Objective: To explore the correlation and lag effects of environmental factors on pediatric respiratory disease visits at hospital, so as to provide scientific basis for disease prediction and optimizing clinical diagnosis and treatment. Methods: Data from 503 889 pediatric respiratory disease outpatient and emergency visits a central hospital in Minhang District of Shanghai between 2017 and 2019, along with concurrent meteorological data were collected. A distributed lag non-linear models (DLNM) was constructed to explore the specific relationship between pediatric respiratory disease consultations and various environmental factors and to quantify the cumulative lag effects of environmental factors on respiratory disease consultations. Results: Among the environmental factors, temperature, fine particulate matter (PM 2.5 ), inhalable particulate matter (PM 10 ), nitrogen dioxide (NO 2), and sulfur dioxide (SO 2) were associated with pediatric respiratory disease visits. After adjusting for temperature, PM 2.5 and PM 10 concentrations did not show significant immediate or lag effects. The relative risk (RR) of pediatric respiratory disease visits increased with rising NO 2 concentrations. When NO 2 concentration ≥55 μg/m 3, significant immediate and lagged effects (lag 3, 5, and 7 days) were observed. The RR values were 1.05, 1.13, 1.17, and 1.21( P <0.05). The RR values showed an inverted “U” shaped relationship with SO 2 concentrations. When SO 2 concentration ≥5 μg/m 3, significant lagged effects (lag 3, 5, and 7 days) were observed. The RR values were 1.03 , 1.03, and 1.04 ( P <0.05). Conclusion High concentrations of NO 2 and SO 2 increase the risk of pediatric respiratory disease visits, with observable lag effects.

Objective To investigate the clinical application value of MRI Radiomics score(Radscore)combined with clinicopatho-logical features in predicting postoperative progression-free survival(PFS)of patients with endometrial cancer(EC).Methods A total of 127 patients with EC were selected.The radiomic features of the lesions were extracted from T2 WI,diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)images.The features were screened by random forest model and Radscore was calcu-lated.Simultaneously,clinical and pathological characteristics of patients were collected and incorporated,and multivariate Cox regression analysis was used to screen the risk factors related to PFS.The MRI Radscore and clinicopathological features were mapped to the nomogram,and the performance of nomogram was evaluated by receiver operating characteristic(ROC)curve and calibration curve.Results Multivariate Cox regression analysis showed that progesterone receptor(PR),human epididymis protein 4(HE4)and MRI Radscore were independent risk factors for predicting PFS in patients with EC(P＜0.05).The area under the curve(AUC)of the predicted PFS at 1,3 and 5 years after surgery were 0.91,0.804 and 0.776,respectively.Calibration curves showed that nomogram had a good fit in predicting PFS in patients with EC 1,3 and 5 years after surgery.Conclusion The nomogram con-structed based on multi-sequence MRI Radscore and clinicopathological features has favorable accuracy and stability in predicting postoperative PFS in individuals diagnosed with EC.

[摘 要] 目的：探究益气活血汤对恶性肿瘤患者癌痛及癌因性疲乏（CRF）的疗效。方法: 选取2020年1月至2022年12月间安徽省中医药大学第二附属医院收治的82例确诊发生CRF的恶性肿瘤患者（气血亏虚证），采用随机数字表余数分组法将其分为对照组与观察组，每组各41例。对照组患者采用常规止痛、止吐、化痰等对症治疗及健康、心理指导，观察组患者在对照组干预的基础上联合益气活血汤治疗，4周为1个疗程。治疗前及治疗4周后，对两组患者进行中医证候积分评估，以积分变化评估中医临床疗效；采用修订版Piper疲乏量表（RPFS）评估CRF的改善情况；采用数字疼痛分级法（NRS）评分比较癌痛情况；检测患者外周血纤维蛋白原（FIB）、D-二聚体（D-D）评价凝血功能差异，检测患者肝、肾功能指标以评估益气活血汤治疗的安全性。结果：治疗前，两组患者在中医证候积分、RPFS评分、NRS评分及外周血FIB、D-D方面的差异均无显著统计学意义（均P>0.05）。治疗4周后，两组患者在神疲乏力、面色淡白或萎黄、自汗、失眠健忘、手足麻木的证候评分及总积分均较治疗前明显降低（均P<0.05），且观察组各项评分均低于对照组（均P<0.05），中医临床疗效明显高于对照组（P<0.05）；两组患者RPFS各维度评分及总分均较治疗前降低（均P<0.05），观察组行为、情感、感觉维度RPFS评分及总分均低于对照组（均P<0.05），观察组CRF的改善明显优于对照组（P<0.05）；两组患者NRS评分及外周血FIB、D-D指标均较治疗前降低（均P<0.05），且观察组均低于对照组（均P<0.05）。两组患者治疗期间均未发生肝功能、肾功能等明显异常，说明益气活血汤安全性良好。结论：益气活血汤可纠正气血亏虚之证，改善机体凝血功能，促进恶性肿瘤患者CRF及癌痛的减轻，临床应用价值较高。

Lingguizhugan Decoction (LGZG) has been investigated in basic studies, with satisfactory effects on insulin resistance in non-alcoholic fatty liver disease (NAFLD). This translational approach aimed to explore the effect and underlying mechanism of LGZG in clinical setting. A randomized, double-blinded, placebo-controlled trial was performed. A total of 243 eligible participants with NAFLD were equally allocated to receive LGZG (two groups: standard dose and low dose) or placebo for 12 weeks on the basis of lifestyle modifications. The primary efficacy variable was homeostasis model assessment of insulin resistance (HOMA-IR). Analyses were performed in two populations in accordance with body mass index (BMI; overweight/obese, BMI ⩾ 24 kg/m²; lean, BMI < 24 kg/m²). For overweight/obese participants, low-dose LGZG significantly decreased their HOMA-IR level compared with placebo (-0.19 (1.47) versus 0.08 (1.99), P = 0.038). For lean subjects, neither dose of LGZG showed a superior effect compared with placebo. Methylated DNA immunoprecipitation sequencing and real-time qPCR found that the DNA N6-methyladenine modification levels of protein phosphatase 1 regulatory subunit 3A (PPP1R3A) and autophagy related 3 (ATG3) significantly increased after LGZG intervention in overweight/obese population. Low-dose LGZG effectively improved insulin resistance in overweight/obese subjects with NAFLD. The underlying mechanism may be related to the regulation of DNA N6-methyladenine modification of PPP1R3A and ATG3. Lean subjects may not be a targeted population for LGZG.
Humans ; Non-alcoholic Fatty Liver Disease/drug therapy* ; Overweight/drug therapy* ; Insulin Resistance ; Obesity/drug therapy* ; China ; DNA/therapeutic use*

Objective: To investigate the role of epidemiological history in the screening of Corona Virus Disease 2019 (COVID-19) in fever clinic, to improve the efficiency in fever clinic and reduce the incidence of cross infection. Methods: This is a retrospective study. Patients who were admitted to the fever clinic in West China Hospital of Sichuan University from January 23^th, 2020 to February 11^th, 2020 included the study. According to epidemiological history, the patients were divided into epidemiological history group (the experimental group) and no epidemiological history group (the control group). The two groups of patients were admitted and treated separately. The clinical data, NEWS score, etiology results, viral pneumonia showed on CT, time of visit, COVID-19 patient ratio, and admission composition ratio were compared between the two groups. The measurement data were presented as the mean ± standard deviation (SD), and the numeration data were expressed as ratio or constituent ratio. The measurement data of normal distribution between the two groups were compared by independent sample t test. The measurement data of skewed distribution are expressed by the median (interquartile range), and the comparison between the two groups is tested by non-parameter. The differences between enumeration data were assessed by chi-square test. A P<0.05 was considered statistically significant. Results: A total of 2423 patients were included, including 927 patients in the experimental group and 1296 patients in the control group. There were no significant differences in gender, NEWS score and clinical symptoms between the two groups (P> 0.05). The age (35.00 ± 12.80 vs 38.13 ± 15.57 years) , the proportion of fever patients (28.80% vs 32.75%) and waiting time (31.72 vs 58.08 min) of the experimental group were lower than the control group, the difference was statistically significant (P <0.05). The CT examination ratio (37.54% vs 20.39%), viral pneumonia ratio showed on CT (9.77% vs 2.95%), ratio of examined COVID-19 nucleic acid test (85.44% vs 56.75%), and the admission ratio (16.72% vs 9.63%) of the experimental group were higher than the control group, and the differences were statistically significant (P <0.05); There was no significant difference in the positive rates of influenza virus and rhinovirus between the two groups (P> 0.05). Conclusion It is necessary to adjust the management mode of fever clinic during the Corona Virus Disease 2019, and to manage the patients according to the epidemiological history which can improve the screening efficiency and reduce the risk of cross infection.

Objective:To explore the effects of helmet-eyeball movement training system in rehabilitation training among orbital fracture patients.Methods:From April to December 2018, we selected 60 patients with orbital fracture surgeries by the same doctor in the Ophthalmology Department, Beijing Tongren Hospital, Capital Medical University, with the method of convenience sampling as the research objects. All patients were randomly divided into experimental group and control group, 30 cases in each group. Control group carried out the eyeball movement training with the fingers of patients as visual markers, while experimental group implemented the training with the helmet-eyeball movement training system. Diplopia rating and binocular stereoscopic vision function of patients of two groups were compared before training, one week, one month and three months after training.Results:At one and three months after training, the diplopia rating and static/dynamic stereoscopic vision function of patients in experimental group were better than those in control group with statistical differences ( P<0.05) . Conclusions:Helmet-eyeball movement training system can improve the training effect of patients and help them restore stereoscopic vision.

OBJECTIVE： To observe the effects of dihydroquercetin （DHQ） on hemorheology and other relevant related indexes in local cerebral ischemic injury model rats. METHODS： SD rats were randomly divided into sham operation group， model group， nimodipine group （positive control， 20 mg/kg） and DHQ low-dose， medium-dose and high-dose groups （15， 30， 60 mg/kg）， with 10 rats in each group. Administration groups were given relevant medicine intragastrically， sham operation group and model group were given constant volume of 0.4％ Sodium carboxymethyl cellulose solution， once a day， for consecutive 14 d. After last administration， local cerebral ischemic injury model was induced by bilateral common carotid artery ligation in other groups except for sham operation group. After 24 h of cerebral ischemia， histopathological changes of brain tissue in rats of each group were observed； the levels of hemorheology indexes [whole blood viscosity （low， medium and high shear）， whole blood reduced viscosity （low， medium and high shear）， plasma viscosity]， erythrocyte parameters （hematocrit， EAI， DI， IR）， coagulation function indexes （APTT， PT， TT， FIB） were detected. RESULTS： Compared with sham operation group， the cells in the brain tissue of model group were loose， the gap was obvious， and the neurons around the ischemic area were damaged obviously； the levels of whole blood viscosity， whole blood reduced viscosity， plasma viscosity， hematocrit， EAI， IR and FIB were increased significantly， while the levels of DI， APTT， PT and TT were decreased or shortened significantly （P＜0.05 or P＜0.01）. Compared with model group， above symptoms of administration groups were improved to different extents， whole blood viscosity， plasma viscosity， EAI and IR of nimodipine group， whole blood viscosity and hematocrit of DHQ high-dose group， plasma viscosity and EAI of DHQ groups， and IR of DHQ medium-dose and high-dose groups were decreased significantly； DI， APTT， PT and TT of nimodipine group， DI， APTT and TT of DHQ groups and PT of DHQ high-dose group were increased or prolonged significantly （P＜0.05 or P＜0.01）. There was no statistical significance in other indexes among those groups （P＞0.05）. CONCLUSIONS： DHQ can protect against local cerebral ischemic injury model rats， the mechanism of which may be associated with improving hemorheology indexes and coagulation function disorder.

Objective To explore the reliability and validity of the preliminary revision of the Philadelphia Mindfulness Scale (PHLMS) in Chinese undergraduates.Methods Considering the differences in the cultural and linguistic,the PHLMS was translated and used to conduct a questionnaire survey among 1 221 undergraduates.All participants were also surveyed with five facets mindfulness questionnaire (FFMQ),the white bear suppression inventory (WBSI) and acceptance and action questionnaire-2rd edition (AAQ-Ⅱ) as conduct reliability and validity test.Results The exploratory factor analysis showed that PHLMS could extract two factors,and the cumulative variance contribution rate was 40.355％.The confirmatory factor analysis indicated good fit (x2/df=2.781,CFI =0.945,NFI =0.884,IFI =0.922,TLI =0.906,CFI =0.922,RMSEA =0.053).The internal consistency reliability of the awareness subscales was 0.785,and the internal consistency reliability of the acceptance subscales was 0.772.The correlation coefficients among the PHLMS and FFMQ was significant(r=0.398,P＜0.01).The acceptance subscales were significantly negatively correlated with WBSI and AAQ-Ⅱ(r=-0.458,-0.288,P＜0.01).Conclusion The validity and reliability of the Chinese version of PHLMS meet the measurement criterion.

Objective To compare the lung protection roles of intraperitoneal pre-injection with penehyclidine for two kinds of rat models with pulmonary and extrapulmonary acute respiratory distress syndrome (ARDSp and ARDSexp). Methods Forty healthy adult Sprague-Dawley (SD) rats were randomly divided into five groups (each n = 8): the rats in sham group received only tracheotomy; the ARDS rat models were reproduced by intratracheal inhalation of 0.1 mol/L hydrochloric acid (HCl) 2 mL/kg to simulate ARDSexp (HCl group) and 0.15 mL/kg oleic acid (OA) intravenous injection to simulate ARDSp (OA group) after tracheotomy; and the rats in two intervention groups were intraperitoneal injected with penehyclidine 0.5 mg/kg. All rats were received mechanical ventilation immediately after model reproduction. Carotid arterial blood was collected 4 hours after model reproduction for determining the arterial partial pressure of oxygen (PaO2), and oxygenation index (PaO2/FiO2) was calculated. Carotid venous blood and lung tissues were harvested, and the levels of myeloperoxidase (MPO), interleukin-8 (IL-8) and nuclear factor-κB (NF-κB) in serum and lung tissue were determined by enzyme linked immunosorbent assay (ELISA). Pulmonary pathology was observed under optical microscope, and pathological score of Smith was calculated. Results Under optical microscope, a large number of inflammatory cells infiltration in lung tissue, obvious alveolar collapse, fibrous exudation in alveolar and alveolar hyaline were found in HCl group. In OA group, however, microvascular congestion and interstitial pulmonary edema were the main pathological changes, with alveolar structure being kept relatively intact. Compared with sham group, pathological score of Smith in HCl and OA groups were increased, oxygenation was lowered, and inflammatory factors levels in serum and lung tissue were increased with levels in lung tissue being higher than those in serum, without significant difference between the two models. When pretreated with penehyclidine, however, pathological injury induced by HCl or OA was alleviated, and pathological score of Smith was also decreased as compared with that of corresponding model groups (5.48±1.76 vs. 9.69±2.02, 3.97±2.14 vs. 8.71±2.18, both P < 0.05), PaO2/FiO2was raised significantly [mmHg (1 mmHg = 0.133 kPa): 323±55 vs. 211±27, 307±56 vs. 207±31, both P < 0.05], the inflammatory factors levels in serum and lung tissue were obviously decreased [MPO (μg/L): 11.91±1.55 vs. 14.82±1.25, 12.75±1.16 vs. 16.97±2.06 in serum, 25.80±3.36 vs. 35.18±4.01, 24.23±1.24 vs. 33.94±1.43 in lung tissue; IL-8 (ng/L): 358±30 vs. 459±25, 377±38 vs. 427±34 in serum, 736±53 vs. 866±51, 701±53 vs. 809±39 in lung tissue; NF-κB (ng/L):483±68 vs. 632±73, 514±83 vs. 685±78 in serum, 984±75 vs. 1 217±123, 944±90 vs. 1 163±105 in lung tissue;all P < 0.05]. But all parameters above were similar between the two pretreatment groups (all P > 0.05). Conclusions Inflammatory cell infiltration and alveolar collapse mainly happened in HCl induced ARDSp, while pulmonary interstitial edema and hemorrhage was mostly seen in ARDSexp rats induced by OA intravenous injection. There was no significant difference in oxygenation and inflammatory response between the two models of rats. Pre-intraperitoneal injection of penehyclidine equally improved oxygenation state, inhibited lung inflammation response, and reduced lung injury in the two kinds of ARDS, but there was no difference in protective role between two models pretreated with penehyclidine.

Objective To revise rumination on sadness scale (RSS) and evaluate the reliability and validity of the Chinese version rumination on sadness scale (RSS-C) in Chinese undergraduates.Methods A total of 1 166 undergraduates from 4 universities in Hunan province completed RSS,ruminative response scale (RRS) and Beck depression inventory-Ⅱ (BDI-Ⅱ).The test-retest was conducted in 111 participants 2 weeks later.Results Item analysis and exploratory factor analysis showed the RSS-C included 11 items,consisting of causal analysis,understanding oneself and one's sadness and uncontrollability of ruminative thinking factors.The scores of each item in the high score group were significantly higher than those in the low group(P＜0.001),and the correlation between each item and the total score was significant(r=0.594-0.719,P＜0.001).The confirmatory factor analysis indicated good fit(x2/df=3.938,GFI =0.957,NFI =0.940,CFI =0.954,TLI =0.930,IFI =0.954,RMSEA =0.070).The internal consistency for RSS-C and three factors ranged from 0.694 to 0.868,and the test-retest reliability ranged from 0.620 to 0.833.The scores on RSS-C and three factors were significantly associated with RRS(r=0.555-0.637,P＜0.01),BDI-Ⅱ (r=0.211-0.403,P＜0.01) respectively.Conclusion RSS-C has good reliability and validity and can be used as an effective instrument to assess rumination on sadness in Chinese undergraduates.