Objective: To explore the potential causal association between adolescent compulsive behaviour and smartphone addiction based on longitudinal data, so as to provide reference for the establishment of adolescent smartphone addiction interventions. Methods: A preliminary survey and follow-up were conducted on 8 907 middle and high school students in a district of Shenzhen in 2022 and 2023, respectively. Compulsive behaviours were measured by using the Mental Health Inventory for Middle School Students-60 Items (MMHI-60), smartphone addiction was assessed by using the Smartphone Addiction Scale-Short Version ( SAS- SV), and the associations between compulsive behaviours and smartphone addiction were analysed by using multilevel mixed-effects models and subgroup analyses. Results: Smartphone addiction detection rates among middle school students were significantly associated with genders, father s education level, mother s education level, study load subgroups, and whether or not they were single-parent families, and there were statistical differences ( χ 2=17.21-175.34, P <0.05). Students with compulsive behaviours were 2.98 times more likely to develop smartphone addiction than those without compulsive behaviours ( OR=2.98, 95%CI=2.77-3.22, P <0.05). Subgroup analysis of middle school students without smartphone addiction in the first year found that compulsive behaviours significantly predicted smartphone addiction ( OR= 1.76 , 95%CI=1.54-2.01, P <0.05). Conclusion There is a potential causal association between obsessive-compulsive behaviours and smartphone addiction in middle school students, and obsessive-compulsive behaviours in middle school students could significantly predicted the occurrence of smartphone addiction.

Objective:To evaluate the effectiveness of amplification intervention with hearing aids for restoring binaural auditory function in patients with unilateral moderate to severe sensorineural hearing loss. Methods:This study selected 30 patients with normal hearing in one ear and moderate to severe sensorineural hearing loss in the other ear. They were fitted with hearing aids for the worse ear and underwent more than half a year and one year of adaptation training. The Chinese translation of the Twelve-item version of SSQ（C-SSQ12）, angle identification test, speech recognition score（SRS） at different signal-to-noise ratios（SNR=5 and SNR=10） and audiometric thresholds were used to compare the results before and after hearing aid use to evaluate the effectiveness of the unilateral hearing loss intervention. Results:The results of the audiometric thresholds, C-SSQ12 scores, angle identification test, and SRS at SNR=5 and SNR=10 in the worse ear of the unilateral hearing loss patients after hearing aid use were all statistically significant compared to before hearing aid use（P<0.01）. Conclusion:Amplification intervention with hearing aids has significant effects on restoring binaural auditory function in patients with unilateral moderate to severe sensorineural hearing loss.
Humans ; Hearing Aids ; Hearing Loss, Unilateral/therapy* ; Middle Aged ; Hearing Loss, Sensorineural/rehabilitation* ; Adult ; Female ; Male ; Auditory Threshold ; Young Adult ; Aged

Ulcerative colitis (UC) is a chronic and non-specific inflammatory bowel disease (IBD). Huanglian Ganjiang decoction (HGD), derived from ancient book Beiji Qianjin Yao Fang, has demonstrated efficacy in treating UC patients traditionally. Previous research established that the compatibility of cold herb Coptidis Rhizoma + Phellodendri Chinensis Cortex (CP) and hot herb Angelicae Sinensis Radix + Zingiberis Rhizoma (AZ) in HGD synergistically improved colitis mice. This study investigated the compatibility mechanisms through which CP and AZ regulated inflammatory balance in colitis mice. The experimental colitis model was established by administering 3% dextran sulphate sodium (DSS) to mice for 7 days, followed by CP, AZ and CPAZ treatment for an additional 7 days. M1/M2 macrophage polarization levels, glucose metabolites levels and pyruvate dehydrogenase kinase 4 (PDK4) expression were analyzed using flow cytometry, Western blot, immunofluorescence and targeted glucose metabolomics. The findings indicated that CP inhibited M1 macrophage polarization, decreased inflammatory metabolites associated with tricarboxylic acid (TCA) cycle, and suppressed PDK4 expression and pyruvate dehydrogenase (PDH) (Ser-293) phosphorylation level. AZ enhanced M2 macrophage polarization, increased lactate axis metabolite lactate levels, and upregulated PDK4 expression and PDH (Ser-293) phosphorylation level. TCA cycle blocker AG-221 and adeno-associated virus (AAV)-PDK4 partially negated CP's inhibition of M1 macrophage polarization. Lactate axis antagonist oxamate and PDK4 inhibitor dichloroacetate (DCA) partially reduced AZ's activation of M2 macrophage polarization. In conclusion, the compatibility of CP and AZ synergistically alleviated colitis in mice through M1/M2 macrophage polarization balance via PDK4-mediated glucose metabolism reprogramming. Specifically, CP reduced M1 macrophage polarization by restoration of TCA cycle via PDK4 inhibition, while AZ increased M2 macrophage polarization through activation of PDK4/lactate axis.
Animals ; Drugs, Chinese Herbal/chemistry* ; Mice ; Macrophages/immunology* ; Glucose/metabolism* ; Pyruvate Dehydrogenase Acetyl-Transferring Kinase/genetics* ; Male ; Mice, Inbred C57BL ; Humans ; Colitis/drug therapy* ; Disease Models, Animal ; Colitis, Ulcerative/drug therapy* ; Metabolic Reprogramming

Objective To investigate the clinical features of elderly patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF)and the risk factors affecting the short-term prognosis of patients.Methods A retrospective analysis was performed for 417 patients with HBV-ACLF who were admitted to The General Hospital of Western Theater Command from January 2015 to January 2023,and related clinical data were collected,including general status,routine blood test results,biochemical parameters,and conditions of liver cirrhosis and decompensated events(ascites,hepatic encephalopathy,and their severities).The patients were followed up to observe 90-day survival.According to the age,the patients were divided into elderly group(with 106 patients aged≥60 years)and non-elderly group(with 311 patients aged＜60 years),and according to the 90-day survival,the elderly group were further divided into survival group with 41 patients and death/transplantation group with 65 patients.The independent-samples t test or the Mann-Whitney U test was used for comparison of quantitative data between two groups,and the chi-square test was used for comparison of qualitative data between two groups.The binary logistic regression analysis was used to determine the independent influencing factors for the risk of death within 90 days in elderly patients with HBV-ACLF,and a nomogram model was constructed for predicting the risk of death.The receiver operating characteristic(ROC)curve was used to investigate the value of the model in predicting the prognosis of HBV-ACLF patients in both the training set and the validation set.Calibration curve and decision curve were plotted for the models constructed in the training set and the validation set,and the model was assessed in terms of the degree of fitness and predicting benefits.Results The elderly patients had a significantly higher 90-day mortality rate than the non-elderly patients(P＜0.05),and compared with the non-elderly group,the elderly group had significantly higher incidence rate in female individuals,basic incidence rate of liver cirrhosis,incidence rate and grade of hepatic encephalopathy,incidence rate of ascites,and liver fibrosis markers(aspartate aminotransferase-to-platelet ratio index and fibrosis-4)(all P＜0.05),as well as significantly lower total cholesterol,high-density lipoprotein,albumin,alpha-fetoprotein,and lymphocytes(all P＜0.05).As for the elderly patients with HBV-ACLF,there were significant differences between the survival group and the death/transplantation group in total cholesterol,total bilirubin,international normalized ratio(INR),alpha-fetoprotein,platelet,creatinine,serum sodium,monocytes,and the incidence rate and grade of hepatic encephalopathy(all P＜0.05).In addition,the multivariate logistic regression analysis showed that INR(odds ratio[OR]=11.351,95%confidence interval[CI]:1.942-66.362,P＜0.05),monocyte count(OR=23.636,95%CI:1.388-402.529,P＜0.05),total bilirubin(OR=1.007,95%CI:1.001-1.013,P＜0.05),and platelet count(OR=0.968,95%CI:0.945-0.993,P＜0.05)were independent influencing factors for the 90-day prognosis of elderly patients with HBV-ACLF,and the nomogram model constructed based on these factors had a relatively high predictive value,with an area under the ROC curve of 0.915,a sensitivity of 88.0%,and a specificity of 86.7%.The nomogram model showed relatively high efficiency and degree of fitness in the verification set,and the decision curve suggested that the model had good benefits,with a higher prediction efficiency compared with the commonly used prediction models such as MELD score and COSSH-ACLF Ⅱ score.Conclusion Elderly HBV-ACLF patients may have a high short-term mortality rate due to the reductions in liver synthesis,reserve function,and regenerative ability and immune dysfunction.INR,monocyte count,total bilirubin,and platelet count have a relatively high value in predicting the risk of death in elderly HBV-ACLF patients,and the nomogram model constructed based on these factors has a relatively high prediction efficiency.

Objective The aim of this study was to evaluate the efficacy and side effects of sacubitril/valsartan in the treatment of patients with chronic kidney disease(CKD)at stage 5 with resistant hypertension,and to explore the cardiovascular benefits and security of medical in the patients.Methods Patients with CKD5 resistant hypertension diagnosed and treated in the First Affiliated Hospital of Guangxi Medical University from September 2020 to March 2022 were selected and divided into the observation group(treated with routine treatment of kidney disease at end-stage and sacubitril/valsartan)and control group(include droutine treatment of renal disease at end-stage and ACEI or ARB drugs)according to treatment strategy.The patients in both two groups were treated with adequate dialysis treatment and conventional drug treatment of renal disease at end-stage.The patients were followed up for at least 3 months,the clinical efficacy of three months after treated with sacubitril/valsartan was observed,and the efficacy indicators and security indicators and adverse cardiovascular events were observed,the occurrence of adverse effects during the period of drug use were compared with the control group.Results A total of 110 patients were included in this study and there were 55 cases in each group.There were no significant differences in gender,age,age of dialysis,etiology,dialysis mode and blood pressure between the two groups(P>0.05).The Systolic blood pressure(SBP),diastolic blood pressure(DBP),b-type urinary natriuretic peptide precursor(Pro-BNP)and cardiac function grade in the observation group after treatment was significantly decreased compared with before treatment.The left ventricular ejection fraction(LVEF)and the ratio of LVEF<50%in the observation group was significantly reduced after treatment(P<0.05).SBP,DBP and Pro-BNP decreased 3 months after treatment compared with the baseline before treatment,and improved significantly in the first month after treatment(P<0.05).The decrease of DBP and BNP before and after treatment was significantly different between the two groups,and the decrease of DBP and BNP was more significant in the observation group(P<0.05).The difference of LVEF and left ventricular end diastolic diameter(LVEDD)between the two groups before and after treatment was statistically significant,and the improvement was more obvious in the observation group(P<0.05).There were no significant differences in the safety indicators of serum potassium,estimated glomerular filtration rate(eGFR)and liver function between two groups before and after treatment(P>0.05).In terms of adverse reactions,only 1 case in the control group developed hyperkalemia within 3 months of follow-up,and no hypotension or other adverse reactions occurred in the two groups.Conclusions The treatment of patients with CKD stage 5 hypertension with sacubitril/valsartan has obvious cardiovascular benefits.Sacubitril/Valsartan has efficacy in lowering blood pressure,improving cardiac function and reducing volume load,with less adverse events and higher safety than control group.

Objectives:To investigate the clinical feasibility of three-dimensional(3D)high-resolution late gadolinium enhancement(LGE)MRI in accessing left atrial myocardial fibrosis in patients with atrial fibrillation(AF). Methods:A total of 34 AF patients referred for hybrid surgical ablation were retrospectively enrolled in this study.3D-LGE-MRI images were acquired by Siemens 3.0 T machine and analyzed by ADAS post-processing software by two experienced radiologists to obtain parameters such as the area and the area percentage of LGE.Regional analysis was performed by one of the two radiologists at ten left atrial segments.The Kappa test was used to assess the agreement for scoring image quality,and the interclass correlation coefficient(ICC)was used to evaluate the interobserver agreement of LGE parameters.The parameters of left atrial morphology,area(and area percentage)of LGE,and location of LGE were compared between patients with persistent AF and paroxysmal AF. Results:Images of all 34 patients were considered to have diagnostic value.The scores of the overall image quality and the clarity of the left atrial wall evaluated by two radiologists were(2.88±0.64)points and(3.26±0.75)points(radiologist 1),(2.97±0.58)points and(3.24±0.70)points(radiologist 2),respectively.The corresponding Kappa values were 0.724 and 0.859.Both the area and the area percentage of LGE showed good consistency among observers,and the ICCs were 0.969 and 0.950,respectively.The difference in the area of LGE and the area percentage of LGE between patients with paroxysmal and persistent atrial fibrillation was similar(both P＞0.05).Compared with patients with paroxysmal AF,patients with persistent AF had a higher Utah stage and more severe myocardial fibrosis in the right inferior pulmonary vein antrum and the left atrial septum(all P＜0.05). Conclusions:3D high-resolution LGE-MRI provides a non-invasive way to visualize and quantify left atrial myocardial fibrosis.The extent of left atrial fibrosis in patients with persistent AF is more severe than that in patients with paroxysmal AF,with a preferential distribution in the right inferior pulmonary vein antrum and the left atrial septum.

Objective To investigate the correlation between clinical characteristics of self-limited epilepsy in children with spines in the central temporal region(SeLECTS)and plasma levels of ammonia,25-hydroxyvitamin D[25(OH)D].Methods A total of 90 SeLECTS children admitted to Suzhou Hospital Affiliated to Anhui Medical University from September 2021 to October 2023 were selected as the case group,and 90 healthy children were included in the control group during the same period.The differences in plasma ammonia and serum 25(OH)D levels between the two groups were compared.The correlation between clinical characteristics of SeLECTS and plasma levels of ammonia,25(OH)D was retrospectively analyzed.Results Plasma ammonia concentration in case group was significantly higher than that in control group(P＜0.05).The level of 25(OH)D was significantly lower than that of control group(P＜0.05).There were statistically significant differences in plasma ammonia concentration among patients with different age,duration and frequency of SeLECTS(P＜0.05).There were statistically significant differences in serum 25(OH)D content among children with different age,frequency and season of SeLECTS(P＜0.05).The correlation between onset time,onset age and onset frequency was significant at 0.01 level.The correlation between plasma ammonia concentration and age of onset,time of onset and frequency of onset was significant at 0.05 level.At the same time,the correlation between 25(OH)D content and seizure time,seizure frequency and plasma ammonia concentration was significant at 0.05 level.The age of onset,frequency and duration of attacks were positively correlated with plasma ammonia levels of SeLECTS.Age of onset was positively correlated with 25(OH)D level,and frequency of onset was negatively correlated with 25(OH)D level.Conclusion SeLECTS attacks are significantly correlated with plasma ammonia and serum 25(OH)D levels,and both elevated plasma ammonia levels and decreased 25(OH)D levels increase the risk of SeLECTS attacks.Therefore,detection of plasma ammonia and serum 25(OH)D levels in children can provide evidence for prevention,disease assessment,diagnosis and treatment of SeLECTS.

Objective:To analyze the molecular characteristics of antibiotic resistance in Helicobacter pylori(HP)and provide a molecular bio-logical basis for clinical eradication of HP by means of rational antibiotic use.Methods:From February 2019 to November 2023,1,144 pa-tients at the Gansu Wuwei Cancer Hospital who tested positive for HP using the 14C-urea breath test were enrolled in the study.Antibiotic resistance and related molecular characteristics of HP,and CYP2C19 polymorphisms in the patients were detected by diffusion drug suscept-ibility testing,drug resistance gene testing,and next-generation sequencing,respectively.Results:Among the six antibiotics assessed,the resistance rate and the prevalence of resistance genes(rdxA)were highest for metronidazole(92.00%and 86.12%,respectively),and lowest for amoxicillin(Pbp1)(11.78%and 37.11%,respectively).The prevalence of CYP2C19 alleles showed that 46.77%,44.58%,and 8.65%of par-ticipants were fast,medium,and slow metabolizers,respectively.Of the participants,148(18.55%)had immunohistochemical sphericity.The eradication rate of HP lower using conventional treatment regimens than that using personalized treatment regimens(χ2=8.627,P=0.003).The HP eradication rate was higher among patients with a first diagnosis of drug resistancebased on molecular testing,than that in patients undergoing retreatment(χ2=6.242,P=0.012).Conclusions:The prevalence of amoxicillin-resistant HP is low in Wuwei City,which has a high incidence of gastric cancer.Molecular diagnosis of antimicrobial resistance could improve the HP eradication rate and provide a refer-ence for rational use of antibiotics in clinical practice.

Objective:To establish a classification system for the repair band in the subchondral bone origination point in MRI for traumatic osteonecrosis of the femoral head (ONFH) and preliminarily explore the correlation between this classification and the progression of femoral head collapse.Methods:A retrospective analysis was conducted on 73 cases of traumatic ON-FH treated at the Quanzhou Orthopedic-traumatological hospital from January 2000 to December 2019. Among them, there were 46 males and 27 females with an average age of 34.9±8.3 years (range 19-55 years). Clinical and radiological data such as age, gender, side, fracture classification, reduction quality, JIC classification, and bone repair band (BRB) classification were recorded. The progression of traumatic ONFH was assessed using the ARCO staging system, with stages IIIA and IIIB defined as mild collapse and progressive collapse, respectively. The BRB classification was established based on MRI findings, and the inter- and intra-observer consistency of the BRB classification was analyzed using Kappa test. The correlation between the BRB classification and progressive femoral head collapse was analyzed using the Kaplan-Meier survival curve and binary variable Cox regression analysis.Results:According to the BRB classification, 73 cases were divided into type 1 with superficial lesion in 38.4%, type 2 with uncertain lesion in 21.9%, and type 3 with extensive lesion in 39.7%. The inter-observer consistency Kappa value for the BRB classification was 0.798, and the intra-observer consistency Kappa value was 0.896, indicating a high level of consistency. A follow-up of 73 cases (54.8±34.9 months, range 24-165 months) showed a significant correlation between the BRB classification and ARCO staging at the last follow-up (χ 2=37.556, P<0.001), with progression to stages IIIA and IIIB as follows: type 1 had 3 and 1 cases, type 2 had 4 and 1 cases, and type 3 had 14 and 12 cases, respectively. Using the occurrence of progressive collapse (stage IIIB) as the endpoint, the risk of progression to stage IIIB for type 2 was not statistically different from type 1 [ HR=1.766, 95% CI (0.465, 6.702), P=0.403]; the risk of progression to stage IIIB for type 3 was significantly higher than for type 1 [ HR=15.126, 95% CI (4.708, 48.592), P<0.001]. Conclusion:The BRB classification is closely related to the progression of traumatic ONFH and is an independent risk factor for predicting the occurrence of progressive collapse; this classification is helpful for early diagnosis and predicting the progression of collapse and treatment plan decision-making.

Humans ; Amyloidosis ; Amyloid ; Cardiomyopathies