Objective:To evaluate the effect of smoking on the sedative potency of remimazolam combined with alfentanil in patients undergoing painless gastroscopy.Methods:This was a prospecctive single-center study. American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ male patients, aged 30-75 yr, with a body mass index of 18-28 kg/m 2, undergoing elective painless gastroscopy at Baoding First Central Hospital from October to December 2023, were divided into non-smoking group, mild smoking group (smoking index≤200), moderate smoking group (200 1 after 3 min of remimazolam injection or development of bucking, swallowing, body movement and other responses that affected operations during insertion of the endoscope. Results:A total of 85 patients were finally included, with 21 in non-smoking group, 21 in mild smoking group, 20 in moderate smoking group and 23 in heavy smoking group. The ED 50 of remimazolam was significantly higher in smoking groups than in non-smoking group ( P<0.05). The ED 50 of remimazolam gradually increased in mild, moderate and heavy smoking groups ( P<0.05). Conclusions:Smoking can decrease the sedative potency of remimazolam when combined with alfentanil in patients undergoing painless gastroscopy.

Objective:To investigate the influences of paeonol(PAE)on balance of Th17/Treg in autoimmune thyroiditis(AIT)rats by regulating high-mobility group box 1(HMGB1)/receptor for advanced glycation end product(RAGE)signal axis.Methods:Eighty-four rats were randomly divided into control group(NC group),Model group,low-dose PAE group(PAE-L group,8 mg/kg),medium-dose PAE group(PAE-M group,16 mg/kg),high-dose PAE group(PAE-H group,32 mg/kg),selenious yeast group(SY group,36 μg/kg)and PAE-H+rHMGB1(HMGB1 activator)group(32 mg/kg+8 μg/kg),with 12 rats in each group.Except for NC group,AIT models were established in other groups,and after successful modeling,rats were administered once a day for 6 weeks.ELISA was applied to detect the levels of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),free triiodothyro-nine(FT3),free thyroxine(FT4),IL-17 and IL-10 in rat serum;flow cytometry was applied to detect ratios of Th17,Treg,Th17/Treg in peripheral blood of rats in each group;HE staining was applied to detect pathological changes of thyroid tissue in rats;qRT-PCR was applied to detect expression levels of retinoic acid-related orphan receptor γt(RORγt)and forkhead box protein P3(Foxp3)mRNA in rat thyroid tissue;Western blot was applied to detect expressions of HMGB1 and RAGE proteins in thyroid tissue of rats.Results:Compared with NC group,pathological damages of thyroid tissue in Model group were serious,TPOAb,TGAb,FT3,FT4,IL-17 levels,Th17 ratio,Th17/Treg,RORγt mRNA level,HMGB1 and RAGE protein expressions were increased,while IL-10 level,Treg ratio,and Foxp3 mRNA level were decreased(P<0.05);compared with Model group,pathological damages of thyroid tissue in PAE-L group,PAE-M group,PAE-H group and SY group were reduced,TPOAb,TGAb,FT3,FT4,IL-17 levels,Th17 ratio,Th17/Treg,RORγt mRNA level,HMGB1 and RAGE protein expressions were decreased,while IL-10 level,Treg ratio,and Foxp3 mRNA level were increased(P<0.05);rHMGB1 attenuated the promotion of high dose PAE on Th17/Treg balance in AIT rats.Conclusion:PAE may promote Th17/Treg balance in AIT rats by inhibiting HMGB1/RAGE pathway.

Objective:To evaluate the effect of smoking on the sedative potency of remimazolam combined with alfentanil in patients undergoing painless gastroscopy.Methods:This was a prospecctive single-center study. American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ male patients, aged 30-75 yr, with a body mass index of 18-28 kg/m 2, undergoing elective painless gastroscopy at Baoding First Central Hospital from October to December 2023, were divided into non-smoking group, mild smoking group (smoking index≤200), moderate smoking group (200 1 after 3 min of remimazolam injection or development of bucking, swallowing, body movement and other responses that affected operations during insertion of the endoscope. Results:A total of 85 patients were finally included, with 21 in non-smoking group, 21 in mild smoking group, 20 in moderate smoking group and 23 in heavy smoking group. The ED 50 of remimazolam was significantly higher in smoking groups than in non-smoking group ( P<0.05). The ED 50 of remimazolam gradually increased in mild, moderate and heavy smoking groups ( P<0.05). Conclusions:Smoking can decrease the sedative potency of remimazolam when combined with alfentanil in patients undergoing painless gastroscopy.

Objective:To investigate the influences of paeonol(PAE)on balance of Th17/Treg in autoimmune thyroiditis(AIT)rats by regulating high-mobility group box 1(HMGB1)/receptor for advanced glycation end product(RAGE)signal axis.Methods:Eighty-four rats were randomly divided into control group(NC group),Model group,low-dose PAE group(PAE-L group,8 mg/kg),medium-dose PAE group(PAE-M group,16 mg/kg),high-dose PAE group(PAE-H group,32 mg/kg),selenious yeast group(SY group,36 μg/kg)and PAE-H+rHMGB1(HMGB1 activator)group(32 mg/kg+8 μg/kg),with 12 rats in each group.Except for NC group,AIT models were established in other groups,and after successful modeling,rats were administered once a day for 6 weeks.ELISA was applied to detect the levels of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),free triiodothyro-nine(FT3),free thyroxine(FT4),IL-17 and IL-10 in rat serum;flow cytometry was applied to detect ratios of Th17,Treg,Th17/Treg in peripheral blood of rats in each group;HE staining was applied to detect pathological changes of thyroid tissue in rats;qRT-PCR was applied to detect expression levels of retinoic acid-related orphan receptor γt(RORγt)and forkhead box protein P3(Foxp3)mRNA in rat thyroid tissue;Western blot was applied to detect expressions of HMGB1 and RAGE proteins in thyroid tissue of rats.Results:Compared with NC group,pathological damages of thyroid tissue in Model group were serious,TPOAb,TGAb,FT3,FT4,IL-17 levels,Th17 ratio,Th17/Treg,RORγt mRNA level,HMGB1 and RAGE protein expressions were increased,while IL-10 level,Treg ratio,and Foxp3 mRNA level were decreased(P<0.05);compared with Model group,pathological damages of thyroid tissue in PAE-L group,PAE-M group,PAE-H group and SY group were reduced,TPOAb,TGAb,FT3,FT4,IL-17 levels,Th17 ratio,Th17/Treg,RORγt mRNA level,HMGB1 and RAGE protein expressions were decreased,while IL-10 level,Treg ratio,and Foxp3 mRNA level were increased(P<0.05);rHMGB1 attenuated the promotion of high dose PAE on Th17/Treg balance in AIT rats.Conclusion:PAE may promote Th17/Treg balance in AIT rats by inhibiting HMGB1/RAGE pathway.

The article summarizes the clinical experience of Professor JIA Chunsheng in treating cubital tunnel syndrome with various traditional Chinese medicine therapies,including superficial point-toward-point auricular acupuncture,ordinary acupuncture,fire-needle therapy,and oral Chinese medication,to inherit his academic characteristics,such as meridian-identified and stage-identified treatments,stressing the patient's body constitution and state,and emphasizing the holistic treatment,and to provide references for the popular science education and clinical treatment of cubital tunnel syndrome.

Objective: To explore the mediating effect and gender difference of mobile phone use in the association between different types of childhood abuse experiences and sleep quality of medical students, so as to provide reference for promoting sleep quality of medical students. Methods: A longitudinal study design method was used to select freshmen and sophomores in two medical colleges in Anhui Province from November to December 2019, follow up data were collected from May to June 2020, and a total of 6 879 students were included in this study. Spearman correlation was used to analyze the association between baseline childhood abuse experiences, baseline mobile phone use and follow up sleep quality. Bootstrap program and Process software were applied to test the mediating effect of mobile phone use in the relationship between childhood abuse and sleep quality. Results: Childhood abuse experiences were positively correlated with mobile phone use and sleep quality score ( r = 0.27 , 0.24, P <0.01), and mobile phone use was positively correlated with sleep quality score ( r =0.31, P <0.01). In the total sample, after adjusting for confounding factors, mobile phone use played a partial mediating role in childhood abuse experiences (including emotional abuse, physical abuse, sexual abuse) and sleep quality, and the mediating effect was 18.08% (18.12%, 17.15%, 24.09%). The mediating effect of mobile phone use on the relationship between childhood emotional abuse, sexual abuse, childhood abuse and sleep quality in girls(18.32%, 28.05%, 18.24%) was higher than in boys(17.81%, 18.94%, 17.63%). Conclusion Mobile phone use has a mediating effect on the relationship between childhood abuse and sleep quality, controlling mobile phone overuse may contribute to improving the sleep quality for those who have experienced childhood abuse.

Objective:To investigate the value of plasma Epstein-Barr virus (EBV) DNA detection in the screening of nasopharyngeal carcinoma (NPC) and its clinical application in non-high-risk areas.Methods:Plasma EBV DNA results in 1 153 newly diagnosed nasopharyngeal carcinoma patients who were treated in Sichuan Cancer Hospital from 2015 to 2020 and 244 healthy control cases with matched sex and age were retrospectively analyzed. EBV DNA were detected by quantitative real-time PCR. Positive rate of EBV DNA was determined by the cutoff value of 400 (≥400 copies/ml as positive) and optimization threshold method (presence of S amplification curve as positive). Further analyses were conducted to compare EBV DNA load in different clinical stage, TNM stage and regions distribution characteristics. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of the cutoff value of 400 and optimization threshold method for NPC.Results:Compared with healthy controls, EBV DNA increased significantly in newly diagnosed NPC patients ( P<0.001). Both evaluation methods revealed that the EBV DNA positive percentage increased with TNM and clinical stage ( P<0.001). With 400 copies/ml as cutoff value, the diagnostic sensitivity and specificity were 40.85% and 100%, respectively. The area under the curve was 0.704 (95% CI 0.676-0.733, P<0.001). Evaluated by the optimization threshold method, the sensitivity and specificity could improve to 82.0% and 99.2%, respectively, and the area under the curve reached 0.910 (95% CI 0.894-0.924, P<0.001). Conclusions:In the low prevalence area of nasopharyngeal carcinoma, the sensitivity for diagnosis of nasopharyngeal carcinoma is only 40.9% by the 400 copies/ml cutoff value method. The optimization threshold method is a better choice to improve the diagnostic sensitivity without lowering the diagnostic specificity.

BACKGROUND: Suicidal behaviors are seriously social issues among adolescents in the world. Exposed to smoking and being bullied are risk factors of suicidal behaviors. The present study was aimed to examine the interaction of smoking and being bullied on suicidal behaviors among Chinese adolescents. METHODS: A total of 18,900 students were involved in the questionnaire study, in four cities of China from November 2017 to January 2018. Suicidal behaviors, smoking, and being bullied were measured by self-reported validated instruments. Chi-square tests and logistic regression were used to analyze the associations of suicidal ideation (SI)/suicidal plan (SP)/suicidal attempt (SA), smoking, and being bullied. RESULTS: The prevalence of smoking, being bullied, SI/SP/SA, were 3.1%, 20.6%, 26.4%, 13.2%, and 5.2% respectively. Interaction analysis indicated that being bullied was associated with a greater increase in the likelihood of suicidal behaviors for adolescents with smoking than for those without smoking. CONCLUSIONS These finding suggest that smoking exacerbates the association between being bullied and suicidal behaviors. Future research should explore how and why smoking appears to more bully-victims than for those without smoking and how to mitigate it.
Adolescent ; Adolescent Behavior/psychology* ; Bullying/psychology* ; Child ; China/epidemiology* ; Cross-Sectional Studies ; Humans ; Prevalence ; Smoking/psychology* ; Students/statistics & numerical data* ; Suicidal Ideation

Objective: The purpose of the current study was to determinate the prevalence of dating violence perpetration and victimization and to examine its relationship with childhood abuse among medical college students. Methods: Cluster sampling survey was carried out among 3 727 freshmen and sophomores in two medical colleges from Anhui Province. Information with general demographic variables, childhood abuse and dating violence was obtained. Logistic regression was used to identify the relationship of different types of childhood abuse and dating violence after controlled for confounding factors. Results: The rate of dating violence perpetration and victimization was 37.8% and 27.8%, respectively. Female students had higher childhood emotional abuse experience (61.9%) than male students (51.6%), while male students had higher childhood physical and sexual abuse (28.2% and 19.4%) than females (24.3% and 10.5%) (χ2=33.84，6.33，52.97，P<0.01). Results showed that increased dating violence perpetration [OR(95%CI)=1.71(1.48-1.98),1.55(1.33-1.82),1.75(1.43-2.15)]and victimization [OR(95%CI)=1.84(1.43-2.16),1.59(1.34-1.87),1.62(1.32-2.00)](P<0.01) among individuals with physical, emotional and sexual abuse after controlling for confounding variables. No gender difference was found within other groups in the relationship between childhood abuse and dating violence(P>0.05). Conclusion Childhood abuse experiences are associated with higher risk of dating violence perpetration and victimization among college students. Reducing childhood abuse is beneficial to the prevention and control of dating violence among medical college students.

Objective: The aim of this paper is to understand the associations between childhood abuse experience,parent-child relationship and non-suicidal self-injury (NSSI) in middle school students. Methods: Stratified cluster sampling method was used to select 14 500 middle school students from Shenzhen,Zhengzhou,Nanchang and Guiyang as participants. Questionnaire survey was conducted to collect information on childhood abuse exposure,parent-child relationship and NSSI. Results: The prevalence of NSSI was 14.81%,while it was higher among male students (15.95%) than female students (13.64%) (χ2=15.29,P<0.01). A multivariate Logistic regression models showed that the moderate and high level of childhood abuse (OR=2.23,3.27) and the low level of parents-child relationship (OR=1.80,1.36) were associated with high NSSI detection rate among middle school students (P<0.01). In each group of childhood abuse,low level of father-child relationship was associated with high NSSI detection rate among middle school students (OR=1.36,1.34,1.56,P<0.05). In the group with high level of childhood abuse experience,low level of mother-child relationship was associated with high NSSI detection rate (OR=1.20,P<0.05). Among male students,those with high level of childhood abuse experience,low level of parentchild relationship were associated with high NSSI detection rate (OR=1.46,1.35,P<0.01); regardless of the level of childhood abuse experience,low level of father-daughter relationship was associated with NSSI detection rate (OR=1.64,1.54,1.68,P<0.01) among females. Conclusion Childhood abuse experience and poor parent-child relationship are associated with NSSI in middle school students, with distinct gender difference. Prevention of childhood abuse and the improvement of parent-child relationship are beneficial to the prevention and control of NSSI.