ObjectiveTo analyze the protective effect of different types of influenza vaccines (InfV) against influenza A among the individuals aged between 3‒17 years old, and to provide a scientific basis for the prevention and control of influenza in the future. MethodsA retrospective cohort study was conducted to collect data on the incidence and InfV vaccination of the individuals aged between 3‒17 years during the influenza epidemic season from 2022 to 2023. Vaccine effectiveness (VE) was calculated, and a log-binomial regression model was used to calculate the corrected VE. ResultsThe incidence rate of influenza in InfV vaccinated and un-vaccinated groups was 7.32% (1 937/ 26 446) and 9.65% (4 421/45 837), respectively. After adjusting for age and gender factors, the unadjusted VE (95%CI) was 54.57% (52.24%‒56.78%). The unadjusted VE (95%CI) was 53.66% (50.36%‒56.74%) for males and 55.60% (52.24%‒58.72%) for females, respectively. The unadjusted VE (95%CI) for the age group of 3‒ years, 6‒ years, 9‒ years, 12‒ years, and 15‒17 years were 64.08% (60.89%‒67.01%), 57.40% (53.71%‒60.80%), 57.77% (52.49%‒62.47%), 24.36% (9.49%‒36.79%), and 24.09% (-17.59%‒51.00%), respectively. The unadjusted VE (95%CI) for quadrivalent split-virion inactivated influenza vaccine, trivalent split-virion inactivated influenza vaccine, trivalent subunit influenza vaccine, and trivalent live attenuated influenza vaccine were 53.84% (51.32%‒56.24%), 62.17% (56.28%‒67.26%), 79.83% (69.94%‒86.46%), and 31.59% (19.07%‒42.18%), respectively. ConclusionThe InfV used during the 2022‒2023 influenza season had a good protective effect against influenza A among the individuals aged between 3‒17 years old, especially in those aged between 3‒11 years old.

This paper summarized the characteristics of constitution， disease， and syndrome of five different phenotypes of bronchial asthma including allergic asthma， cough variant asthma， chest tightness variant asthma， psychological stress asthma， and hormone-dependent asthma， and systematically expounds the application of three-dimensional diagnosis and treatment pattern， that is differentiation of constitution， disease and syndromes in the five phenotypes of bronchial asthma. It is considered that the allergic constitution is the main one of bronchial asthma， which is usually combined with the constitutions of qi-deficiency， yin-deficiency， yang-deficiency， qi-stagnation and others. In the treatment of bronchial asthma， constitution， disease and syndromes should all be taken into account but applied flexibly according to the order of the urgency and priority. The three-dimensional diagnosis and treatment pattern can reflect the essential characteristics and clinical panorama of bronchial asthma more comprehensively and objectively and provide effective intervention measures and management programs for the prevention and treatment by traditional Chinese medicine.

Objective:To evaluate the feasibility and the application values of quantitative susceptibility mapping (QSM) for the assessment of meniscal injury and in distinguishing meniscus degeneration and tears.Methods:The clinical and imaging data of 70 patients suspected of meniscus injury and scheduled for arthroscopy in Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University from November 2019 to June 2020 were analyzed retrospectively. Thirty age-and sex-matched healthy subjects were also examined as controls. All subjects received knee joint QSM and routine MR imaging. According to the results of arthroscopy, the patients was divided into meniscus degeneration and meniscus tear groups, respectively. The conventional MR was evaluated by two radiologists. The meniscus injury area was delineated on the original QSM magnitude images (the central area of the posterior corner of the lateral meniscus was selected in the healthy controls) and mapped to the corresponding QSM maps, and the magnetic susceptibility values were measured. Kruskal-Wallis H test was used to analyze the magnetic sensitivity values of meniscal degeneration, meniscal tear and healthy control groups; and Bonferroni was used to correct the pairwise comparison. ROC curve was established to evaluate the threshold and efficacy of magnetic susceptibility value in the diagnosis of meniscal tear. The results were compared with those of conventional MRI. Results:The magnetic susceptibility values of meniscus of healthy controls, meniscal degeneration and meniscal tear groups were (0.035±0.016)ppm, -0.031(-0.040,-0.005)ppm, and(-0.122±0.115)ppm, respectively, with significant difference found among the three groups (χ2=44.419, P<0.05). The magnetic susceptibility values of meniscus of healthy controls was significantly higher than those of meniscus degeneration patients and meniscus tear patients (χ2=-23.843, -48.253, P<0.05). The magnetic susceptibility values of meniscus of meniscus tear group was significant lower than those of meniscus degeneration group (χ2=-24.410, P<0.05). Taking magnetic susceptibility values of -0.062 5 ppm as threshold, the area under the ROC curve for the diagnosis of meniscal tears was 0.949, with the sensitivity as 87% and the specificity as 100%. The sensitivity and specificity of conventional MRI in the diagnosis of meniscal tears were 86.8% and 87.5%, respectively. Conclusion:QSM can quantitatively evaluate meniscus injury and can be used as an effective supplement method to conventional MRI, which is helpful to improve the diagnosis of meniscus tear.

Objective To analyze the difference of echocardiography in patients with chronic Keshan disease (CKD) at different altitudes areas,explore the effects of altitude on the structure and functional of right heart in CKD patients,and provide a reference for imaging diagnosis of CKD.Methods According to the three step distribution of the terrain in China,30 cases of CKD patients in the first step (altitude ＞ 4 000 m) of Tibet autonomous region were randomly selected as the Tibetan plateau group.In the second step (altitude:1 000-2 000 m),31 cases were randomly selected in Gansu Province as the Loess plateau group.In the third step (altitude ＜ 500 m),42 cases were randomly selected in Shandong Province as the plain group.Echocardiography was used to analyze the morphology,hemodynamics and function of right heart.Results Right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD),right ventricular lateral wall thickness (RVWT) and main pulmonary artery diameter (MPAD) of the Tibetan plateau group,the Loess plateau group and the plain group (mm:49.75 ± 8.40,45.64 ± 7.63,43.56 ± 7.34;50.89 ± 7.13,46.56 ± 5.62,43.27 ± 6.01;4.75 ± 1.02,3.53 ± 0.61,3.37 ± 0.51;32.87 ± 3.62,28.93 ± 2.12,28.44 ± 2.71) were significant differences among the three groups (F =5.36,12.91,37.08,23.33,P ＜ 0.01).The above indexes of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P ＜ 0.05).RVTD of Loess plateau group was higher than that of plain group (P ＜ 0.05).The fractional area change [FAC,(24.85 ± 2.75)％,(26.26 ± 3.42)％,(26.73 ± 3.14)％],tricuspid annular plane systolic excursion [TAPSE,(12.87 ± 1.12),(14.59 ± 1.63),(14.13 ± 1.31) mm] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =3.36,13.47,P ＜ 0.05 or ＜ 0.01);the above indexes of the Tibetan plateau group were lower than those of the Loess plateau group and the plain group (P ＜ 0.05).Tei index (0.87 ± 0.18,0.78 ± 0.16,0.71 ± 0.14),tricuspid flap diastolic maximum filling speed/tricuspid annulus early diastolic peak velocity (E/E',9.48 ± 1.22,8.64 ± 0.91,8.12 ± 1.13),systolic pulmonary artery pressure [SPAP,(49.58 ± 11.76),(44.35 ± 11.41),(42.67 ± 12.13) mmHg,1 mmHg =0.133 kPa] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =12.89,13.99,3.12,P ＜ 0.01 or ＜ 0.05);the Tei index and E/E'of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P ＜ 0.05).Tei index,E/E'of the Loess plateau group were higher than those of the plain group (P ＜ 0.05).Conclusions The right heart structure and function of CKD patients are affected by the altitude of their residence.With the increase of altitude,the right heart is enlarged,the right ventricular systolic and diastolic functions are decreased,and SPAP is increased in CKD patients.

Objective To assess the optimal visiualization capacity of brachial plexus with three-dimensional nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation imaging (3D SHINKEI), exploring the feasibility of preliminary diagnostic value on brachial plexus diseases. Methods MRI scans were performed on 24 healthy volunteers with no history of brachial plexus injury, and 46 patients whose outcomes of lesions had been verified as post-ganglionic brachial plexus injuries by surgery or clinical follows-up . The scan series consist 3D SHINKEI, STIR in the coronal plane as well as DW-MRN in the axial plane using a 3.0 T MR system. The source and post-processed images of 3D SHINKEI and DW-MRN were scored according to the optimal visibility on brachial plexus, in the meanwhile, contrast-to-noise ratio of the original images in the 3D SHINKEI and STIR sequences were calculated separately. Two radiologists blindly compared the detection rate of positive brachial plexus injuries between 3D SHINKEI and STIR in 46 patients. And then analyze the outcomes by means of Kappa test, Mann-Whitney test , independent sample t test, and Chi-square test. Results Post-ganglionic brachial plexus showed high intensity in the 3D SHINKEI sequence. In the 24 healthy volunteers, the scores by the two radiologists were 3.6 ± 0.6, 3.5 ± 0.6, 3.0 ± 0.2, 2.9 ± 0.1, respectively. There was statistical difference between the two sequences (Z=2.667,P=0.008,P<0.05). And the Kappa was 0.8 and 0.6 with favorable consistency. The CNR of 3D SHINKEI and STIR were 0.61 ± 0.07, 0.42 ± 0.03 (t=12.78, P=0.001, P<0.05). The positive detection rates of post-ganglionic brachial plexus injuries on 3D SKINKEI and STIR were, 78.3%, 52.2%(χ2=9.421, P<0.05). Conclusions 3D SHINKEI sequence demonstrates robust visibility consistently and can clearly display the structures and signals of post-ganglionic abnormality, compared with DW-MRN and STIR. This technique can be helpful to provide more complementary information to further confirm the diagnosis of brachial plexus injuries.

Objective To observe the surface electromyography (sEMG) characteristics of pharyngeal swallowing muscles in different swallowing modes in asymptomatic lacunar infarction (LI) patients. Methods From January, 2015 to January, 2017, a total of 32 asymptom-atic LI patients (LI group) aged over 60 years were consecutively collected, and 30 normal old subjects matched with age and gender (nor-mal group) were also enrolled. The amplitudes of sEMG activity of infrahyoid muscles and submental muscles in different swallowing modes were recorded, and the root mean square (RMS) was analyzed. Results Significant difference was found in both muscle groups in dif-ferent swallowing modes in both groups (F>110.67, P<0.001). There was no significance in the RMS in both two muscle groups in rest and dry swallowing modes between two groups (t<1.484, P>0.05). In the 20 ml water swallowing mode, the RMS was lower in the submental muscles in the LI group than in the normal group (t=3.334, P<0.01), and no significant difference was found in the infrahyoid muscles (t=1.871, P>0.05). In the 100 ml continuous drinking mode, the RMSs were significantly lower in both two muscle groups in LI group than in the normal group (t>3.118, P<0.01). Conclusion Swallow abilities decrease in asymptomatic LI. sEMG could be used to evaluate their swallowing function.

PURPOSE: Periostin mediates critical steps in gastric cancer and is involved in various signaling pathways. However, the roles of periostin in promoting gastric cancer metastasis are not clear. The aim of this study was to investigate the relevance between periostin expression and gastric cancer progression and the role of stress-related hormones in the regulation of cancer development and progression. MATERIALS AND METHODS: Normal, cancerous and metastatic gastric tissues were collected from patients diagnosed with advanced gastric cancer. The in vivo expression of periostin was evaluated by in situ hybridization and immunofluorescent staining. Meanwhile, human gastric adenocarcinoma cell lines MKN-45 and BGC-803 were used to detect the in vitro expression of periostin by using quantitative real-time polymerase chain reaction (PCR) and western blotting. RESULTS: Periostin is expressed in the stroma of the primary gastric tumors and metastases, but not in normal gastric tissue. In addition, we observed that periostin is located mainly in pericryptal fibroblasts, but not in the tumor cells, and strongly correlated to the expression of α-smooth muscle actin (SMA). Furthermore, the distribution patterns of periostin were broader as the clinical staging of tumors progressed. We also identified a role of stress-related signaling in promoting cancer development and progression, and found that isoprenaline upregulated expression levels of periostin in gastric cancer cells. CONCLUSION: These findings suggest that the distribution pattern of periostin was broader as the clinical staging of the tumor progressed and found that isoprenaline upregulated expression levels of periostin in gastric cancer cells.
Adenocarcinoma/*metabolism/pathology ; Adrenergic beta-Agonists/pharmacology ; Aged ; Blotting, Western ; Cell Adhesion Molecules/drug effects/*metabolism ; Cell Line, Tumor ; Fibroblasts/*metabolism ; Gene Expression Regulation, Neoplastic/*drug effects ; Humans ; Isoproterenol/*pharmacology ; Male ; Neoplasm Staging ; RNA, Messenger/genetics/metabolism ; Real-Time Polymerase Chain Reaction ; Signal Transduction ; Stomach/metabolism/pathology ; Stomach Neoplasms/*metabolism/pathology ; Up-Regulation

Objective To observe the character of amplitude of myoelectric activity with surface electromyography (sEMG) on pharyn-geal swallowing in healthy middle-aged and elderly people. Methods From January, 2015 to January, 2016, 78 healthy subjects were separat-ed into middle-aged group (38~60 years old, n=38) and elderly group (61~82 years old, n=40). The amplitudes of sEMG activity of related muscles under different swallowing modes were recorded by sEMG technique and analysis system. The root mean square (RMS) was ana-lyzed. Results There was significant difference in RMS among different swallowing modes (F>105.120, P<0.001). There was no difference in RMS between two muscles under all the swallowing modes in both groups (t<1.135, P>0.05). There was no difference between two groups in both muscles under relax and dry swallow (t<1.412, P>0.05), and was different under water swallow and continuous drinking (t>2.700, P<0.05). Conclusion sEMG could be used for analyzing the characteristics of amplitude of myoelectric activity in healthy mid-dle-aged and elderly people during pharyngeal swallowing in different swallowing modes, that can be used to evaluate and screen swallow-ing and dysphagia in clinic.

Objective To observe the effect of surface electromyographic biofeedback on the pharyngeal phase activities in patients with dysphagia after stroke. Methods Seventy-six consecutive patients with pharyngeal dysphagia after stroke admitted to the departments of rehabilitation and neurology,brain hospital affiliated to nanjing medical university from August 2014 to February 2015 were enrolled retrospectively. After excluding 40 patients,the remaining 36 patients were divided into either a conventional training group (n =19)or a biofeedback group (n =17)by using the random number table. The patients of the conventional training group received swallowing function training only,while those of the biofeedback group also received the surface electromyographic biofeedback treatment on the basis of the therapy program of the conventional training group. The patients of both groups were treated 6 times a week for 4 weeks. The assessment of swallowing angiography,the digital measurement and analysis were performed before and after treatment. The outcome measures included the degree of openness of upper esophageal sphincter (UES),0pharyngeal transit time (PTT),and the maximum displacement of the hyoid bone (HmaxD). Results (1)The proportions of UES complete opening of the conventional training group before and after training were 26. 3% (5 / 19)and 47. 4% (9 / 19)respectively. There was significant difference between before and after training (χ2 = 5. 08, P =0.020). The proportions of UES complete opening of the biofeedback group before and after training were 47.1% (8/ 17)and 82.4% (14/ 17)respectively. There was significant difference between before training and after training (χ2 =11.46,P = 0. 001). There was no significant difference in the degrees of UES complete opening before training between the conventional training group and the biofeedback group (P >0. 05). There was significant difference in the degree of UES complete opening after training between the 2 groups (χ2 =4. 63,P = 0. 040). (2)PTT of the conventional training group before and after training was 0.24 ±0.07 and 0.19 ±0.06 s respectively. PTT of the biofeedback before and after training was 0.23 ±0.06 and 0. 15 ± 0. 05 s. There was significant difference between before training and after training (F = 154. 50,P = 0. 000). There was no significant difference in PTT before training between the conventional training group and the biofeedback group (P > 0. 05). There was significant difference in PTT after training between the 2 groups (F =4.66,P = 0. 038). (3)The HmaxD distances of the conventional training group before and after training were 0. 5 ± 0. 4 and 0. 9 ± 0. 4 cm respectively,the PTT of the biofeedback training before and after training was 0. 6 ± 0. 4 and 1. 3 ± 0. 6 cm respectively. There was significant difference between before training and after training (F = 137. 56,P = 0. 000). There was no significant difference in the HmaxD distance of the conventional training group and the biofeedback training group before training (P > 0. 05). There was significant difference in the HmaxD distance after training between the 2 groups (F = 4. 29,P = 0. 033). Conclusion The surface electromyographic biofeedback therapy in combination with the conventional swallowing training for the treatment of dysphagia after stroke has the synergistic efficacy.

Objective To explore the effect of occupational therapy (OT) on the depressive mood and activity of daily living (ADL) in patients with post stroke depression (PSD). Methods 42 patients with PSD were divided into OT group (n=21) and control group (n=21).Both 2 groups received routine therapy, and OT group received ADL training, selective recreation and sport and appreciation of music in addition.They were evaluated by modified Bathel index (MBI) and Hamilton Self-rating Scale for Depression (HAMD) before and after treatment.Results The scores of MBI increased and the scores of HAMD decreased significantly after 4 weeks in both 2 groups (P<0.001), especially in the OT group (P<0.01). Conclusion OT can improve not only ADL, but also the depressive mood in patients with PSD.