OBJECTIVE To investigate the effects of Buyang huanwu decoction on red blood cells in hyperlipidemia model mice. METHODS Male C57BL/6 mice were fed a high-fat diet to prepare a hyperlipidemia model. Successfully modeled mice were randomly assigned to the model group， atorvastatin calcium group （0.26 g/kg）， fenofibrate group （1.3 mg/kg）， and high-， medium-， and low- dose groups of Buyang huanwu decoction （18.6， 9.3， 4.6 g/kg）， with 10 mice in each group. Additionally， 10 mice fed with regular chow served as the normal group. Each group of mice received intragastric administration with the corresponding drug or normal saline once daily for 21 consecutive days. After the last administration， the body weight of the mice in each group was measured， and blood glucose， total cholesterol （TC）， triglyceride （TAG）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C） levels were measured. Red blood cell morphology changes were observed， and the expression levels of glucose transporter type 1 （GLUT1）， erythrocyte membrane protein band 4.2 （protein 4.2）， caveolin-1， and flotillin-1 in erythrocyte membrane were determined. RESULTS Compared with the model group， the body weight and levels of TC， TAG， HDL-C， LDL-C， and the expression levels of GLUT1， caveolin-1 and flotillin-1 in the Buyang huanwu decoction groups were significantly decreased， while blood glucose levels and the expression levels of protein 4.2 were significantly increased （P＜0.05）. The red blood cell morphology in the low- and medium-dose groups of Buyang huanwu decoction was significantly promoted. CONCLUSIONS Buyang huanwu decoction can reduce blood lipid levels in hyperlipidemia model mice and strengthen the morphology and function of red blood cells in a hyperlipidemic environment， which has the potential to be used for preventing hyperlipidemia complications such as atherosclerosis.

Objectives:Analyze the clinical characteristics of patients with primary antiphospholipid syndrome (PAPS) progressing to systemic lupus erythematosus (SLE).Explore the risk factors for the progression from PAPS to SLE.Methods:The clinical data of 262 patients with PAPS enrolled in Peking Union Medical College Hospital from February 2005 to September 2021 were evaluated. Assessments included demographic data, clinical manifestations, laboratory tests (serum levels of complement, anti-nuclear antibodies, anti-double-stranded DNA antibodies), treatment, and outcomes. Kaplan-Meier analysis was used to calculate the prevalence of SLE in patients with PAPS. Univariate Cox regression analysis was employed to identify the risk factors for PAPS progressing to SLE.Results:Among 262 patients with PAPS, 249 had PAPS (PAPS group) and 13 progressed to SLE (5.0%) (PAPS-SLE group). Univariate Cox regression analysis indicated that cardiac valve disease ( HR=6.360), positive anti-double-stranded DNA antibodies ( HR=7.203), low level of complement C3 ( HR=25.715), and low level of complement C4 ( HR=10.466) were risk factors for the progression of PAPS to SLE, whereas arterial thrombotic events ( HR=0.109) were protective factors ( P<0.05 for all). Kaplan-Meier analysis showed that the prevalence of SLE in patients suffering from PAPS with a disease course>10 years was 9%-15%. Hydroxychloroquine treatment had no effect on the occurrence of SLE in patients with PAPS ( HR=0.753, 95% CI 0.231-2.450, P=0.638). Patients with≥2 risk factors had a significantly higher prevalence of SLE compared with those with no or one risk factor (13-year cumulative prevalence of SLE 48.7% vs. 0 vs. 6.2%, P<0.001 for both). Conclusions:PAPS may progress to SLE in some patients. Early onset, cardiac-valve disease, positive anti-dsDNA antibody, and low levels of complement are risk factors for the progression of PAPS to SLE (especially in patients with≥2 risk factors). Whether application of hydroxychloroquine can delay this transition has yet to be demonstrated.

Objective:To investigate the knowledge, attitude and practice of general practitioners (GPs) in Shenzhen towards managing patients with common mental health problems.Methods:It was a cross-sectional study, from September 19 to October 31, 2020, 500 GPs from 100 community health centers (CHC) in 10 districts of Shenzhen municipality were randomly selected as the research subjects by stratified random sampling; the survey was conducted by self-filled questionnaire, which included general conditions, knowledge tests of common psychological problems (generalized anxiety disorder, depressive disorder, panic attacks, sleep disorders), GPs′ attitudes to take care of common psychological problems, and GPs′ practice of caring for common psychological problems.Results:A total of 500 questionnaires were distributed and 329 valid ones were collected. In terms of knowledge, GPs had the highest accuracy of answering the characteristics of depressive disorder (97.3%, 320/329), and the lowest accuracy of case analysis of panic attacks (50.2%, 165/329). In terms of attitude, 71.1%(234/329)of GPs agreed that "common psychological problems should be taken care of",there was a statistically significant difference in attitude scores among GPs with different years of working in CHC ( Z=14.60, P=0.006). In terms of practice, the most encountered mental health problem was insomnia (91.2%, 300/329), 46.5% (153/329) of GPs would use psychological assessment scales, 52.9% (174/329) of GPs would choose direct referral, and there were statistically significant differences in attitude scores among GPs with different years of working ( Z=10.70, P=0.030) and years of working in CHC ( Z=22.14, P<0.001). Conclusions:GPs have a positive attitude in taking care of common psychological problems, but lack of knowledge and confidence. As working in CHC for more years, GPs are more inclined to care for patients with common psychological problems in practice.

New threats posed by the emerging circulating variants of SARS-CoV-2 highlight the need to find conserved neutralizing epitopes for therapeutic antibodies and efficient vaccine design. Here, we identified a receptor-binding domain (RBD)-binding antibody, XG014, which potently neutralizes β-coronavirus lineage B (β-CoV-B), including SARS-CoV-2, its circulating variants, SARS-CoV and bat SARSr-CoV WIV1. Interestingly, antibody family members competing with XG014 binding show reduced levels of cross-reactivity and induce antibody-dependent SARS-CoV-2 spike (S) protein-mediated cell-cell fusion, suggesting a unique mode of recognition by XG014. Structural analyses reveal that XG014 recognizes a conserved epitope outside the ACE2 binding site and completely locks RBD in the non-functional "down" conformation, while its family member XG005 directly competes with ACE2 binding and position the RBD "up". Single administration of XG014 is effective in protection against and therapy of SARS-CoV-2 infection in vivo. Our findings suggest the potential to develop XG014 as pan-β-CoV-B therapeutics and the importance of the XG014 conserved antigenic epitope for designing broadly protective vaccines against β-CoV-B and newly emerging SARS-CoV-2 variants of concern.
Angiotensin-Converting Enzyme 2 ; Antibodies, Neutralizing ; Antibodies, Viral ; COVID-19 ; Epitopes ; Humans ; SARS-CoV-2/genetics* ; Spike Glycoprotein, Coronavirus/genetics*

Objective: To investigate the awareness of Internet based sex education and associated among middle school students, and to provide scientific basis to improve sex education using online resources. Methods: By using stratified cluster random sampling method, 449 students from 8 middle schools in Zhejiang Province were investigated with a self designed questionnaire by Chi square test, Logistic regression, and Importance Performance Analysis (IPA). Results: The awareness of Internet based sex education was 66.59%(299), among which 17.15%(77) chose "WeChat", 7.35%(33) chose "sex education website", and 42.09%(189) chose"video platform" as the primary resources of online sex education, respectively. In the sexual health literacy of middle school students, the correct rate in sexual safety and sexual assault was higher than 40%, with STD transmission and prevention higher than 70%. The correct rate was more than 80% when it came to sexual physiology and sexual development. Logistic regression analysis showed that higher score of sexual health literacy was associated with higher awareness of Internet based sex education ( OR =1.06, 95% CI =1.01-1.11, P <0.05). According to the IPA, the teaching effect and content in area A (the dominant area) had higher scores of importance and satisfaction.The funniness of content in area B (retention area) had a lower importance score and a higher satisfaction score. The practicality and interactivity in area C (opportunity area) had low scores of importance and satisfaction. The curriculum model in area D (improvement area) scored higher in importance and lower in satisfaction. Conclusion The awareness of Internet based sex education needs to be improved among middle school students. Efforts should be made to improve sexual health literacy. Online platforms providing sex education should focus on improving the relevant course model, strengthening the practicability and interactivity of the course, and continue to maintain the advantage of teaching effect, teaching content and interesting aspects of the course.

Objective:To analyze a Risk Scale for Emergence Agitation After General Anesthesia in Children (the EA risk scale) into simplified Chinese and evaluate the reliability and validity in children with strabismus correction surgery.Methods:After obtaining the authorization of the original author, the English version of the EA risk scale was translated, translated back and culturally debugged to form the Chinese version of the EA risk scale. Then 279 children with strabismus correction surgery were selected from a tertiary hospital of ophthalmology in Tianjin and were investigated to validate the scale.Results:The correlation coefficients of each item and the total score of the scale were respectively 0.768 (item 1) ,0.717(item 2), 0.676(item 3), 0.634(item 4) (all P < 0.01). Content validity index of the scale was 0.920, and each item was 0.80-1.00. One factors including 4 items were identified using exploratory factor analysis, accounting for 62.052% of the total variance. The optimal cut-off value for the EA risk in children was 10, with the AUG was 0.816, specificity of 0.704, and sensitivity of 0.839. The Cronbach α coefficient for the total scale was 0.819, and the intraclass correlation coefficient value between the scorers was 0.835. Conclusion:The Chinese version of the EA risk scale has good reliability and validity. The items are concise, clear, and easy to understand. It is suitable for clinical departments as a preliminary screening tool to identify emergence agitation after general anesthesia on children with strabismus correction surgery and to assess the risk of its occurrence.

ObjectiveTo investigate the prevenance rate and related factors of anxiety among the public before and after outbreak of COVID-19， and to provide scientific guidance for public health emergency response in psychological intervention field. MethodsBy using the convenient sampling method， residents in Chinese mainland participated in predesigned questionnaire survey from February 7^th to February 14^th， 2020， meantime， all the selected individuals were assessed using Self-rating Anxiety Scale （SAS）. The anxiety status was also retrospectively evaluated before January 20^th， prior to the outbreak. Thereafter， a before-and-after comparison was conducted on the anxiety status， and the related influencing factors were discussed. ResultsA total of 1 222 valid questionnaires were collected， with a valid rate of 93.8%. After the outbreak， the number of people with anxiety symptoms increased from 90 （7.4%） to 172 （14.1%）， with statistical difference （P<0.01）. The SAS score increased from （40.65±10.43） to （36.32±8.46）， with statistical difference （P<0.01）. For overall sample， the independent risk factors of anxiety aggravation included serious disruptions of daily life （P<0.01）， older age （P<0.01）， female （P<0.01）， poor education background （P=0.005）， occupied in medical staff （P=0.031） and lack of medical education （P=0.039）. For medical staff， the independent risk factors of anxiety aggravation included sense of being-alienated （P<0.01）， older age （P<0.01）， female （P=0.002） and serious disruptions of daily life （P=0.044）. ConclusionThe prevalence rate of anxiety is increased after the outbreak of COVID-19， especially among the general public with serious disruptions of daily life， older age， females， poor education background， and the lack of medical education， and among medical staff with sense of being-alienated， older age， females， and serious disruptions of daily life.

Objective:To explore the relationship between executive dysfunction and brain functional connectivity in deaf children and its mechanisms.Methods:Twenty-eight deaf children were recruited from special education schools and twenty-seven children with normal hearing were treated as controls matched with deaf children in age, sex and education. All human subjects were scheduled to complete brain magnetic resonance scanning, based on the voxel-based morphometry (VBM) technique for detecting differences in gray matter volume (GMV) and a set of executive function (EF) tasks for detecting differences in EF behavior performance between deaf and normal hearing children. All human subjects were also performed resting-state fMRI, which were analyzed by independent component analysis (ICA) and the executive control network was selected and compared between the deaf and normal hearing children.Results:Compared with the children with normal hearing, deaf children had smaller volume of gray matter in the left angular gyrus (MIN coordinates: -48, -72, 45; 700 voxels), right superior parietal gyrus (MIN coordinates: 20, -62, 57; 594 voxels) and left middle occipital gyrus(MIN coordinates: -32, -87, 42; 782 voxels). Deaf children had weaker functional connectivity (FC) in the left middle frontal gyrus, orbital part/left inferior frontal gyrus (MIN coordinates: -24, 21, 3; 54 voxels) with normal hearing children. In the behavioral test, deaf children had defects in the switching function compared with normal children, which was statistically significant ( t(42)=2.39, P=0.02). Conclusion:The EF of deaf children has some defects, and its neural mechanism may be related with the reduced functional connectivity and gray matter volume in the brain regions related to executive function.

Objective:To comprehensively and systematically measure and analyze deaf children's gray matter cortex and white matter fibers by surface-based morphometry (SBM) and tract-based spatial statistics(TBSS).Methods:Twenty-seven deaf children aged 9-13 years old and twenty-seven age and sex matched normal controls were selected. T1 structural images and diffusion tensor imaging data were collected and analyzed by SBM and TBSS to calculate the cortical thickness, back index and anisotropic index (fractional anisotropy, FA). The SPSS 20.0 software and FSL software were used for data analysis.Results:Compared with the control group, the thickness of the cortex in the left cerebral hemisphere central posterior gyrus, the superior lobule, the central lateral lobule, and the anterior lobe were significantly reduced(cluster size 4 150, P<0.05), and in the right cerebral hemisphere squats and the middle sacral region reduced(cluster size 2 592, P<0.05). The local regression index of the left anterior wedge region was significantly increased(cluster size 3 225, P<0.05). The DTI results showed a decrease in FA values in the areas of radiation crown, cortical bundle, cingulate gyrus, corpus callosum, thalamus radiation, and sub-occipital bundle( P<0.05, TFCE corrected). Conclusion:There are different degrees of damage in the cerebral cortex and white matter microstructure of deaf children, and the brain structure remodeling and compensatory reconstruction appeared in the anterior wedge, which provide strong evidence for in-depth study of relationship between the loss of auditory function and changes in the brain structure.

Objective:To investigate characteristic CT manifestations of primary pulmonary diffuse large B-cell lymphoma (DLBCL).Methods:CT images of 14 patients [10 males and 4 females, age （54±2） years old, range 32 to 91] with pathologically-proved pulmonary DLBCL lymphoma were retrospectively analyzed．Plain CT and contrast enhanced CT imaging were performed in all 14 patients. Image characteristics including lesion size, locations and distribution, morphology and margin, density and enhancement degrees, bronchia and lesion surroundings, other thoracic extra-pulmonary manifestations, as well as distant metastasis were analyzed and recorded. The maximal diameter of mass and/or nodules, pre and post-contrast CT values were measured. Among all 14 cases, 8 cases were initially diagnosed as lung carcinoma, 5 cases as infection, one case as lymphoma.Results:Among all 14 primary lung DLBCL cases, there were 10 case with multiple lesions and 4 with single lesion. Masses and/or nodules were found in 12 cases, with the maximum diameter of the lesions as 0.8-8.2 cm, the median value as 5.3 (2.9, 7.8) cm. Two cases showed simple consolidation. The margins of the lesions were clear and smooth in 12 cases, and fuzzy in 2 cases. The density of the lesions on pre-contrast CT was relatively uniform, with mean CT value (35.1±1.0) HU. After contrast, 10 cases displayed mild to moderate homogeneous enhancement, 4 cases showed heterogenous enhancement. The mean CT value of post-contrast images was (61.8±1.5) HU. In arterial phase, the mean CT value was (50.9±1.3) HU. Angiographic sign was found in 9 cases in arterial phase. Of the 14 cases, bronchus was clear and smooth in 5 cases. In 4 cases, bronchus was found slight compressed or stenosis; and 5 cases showed intra-lesion bronchi invasion or occlusion. Interstitial tissue around the lesion was found slightly thickened in 8 cases. The pleura showed unevenly thickened and invaded in 8 cases. Mediastinal or hilar lymphadenopathy and fusion were found in 10 cases, with 3 cases involving mediastinal large blood vessels, and 7 cases displaying infiltrative growth pattern. There were 4 cases with pleural effusion. CT follow-up after treatment in 8 cases showed no distant metastasis (7 cases showed good prognosis, with lesions disappearing after radiotherapy, chemotherapy or surgical resection; 1 case showed progressed with lesion increased after chemotherapy). Six patients abandoned the treatment and discharged from the hospital.Conclusions:Primary DLBCL is a high invasive and malignant entity with certain CT characteristics. The confirmed diagnosis of pulmonary DLBCL depends on pathological results.