Objective To establish the methods of galvanic vestibular stimulation-vestibular evoked myogenic potentials(GVS-VEMPs)in healthy children and to obtain the normal value of GVS-cVEMP and GVS-oVEMP in these children in China.Methods Twenty(3～14 years)healthy children and 24 healthy adults(18～30 years)were enrolled for conventional examinations of GVS-cVEMP and GVS-oVEMP.Using the galvanic stimulation in-tensity under 3 mA/1 ms for children and 5 mA/1 ms for adults.The characteristics of elicitation and parameter re-sults of GVS-cVEMP and GVS-oVEMP in children and adults,as well as the pain scores and the elicitation of differ-ent stimulus intensities in the two age groups were recorded.Results The elicitation of GVS-cVEMP and GVS-oVEMP were both 100.0％in children and adult groups.The p1 latency,n1 latency and p1-n1 interval latency of GVS-cVEMP were 10.46±1.84 ms,16.98±2.12 ms and 6.52±1.42 ms respectively in children group,the n1 la-tency and p1-n1 interval latency were significantly shorter than the adult group(P＜0.05).The n1 latency,p1 la-tency and p1-n1 interval latency of GVS-oVEMP were 8.87±1.40 ms,12.25±1.80 ms and 3.39±1.07 ms re-spectively in children group with no significant difference between the two groups.The thresholds of GVS-cVEMP and GVS-oVEMP in children group were significantly lower than adult group(P＜0.01),but no differences were found in adult group regarding on the amplitude and interaural amplitude asymmetry ratio.In addition,with the in-crease of the intensity of galvanic stimulation,the correlation between pain scores and the elicitation rates of GVS-cVEMP and GVS-oVEMP also increased.Conclusion Using appropriate stimulus intensity and recording methods,GVS-cVEMP and GVS-oVEMP could be successfully assessed and detected in healthy children over 3 years old and adolescents.The latency of GVS-cVEMP in children is slightly shorter than that in adults,therefore we recommend selecting the matched age group for assessment in the children group.

Objective:To evaluate the knowledge of autism among child health care professionals in primary health care institutions.Methods:The study was a cross-sectional survey. An online questionnaire survey was conducted from February to March 2023 in primary health care institutions in Guangzhou to investigate the knowledge on autism among medical staff engaged in children′s health services and the influencing factors.Results:A total of 341 questionnaires were returned and 312 questionnaires were valid with a recovery rate of 91.5%. The age of 312 respondents was (35.9±7.9) years, of which 303 (97.1%) were female. One hundred and fifty-two (48.7%) child health care professionals in primary health care institutions had received specialist training in assessing the psychological and behavioral development of children, and only 139 (44.6%) reported that they were aware of the"five no"principle for early identification of autism. The questionnaire scores were 88.1% pass (275/312) and 53.2% excellent (166/312). The three questions with low accuracy were: autism can be cured with drugs, autism has a genetic basis and rehabilitation training has no effect, and the accuracy for these questions was 42.6% (133/312), 52.2% (163/312) and 70.2% (219/312), respectively. The passing of autism-related knowledge was positively associated with receiving relevant training ( OR=2.585, 95% CI:1.200-5.569), and the excellence was positively associated with the highest education ( OR=1.939, 95% CI:1.220-3.083) and receiving relevant training ( OR=2.016, 95% CI:1.247-3.260). Conclusions:There is a need for more professional training in autism knowledge among child health care professionals in primary health care institutions.

Objective To investigate the clinical diagnostic value of extra-spindle pole-like protein 1(ESPL1)in the progression of hepatitis B virus(HBV)-related liver fibrosis.Methods A total of 228 patients with HBV infection who were admitted to The First Affiliated Hospital of Guangxi Medical University from June 2017 to August 2023 were enrolled.The transient elastography system FibroScan was used to determine liver stiffness measurement(LSM)for all patients,and according to the LSM value,they were divided into non-liver fibrosis group with 80 patients,mild liver fibrosis group with 83 patients,advanced liver fibrosis group with 30 patients,and liver cirrhosis group with 35 patients.ELISA was used to measure the serum level of ESPL1.The Kruskal-Wallis H test was used for comparison of the serum level of ESPL1 between the four groups;the Spearman correlation analysis was used to investigate the correlation between ESPL1 and LSM;the receiver operating characteristic(ROC)curve was used to analyze the value of serum ESPL1 in predicting the progression of liver fibrosis.Results The liver cirrhosis group had a significantly higher serum level of ESPL1 than the non-liver fibrosis group and the mild liver fibrosis group(both P<0.05),and the advanced liver fibrosis group and the mild liver fibrosis group had a significantly higher serum level of ESPL1 than the non-liver fibrosis group(both P<0.05).The correlation analysis showed that there was a positive correlation between serum ESPL1 and LSM in the patients with HBV infection and varying degrees of liver fibrosis(r=0.515,P<0.001).Serum ESPL1 had an area under the ROC curve(AUC)of 0.809 in predicting liver cirrhosis and an AUC of 0.638 in predicting advanced liver fibrosis,with a sensitivity of 87.5%and 100%,respectively,and a specificity of 59.7%and 31.3%,respectively.Conclusion There is a certain correlation between serum ESPL1 and HBV-related liver fibrosis,and higher serum ESPL1 may indicate a higher degree of liver fibrosis.Serum ESPL1 is expected to become one of the serum markers for assisting in the diagnosis of liver cirrhosis and an important clinical method for dynamically monitoring the progression of liver fibrosis in patients with HBV infection.

Objective:To discuss the effects of moxibustion combined with acupuncture on nasal resistance and quality of life in allergic rhinitis (AR) patients with lung qi deficiency and cold syndrome.Methods:Randomized controlled trial was conducted. Totally 82 patients of AR were divided into two groups according to random number table method, with 41 cases in each group. The control group received routine intervention, and the observation group received moxibustion combined with acupuncture intervention on the basis of routine intervention. The treatment for both groups lasted for 4 weeks. The severity of nasal symptoms was evaluated using the Total Nasal Symptom Score (TNSS) before and after treatment. The Rhinoconjunctival Quality of Life Questionnaire (RQLQ) was used to evaluate the quality of life, patient nasal resistance was measured, and clinical efficacy was evaluated.Results:The total effective rate was 95.12% (39/41) in the observation group and 75.61% (31/41) in the control group, with statistical significance ( χ2=4.78, P=0.029). The scores and total scores of nasal itching, sneezing, runny nose and congestion in the observation group after treatment were lower than those in the control group ( t values were 4.45, 4.73, 4.64, 4.68, 9.09, respectively, P<0.01). The scores of daily activities, sleep, non-nasal/eye symptoms, behavioral problems, nasal symptoms, eye symptoms, and emotion were lower than those in the control group ( t values were 4.83, 4.63, 4.50, 5.32, 5.56, 5.29, 4.84, respectively, P<0.01). The nasal resistance of the observation group after treatment [(0.15±0.03) Pa/(cm?s) vs. (0.21±0.03) Pa/(cm?s), t=9.06] was lower than that of the control group ( P<0.001). Conclusion:Moxibustion combined with acupuncture in patients with AR can further reduce nasal resistance and improve their quality of life and clinical efficacy.

Objective:To identify the independent factors of unplanned interruption during continuous renal replacement therapy (CRRT) and construct a risk prediction model, and to verify the clinical application effectiveness of the model.Methods:A retrospective study was conducted on critically ill adult patients who received CRRT treatment in the intensive care unit (ICU) of Zhejiang Hospital from January 2021 to August 2022 for model construction. According to whether unplanned weaning occurred, the patients were divided into two groups. The potential influencing factors of unplanned CRRT weaning in the two groups were compared. The independent influencing factors of unplanned CRRT weaning were screened by binary Logistic regression and a risk prediction model was constructed. The goodness of fit of the model was verified by a Hosmer-Lemeshow test and its predictive validity was evaluated by receiver operator characteristic curve (ROC curve). Then embed the risk prediction model into the hospital's ICU multifunctional electronic medical record system for severe illness, critically ill patients with CRRT admitted to the ICU of Zhejiang Hospital from November 2022 to October 2023 were prospectively analyzed to verify the model's clinical application effect.Results:① Model construction and internal validation: a total of 331 critically ill patients with CRRT were included to be retrospectively analyzed. Among them, there were 238 patients in planned interruption group and 93 patients in unplanned interruption group. Compared with the planned interruption group, the unplanned interruption group was shown as a lower proportion of males (80.6% vs. 91.6%) and a higher proportion of chronic diseases (60.2% vs. 41.6%), poor blood purification catheter function (31.2% vs. 6.3%), as a higher platelet count (PLT) before CRRT initiation [×10 9/L: 137 (101, 187) vs. 109 (74, 160)], lower level of blood flow rate [mL/min: 120 (120, 150) vs. 150 (140, 180)], higher proportion of using pre-dilution (37.6% vs. 23.5%), higher filtration fraction [23.0% (17.5%, 32.9%) vs. 19.1% (15.7%, 22.6%)], and frequency of blood pump stops [times: 19 (14, 21) vs. 9 (6, 13)], the differences of the above 8 factors between the two groups were statistically significant (all P < 0.05). Binary Logistic regression analysis showed that chronic diseases [odds ratio ( OR) = 3.063, 95% confidence interval (95% CI) was 1.200-7.819], blood purification catheter function ( OR = 4.429, 95% CI was 1.270-15.451), blood flow rate ( OR = 0.928, 95% CI was 0.900-0.957), and frequency of blood pump stops ( OR = 1.339, 95% CI was 1.231-1.457) were the independent factors for the unplanned interruption of CRRT (all P < 0.05). These 4 factors were used to construct a risk prediction model, and ROC curve analysis showed that the area under the curve (AUC) predicted by the model was 0.952 (95% CI was 0.930-0.973, P = 0.003 0), with a sensitivity of 88.2%, a specificity of 89.9%, and a maximum value of 1.781 for the Youden index. ② External validation: prospective inclusion of 110 patients, including 63 planned interruption group and 47 unplanned interruption group. ROC curve analysis showed that the AUC of the risk prediction model was 0.919 (95% CI was 0.870-0.969, P = 0.004 3), with a sensitivity of 91.5%, a specificity of 79.4%, and a maximum value of the Youden index of 1.709. Conclusion:The risk prediction model for unplanned interruption during CRRT has a high predictive efficiency, allowing for rapid and real-time identification of the high risk patients, thus providing references for preventative nursing.

Objective:To investigate the predictive efficacy of spiral computed tomography(CT)combined with serum fibrinogen(Fbg)detection in the prognosis of patients with locally advanced non-small cell lung cancer(NSCLC)who underwent concurrent radiotherapy and chemotherapy.Methods:From April 2018 to January 2023,a total of 60 patients with locally advanced NSCLC patients,who admitted to Hefei Cancer Hospital of the Chinese Academy of Sciences and underwent the treatment of concurrent radiotherapy and chemotherapy,were selected.They were divided into survival group(50 cases)and endpoint event group(10 cases)according to the prognosis.Before treatment,both two groups were examined by spiral CT,and the average CT values,noise values,and signal to noise ratio(SNR)values of CT related indicators of two groups were counted by using statistical method.The serum Fbg levels of two groups were detected before treatment,and the follow up was conducted until October 2023,and the record of the follow-up time within 9 months were counted by using statistical method.Kaplan-Meier method and Logrank analysis were used to analyze prognosis.The mean CT values,noise values,SNR and Fbg data were included in the binary regression analysis for the receiver operating characteristic(ROC)curve analysis,so as to obtain the efficacy values of each indicator and the combination of the each indicator in predicting prognosis.Results:The average CT value and noise value of the endpoint event group were significantly higher than those of the survival group,while the SNR was significantly lower than that of the survival group,and the serum Fbg level of the endpoint event group was significantly higher than that of the survival group,and the differences were statistically significant(t=5.445,18.323,7.580,78.628,P<0.05),respectively.The area under curve(AUC)values of ROC curve of average CT value,noise value,SNR,Fbg alone and the combination of 4 indicators were 0.665(95%CI:0.493-0.837),0.581(95%CI:0.410-0.752),0.734(95%CI:0.598-0.870),0.668(95%CI:0.533-0.803)and 0.776(95%CI:0.657-0.895)in predicting the prognosis of concurrent radiotherapy and chemotherapy of NSCLC patients,respectively.The ROC curve was adopted to analyze the diagnostic thresholds of the obtained CT value(56.832%),noise value(12.283%),SNR(10.149%)and Fbg(5.102 g/L).Based on the thresholds of each indicator,35 patients with high average CT value and 25 patients with low average CT value were identified.The survival time of patients with high average CT value was significantly lower than that of patients with low average CT value,and the difference was statistically significant(Logrank=25.554,P<0.05).In these patients,37 patients appeared high noise and 23 patients appeared low noise,and the survival time of patients with high noise was significantly lower than that of patients with low noise,and the difference was statistically significant(Logrank=28.109,P<0.05).The survival time of 38 patients with high SNR was significantly higher than that of 22 patients with low SNR,and the difference was statistically significant(Logrank=17.502,P<0.05).The survival time of 26 patients with high Fbg was significantly lower than that of 34 patients with low Fbg,and the difference was significant(Logrank=17.809,P<0.05).Conclusion:The average CT value,noise value and SNR combined with serum Fbg level of the relative indicators of CT scan relate to the prognosis of patients with tumor,and the combined detection of them can predict the prognosis of NSCLC patients undergoing concurrent radiotherapy and chemotherapy.

Objective To investigate the prognostic value of atherogenic index of plasma(AIP)for the occurrence of major adverse cardiovascular events(MACE)in elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 355 elderly patients with acute STEMI who received coronary interventional therapy in Department of Cardiology,Affilia-ted Hospital of Hebei University from January to May 2023 were recruited retrospectively,and fi-nally 343 of them with complete telephone follow-up data were included in this study.According to their AIP quartile level,they were divided into A1 group(＜0.212,84 cases),A2 group(0.212-0.339,87 cases),A3 group(0.339-0.434,86 cases)and A4 group(≥0.434,86 cases).The incidences of cardiac death,nonfatal myocardial infarction,ischemia-driven target vessel re-modeling and heart failure re-hospitalization were observed during 1-year follow-up.Kaplan-Meier survival curve was plotted to compare the incidence of MACE in the 4 groups.ROC curve analysis was employed to determine the predictive value of AIP.Results During 1-year follow-up,signifi-cant differences were observed in the proportions of ischemia-driven target vessel revasculariza-tion,heart failure re-hospitalization and non-fatal acute myocardial infarction among the 4 groups(P＜0.05,P＜0.01),and such difference was also seen in the cumulative survival rate among them(log rankx2=8.528,P=0.036).Multivariate Cox proportional hazards regression analysis showed that gender,hypertension,atrial fibrillation,multi-vessel disease,left main artery disease,number of stents,SYNTAX score,Killip grade,BNP,HbA1c,TC,LDL-C and HDL-C levels,and AIP were independent predictors of MACE.The AUC value of AIP in predicting MACE in elderly patients with acute STEMI was 0.855(95％CI:0.776-0.933),with a sensitivity of 66.7％and a specificity of 93.0％.When the above indicators combined together,the AUC value was 0.907(95％CI:0.954-0.987),and the sensitivity and specificity was 100.0％and 90.7％,respectively.The AUC value of combined prediction was significantly better than that of single indicator(P＜0.05).Conclusion AIP is a powerful biomarker,and can be used to predict the prognosis of elderly acute STEMI after coronary interventional therapy,and it combined with Killip grade,SYNTAX score,HbA1c,and number of stents shows better predictive efficacy.

Objective To evaluate the effect of the current immunization strategy for hepatitis B virus (Hepatitis B) in blocking mother-to-infant transmission in Hubei Province, and to explore the mechanism and possible influencing factors of failure of mother-to-infant blockade. Methods A multi-stage random sampling method was used to select 2 counties or districts in Hubei Province. Through maternity hospital health handbook, neonatal health record or hospital medical record system, hepatitis B virus (HBV) surface antigen (HBsAg)-positive pregnant women in 2012-2018 years were included to retrospectively investigate their delivery status and the HBV infection status of their children. Results Among the 302 newborns, 32 were positive for HBsAg, and the success rate of blockade of mother-to-infant transmission of hepatitis B was 89.45%. Further analysis showed that 68.21% (206 / 302) of newborns were delivered in township hospitals, 66.23% (200 / 302) were delivered by caesarean section and 41.72% (126 / 302) were breastfed, while 16.89% (51/302) were positive for hepatitis B virus e antigen (HBeAg), and 41.06% (124/302) were positive for anti-HBe. The vaccination rate of hepatitis B immunoglobulin (HBIG) during pregnancy was 3.31% (10/302), and the newborn HBIG vaccination rate was 94.37% (285/302). There were 84.11% (254/302) of pregnant women taking protective measures in daily life. Logistic regression analysis showed that township hospitals (OR=2.82, P<0.05), HBeAg positivity during pregnancy (OR=8.68, P<0.05), and HBIG vaccination during pregnancy (OR=12.62 , P<0.05) were risk factors for failure of mother-to-infant blockade, while anti-HBe positivity during pregnancy (OR=0.22, P<0.05), vaccination of newborns with HBIG (OR=0.20, P<0.05), and protective measures taken in daily life (OR=0.28, P<0.05) were protective factors for mother-to-infant interruption. Conclusion Deliveries in township hospitals and HBeAg-positivity during pregnancy are more likely to fail in blocking of mother-to-infant transmission of hepatitis B. HBIG vaccination during pregnancy does not reduce the risk of blockade failure. Neonatal HBIG vaccination, anti-HBe positivity during pregnancy, and protective measures in daily life can reduce the risk of blockade failure of mother-to-infant transmission of hepatitis B.

Oligoasthenospermia is the primary cause of infertility. However, there are still enormous challenges in the screening of critical candidates and targets of oligoasthenospermia owing to its complex mechanism. In this study, stem cell factor (SCF), c-kit, and transient receptor potential vanilloid 1 (TRPV1) biosensors were successfully established and applied to studying apoptosis and autophagy mechanisms. Interestingly, the detection limit reached 2.787 × 10^-15 g/L, and the quantitative limit reached 1.0 × 10^-13 g/L. Furthermore, biosensors were used to investigate the interplay between autophagy and apoptosis. Schisandrin A is an excellent candidate to form a system with c-kit similar to SCF/c-kit with a detection constant (K_D) of 5.701 × 10^-11 mol/L, whereas it had no affinity for SCF. In addition, it also inhibited autophagy in oligoasthenospermia through antagonizing TRPV1 with a K_D of up to 4.181 × 10^-10 mol/L. In addition, in vivo and in vitro experiments were highly consistent with the biosensor. In summary, high-potency schisandrin A and two potential targets were identified, through which schisandrin A could reverse the apoptosis caused by excessive autophagy during oligoasthenospermia. Our study provides promising insights into the discovery of effective compounds and potential targets via a well-established in vitro-in vivo strategy.

Objective:This study investigated the changes of cortical thickness in patients with Parkinson's cognitive dysfunction.Methods:In this cross-sectional study, general clinical data and head magnetic resonance imaging data were collected from Parkinson's disease(PD)patients and healthy controls who were hospitalized or outpatient in the Department of Geriatric Neurology of the First Affiliated Hospital of Kunming Medical University from January 2019 to December 2020.We observed the changes of cortical thickness in each group, and analyzed the correlation between cortical thickness and cognitive dysfunction in PD.Results:Compared with PD normal cognitive group, the cortical thickness of the left superiortemporal gyrus[(2.7±0.1)mm, (2.4±0.1)mm, t=-4.194], left supramarginal[(2.4±0.1)mm, (2.2±0.1)mm, t=-4.845], right insula[(3.0±0.1)mm, (2.7±0.1)mm, t=-4.170], left parahippocampal[(2.8±0.3)mm, (2.4±0.3)mm, t=-4.164]decreased in PD cognitive impairment group(all P<0.05), and cortical thickness of the right parsorbitalis[(2.5±0.2)mm, (2.4±0.2)mm, t=-4.226], left entorhinal[(3.5±0.3)mm, (3.1±0.4)mm, t=-4.583], left inferiortemporal[(2.7±0.2)mm, (2.5±0.1)mm, t=-6.229], left supramarginal[(2.4±0.1)mm, (2.1±0.1)mm, t=-3.236], right fusiform[(2.8±0.1)mm, (2.5±0.1)mm, t=-5.364], right lingual[(2.0±0.1)mm, (1.9±0.1)mm, t=-3.887], right insula[(3.0±0.1)mm, (2.7±0.2)mm, t=-5.326], right isthmuscingulate[(2.6±0.2)mm, (2.3±0.2)mm, t=-3.743]decreased in PD severe cognitive impairment group, the statistical difference was significant(all P<0.05). The cerebral cortex thickness was positively correlated with Mini-Mental State Examination and different cognitive areas, and negatively correlated with Hoehn-Yahrr grading. Conclusions:Local cortical thinning was observed in PD patients with cognitive impairment, whereas cortical involvement was more extensive in PD patients with severe cognitive impairment.