BACKGROUND:Changes in skeletal muscle mass have been indicated in studies addressing the effects of low-frequency pulsed magnetic fields on the structure and morphology of the skeletal muscle,but no relevant studies have been conducted on the morphologic changes that occur after chronic exposure to the low-frequency pulsed magnetic field. OBJECTIVE:To observe the effects of chronic exposure to low-frequency pulsed magnetic fields on the maximal voluntary contraction and morphologic indicators of the quadriceps muscle of the leg,thereby providing a reference of muscle morphologic changes for the use of this technique as a strategy for muscle function improvement. METHODS:Seventy healthy subjects were recruited and randomly divided into a test group that received magnetic field stimulation and a control group that underwent sham treatment,with 35 subjects in each group,and the total duration of the trial was 4 weeks.The test group underwent low-frequency pulsed magnetic stimulation for 15 minutes every 48 hours,while the control group underwent sham treatment,with the same intervention interval and duration as the test group.After 4 weeks of intervention,changes in the maximum voluntary contraction value of the quadriceps muscle in different groups were observed,and B-mode ultrasonography was utilized as a means of assessment to observe changes in muscle thickness,muscle cross-sectional area,and pinnation angle indexes. RESULTS AND CONCLUSION:After 4 weeks of chronic exposure to low-frequency pulsed magnetic fields,68 subjects completed the test.The maximum voluntary contraction value of the quadriceps muscle in the test group increased significantly(P=0.000),and the increment was significantly higher than that of the control group(P=0.008).Three indexes related to muscle morphology in the test group were significantly higher than the pre-test values(P=0.000),while in the control group,muscle thickness showed a significant reduction(P=0.020),there was no significant change in the pinnation angle,but a significant increase in the cross-sectional area(P=0.000).Intergroup comparisons revealed that the three indicators related to muscle morphology,including muscle thickness(P=0.012),pinnation angle(P=0.003),and cross-sectional area(P=0.049),were significantly higher in the test group than in the control group.The above data confirmed that the maximum voluntary contraction of the quadriceps muscle was significantly increased in healthy adults after 4 weeks of chronic exposure to the low-frequency pulsed magnetic field,and significant increases in the three muscle morphometric indices of muscle thickness,cross-sectional area,and pinnation angle were observed in the test group,providing a basis of muscle tissue morphology for the use of this technique as an exercise alternative and medical treatment strategy for muscle improvement.

Attention level evaluation refers to the evaluation of people's attention level through observation or experimental testing, and its research results have great application value in education and teaching, intelligent driving, medical health and other fields. With its objective reliability and security, electroencephalogram signals have become one of the most important technical means to analyze and express attention level. At present, there is little review literature that comprehensively summarize the application of electroencephalogram signals in the field of attention evaluation. To this end, this paper first summarizes the research progress on attention evaluation; then the important methods for electroencephalogram attention evaluation are analyzed, including data preprocessing, feature extraction and selection, attention evaluation methods, etc.; finally, the shortcomings of the current development in the field of electroencephalogram attention evaluation are discussed, and the future development trend is prospected, to provide research references for researchers in related fields.
Humans ; Reproducibility of Results ; Electroencephalography

Inflammatory bowel disease (IBD) is characterized by recurrent non ⁃ specific intestinal inflammatory responses. Intestinal fibrosis is an important cause of IBD complicated with intestinal obstruction. Nuclear factor erythroid 2⁃ related factor 2 (Nrf2) is a transcription factor that has anti ⁃ oxidative stress response in cells. In IBD, Nrf2 and its downstream regulated antioxidant enzymes achieve protective effects against intestinal fibrosis by inhibiting the activation of nuclear factor ⁃ κB, regulating T helper cell 17/regulatory T cell balance of intestinal immunity, and inhibiting transforming growth factor⁃β1/Smads signaling pathway. In this review, the structure of Nrf2, the specific mechanism of Nrf2's effect on intestinal fibrosis in IBD, and the recent studies on the treatment of IBD through Nrf2 pathway were reviewed in an attempt to provide a new direction for the prevention and treatment of IBD.

Objective:To compare the outcomes of watch&wait (W&W) strategy in patients with locally advanced rectal cancer who achieved complete clinical response (cCR) after neoadjuvant therapy, with those who obtained pathological complete response (pCR) after total mesorectal excision (TME).Methods:This is a retrospective cohort analysis study. Patients histologically proven with locally advanced rectal adenocarcinoma (stage Ⅱ-Ⅲ) who had received neoadjuvant chemotherapy were eligible between January 2014 and December 2019. In whom we included patients who had cCR offered management with W&W strategy after completing neoadjuvant therapy and follow-up ≥1 year (W&W group), and patients who did not have cCR but pCR after TME (pCR group). The primary endpoints were 3-year and 5-year overall survival (OS), colostomy-free survival (CFS), disease-free survival (DFS), non-local regrowth disease-free survival (NR-DFS), and organ preservation rate. Kaplan-Meier analysis was used for survival analysis and log-rank test was performed. For comparative analysis, we also derived one-to-one paired cohorts of W&W versus pCR using propensity-score matching (PSM).Results:A total of 118 patients were enrolled, 49 of whom had cCR and managed by W&W, 69 had pCR, with a median follow-up period of 49.5 months (12.1-79.9 months). No difference was observed in the 3-year OS (97.1% vs. 96.7%) and 5-year OS (93.8% vs. 90.9%, P=0.696) between the W&W and pCR groups. Patients managed by W&W had significantly better 3-year and 5-year CFS (89.1% vs. 43.5%, P<0.001), better 3-year DFS (83.6% vs. 97.0%) and 5-year DFS (83.6% vs. 91.2%, P=0.047) compared with those achieving pCR. The 3-year NR-DFS (95.9% vs. 97.0%) and 5-year NR-DFS (92.8% vs. 97.0%, P=0.407) did not significantly differ between the W&W and pCR groups. Local regeneration occurred in six cases, and 87.7% of patients had successful rectum preservation in the W&W group. In the PSM analysis (34 patients in each group), absolutely better CFS (90.1% vs. 26.5%, P<0.001) was noted in the W&W group. A median interval of 17.5 weeks was observed for achieving cCR, while only 23.9% of patients achieved cCR within 5 to 12 weeks from radiation completion. Patients with short-course sequential chemoradiotherapy achieved cCR significantly later when compared with those with long-course concurrent chemoradiotherapy (19.0 vs. 9.8 weeks, P<0.001). Conclusions:The oncological outcomes of W&W strategy in patients with locally advanced rectal cancer are safe and effective, significantly improving the quality of life. Longer interval for cCR evaluation may improve rectal organ preservation rate.

Objective:To explore the effect of pretreatment body mass index (BMI) on the prognosis of patients with unresectable locally advanced non-small cell lung cancer (NSCLC) after chemoradiotherapy.Methods:The clinical data of 711 patients with locally advanced NSCLC treated with radiotherapy, sequential chemoradiotherapy or concurrent chemoradiotherapy from January 2013 to December 2017 in Cancer Hospital of Chinese Academy of Medical Science and Peking Union Medical College were retrospectively analyzed. Radiotherapy was performed with intensity-modulated radiotherapy (IMRT) or volumetric-modulated arc therapy (VMAT), and the chemotherapy regimens were paclitaxel+carboplatin, pemetrexed+cisplatin or etoposide+cisplatin. The effects of pretreatment BMI and other clinical factors on overall survival (OS) of patients were analyzed. Survival analysis was performed by using Kaplan-Meier method; univariate and multivariate analyses were performed by using Cox proportional hazards model.Results:According to the World Health Organization (WHO) recommended BMI grouping method for Asian, the median OS time of low BMI group (<18.5 kg/m 2, 23 cases), normal BMI group (18.5-23.9 kg/m 2, 293 cases) and high BMI group (≥24.0 kg/m 2, 395 cases) was 17 months (95% CI 11-29 months), 29 months (95% CI 22-36 months) and 30 months (95% CI 27-34 months), respectively. OS in the low BMI group was poorer than that in the normal BMI group and high BMI group ( χ2 = 11.20, P = 0.004). Maximally selected rank statistics was used to determine the optimal cut-off value of BMI for prediction of survival as 21.31 kg/m 2, according to which patients were divided into low BMI group (BMI<21.31 kg/m 2, 130 cases) and high BMI group (BMI≥21.31 kg/m 2, 581 cases), the median OS time of the two groups was 20 months (95% CI 17-27 months) and 32 months (95% CI 28-35 months), respectively. OS in the low BMI group was poorer than that in the high BMI group ( χ2 = 12.30, P < 0.001). Multivariate analysis showed that age ≥ 65 years old, male, Karnofsky score < 80 points, low BMI, smoking, histological type of squamous cell carcinoma and radiotherapy alone were independent risk factors for OS (all P < 0.05). Conclusions:For patients with unresectable locally advanced NSCLC who received chemoradiotherapy, those with low pretreatment BMI have poor prognosis.

Objective:To investigate the efficiency and pharmacoeconomics of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) for mobilization of peripheral blood stem cells (PBSCM) in patients with multiple myeloma (MM).Methods:The data of 91 patients with newly treated MM who were hospitalized in the First Hospital of Jilin University and Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College from January 2015 to October 2017 were retrospectively analyzed. According to the patient's wishes, a high-dose chemotherapy combined with subcutaneous injection of PEG-rhG-CSF or recombinant human granulocyte colony-stimulating factor (rhG-CSF) was used for stem cell mobilization in 42 and 49 patients, respectively. The number of mononuclear cells (MNC) and CD34 + cells collected after mobilization, the maximum absolute neutrophil count (mANC), the cost of mobilization, and the engraftment time of white blood cells and platelets after transplantation were compared between the two groups. Results:The median number of MNC collected after mobilization in the PEG-rhG-CSF group and rhG-CSF group were 5.86×10 8/kg [(1.08-24.54)×10 8/kg] and 6.61×10 8/kg [(0.83-33.80)×10 8/kg], and the difference was not statistically significant ( U = 883.00, P = 0.245); while the median number of CD34 + cells collected after mobilization in the PEG-rhG-CSF group was higher than that in the rhG-CSF group [5.56×10 6/kg (0.94-19.90)×10 6/kg and 4.82×10 6/kg (1.12-14.61)×10 6/kg], and the difference was statistically significant ( U = 732.00, P = 0.038). The median number of mANC during mobilization in the PEG-rhG-CSF group was lower than that in the rhG-CSF group [20.50×10 9/L (7.26-61.30)×10 9/L and 32.08×10 9/L (6.92-69.99)×10 9/L], and the difference was statistically significant ( U = 490.00, P = 0.001). After autologous stem cell transplantation (ASCT), the time-to-recovery of white blood cell count (WBC) to 1.0×10 9/L in the PEG-rhG-CSF group was shorter than that in the rhG-CSF group [(11.59±1.98) d vs. (12.93±2.83) d], and the difference was statistically significant ( t = -2.395, P = 0.019), and the time-to-recovery of platelet count (Plt) to 20.0×10 9/L in the PEG-rhG-CSF group was also shorter than that in the rhG-CSF group [(12.86±2.62) d vs. (14.80±5.47) d], but the difference was not statistically significant ( t = -1.749, P = 0.085). The total mobilization cost of the PEG-rhG-CSF group was not statistically different from that of the rhG-CSF group [(21 405.47±7 365.98) yuan vs. (22 976.83±10 264.34) yuan, t = -0.721, P = 0.474]. Conclusions:PEG-rhG-CSF combined with high-dose chemotherapy is an effective option for PBSCM in MM patients, and its mobilization cost is equivalent to rhG-CSF. Therefore, PEG-rhG-CSF may be a better choice for PBSCM in MM patients.

Objective:To test the psychometric properties of the super brief-pathological narcissism inventory(SB-PNI) in Chinese college students.Methods:A total of 541 college students were recruited through convenient sampling method.All subjects were measured by SB-PNI, fear of missing out scale(FOMOs), Interpersonal Communication Scale and Social Interaction Scale.SPSS 25.0 was used for item analysis, criterion related validity analysis and Cronbach α coefficient. Mplus 7.4 software was used for structural validity analysis.Results:Through the construct validity analysis, it was found that the Bi-factor model was well fitted.SB-PNI presented a better Bi-factor structure(χ 2/ df=2.03, CFI =0.96, TLI=0.94, RMSEA=0.04, SRMR=0.04), namely a general factor and two local factors (grandiose narcissism and vulnerable narcissism). The score of SB-PNI was positively correlated with grandiose narcissism, vulnerable narcissism, interpersonal communication, social interaction and fear of missing out ( r=0.13-0.85, all P<0.01). The Cronbach's α coefficients of SB-PNI degreed from 0.74 to 0.81.The composite reliability of SB-PNI degreed from 0.75 to 0.84.The retest reliability of SB-PNI degreed from 0.75 to 0.85.The homogeneity reliability of SB-PNI was 0.64. Conclusion:The Chinese version of the SB-PNI has good validity and reliability among Chinese college students.

Objective:To investigate the relationship between gastric filling status and intra-or inter-fractional tumor displacement in patients with adenocarcinoma of the esophagogastric junction (AEG) undergoing preoperative radiotherapy.Methods:From October 2018 to June 2019, 10 patients with locally advanced AEG who received totally neoadjuvant therapy were enrolled in this prospective study. Patients received two markers implanted at the cranial and caudal borders of the tumors under gastroscope and a total of 20 fiducial markers were implanted finally. All patients underwent 4DCT scan under the gastric fasting and filling status. Ten images of 0% to 90% respiratory phase were automatically reconstructed by the system (Pinnacle 3, version 9.1, Philips Medical Systems, Eindhoven, The Netherland). Each patient obtained one hundred sets of images. Results:In the tumors proximal to the chest, gastric filling did not significantly affect intrafractional or interfractional tumor displacements. Nevertheless, in the tumors distal to the chest, the interfractional displacement in the cranio-caudal (CC) direction under the gastric fasting status was significantly larger compared with that under the gastric filling status (6.22±4.67 mm vs. 4.13±3.68 mm, P=0.013). To ensure 95% of the prescribed dose irradiated to at least 90% of the tumor volume during the radiotherapy, the margins of tumors proximal to the chest in the left-right (LR), antero-posterior (AP) and CC directions were 9 mm, 8.5 mm, 12.1 mm under gastric filling status with 300 ml semi-fluid. Six patients diagnosed with gastric cancer with proximal thoracic fiducial markers treated by preoperative radiotherapy were included in the validation group, revealing that the fiducial markers of 93% patients were covered in this margin. Conclusion:During the preoperative radiotherapy in AEG patient, the approach of quantitative gastric filling can be considered.

Objective:To explore the motion and influencing factors of implanted gold markers in guiding liver stereotactic body radiation therapy (SBRT) using abdominal compression.Methods:Twenty patients with oligometastatic colorectal cancer or primary hepatocellular carcinoma from January 2016 to December 2019 were included. All patients were treated with SBRT under abdominal compression, with 1-3 gold markers were implanted within 2 cm from the lesion before positioning. Four-dimensional computed tomography (4DCT) scan was used for treatment planning. The respiratory cycle was divided into 0-90% respiratory phase images based on the respiratory signal, which were reconstructed by the system (Pinnacle 3 version 9.1; Philips Medical System, Madison, WI, USA), and cone beam CT validation images before radiation exposure were obtained. The liver volume was divided into 3 parts: within 2 cm from the main hepatic portal vein, 2-5 cm from the main hepatic portal vein, and>5 cm from the main hepatic portal vein. The motion of different tumor locations was evaluated. Results:The average intrafractional motion amplitude was (2.63±2.81) mm in the cranial-caudal (CC) direction, (1.35±1.23) mm in the anterior-posterior (AP) direction, and (0.76±0.88) mm in the left-right (LR) direction, respectively. The average interfractional motion amplitude was (3.45±3.06) mm, (2.64±2.60) mm, and (2.23±2.07) mm, respectively. Both the intra-or inter-fractional motion amplitudes in the CC direction were the highest, followed by those in the AP and LR direction (all P<0.001). The motion varied at different tumor locations. The longer distance from the main hepatic portal vein, the larger the intrafractional motion (all P<0.05). To cover the 95% population-based confidence interval, the internal target volume (ITV) was suggested to include the expansion of 3.9 mm, 5.2 mm and 7.9 mm in the LR, AP and CC direction. The expansion of 4.3 mm, 4.4 mm and 6.1 mm was delivered within 2 cm from the main hepatic portal vein, and 3.5 mm, 7.3 mm and 9.7 mm>5 cm from the main hepatic portal vein, respectively. The expansion varied significantly depending on the tumor location, whereas the motion in the CC direction was the largest regardless of the tumor location. The longer distance of the tumor from the main portal vein, the larger expansion in the CC direction. The expansion of tumor > 5 cm from the main portal vein in the AP direction was larger than that of inner parts. Conclusion:Liver tumors at different locations require individual external expansion of ITV.

Objective The aim of this study was to investigate whether the addition of neoadjuvant chemoradiotherapy ( NACRT ) to surgery can improve outcomes better than neoadjuvant chemotherapy in terms of rate of R0 resection, pathological complete response ( pCR ) and side effects. Methods This exploratory study included primary gastric adenocarcinoma patients staged as clinical T4N0 or anyTN1-3. Intensity modulated radiotherapy was delivered of 40 to 50 Gy in 22 to 25 fractions,5 days/week.Concurrent chemotherapy regimens included S-1 or Capecitabine or a combination of Paclitaxel plus Carboplatin.Results Eleven eligible patients were enrolled. R0 and R2 resections were performed in 9 ( 9/11) and 1 patients, respectively.Peritoneal metastasis was found in 1 case during exploratory laparotomy.The pCR was observed in 1 patient with R0 resection ( 1/10 ) . Ten cases completed radiotherapy and 8 cases completed chemotherapy. Nausea ( 3/11 ) , vomit ( 2/11 ) and anorexia ( 2/11 ) were the most common Grade 3 toxicities. Conclusions NACRT showed an acceptable toxicity and promising activity in locally advanced gastric adenocarcinoma.