developmental group (sensitivity, 94.1%; specificity, 83.4%) and 0.937 in the validation group (sensitivity, 87.2%; specificity, 84.2%). The mortality rate was not significantly different between the developmental ( n = 85,20.7%) and validation ( n = 94, 22.9%, P = 0.608) groups. Conclusions::The CORE-G score provides an estimate of the risk of in-hospital death. This is the first step toward the clinical use of the CORE-G score for predicting outcome in COVID-19 patients.

Objective:To investigate the protective effect and mechanism of hyperbaric oxygen (HBO) on cardiac function in model rats with myocarditis.Methods:A total of 30 specific pathogen free (SPF) male SD rats aged 4~5 weeks were randomly divided into three groups with 10 rats in each group, which were the control group, the model group, and the HBO group. The control group was only given 1 ml/kg normal saline by tail vein injection without any other treatment; the rat models of myocarditis in the model group and the HBO group were established by injecting lipopolysaccharide (LPS) via tail vein; the HBO group was additionally treated with HBO. After 6 days of treatment, echocardiography was obtained by ultrasound imaging system for small animals; and the data of left ventricular ejection fraction (EF), fraction shortening (FS), and maximum ascending and descending rate (+ dP/dt max) were collected. The levels of serum interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), brain natriuretic peptide (BNP), and catalase (CAT) were detected by enzyme-linked immunosorbent assay (ELISA) kit. After euthanasia, the myocardial tissue was taken. Some of them was stained by Hematoxylin and Eosin (HE) for morphological observation; the rest was ground for detecting the expression levels of oxidative stress related factors, including superoxide dismutase (SOD) and malondialdehyde (MDA), by ELISA. Results:The results of echocardiography showed that EF, FS, + dP/dt max, and - dP/dt max in the model group were significantly lower than those in the control group ( P<0.05); after HBO treatment, EF, FS, + dP/dt max, and -dP/dt max in the HBO group were significantly higher than those in the model group ( P<0.05). The results of ELISA showed that IL-6, IL-1 β, TNF-α, and BNP in the model group were significantly higher than those in the control group ( P<0.05); after HBO treatment, IL-6, IL-1β, TNF-α, and BNP in the HBO group were significantly lower than those in the model group ( P<0.05). Under light microscope, there was no focal infiltration of inflammatory cells in the myocardial tissue of the control group. The cardiomyocytes of the model group were arranged disorderly with more inflammatory cell infiltration. And some pink protein mucus could be seen in some blood vessels. In the HBO group, inflammatory cell infiltration was milder than that in the model group. And there were some edematous cardiomyocytes. Compared with the control group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the model group were significantly decreased, while the expression level of MDA in myocardial tissue was significantly increased ( P<0.05). After HBO treatment, compared with the model group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the HBO group were significantly increased, while the expression of MDA in myocardial tissue was significantly decreased ( P<0.05). Conclusion:HBO treatment can improve the cardiac function in model rats with myocarditis by inhibiting the inflammatory response and alleviating oxidative stress damage.

Objective::Coronavirus disease 2019 (COVID-19) is a global public health crisis. There are no specific antiviral agents for the treatment of SARS-CoV-2. Information regarding the effect of Abidol on in-hospital mortality is scarce. The present study aimed to evaluate the treatment effect of Abidol for patients with COVID-19 before and after propensity score matching (PSM).Methods::This retrospective cohort study analyzed 1019 patients with confirmed COVID-19 in China from December 22, 2019 to March 13, 2020. Patients were divided to Abidol (200 mg, tid, 5-7 days, n = 788, 77.3%) and No-Abidol ( n = 231, 22.7%) groups. The primary outcome was the mortality during hospitalization. Results::Among 1019 COVID-19 patients, the age was (60.4 ± 14.5) years. Abidol-treated patients, compared with No-Abidol-treated patients, had a shorter duration from onset of symptoms to admission, less frequent renal dysfunction, lower white blood cell counts (lymphocytes <0.8) and erythrocyte sending rate, lower interleukin-6, higher platelet counts and plasma IgG and oxygen saturation, and less frequent myocardial injury. The mortality during hospitalization before PSM was 17.9% in Abidol group and 34.6% in No-Abidol (hazard ratio (HR) = 2.610, 95% confident interval (CI): 1.980-3.440), all seen in severe and critical patients. After PSM, the in-hospital death was 13.6% in Abidol and 28.6% in No-Abidol group (HR= 2.728, 95% CI: 1.598-4.659).Conclusions::Abidol-treatment results in less in-hospital death for severe and critical patients with COVID-19. Further randomized study is warranted to confirm the findings from this study.

Objective::Coronavirus disease 2019 (COVID-19) is a global public health crisis. There are no specific antiviral agents for the treatment of SARS-CoV-2. Information regarding the effect of Abidol on in-hospital mortality is scarce. The present study aimed to evaluate the treatment effect of Abidol for patients with COVID-19 before and after propensity score matching (PSM).Methods::This retrospective cohort study analyzed 1019 patients with confirmed COVID-19 in China from December 22, 2019 to March 13, 2020. Patients were divided to Abidol (200 mg, tid, 5-7 days, n = 788, 77.3%) and No-Abidol ( n = 231, 22.7%) groups. The primary outcome was the mortality during hospitalization. Results::Among 1019 COVID-19 patients, the age was (60.4 ± 14.5) years. Abidol-treated patients, compared with No-Abidol-treated patients, had a shorter duration from onset of symptoms to admission, less frequent renal dysfunction, lower white blood cell counts (lymphocytes <0.8) and erythrocyte sending rate, lower interleukin-6, higher platelet counts and plasma IgG and oxygen saturation, and less frequent myocardial injury. The mortality during hospitalization before PSM was 17.9% in Abidol group and 34.6% in No-Abidol (hazard ratio (HR) = 2.610, 95% confident interval (CI): 1.980-3.440), all seen in severe and critical patients. After PSM, the in-hospital death was 13.6% in Abidol and 28.6% in No-Abidol group (HR= 2.728, 95% CI: 1.598-4.659).Conclusions::Abidol-treatment results in less in-hospital death for severe and critical patients with COVID-19. Further randomized study is warranted to confirm the findings from this study.

Objective:To investigate the protective effect and mechanism of hyperbaric oxygen (HBO) on cardiac function in model rats with myocarditis.Methods:A total of 30 specific pathogen free (SPF) male SD rats aged 4~5 weeks were randomly divided into three groups with 10 rats in each group, which were the control group, the model group, and the HBO group. The control group was only given 1 ml/kg normal saline by tail vein injection without any other treatment; the rat models of myocarditis in the model group and the HBO group were established by injecting lipopolysaccharide (LPS) via tail vein; the HBO group was additionally treated with HBO. After 6 days of treatment, echocardiography was obtained by ultrasound imaging system for small animals; and the data of left ventricular ejection fraction (EF), fraction shortening (FS), and maximum ascending and descending rate (+ dP/dt max) were collected. The levels of serum interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), brain natriuretic peptide (BNP), and catalase (CAT) were detected by enzyme-linked immunosorbent assay (ELISA) kit. After euthanasia, the myocardial tissue was taken. Some of them was stained by Hematoxylin and Eosin (HE) for morphological observation; the rest was ground for detecting the expression levels of oxidative stress related factors, including superoxide dismutase (SOD) and malondialdehyde (MDA), by ELISA. Results:The results of echocardiography showed that EF, FS, + dP/dt max, and - dP/dt max in the model group were significantly lower than those in the control group ( P<0.05); after HBO treatment, EF, FS, + dP/dt max, and -dP/dt max in the HBO group were significantly higher than those in the model group ( P<0.05). The results of ELISA showed that IL-6, IL-1 β, TNF-α, and BNP in the model group were significantly higher than those in the control group ( P<0.05); after HBO treatment, IL-6, IL-1β, TNF-α, and BNP in the HBO group were significantly lower than those in the model group ( P<0.05). Under light microscope, there was no focal infiltration of inflammatory cells in the myocardial tissue of the control group. The cardiomyocytes of the model group were arranged disorderly with more inflammatory cell infiltration. And some pink protein mucus could be seen in some blood vessels. In the HBO group, inflammatory cell infiltration was milder than that in the model group. And there were some edematous cardiomyocytes. Compared with the control group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the model group were significantly decreased, while the expression level of MDA in myocardial tissue was significantly increased ( P<0.05). After HBO treatment, compared with the model group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the HBO group were significantly increased, while the expression of MDA in myocardial tissue was significantly decreased ( P<0.05). Conclusion:HBO treatment can improve the cardiac function in model rats with myocarditis by inhibiting the inflammatory response and alleviating oxidative stress damage.