ObjectiveTo elucidate the active compounds for the anti-inflammatory and analgesic effects of Paeoniae Radix Alba from structure-activity omics. MethodOn the basis of the previous in vitro efficacy study by our research group， a mouse model of foot swelling was induced by methyl aldehyde and used to study the anti-inflammatory and analgesic effects of total glycosides of Paeoniae Radix Alba in vivo. The core targets of the active compounds for the anti-inflammatory and analgesic effects of Paeoniae Radix Alba were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）， Online Mendelian Inheritance in Man （OMIM）， and Search Tool for Recurring Instances of Neighbouring Genes （STRING）. Molecular docking was conducted for the total glucosides of Paeoniae Radix Alba with the core targets， and the key core targets with high binding affinity were screened out according to the comprehensive score of each target and active structure. The structure-activity relationship was analyzed with targets as a bridge through the combination of compound structures and pharmacological effects. ResultThe total glucosides of Paeoniae Radix Alba had good anti-inflammatory and analgesic effects in vivo. The core targets of 23 active components of Paeoniae Radix Alba were epidermal growth factor receptor （EGFR）， signal transducer and activator of transcription 3 （STAT3）， vascular endothelial growth factor A （VEGFA）， cellular tumor antigen p53 （TP53）， and proto-oncogene transcription factor （JUN）. According to the structure of the parent nucleus， there were 16 pinane monoterpene glycosides， 4 pinene monoterpene glycosides， 2 monoterpene lactone glycosides， and 1 monoterpene ketone. The key core targets screened out by molecular docking were EGFR and STAT3. The structure-activity analysis of the active compound structures and the key core targets showed that the introduction of ketone group and benzene ring group on the parent nucleus affected the binding activity. ConclusionThis study analyzed the material basis for the anti-inflammatory and analgesic effects of total glycosides of Paeoniae Radix Alba from structure-activity omics， providing new ideas and methods for revealing the pharmacodynamic substances in traditional Chinese medicine.

Objective:To discuss the clinical phenotype and genotype characteristics of two pediatric patients with late-onset methylmalonic acidemia(MMA)cblC type,and to provide the basis for early clinical recognition of MMA.Methods:The clinical data of two pediatric patients with late-onset MMA cblC type were collected,including clinical phenotypes,biochemical detection results,blood and urine organic acid analyses,neuroimaging,electroencephalograms,genotypes and so on.The characteristics of the disease were analyzed in combination with the related literature review.Results:Both pediatric patients were female,with onset in adolescence.Patient 1 presented with psychiatric symptoms,while pediatric patient 2 presented with cognitive impairment.Both pediatric patients experienced weakness in both lower limbs and speech disorders.At initial diagnosis,the serum homocysteine(Hcy)levels were severely increased,the urine methylmalonic acid levels were increased,the brain magnetic resonance imaging results indicated brain atrophy,and the electroencephalogram results showed the increased slow wave activity in both cerebral hemispheres.The pediatric patient 2 exhibited epileptiform discharges in bilateral frontal and temporal regions.The genetic testing results showed the c.482G＞A mutation in the MMACHC gene.Both two pediatric patients were treated with intramuscular injections of vitamin B12,along with oral folic acid,vitamin B6,levocamitine,and betaine.The symptoms of two patierts were improved,the serum Hcy levels were decreased,and the urine methylmalonic acid levels returned to normal.Conclusion:The phenotype of late-onset MM A cblC type is diverse,primarily involving neuropsychiatric impairment,with the c.482G＞A mutation being the most common genotype.The increasing of serum Hcy levels and brain atrophy can serve as the biomarkers for the early recognition of late-onset cblC type pediatric patients.

ObjectiveTo explore the application of Brain and Spinal Injury Center (BASIC) score in evaluation of traumatic cervical spinal cord injury. MethodsFrom January, 2015 to December, 2021, 175 patients with traumatic cervical spinal cord injury in Beijing Bo'ai Hospital were analyzed. Gender, age, cause of injury, injury mechanism and American Spinal Injury Association Impairment Scale (AIS) grade were collected. The sagittal and axial T₂ weighted imaging (T₂WI) of the patients were evaluated with BASIC score, single/multi-segment injury, and with/without intramedullary hemorrhage. According to the injury mechanism, the patients were divided into two groups: with fracture/fracture dislocation (n = 92) and without fracture and dislocation (n = 83). The baseline demographic indicators and T₂WI evaluation indicators were compared between the two groups, and the relationship between AIS grade and BASIC score, intramedullary hemorrhage, single/multi-segment injury were investigated. ResultsThere were significant differences in gender, age and AIS grade, BASIC score, and the rates of inntramedullary hemorrhage and single segment injury of T₂WI between two groups (t = -10.276, χ² > 8.703, P < 0.01); however, no difference was found in the cause of injury (P > 0.05). The AIS grade was significantly correlated with the BASIC score (r = 0.790, P < 0.001). There was significant difference in AIS grade between intramedullary hemorrhage or not, and single/multi-segment injury (χ² > 5.516, P < 0.05). ConclusionThe BASIC score of T₂WI is a predictor of the severity of spinal cord injury after traumatic cervical spinal cord injury, and is different with the injury mechanisms.

Objective:To investigate the influencing factors of endotracheal intubation and mechanical ventilation (ETI-MV) in patients with acute respiratory distress syndrome (ARDS) caused by viral pneumonia, and to provide evidence for individualized use of ETI-MV.Methods:Patients with ARDS due to viral pneumonia admitted to the respiratory intensive care unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed from November 2017 to March 2022. The gender, age, concomitant diseases, clinical symptoms and signs, complications, lab results, ARDS severity, infectious virus type, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), respiratory support methods and prognosis-related variables were collected. Univariate analysis was performed on each factor, and the variables with statistical significance in the univariate analysis were subjected multivariate logistic regression analysis. The receiver operating characteristic curve (ROC curve) was drawn to evaluate the predictive value of each index for the implementation of ETI-MV.Results:A total of 117 patients were enrolled in the study, including 61 patients in the ETI-MV group, and 3 patients (4.9%), 39 patients (63.9%) and 19 patients (31.1%) with mild, moderate and severe ARDS, respectively. There were 56 patients in non-ETI-MV group, and the mild, moderate and severe ARDS cases were 16 cases (28.6%), 38 cases (67.8%) and 2 cases (3.6%), respectively. There was significant difference between the two groups ( P < 0.05). Univariate analysis showed that during 24 hours admitted to RICU, the levels of interleukin-6 [IL-6 (ng/L): 104.0±90.0 vs. 62.4±76.0], oxygenation index [PaO 2/FiO 2 (mmHg, 1 mmHg≈0.133 kPa): 123.9±30.9 vs. 173.6±28.5], the proportion of cases with pulmonary infiltrating opacity distribution range ≥ 3/4 lung fields [85.3% (52/61) vs. 21.5% (12/56)], APACHE Ⅱ score ≥ 16.5 [67.2% (41/61) vs. 42.9% (24/56)], the rate of nosocomial invasive aspergillus infection [14.8% (9/61) vs. 3.6% (2/56)], the percentage of nosocomial bacterial infection [16.4% (10/61) vs. 3.6% (2/56)], and the lowest CD4 + T lymphocyte count in the course of the disease [cells/mm 3: 192.2±35.8 vs. 215.0±58.3] had significant differences between ETI-MV and non-ETI-MV group (all P < 0.05). Multivariate Logistic regression analysis showed that during 24 hours admitted to RICU the distribution range of pulmonary infiltrating opacity ≥ 3/4 the lung fields [odds ratio ( OR) = 12.527, 95% confidence interval (95% CI) = 3.279-47.859, P < 0.001], APACHE Ⅱ score ≥ 16.5 ( OR = 30.604, 95% CI = 4.318-216.932, P = 0.001), PaO 2/FiO 2 ( OR = 0.948, 95% CI = 0.925-0.972, P < 0.001), CD4 + T lymphocytes cell count ( OR = 0.975, 95% CI = 0.955-0.995, P = 0.015), and nosocomial bacterial infection ( OR = 38.338, 95% CI = 1.638-897.158, P = 0.023) were independent risk factors for ETI-MV. The area under the ROC curve (AUC) of ROC showed that PaO 2/FiO 2 had the greatest predictive value for ETI-MV, with AUC of 0.903, sensitivity of 91.1% and specificity of 95.1% in case of cutoff value of 151 mmHg. The AUC of pulmonary infiltrating opacity distribution range was 0.809, the sensitivity of 85.2%, specificity of 78.6% when the cutoff value was ≥ 3/4 lung field. APACHE Ⅱ scores had the lowest predictive value for selecting ETI-MV, with AUC of 0.704, sensitivity of 83.6% and specificity of 57.1% under the cutoff value was 16.5. Conclusions:For patients with ARDS caused by viral pneumonia, PaO 2/FiO 2 is still the classic reference for selecting ETI-MV, however, the distribution range of pulmonary infiltrating opacity and the systemic severity of the disease during 24 hours admitted to the RICU may provide supplemental helpful information to determine whether the patients choose ETI-MV, especially for moderate ARDS.

Objective:To describe the current situation on quit intention and quit attempts among current smokers aged 15 years and above in China and explore the main factors affecting their smoking cessation behaviors.Methods:The subjects were people aged 15 years and above in China. A stratified multi-phased randomized cluster sampling method was used. The survey covered 200 districts/counties in 31 provinces (autonomous regions and municipalities directly under the central government), including 19 376 people under investigation. The data were weighted with SAS 9.4 for complex sampling analysis, and the frequency and weighted component ratio were used for description. The influencing factors were studied using the Rao Scott χ2 test and unconditional multivariate logistic regression. Results:Among current smokers, 6.63% reported that they planned to quit smoking in the next month, 5.44% for men and 8.49% for women. 17.96% of the current smokers made quit attempts in the past 12 months, with 17.80% men and 22.15% women. People who smoke occasionally ( OR=3.42, 95% CI: 2.09-5.59) made quit attempts in the past ( OR=4.91, 95% CI: 0.33-0.52) and knew that smoking would lead to three diseases ( OR=2.24, 95% CI: 1.48-3.40) had higher quit intention. People who occasionally smoke ( OR=1.68, 95% CI: 1.20-2.34) received smoking cessation suggestions from medical staff ( OR=1.96, 95% CI: 1.62-2.37), were a ware of that smoking causes three diseases ( OR=1.63, 95% CI: 1.32-2.02) and had smoking prohibition regulations in indoor areas of their homes, had a higher rate of quit attempts. Conclusion:Providing effective smoking cessation intervention services and creating a supportive tobacco control environment are significant in promoting smoking cessation behavior.

Objective:To investigate secondhand smoke (SHS) exposure among non-current smokers aged 15 and over and its influencing factors in China in 2010 and 2018.Methods:The 2010 and 2018 China Adult Tobacco Surveys used multistage stratified cluster random sampling methods to obtain national representative samples across 31 provinces (autonomous regions and municipalities) in China. This study selected non-current smokers aged 15 and over as the research subjects to describe the general demographic characteristics, perceptions of SHS hazards, attitudes towards smoking bans in indoor areas in public places, and SHS exposure and the smoking restriction regulations in different places. The Rao-Scott χ2 test was used to compare the rates, and the unconditional logistic regression was used to analyze the influencing factors of SHS exposure. All the subjects in the analysis were weighted based on a complex sampling design. Results:Among non-current smokers aged 15 and over, from 2010 to 2018, the percentage of indoor smokers had decreased from 84.7% to 71.9%. The rates of people who saw smoking in various places declined with a statistically significant difference ( P<0.001). The exposure to SHS for females, people aged 45-64, teachers, medical staff, workers in enterprises, businesses, waiters, and people who live in rural and central areas declined. The differences were statistically significant ( P<0.05). In 2018, the percentage of SHS exposure for those who reported a comprehensive smoking ban in households or allowed smoking in certain areas was lower than for those who reported allowed or without a smoking ban. Among those aged 25-44, SHS exposure for those who reported complete smoking prohibition in workplaces was lower than those who reported allowed or without smoking prohibition ( OR=0.65, 95% CI: 0.49-0.87). The proportion of SHS exposure for those who believe that smoking should not be allowed in indoor areas of 0-5 public places is higher than that smoking should not be allowed in the indoor spaces of 8 public places ( OR=2.13, 95% CI: 1.35-3.36). Among people aged 45-64, the proportions of SHS exposure for teachers ( OR=0.37, 95% CI: 0.17-0.78) and medical staff ( OR=0.35, 95% CI: 0.16-0.76) and staff working in agriculture, forestry, animal husbandry, fishery, and water conservancy were lower than governmental staff ( OR=0.49, 95% CI: 0.29-0.84). Conclusions:Data from the decreased exposure of Chinese non-current smokers aged 15 and over to SHS suggests the initial achievement through constructing a smoke-free environment, but continued efforts are needed. It is necessary to actively advocate for smoke-free families, strengthen publicity and education on the hazards of tobacco and SHS, and improve the skills of non-smokers in rejecting SHS exposure.

Objective:To investigate the exposure to tobacco advertisements and promotions among Chinese adults aged 15 and above, identify the publicity channels and forms of tobacco advertising and promotion in 2010 and 2018, and implicate further tobacco control measures in China.Methods:A multistage, stratified, randomized cluster sampling design was used in 2010 and 2018 China Adult Tobacco Survey, with national representativeness. 13 354 and 19 376 permanent residents were selected in the 2010 and 2018 surveys. SAS 9.4 software was applied for data analysis, and all the data were weighted based on a complex sampling design. Rao Scott χ2 test was used for group comparison of a single factor. Results:In 2010 and 2018, 19.61% and 18.14% of the survey respondents did see tobacco advertising and promotion. From 2010 to 2018, there was no significant change in the situation of tobacco advertisements and promotions. Among those who had gone to a cigarette shop, the proportion of seeing tobacco advertisements increased from 29.28% in 2010 to 43.28% in 2018. Among those who had seen tobacco advertisements on TV, the rate fell from 50.93% in 2010 to 28.58% in 2018. Among those who had gone to movie theaters, the proportion of seeing tobacco advertisements increased from 2.17% in 2010 to 9.89% in 2018. Among those who had used the Internet, the proportion of seeing tobacco advertisements online rose from 19.20% in 2010 to 42.30% in 2018. In terms of tobacco promotion, the percentages of people who had seen tobacco promotions, cigarette price discounts, cigarette discount coupons, gifts, and other preferential activities in various places in the past 30 days were 4.99% vs. 9.30%, 0.78% vs. 4.09%, 0.04% vs. 0.33% and 0.98% vs. 3.33% in 2010 and 2018, respectively ( P<0.001). Conclusions:Tobacco advertising and promotion are still prevalent in China, with no significant change in 2010 and 2018. Tobacco advertising and promotion have been with the constant changes and development of media platforms. It is necessary to improve the implementation of relevant policies, comprehensively ban tobacco advertisements and promotions, and strengthen the supervision of ads and promotions.

Background: Computer-aided diagnosis based on deep learning technology is a research hotspot in the field of gastroenterology, and computer-aided diagnosis of colorectal polyps has received more and more attention. Aims: To validate a model based on deep learning for the automatic identification of colorectal polyps, and to analyze its auxiliary learning function for helping novice endoscopists. Methods: A total of 1 200 colonoscopy images (600 colorectal polyp images and 600 normal images) in the endoscopy center database of Qingdao Municipal Hospital (East) from January 2019 to January 2020 were retrospectively collected. Deep learning model was used to identify the 1 200 images. The sensitivity, specificity, accuracy and diagnosis time of deep learning model and 5 novice endoscopists for diagnosis of colorectal polyps were compared. Results: The deep learning model showed a sensitivity of 93.2%, specificity of 98.7%, accuracy of 95.9% for detecting colorectal polyps, and the diagnosis time of each image was (0.20±0.03) second. The sensitivity, accuracy, and diagnosis time of the model were superior to 5 novice endoscopists, and the specificity was superior to some novice endoscopists. The accuracies of model for polyps with size ≤5 mm and 6~9 mm were 88.1% and 96.8%, respectively, and were superior to 5 novice endoscopists; the accuracy of model for polyps with size ≥10 mm was 100%, and was similar to 5 novice endoscopists. The accuracy of model for polyps with protrude type was 94.8%, and was superior to some novice endoscopists; the accuracy of model for polyps with flat type was 91.7%, and was superior to 5 novice endoscopists. Missing the polyps with flat type (38.8%), polyps at mucosal folds (32.7%), and mistaking the mucosal folds as polyps (12.2%) were the main causes of false negative or false positive results of the model. Conclusions: The deep learning model has a high accuracy, sensitivity, specificity and shorter diagnosis time for diagnosis of colorectal polyps, and can be used to assist novice endoscopists in diagnosing small polyps and flat polyps.

Objective To explore the influence of the clinical learning environment on the professional identity of nursing undergraduates.Methods From April to June 2017,we selected 184 nursingundergraduates with clinical practice from three Class Ⅲ Grade A hospitals of Harbin City as subjects by convenience sampling.All of them were investigated with the general information questionnaire,Questionnaire for Baccalaureate Nursing Students(QBNS),Clinical Learning Environment,Supervision and Nurse Teacher Evaluation Scale(CLES+T).Results A total of 184 questionnaires were handed out and 176 valid questionnaires were withdrew.The scores of QBNS and CLES+T of nursing undergraduates were(102.69±9.48)and(129.63±23.73)respectively.Hierarchical regression analysis showed the influencing factors of professional identity of nursing undergraduates included the role of nursing teacher,style of ward manager and teaching atmosphere of ward(P < 0.01).Conclusions Clinical learning environment is the influencing factors of the professional identity of nursing undergraduates.Clinical administrators should continuously improve clinical learning environment so as to enhance professional identity of nursing undergraduates.

Chronic gastritis has varied clinical symptoms and prolonged course,and seriously affects the life quality of patients.Studies have shown that mood disorders might affect the pathogenesis of chronic gastritis.Aims:To investigate the incidence of anxiety and depression and its relationship with digestive symptoms,Helicobacter pylori (Hp) infection,degree and activity of inflammation in patients with chronic gastritis.Methods:A total of 235 patients with chronic non-atrophic gastritis were enrolled.Anxiety,depression,gastrointestinal symptoms,gastric mucosal inflammation and activity were evaluated,and infection of Hp was detected.Results:In the 235 patients,144 (61.3%)were accompanied by anxiety and/or depression:108 patients (46.0%)were accompanied by anxiety,129 patients (54.9%) were accompanied by depression,93 patients (39.6%)were accompanied by anxiety and depression.Incidence of abdominal pain,abdominal distention and early satiety,scores of digestive symptoms,positive rate of Hp infection and incidence of severe inflammation in patients accompanied by anxiety and/or depression were significantly higher than those in patients without anxiety and depression (P<0.05 ),but no significant difference in inflammation activity was seen between the two groups (P>0.05).Conclusions:Incidence of anxiety and depression in patients with chronic gastritis is high.Anxiety and depression are associated with abdominal pain,abdominal distention and early satiety,and can affect the inflammatory degree of gastric mucosa.Patients with anxiety and depression are susceptible to Hp infection.