Objective: To explore the relationship of self-injurious behavior with peer discrimination and depression among AIDS orphans, so as to provide the basis for promoting the mental health of AIDS orphans. Methods: From March 2021 to March 2022, 626 AIDS orphans from 5 counties in Henan Province were selected by stratified cluster random sampling methods. Non suicidal Self-injury assessment Tool, Discrimination Experience Scale, and Zung Self-rating Depression Scale were used to investigate AIDS orphans self-injurious behavior, peer discrimination and depression. Multivariate Logistic regression model was used to analyze the relationship between self-injurious behavior and peer discrimination of AIDS orphans. Multivariate linear regression analysis was used to explore the moderating effect of depression between self-injurious behavior and peer discrimination of AIDS orphans. Results: The detection rates of self-injurious behavior, peer discrimination and depression of AIDS orphans were 80.0%, 73.3% and 67.6 % respectively. The detection rates of the three items mentioned above were 86.9%, 81.5%, and 77.5% for double orphaned children, respectively, which were higher than 74.6%, 67.0%, and 59.8% for single orphaned children, and the differences were statistically significant ( χ 2=21.29, 23.78, 14.23, P <0.01). The score of self-injurious behavior of AIDS orphans was positively correlated with peer discrimination and depression ( r=0.55, 0.40, P <0.01). Depression played a moderating role in the relationship between self-injurious behavior and peer discrimination of AIDS orphans ( β= 0.03, P <0.05). Conclusions AIDS orphans are more likely to engage in self-injurious behaviors after experiencing peer discrimination and psychological depression. The society and schools should adopt targeted intervention strategies to promote the mental health among AIDS orphans.

Objective:To explore the interventional effect of β-sitosterol on ovalbumin(OVA)-induced allergic asthma rats and its potential mechanism.Methods:SD male rats were randomly divided into normal group(CON),model group(M),positive drug dexamethasone group(DEX,0.075 mg/kg)and β-sitosterol group(Sit,50 mg/kg).A rat model of allergic asthma was estab-lished by intraperitoneal injection of OVA with aluminum hydrogen solution,and nebulized inhalation of OVA to stimulate.Rats were given intragastric administration 30 min before aerosol challenge,and after continuous administration for 7 days,the indicators of cough and asthma and tracheal phenol red excretion were detected.HE staining was used to observe pathological changes of lung tis-sue.Flow cytometry was used to detect reactive oxygen species(ROS)generation,apoptosis level and ratios of Th17 and Treg cells in peripheral blood.Biochemical method was used to detect contents of MDA,and activities of T-SOD and GSH-Px in rat lung tissues.ELISA was used to detect levels of Th17 and Treg-related cytokines(TNF-α,IL-4,IL-6,IL-17A,and IL-35).Results:Compared with model group,β-sitosterol significantly prolonged the incubation period of cough and gasp in rats with allergic asthma,reduced the frequency of cough and gasping,and promoted the excretion of phenol red in trachea;significantly reduced inflammatory infiltration in lung tissue of asthmatic rats;observably reduced MDA content in lung tissue,ROS of primary lung cell and apoptosis levels of asthmatic rats,increased the activities of T-SOD and GSH-Px;markedly reduced proportion of Th17 cells and levels of pro-inflammatory cyto-kines TNF-α,IL-4,IL-6 and IL-17A,increased proportion of Treg cells and levels of anti-inflammatory cytokine IL-35.Conclusion:β-sitosterol can ameliorate airway inflammation and oxidative damage in OVA-induced allergic asthmatic rats,and its mecha-nism may be related to the regulation of β-sitosterol on Th17/Treg immune imbalance and oxidative stress response.

Acorus tatarinowii is the dried rhizome of the Araceae plant Acorus tatarinowii Schott.Acorus tata-rinowii was first recorded in Shennong's Classic of Mate-ria Medica.It was used for the treatment of epilepsy,amnesia,insomnia,tinnitus,deafness,silent diarrhea,and other diseases.Alzheimer's disease(AD),also known as senile dementia,is a degenerative disease of the central nervous system.It is mainly manifested as neuropsychiatric symptoms such as progressive memory impairment,cognitive dysfunction,personality changes and language disorders.Acorus tatarinowii mainly con-tains phenylpropylene,lignans,alkaloids,sugars,organic acids and amino acids,among which volatile compo-nents such as β-asarone are the main active compo-nents.The main mechanism of action of Acorus tatari-nowii in the prevention and treatment of AD is as follows:① Improve memory ability.Increasing the expression of brain-derived neurotrophic factor(BDNF),extracellular signal-regulated kinase(ERK)and adenosine cyclic phosphate response element binding protein(CREB)can improve cognitive dysfunction.Studies have shown that Acorus tatarinowii can increase the expression of BDNF,ERK,CREB and tyrosine receptor kinase B in the hippo-campus of mice to varying degrees.It can significantly improve the memory ability of memory-impaired mice,so as to achieve the purpose of prevention and treatment of AD.② Anti-oxidative stress.Studies have shown that Acorus tatarinowii can reduce the production of malondi-aldehyde in skeletal muscle,increase superoxide dis-mutase activity and total antioxidant capacity,and repair the balance of oxidative stress.③ Acetylcholinesterase inhibition.The loss of consciousness caused by deficiency of kidney essence in AD patients is related to the patho-logical changes of the cholinergic nervous system.The results showed that Acorus tatarinowii could significantly increase the contents of glutamate and acetylcholine in the cerebral cortex of AD model mice,and decrease the activity of acetylcholinesterase,to achieve the anti-AD effect.④ Anti-inflammatory and neuroprotective effects.The damage of neurons in the brain of AD patients is related to the excessive inflammatory immune response of nerve cells including microglia and astrocytes.The results showed that Acorus tatarinowii can inhibit the autophagy of microglia in rats with cerebral hemorrhage,and has neuroprotective effect,to achieve the effect of anti-AD.In this study,the effects of Acorus tatarinowii on AD were reviewed to further clarify its pharmacological ef-fects,and to provide a basis for clinical application and research.

Abstract: Objective To compare the application value of metagenomic next generation sequencing (mNGS) with traditional culture in diagnosis of pulmonary infection pathogens. Methods　The clinical documents of 310 patients with suspected pulmonary infection admitted to the General Hospital of Center Theater Command from February 2021 to September 2022 were retrospectively analyzed. The results of mNGS and traditional culture were analyzed, followed by comparison on the positive rate, sensitivity, specificity, accuracy (ACC), positive predictive value (PPV) and negative predictive value (NPV) between the two methods. Results　 The study revealed that mNGS can simultaneously detect multiple pathogens, with the highest efficiency of detection for bacteria and the lowest for fungi. And the sequencing numbers of bacteria, fungi and viruses shown by mNGS were significantly different (H=70.361, P<0.001). In comparison, mNGS displayed a higher positive detection rate (88.40%) than traditional culture (29.70%) (χ2=162.373, P<0.001), but the consistency between the two methods was not significant (Kappa = -0.003, P=0.902). The sensitivity, specificity, ACC, PPV and NPV of mNGS were 91.29%, 28.26%, 81.94%, 87.96%, and 36.11% respectively, compared to corresponding 30.30%, 73.91%, 36.77%, 86.96% and 15.60% of traditional culture respectively. Through analysis, it is confirmed that the sensitivity and specificity between the two methods were statistically significant (91.29% vs 30.30%, χ2=148.120, P<0.001 and 28.26% vs 73.91, χ2=13.793, P<0.001). Conclusions　mNGS can significantly improve the detection rate of pathogens in pulmonary infections and provide a complementary tool besides to traditional culture method for accurate anti-infection therapy. Furthermore, both traditional culture and mNGS pathogen detection methods are highly dependent on sample quality and detection quality control. mNGS requires the correct interpretation of comprehensive, non-destructive pathogenic genetic information to accurately identify pathogens.

Objective:To determine the median effective dose (ED 50) of esketamine for preoperative sedation in different aged pediatric patients. Methods:Pediatric patients, aged 1-6 yr, of American Society of Anaesthesiologists physical status Ⅰ, with the preoperative parental Separation Anxiety Scale (PSAS) score ≥3, undergoing elective surgery under general anesthesia, were selected.According to the age, the children were divided into 1 yr≤age<4 yr low-age group (group L) and 4 yr≤age< 6 yr high-age group (group H). Esketamine 0.5 mg/kg was intravenously injected in the first child in each group.The dose in the next child was determined according to PSAS scores, and the two consecutive dose gradient was 0.1 mg/kg; when the PSAS score in the previous child was ≥3, the dose in the next child was increased; when the PSAS score in the previous child was< 3, the dose in the next child was decreased until appearance of 7 turning points, and then the experiment was terminated.The ED 50 and 95% confidence interval of esketamine for preoperative sedation were calculated by probit analysis. Results:A total of 54 children were enrolled in this study, including 26 cases in group L and 28 cases in group H. The ED 50 and 95% confidence interval of esketamine were 0.413 (0.314-0.530) mg/kg and 0.282 (0.252-0.318) mg/kg in group L and group H, respectively.Compared with group L, ED 50 of esketamine was significantly decreased in group H ( P<0.05). Conclusions:The ED 50 of esketamine for preoperative sedation is 0.413 mg/kg in pediatric patients of 1 yr≤age<4 yr old and 0.282 mg/kg in those of 4 yr≤age<6 yr old, and the efficacy of esketamine for preoperative sedation increases with age.

Objective: To explore trends in the asthma burden among Chinese children and adolescents 1-19 years old during 1990-2019. Methods: Based on data from the 2019 Global Burden of Disease Study, joinpoint regression was used to analyze the dynamic changes in the gender and age specific asthma burden, and the asthma burden in China was compared with countries that have different socio demographic indices(SDI). In addition, trends in asthma burden attributed to different risk factors were also investigated. Results: The asthma burden decreased slightly from 1990 to 1996 [annual percent change (APC)=-1.7%], then rapidly decreased from 1996 to 2005 (APC=-5.7%). The age standardized disability adjusted life years (DALYs) rate decreased from 158.55/100 000 to 88.59/100 000 in patients 1-19 years of age. From 2005 to 2017, the DALYs rate for asthma increased slowly, then rapidly. In 2017, the DALYs rate peaked at 176.18/100 000, then decreased to 126.79/100 000 in 2019. The burden of asthma in boys was higher than girls, and the DALYs rate for asthma in the group 5-9 years of age was higher than the remaining age groups. Furthermore, the age standardized DALYs rate for asthma among Chinese children and adolescents was relatively low among countries with a different SDI. In addition, the DALYs rate attributed to high body mass index increased in all age groups in China. Specifically, the average APC (AAPC) was 2.9% in group 1-4 years of age and the AAPC was 4.2% in the remaining age groups. The DALYs rate attributed to occupational asthmagens in the group 15-19 years of age decreased from 1990 to 2019 and the AAPC was -2.5%. Conclusion The asthma burden was relatively low among Chinese children and adolescents, and there were gender and age differences. The gender and age specific DALYs rate for asthma had a tendency to decrease, increase, then decrease. More attention should be paid to boys and the group 5-9 years of age, and strengthen the intervention of obesity and occupational asthmagens.

A software and hardware platform for gait simulation and system evaluation for lower limb intelligent prosthesis is proposed and designed, in order that the wearable symmetry effect of the intelligent knee prosthesis can be quantitatively analyzed by machine test instead of human wear test. The whole-body three-dimensional gait and motion analysis system instrument, a device to collect gait data such as joint angle and stride of adults, was used for extracting simulated gait characteristic curve. Then, the gait curve was fitted based on the corresponding joint to verify the feasibility of the test platform in the experiment. Finally, the developed artificial knee prosthesis was worn on the prosthetic evaluation system to quantitatively analyze the gait symmetry effect. The results showed that there was no significant difference in gait symmetry between the developed knee joints at different speeds, which could reach more than 88%. The simulation and evaluation of the prosthetic gait have good effects on the functional simulation and evaluation of the lower limb intelligent prosthesis.
Adult ; Artificial Limbs ; Biomechanical Phenomena ; Gait ; Humans ; Knee Joint ; Knee Prosthesis ; Prosthesis Design

Objective To carry out a research of terrain recognition on intelligent knee joint from the perspective of pure visual information.Methods The whole experimental environment was illuminated by halogen lamp, which made the brightness and color temperature of the set scene change less. The machine vision module was embedded in the intelligent knee joint control system. The road image data was collected by the camera in real time, and the captured image was processed in grayscale. The normalized cross correlation algorithm (NCC) was used to match the image pattern to identify the corresponding road conditions.Results The accuracy rates of the road vision, up/down hill, and up/down stairs recognized by the machine vision module were 88.6%, 85.3%, 78.4%, 87.5%, and 77.9%, respectively. The recognition effect was good, and the recognition time was within one second, real-time performance was strong.Conclusion The effectiveness and feasibility of intelligent knee joint prosthetic road condition recognition based on pure visual information is proved.

Objective The aim of this experiment was to explore the effect and mechanism of intestinal microbiota on shaping the growth performance by fecal microbiota transplantation from pigs to pseudo-germ-free mice. Methods Thirty-six barrows with a similar initial body weight of 30 kg were raised for 42 days(ad libitum)within individual metabolic cages. Feed intake and body weight of each pig were recorded every week to calculate the feed conversion rate and average daily gain. At the end of the experiment,feed conversion ratio and average daily gain were integrated to divide the pigs into 3 groups, namely, high growth performance(HP), moderate growth performance(MP)and low growth performance(LP)groups. Feces were collected to calculate the total intestinal nutrient digestibility and prepare for fecal microbiota transplantation to pseudo-germ-free mice, which were induced with several antibiotics for four weeks. Fecal microbiome structure was assayed by profiling V3-V4 region of the 16S rRNA gene. Results Fecal microbiota transplantation from pigs to pseudo-germ-free mice resulted in reappearance of the original phenotype. Compared with the LP pigs, the microbial species richness and microbial diversity in feces were higher in the HP pigs. The HP pigs had improved digestibility of gross energy(P =0.01)and higher abundance of Methanobrevibacter. Enterococcus and Akkermansia were also more abundant in the recipient pseudo-germ-free mice from the HP pigs which may be correlated with a high energy utilization. Conclusions Fecal microbiota transplantation from pigs to mice results in reappearance of the original phenotype and microbial species richness,microbial diversity,and their growth ability. Different nutritional metabolism is shown among pigs with different feed efficiency and the HP pigs have improved energy utilization(P=0.01). At the same time, the bacteria correlated with high energy utilization are more abundant in feces of HP pigs than in LP pigs.

Outpatient care services are usually the patient's first contact between the patients and the most bas-ic health care. The provision of outpatient care contributes to immediate and large gains in health status. The pay-ment method is one of the most common incentive methods applied by purchasers to guide the performance of outpa-tient care providers. This systematic review applied cochrane review method, and searched, screened, assessed and synthesized the relevant original studies. 19 studies were finally included. It was found that existing payment methods combined with P4 P interventions could probably slightly improved the health professionals' use of some tests and treat-ments ( adjusted RR median = 1 . 095 , range 1 . 01 to 1 . 17 ) , but may have led to little or no difference in patients' utilisation of health services ( adjusted RR median = 1 . 01 , range 0 . 96 to 1 . 15 ) and may have led to little or no difference in the control of blood pressure or cholesterol ( adjusted RR = 1 . 01 , range 0 . 98 to 1 . 04 ) . Pay for per-formance involves a complex design, each detail design may contain different incentive effect, therefore policy makers intend to apply pay-for-performance to guide the behavior of health providers, the design on each components of pay for performance should be analyzed in order to find more potential intervention points.