Objective To observe the inter-observer consistency of diameter of inferior vena cava(IVC)and IVC collapsibility index(IVCCI)measured and assessed with echocardiography and the correlations with right heart parameters in patients with right heart dysfunction.Methods Forty-seven patients with right heart dysfunction were prospectively recruited in observation group,while 50 adults with normal right heart function were taken as controls(control group).Parameters of the right heart were obtained with echocardiography,including the right ventricular fractional area change(FAC),the tricuspid annular plane systolic excursion(TAPSE),the myocardial performance index(MPI),the tricuspid annular systolic velocity(S')as well as early and late diastolic velocity(e',a')and e'/a' ratio,also the tricuspid valve orifice early and late diastolic velocities(E,A)and E/A ratio and E/e',the vena contracta width of tricuspid regurgitation(TR-VCW),the maximum velocity of tricuspid regurgitation(TR-Vmax),the pulmonary artery systolic pressure(PASP)and right atrial area(RAA).Besides,the maximal and minimal diameter of IVC(IVCDmax,IVCDmin)during the respiratory cycle were measured with two dimensional(2D)ultrasound and anatomical M-mode ultrasound,respectively,and the IVCCI were calculated.Then 20 subjects were randomly selected from each group,and IVC parameters were obtained.The basic data,right heart parameters and IVC parameters were compared between groups,intra-class correlation coefficient(ICC)between 2 sonographers of IVC parameters were calculated,and correlations between IVC parameters and right heart parameters were assessed.Results No significant differences of gender,age nor body mass index(BMI)was detected between groups(all P＞0.05).Compared with those in control group,MPI,e',e'/a',E,A,E/e',TR-VCW,TR-Vmax,PASP and RAA increased,whereas FAC,TAPSE,S'and a'decreased in observation group(all P＜0.05).The inter-observer consistencies were good for IVCDmax and IVCCI in observation group(ICC=0.787-0.971)and IVCDmax in the control group(ICC=0.971,0.964)obtained with 2D ultrasound and anatomical M-mode ultrasound,but poor for IVCCI in control group(ICC=0.169,0.456).Compared with those in control group,IVC parameters 2D-IVCDmax,2D-IVCDmin,M-IVCDmax and M-IVCDmin increased but 2D-IVCCI and M-IVCCI decreased in observation group(all P＜0.05).In control group,2D-IVCDmax was weakly negatively correlated with TAPSE and a'(r=-0.392,-0.364),weakly positively correlated with e'/a',E,E/A,TR-VCW and RAA(r=0.396,0.483,0.461,0.565,0.582),2D-IVCCI was weakly negatively correlated with TR-VCW and RAA(r=-0.386,-0.380),while M-IVCDmax was weakly negatively correlated with TAPSE(r=-0.384),and weakly positively correlated with e'/a',E,E/A,TR-VCW and RAA(r=0.357,0.453,0.473,0.549,0.550),M-IVCCI was weakly negatively correlated with MPI,E,TR-VCW and RAA(r=-0.347,-0.337,-0.475,-0.421).Conclusion In patients with right heart dysfunction,IVCD diameter and IVCCI obtained with echocardiography had good inter-observer consistencies.Parameters obtained with 2D ultrasound and anatomic M-mode ultrasound had certain relations with the right heart parameters.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Abstract Prevention and control of myopia requires comprehensive measures. Based on the system established earlier, the system is revised and upgraded. The original system emphasizes comprehensive measures and proposes to focus on both the symptoms and root causes. These measures are summarized into six aspects, three address the root cause measures including health education, glasses optics and visual environment, and three address symptoms measures including eye exercises, physical therapy and drugs. The paper is comprehensively supplemented and analyzes the primary and the secondary, and promotes physical therapy from treating the symptoms to treat both the symptoms and the root causes. These improvement measures will help promote the prevention and control of myopia in children and adolescents.

Objective To explore the influencing factors of dwarfism in children and construct a nomogram model. Methods From June 2020 to December 2022, 1, 500 children were selected as the research objects, and 1, 422 cases were effectively investigated. According to incidence of dwarfism, the children were divided into normal group (n=1, 351) and dwarfism group (n=71). Univariate and multivariate Logistic regression analyses were used to explore the influencing factors of dwarfism in children; the R software was used to construct a nomogram model for prediction of the occurrence of dwarfism in children, and the receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the discrimination and consistency of the nomogram model. Results Among the 1 422 children, 71 cases had dwarfism, with an incidence rate of 4.99%. Multivariate Logistic regression analysis showed that birth weight, family history of dwarfism, milk intake and physical exercise were the influencing factors for the occurrence of dwarfism in children (P < 0.05). The area under the curve of the ROC curve predicted by the nomogram model for the occurrence of dwarfism in children was 0.897 (95%CI, 0.856 to 0.938), with good discrimination; the calibration curve slope of the nomogram model for predicting the occurrence of dwarfism in children approached 1, and the Hosmer-Lemeshow goodness of fit test showed that the was 5.020 and P was 0.740, indicating good consistency. Conclusion The nomogram model for predicting the occurrence of dwarfism in children based on four influencing factors of birth weight, family history of dwarfism, milk intake and physical exercise has good discrimination and consistency, which can provide reference for the development of personalized intervention measures in clinical practice.

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.

Objective:To summarize and sort out the best evidence for sleep disorders management in children with autism spectrum disorder.Methods:Literatures related to sleep disorders management in children with autism spectrum disorder were systematically retrieved on UpToDate, BMJ Best Practice, National Guidelines Clearinghouse, Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, National Institute for Health and Clinical Excellence, Guidelines International Network, World Health Organization website, Medlive, Joanna Briggs Institute evidence-based healthcare center database, Web of Science, Cochrane Library, PubMed, Embase, CINAHL, PsychInfo, China Biology Medicine disc, Wanfang Database, CNKI, VIP, Association for Science in Autism Treatment website, Autism Society website, National Autism Society website and other domestic and foreign databases and websites. Literature types included guidelines, systematic review/Meta-analysis, evidence summary, clinical decision making and expert consensus. The search deadline was from the establishment of the databases to November 30, 2022. Two researchers trained in systematic evidence-based knowledge evaluated literature quality and extracted evidence.Results:A total of 14 literatures were included, including 1 clinical decision, 4 guidelines, 7 expert consensus and 2 systematic reviews. A total of 32 pieces of evidence were formed from 8 aspects, including screening, assessment, sleep planning, treatment goals, intervention, follow-up, caregiver support and team management of children with autism spectrum disorder.Conclusions:This study summarizes and forms the best evidence on the management of sleep disorders in children with autism spectrum disorder, and provides an evidence-based basis for the management of sleep disorders in them.

This study was performed to investigate the effects of Arbutin(Ar)on oxidative stress,apoptosis level and inflammatory response of H9c2 cardiomyocytes induced by lipopolysaccharide(LPS).H9c2 cardiomyocytes were randomly divided into blank control group,lipopolysaccharide group(LPS),LPS+Ar(25 μmol/L)group,LPS+Ar(50 μmol/L)group,LPS+Ar(100 μmol/L)group and Ar(50 μmol/L)group.CCK-8 was used to detect the cell viability of H9c2 cardiomyocytes after LPS treatment and Ar treatment;DCFH-DA fluorescence labeling was used to detect the ROS levels of H9c2 cardiomyocytes;flow cytometry was applied to detect cell apoptosis rate;Western blot was used to detect the expression of apoptosis-related proteins(Caspase-3)and inflammatory proteins(IL-1β and TNF-α).Data showed that compared with the LPS group,the cell viabilities were recovered after Ar treatment.The level of oxidative stress markers(ROS),apoptosis rate,and inflammatory factor levels(IL-1β and TNF-α)in the LPS+Ar groups were significantly reduced compared with the LPS group(P<0.05).In conclusion,Ar can alleviate the damage,apoptosis,oxidative stress and inflammatory response of LPS-induced H9c2 cardiomyocytes.

Objective:To explore the clinical significance of event-related potential P300 in the diagnosis and treatment of cognitive function in patients with chronic insomnia combined with anxiety and depression.Methods:Sixty patients with chronic insomnia complicated with anxiety and depression treated in Wuhan First Hospital from October 2020 to March 2021 were selected as the observation group, and 60 healthy volunteers were selected as the control group in the same period.Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were used to evaluate the anxiety and depression status of patients.Mini mental state examination (MMSE) and Montreal cognitive assessment scale (MoCA) were used to evaluate the cognitive function of the subjects.All subjects were tested for P300 event-related potential, and the latency and amplitude of P300 event-related potential were recorded.SPSS 25.0 software was used for statistical analysis.Independent sample t-test was used for comparison between groups.Pearson correlation analysis was used to analyze the correlation between cognitive function and P300 event-related potential. Results:The scores of HAMA ((16.65±5.10), (9.30±4.42)) and HAMD ((18.07±3.97), (8.48±3.21)) in the observation group were higher than those in the control group ( t=8.438, 14.545, both P<0.05), and the MoCA score (22.35±4.25) was lower than that(25.65±2.29) in the control group ( t=-5.291, P<0.05). In the eight dimensions of MoCA, the scores of visual space and executive ability ((3.38±1.46), (4.63±0.69)), naming ((2.37±0.78), (2.65±0.48)), language ((2.17±0.96), (2.53±0.81)) and delayed recall ((2.58±1.45), (4.17±0.85))in the observation group were lower than those in the control group ( t=-5.991, -2.394, -2.259, -7.292, all P<0.05). Compared with the control group, the latencies of P300 (N1, N2, P3) in the observation group were significantly prolonged ( t=3.281, 4.342, 4.492, all P<0.01). The latencies of P300 (N1, N2, P3) were positively correlated with HAMD score ( r=0.242, 0.301, 0.311, all P<0.05). The latencies of P300 (N2, P3) were positively correlated with HAMA score ( r=0.205, 0.207, both P<0.05). The latencies of P300 (N2, P3) were negatively correlated with the delayed recall score of MoCA ( r=-0.197, -0.236, both P<0.05). Conclusion:There are different degrees of cognitive impairment in patients with chronic insomnia combined with anxiety and depression.P300 in patients with chronic insomnia combined with anxiety and depression shows prolonged latency.P300 latency is related to depression, anxiety and cognition in patients with chronic insomnia combined with anxiety and depression.Event-related potential P300 may be used as a neurophysiological objective evaluation tool for cognitive impairment in patients with chronic insomnia combined with anxiety and depression.

CT is an important imaging tool for the diagnosis of novel coronavirus pneumonia (COVID-19), therefore, it′s necessary to strictly control the disinfection of CT workplace and equipment and biosafety to avoid the place from becoming a potential infection source and to reduce the risk of infection of patients and radiological staff. It is also necessary to reduce the CT scan dose to minimize the radiation hazards on patients under the premise of ensuring the CT image quality and diagnostic efficiency. Based on the survey that novel coronavirus residues after disinfection at some CT workplace in domestic and overseas and the application of low-dose CT scan in diagnosis of COVID-19, as well as the current situation of radiological protection management in emergency hospital, this paper summarizes and proposes suggestions on infection control and radiological protection for CT workplace to strengthen the defense line of COVID-19 prevention and control.

Objective:To explore the effect of aquaporin 4 (AQP4) regulated by miR-320a on a cell model of Alzheimer′s disease.Methods:A rat adrenal pheochromocytoma cell line (PC12) was induced into neurons using nerve growth factor (NGF). The morphology of the PC12 cells and the neurons was observed, and ubiquitin carboxy terminal hydrolase L1 (Uch-L1) and neurofilament protein (NFP) were detected. Levels of microtubule-associated protein (MAP2) and AQP4 target genes were related to the mRNA expression of NFP to determine the neuron-inducing effect. The neurons were then randomly divided into a control group (given no treatment), an miR-320a mimic transfection group (cultured by adding 50nmol/L miR-320a as a mimic agent), an miR-320a inhibitor group (cultured by adding 50nmol/L miR-320a as an inhibitor), an Aβ treatment group (cultured by adding Aβ), an Aβ+ miR-320a mimic group (cultured by adding both 50nmol/L miR-320a and Aβ), and an Aβ+ miR-320a inhibitor group (also cultured by adding Aβ, but with 50nmol/L miR-320a as an inhibitor). Cell activity was measured by the CCK8 method. Reverse-transcription polymerase chain reactions were used to detect the relative expression of the target gene miR-320a, AQP4, B-cell bcl2-associated X (Bax), and B-cell bcl-2 (Bcl-2) mRNA. Western blotting was employed to detect the relative expression of AQP4, Bax and Bcl-2 proteins.Results:After PC12 was induced by 50μg/L NGF, the expression of Uch-L1 genes in the induced neuron was significantly down-regulated compared with the PC12. The expressions of NFP, MAP2 and AQP4 genes were significantly up-regulated, and the relative expressions of MAP2 and AQP4 proteins increased significantly. Compared with the control group, the apoptosis and cell activity of neurons in the treatment group increased, the mRNA and protein expressions of miR-320a, AQP4, bcl-2, AQP4 and Bcl-2 decreased significantly, and the mRNA and protein expressions of Bax increased significantly. Compared with the Aβ-treated group, the cell activity of the Aβ+ Mir-320a mimic group increased significantly, the mRNA and protein expressions of miR-320a, AQP4 and Bcl-2 increased significantly, and the mRNA and protein expressions of Bax decreased significantly. Compared with the Aβ+ miR-320a mimic group, the cell activity of the Aβ+ miR-320a inhibitor group decreased significantly, the mRNA and protein expressions of miR-320a, AQP4 and Bcl-2 decreased significantly, and the mRNA and protein expressions of Bax increased significantly.Conclusion:miR-320a can up-regulate AQP4 expression in a cell model of Alzheimer′s disease, reduce apoptosis and increase the cell survival rate.