Objective To investigate the value of predicting the pathological results of labial gland biopsy in Sj?gren's syndrome(SS)based on the labial gland MRI radiomics machine learning models.Methods The labial gland MRI data of 178 suspected SS patients were analyzed retrospectively,and the labial gland biopsy pathology results were positive in 97 cases and negative in 81 cases.The samples were divided into training set(143 cases)and test set(35 cases)using a randomized stratified sampling according to the ratio of 4:1.The region of interest(ROI)was manually outlined at the maximal level of the lower labial gland in T2WI water phase and radiomics features(104)were extracted.Feature screening was performed using the least absolute shrinkage and selection operator(LASSO),and the selected features set was used to construct Extra Trees,LightGBM,and Gradient Boosting classifier models.The predictive efficacy of the models was evaluated using the receiver operating characteristic(ROC)curve,and the DeLong test was used to compare the differences in the area under the curve(AUC)between the models.Decision curve analysis(DCA)was used to evaluate the clinical application value of the models in guiding biopsy.Results After LASSO screening,five optimal radiomics features were obtained.The AUC of Extra Trees,LightGBM,and Gradient Boosting models on the training and test sets were as follows 1.000,0.807,0.960 and 0.655,0.779,0.639,respectively.The DeLong test showed no statistically significant difference in AUC among the three models in the test set.DCA showed that the LightGBM model of guided biopsy had a higher clinical net benefit over a wider range of risk thresholds than other models.Conclusion Based on the radiomics features of the labial gland T2WI water phase,the LightGBM model has a high accuracy in predicting the pathological results of labial gland biopsy in SS,and guiding biopsy can obtain high clinical benefits,which has potential clinical application value.

Objective:To analyze the current situation of pregnant women′s health promotion behavior in early pregnancy, and to explore the multiple mediating effects of self-efficacy and sense of coherence in family function and health promotion behavior.Methods:The convenience sampling method selected 208 early pregnant women who visited the obstetric clinic of the Affiliated Hospital of Qingdao University from August to December 2020 as the research object was used. The electronic questionnaires including self-made general information questionnaire, Family APGAR Questionnaire, General Self-Efficacy Scale (GSES), Sense of Coherence Scale (SOC-13), and the Health-Promoting Lifestyle ProfileⅡ (HPLP-Ⅱ) were provided to women.Results:The total score of health promotion behaviors for early pregnancy was (139.58 ± 17.27) points with a good level. The influencing factors such as exercise habits and medical payment methods had statistical significance in the effects of health-promoting behaviors in the first trimester of pregnancy ( t=4.68, -3.55, both P<0.05). Structural equation model revealed that the total effect value of family function on health-promoting behaviors was 2.654, the direct effect value was 1.729 and the indirect effect value was 0.925. Meanwhile, the mediating effects of self-efficacy, the sense of coherence and self-efficacy upon the sense of coherence accounted for 15.9%, 15.2% and 3.8% of the indirect effect respectively. Conclusions:Family function of pregnant women in early pregnancy can not only affect health promotion behavior through self-efficacy and sense of coherence, but also indirectly affect sense of coherence through self-efficacy, so as to affect health promotion behavior. Maternal related health workers can construct targeted intervention measures from the perspective of self-efficacy and sense of coherence to maintain and improve the health promotion behavior of pregnant women in the early stage of pregnancy.

Objective:To investigate the effects of types of ulnar styloid process fracture on the treatment of distal radius fracture.Methods:The 80 patients were analyzed retrospectively who had been treated at The First Department of Hand Surgery, Honghui Hospital from January 2019 to January 2020 for fracture of distal radius complicated with fracture of ulnar styloid process. They were 25 males and 55 females, aged from 30 to 85 years (average, 58.6 years). According to the types of ulnar styloid process fracture, 40 patients were assigned into a Hauck type Ⅰ group and the other 40 into a Hauck type Ⅱ group. The 2 groups were compared in terms of operation, postoperative complications, hospital stay, bone union, visual analogue scale (VAS) on postoperative 1 to 3 days, and modified Mayo wrist function score, wrist range of motion and quality of life by WHOQOL-BREF at the last follow-up.Results:The 2 groups were comparable because there was no significant difference in age, gender, American Society of Anesthesiologists (ASA) rating, or time from injury to operation between them ( P>0.05). All the patients were followed up for 12 to 24 months (average, 17 months). There was no significant difference between Hauck type Ⅰ group and Hauck type Ⅱ group in operation time, intraoperative blood loss, hospital stay, rate of postoperative complications, fracture union, modified Mayo wrist function score or VAS on postoperative 1 to 3 days ( P>0.05). At the last follow-up, the palm tilt and ulnar inclination angles were 13.8°±1.9° and 21.6°±2.8° in Hauck type Ⅰ group, significantly larger than those in Hauck type Ⅱ group (11.9°±1.6° and 18.8°±2.3°) ( P<0.05). At the last follow-up, Hauck Ⅰ group scored 85.3±6.4,85.6±6.5, 84.7±6.3 and 85.0±6.7 respectively in the domains of physical health, psychology, environment and social relationships, significantly higher than those Hauck type Ⅱ group did (78.5±6.5, 78.9±6.5, 77.8±6.1 and 77.9±6.3) ( P<0.05). Conclusions:In open reduction and internal fixation for distal radius fracture, Hauck Type Ⅰ fracture of ulnar styloid process has no significant effect on the functional recovery of the wrist but Hauck Type Ⅱ fracture of ulnar styloid process may. Therefore, surgical fixation needs to be strengthened if Hauck Type Ⅱ fracture of ulnar styloid process is complicated.

Objective:To investigate the effect of Fuzheng-Peiyuan recipe assisted modified VAD program on M protein, myeloma cells and immune function in patients with multiple myeloma (MM). Methods:A total of 96 patients with MM from January 2017 to May 2019 in our hospital were selected as the research objects, and they were divided into two groups according to the random number table method, with 48 patients in each group. The control group was given a modified VAD regimen (vincristine + adriamycin + dexamethasone), and the observation group was given Fuzheng-Peiyuan recipe as an auxiliary VAD regimen. Both groups were treated for 3 cycles. The clinical efficacy, TCM syndrome score, bone pain score, blood creatinine, hemoglobin, blood calcium, M protein, myeloma cells, immune function [Interleukin-2 (IL-2), Interferon-gamma (INF-γ), Interleukin-4 (IL-4), Interleukin-10 (IL-10)] levels and adverse reactions of the two groups were recorded and compared before and after treatment. Results:The total effective rate of the observation group was 81.3% (39/48), and the control group was 62.5% (30/48). The difference between the two groups was statistically significant ( χ2=4.174, P=0.041). The scores of TCM syndromes ( t=4.674, 13.328) and bone pain scores ( t=4.505, 11.398) in the observation group were significantly lower than those in the control group ( P<0.01) at 1 and 3 cycles after treatment; SCr ( t=4.452, 10.039), blood calcium ( t=4.578, 4.155) in the observation group were significantly lower than those in the control group ( P<0.01); HbAlc levels ( t=5.290, 8.871) in the observation group was significantly higher than that of the control group ( P<0.01); M protein ( t=11.145, 33.812), myeloma cells ( t=6.415, 19.731) in the observation group were significantly lower than those in the control group ( P<0.01); serum IL-2 ( t=4.922, 8.789), INF-γ ( t=5.610, 8.886) in the observation group were significantly higher than those in the control group ( P<0.01); IL-4 ( t=4.709, 6.784), IL-10 ( t=5.287, 12.823) in the observation group were significantly lower than those in the control group ( P<0.01). During the treatment, the incidence of adverse reactions in the observation group was 41.7% (20/48) and that in the control group was 62.5% (30/48). The difference between the two groups was statistically significant ( χ2=4.174, P=0.041). Conclusion:Fuzheng-Peiyuan recipe assisted in improving the VAD regimen in the treatment of MM has a significant clinical effect, which can relieve the clinical symptoms of patients and reduce the degree of bone pain, and promote the reduction of myeloma cells in patients, improve their immune function, and improve the tolerance of chemotherapy.

Objective:To analyze the efficacy and relevant indicators of efficacy prediction of immunosuppre-ssive therapy (IST) that was composed of rabbit anti-human thymocyte immunoglobulin (rATG) and cyclosporine A (CsA) to treat acquired aplastic anemia (AA) in children.Methods:Retrospective analysis of the clinical data from 89 cases of children who were diagnosed with acquired AA and applied IST in Children′s Hospital of the First Affiliated Hospital of Zhengzhou University from January 1, 2012 to November 30, 2016 were collected.Patients were followed up for 2 years.Clinical features, curative effect and relevant indicators of efficacy prediction were analyzed retrospectively.Results:Among the 89 children with acquired AA, there were 27 cases of very severe AA(vSAA), 48 cases of severe AA(SAA) and 14 cases of transfusion-dependent non-severe AA(NSAA), with the median age of 7 years old.There was no significant difference in the curative effect among vSAA, SAA and transfusion dependent NSAA at different follow-up time nodes ( P>0.05). The recurrence rate of acquired AA was 4.49%(4/89 cases) and the median recurrence time was 18 months.The clonal evolution of acquired AA was 2.24%(2/89 cases). In multi-factor analysis, at the 6 th month of IST treatment, the newly diagnosed children displayed increased CD4 +/CD8 + ratio and early treatment response to granulocyte colony stimulating factor (G-CSF), indicating that the children responded well to the treatment of IST. Conclusions:Combined with CsA, the IST of rATG is a safe and effective method for the treatment of acquired AA in children.The higher CD4 +/CD8 + ratio and early treatment response of G-CSF are good predictors of treatment response to immunosuppressive therapy at 6 months, respectively.

Objective: To determine the level of Soluble Suppression of Tumorigenicity-2 (sST2) in patients with heart failure(HF) and atrial fibrillation (AF), and to explore its diagnostic and prognostic value in patients with HF and AF. Methods: A prospective cohort study was carried out to investigate the data of 185 HF patients who were hospitalized between January 2018 and June 2018 in department of cardiology or department of cardiac care unit in TEDA International Cardiovascular Hospital. And according to whether they had atrial fibrillation before admission, we categorized patients into: HF with sinus rhythm (HF-SR, n=90) and HF with AF(HF-AF, n=95). Meanwhile, 40 healthy controls were collected. Baseline data of HF-SR and HF-AF groups and plasma sST2 levels in different ejection fraction groups were compared. Plasma sST2 level was determined by enzyme-linked immunosorbent assay(ELISA). Statistical methods such as nonparametric test and Spearman correlation analysis were used. The receiver operating characteristic curve was applied to evaluate the diagnostic value of sST2 in HF-SR and HF-AF groups. And by using the COX risk model, Multi-factor COX analysis was used to analyze the prognosis of patients. Results: Compared with healthy controls, the median (P₂₅, P₇₅) of Plasma sST2 levels in HF patients increased remarkably [32.93 (20.31-51.39) ng/mL vs 15.99(7.97-22.69) ng/mL, Z=-4.373, P<0.001]. Patients with HF-AF group had significantly higher test results [39.86 (27.20-59.21)] ng/mL than HF-SR group [24.74 (14.83-44.11)] ng/mL, Z=-6.783, P<0.001].In the HFmrEF and HFpEF subgroups, the plasma sST2 level of patients in the HF-AF group was higher than that in the HF-SR group (Z=-2.381, P=0.017; Z=-3.701, P<0.001).Spearman correlation analysis showed that, in HF-AF patients, plasma sST2 level was positively correlated with diastolic blood pressure, Hypertension, New York Association (NYHA) cardiac function classification Ⅲ to Ⅳ, white blood count(WBC), and the level of Alanine Aminotransferase (ALT), Υ-glutamine transaminase (Υ-GT), B-type natriuretic peptide (BNP) (r>0, P<0.05).Also, there is a negative correlation between sST2, left ventricular ejection fraction (LVEF) and estimated Glomerular Filtration Rate (eGFR) (r<0, P<0.05). At ROC analysis, sST2 showed predictive value in both HF-AF and HF-SR group, with an optimal cut-off value of 25.33 ng/mL(AUC 0.872, 95%CI: 0.805-0.935, P<0.001, sensitivity 81.1%, specificity 87.5%) and 23.34 ng/mL(AUC 0.665, 95%CI: 0.570-0.761, P<0.001, sensitivity 55.6%, specificity 77.5%).The AUC of BNP and sST2 in differential diagnosis of HF-SR and HF-AF was 0.604 and 0.699, respectively, and the AUC of sST2 was higher than that of BNP. Multi-factor COX analysis indicated that plasma sST2 level, BNP, NYHA cardiac function grading could be risk factors for cardiac events in HF patients. Plasma sST2, left atrial diameter (LA-D), and associated cardiomyopathy are risk factors for cardiac events in patients with HF-AF. The incidence of cardiac events in HF patients with sST2≥20.31 ng/mL was significantly higher than that of patients with sST2<20.31 ng/mL (χ²=7.625, P=0.006). The incidence of cardiac events in HF-AF patients with plasma sST2≥39.86 ng/mL was significantly higher than that in patients with sST2<39.86 ng/mL (χ²=4.287, P=0.038). Conclusions The plasma sST2 level in patients with HF-AF is significantly higher than that both in HF-SR and healthy controls. The diagnostic value of plasma sST2 in patients with HF-AF is higher than that in patients with HF-SR. It is suggested that sST2 are more valuable for the differential diagnosis of HF-SR, HF-AF than BNP. HF-AF Patients with plasma sST2 ≥ 39.86 ng/mL are prone to cardiovascular events.

Objective To analyze the gonadal hormone and seminal plasma of patients with abnormal semen liquefaction and investigate the influence mechanism in order to provide guidance for the diagnosis and treatment. Methods 152 men of childbearing age were divided into two groups according to the liquefaction time (cut?off point: 60 minutes). Routine semen parameters,gonadal hormone and seminal plasma were tested and compared between the above groups. T?test was applied to compare individual gland function (pH value,neutralα?glycosidase,fructopyranose,seminal plasma zinc and citric acid) and gonadal hormone (FSH,LH,PRL,T and E2). Logistic regression analysis was adopted to probe the influencing factors for abnormal semen liquefaction. Results Seminal pH value (7.47 ± 0.13 vs. 7.32 ± 0.18),citric acid(51.12 ± 12.95 vs. 83.11 ± 33.46)and FSH (4.40 ± 1.03 vs. 4.85 ± 1.50)levels were significant different between the two groups (P < 0.05),but the other indexes showed no significant difference. Correlation regression analysis showed that semen liquefaction capacity has correlative relationship with seminal plasma fructose (OR=2.644),citric acid (OR=0.922),serum T (OR=1.029) and E2,while no correlative relationship with other indexes. Conclusions Correlation between two glands (seminal vesicle and prostate) and balance in the two hormones (T and E2) influence the liquefaction time. Specific causes should be distinguished before diagnosis.

Objective To analyze the survey results of iodine nutritional level among women of childbearing age,pregnant,lactating women and infants before and after the adjustment of iodine concentration in salt of Zibo City,in order to provide a scientific basis for reasonable iodine supplement.Methods The iodine content in the residents' edible salt samples was determined in 2011 and 2015.Four groups of target populations including women of childbearing age,pregnant,lactating women and infants from 7 districts and towns of Zibo were investigated to test their urinary iodine level in 2011 and 2015.The monitoring results of the two years were compared and analyzed.Results A total of 2 100 and 2 160 residents edible salt were monitored in 2011 and 2015,and the median of salt iodine were 30.2 and 22.7 mg/kg,there was statistically significant difference in the constitute of salt iodine level between the two years (x2 =141.90,P ＜ 0.01).A total of 354,402,403,362 urine samples of women of childbearing age,pregnant,lactating women and infants' were detected and the median urinary iodine were 161.80,127.20,138.80,147.10 μg/L in 2011,and 350,706,350 and 352 of the corresponding target population's urine samples were detected and the median urinary iodine were 127.80,129.95,70.20 and 152.35 μg/L in 2015.Conclusions The salt iodine median has reduced and the urinary iodine in childbearing age women and infant is in the appropriate level,while it is insufficient in the pregnant women and lactating women after the adjustment of iodized salt concentration in Zibo.It is necessary to promote health education and instruct pregnant women and lactating women to supplement iodine,additionally,surveillance of the iodine nutrition status of the targeted populations should be strengthened.

Objective To evaluate the value of serum E2 levels during COH in predicting IVF-ET outcome. Method Data from 311 IVF-ET cycles received long protocol were collected and analyzed according to E 2 levels 5 days after stimulation:Group A (E2≤500 pmol/L), Group B (500 2 000 pmol/L). Results In groups with E2>1 000 pmol/L, the conditions of oocyte and embryo are higher than E2<1 000 pmol/L. With the increase of E2 levels, period cancellation rate increases. When E2> 2 000 pmol/L, the pregnancy rate become lowest. Conclusion E2 levels among 1 000~1 500 pmol/L during early COH predicts a better pregnancy outcome.

OBJECTIVEA Meta-analysis was performed to assess the association of defective hepatic cytochrome P450 2A6 (CYP2A6) gene with smoking behaviors.

METHODSAll eligible studies published up to 2014 were searched out from PubMed, China National Knowledge Internet (CNKI), ISI Web of knowledge (ISI), vip citation databases (VIP), Chinese BioMedical Literature (CBM) and Elsevier Science Direct, searching words were "smok*","nicotine dependence","CYP2A6","cytochrome P450 2A6","polymorphism","mut*"and"varia*", while 436 articles were concluded. Meta-analysis was performed using Statal 3.1.

RESULTSA total of ten studies were finally included. We didn't find a significant effect of defective CYP2A6 gene on smoking initiation (fixed effect model (FEM): OR = 0.90, 95%CI: 0.78-1.03, I(2) = 25.8%), smoking persistence (random effect model (REM): OR = 0.85, 95%CI: 0.59-1.23, I(2) = 66.3%) and smoking cessation (REM: OR = 0.89, 95%CI: 0.57-1.40, I(2) = 67.1%). But it showed a significant protective effect of CYP2A6*4 on smoking initiation (FEM: OR = 0.78, 95%CI: 0.61-0.99, I(2) = 28.2%), smoking persistence (FEM: OR = 0.53, 95%CI: 0.36-0.77, I(2) = 41.0%) and smoking cessation (REM: OR = 0.49, 95%CI: 0.31-0.80, I(2) = 0.0%).

CONCLUSIONSThis Meta-analysis suggested that there was not a protective effect of defective CYP2A6 gene against smoking behaviors. But smokers with whole CYP2A6 gene deletion would be less likely to start smoking, less smoking persistence and more likely to quit smoking successful than smokers with wild CYP2A6 gene.

Aryl Hydrocarbon Hydroxylases ; Asian Continental Ancestry Group ; China ; Cytochrome P-450 CYP2A6 ; Gene Deletion ; Humans ; Polymorphism, Genetic ; Protective Factors ; Smoking ; Smoking Cessation ; Tobacco Use Disorder