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Objective:To investigate the effects of the hybrid scenario simulation teaching method based on small private online courses (SPOC) in undergraduate clinical teaching of pediatric dentistry.Methods:A total of 44 students of dentistry practicing in the Department of Pediatric Dentistry, The Third Affiliated Hospital, The Air Force Military Medical University, from January 2020 to December 2021 were selected, with 23 students practicing from January to December 2020 in control group (receiving traditional teaching) and 21 students practicing from January to December 2021 in experimental group (employing SPOC-based hybrid scenario simulation teaching method). At the end of the internship, an exam was given to assess the students' doctor-patient communication and standardized operation, and parental satisfaction and students' satisfaction were scored. SPSS 20.0 software was used to perform the independent samples t test for data analysis. Results:Compared with the control group, the experimental group had significantly higher scores of doctor-patient communication [(82.83±2.09) points vs. (88.40±2.22) points] and standardized operation [(82.26±4.38) points vs. (86.67±2.62) points] as well as significantly higher scores of parental satisfaction and students' satisfaction [(18.85±1.73) points vs. (20.71±0.85) points] and [(17.37±0.98) points vs. (20.57±0.66) points; all P<0.05]. Conclusions:The SPOC-based hybrid scenario simulation teaching method can effectively improve the quality of clinical teaching for undergraduate internships in pediatric dentistry, especially for cultivating doctor-patient communication ability.

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Nasal drug delivery efficiency is highly dependent on the position in which the drug is deposited in the nasal cavity. However, no reliable method is currently available to assess its impact on delivery performance. In this study, a biomimetic nasal model based on three-dimensional (3D) reconstruction and three-dimensional printing (3DP) technology was developed for visualizing the deposition of drug powders in the nasal cavity. The results showed significant differences in cavity area and volume and powder distribution in the anterior part of the biomimetic nasal model of Chinese males and females. The nasal cavity model was modified with dimethicone and validated to be suitable for the deposition test. The experimental device produced the most satisfactory results with five spray times. Furthermore, particle sizes and spray angles were found to significantly affect the experimental device's performance and alter drug distribution, respectively. Additionally, mometasone furoate (MF) nasal spray (NS) distribution patterns were investigated in a goat nasal cavity model and three male goat noses, confirming the in vitro and in vivo correlation. In conclusion, the developed human nasal structure biomimetic device has the potential to be a valuable tool for assessing nasal drug delivery system deposition and distribution.

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A major challenge facing photodynamic therapy (PDT) is that the activity of the immune-induced infiltrating CD8+ T cells is subject to the regulatory T lymphocytes (Tregs), leaving the tumor at risk of recurrence and metastasis after the initial ablation. To augment the antitumor response and reprogram the immunosuppressive tumor microenvironment (TME), a supramolecular photodynamic nanoparticle (DACss) is constructed by the host-guest interaction between demethylcantharidin-conjugated β-cyclodextrin (DMC-CD) and amantadine-terminated disulfide-conjugated FFVLGGGC peptide with chlorin e6 decoration (Ad-ss-pep-Ce6) to achieve intelligent delivery of photosensitizer and immunomodulator for breast cancer treatment. The acid-labile β-carboxamide bond of DMC-CD is hydrolyzed in response to the acidic TME, resulting in the localized release of DMC and subsequent inhibition of Tregs. The guest molecule Ad-ss-pep-Ce6 can be cleaved by a high level of intracellular GSH, reducing photosensitizer toxicity and increasing photosensitizer retention in the tumor. With a significant increase in the CTL/Treg ratio, the combination of Ce6-based PDT and DMC-mediated immunomodulation adequately achieved spatiotemporal regulation and remodeling of the TME, as well as improved primary tumor and in situ lung metastasis suppression with the aid of PD-1 antibody.

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Purpose@#During the major shift in China's policies on coronavirus disease 2019 (COVID-19), many residents will be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) over a short period, including a few patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Moreover, it is unknown whether this comorbidity affects the efficacy of NAC for breast cancer and the patient's psychological state and quality of life (QOL). This study aims to answer these questions. @*Methods@#The clinical data of 2,793 patients with breast cancer who received NAC at The Affiliated Hospital of Qingdao University were retrospectively collected. The infected and non-infected groups were divided according to whether they were infected with COVID-19 during NAC. Propensity score matching was used to reduce patient selection bias. The effectiveness, psychological well-being, and QOL of the two groups were compared. @*Results@#No discernible differences were observed in the pathological complete response rates (p = 0.307) and major histological responses rate (p = 0.398) between the infected and non-infected groups. Following the full course of NAC, the Functional Assessment of Cancer Treatment General (p < 0.001) and Functional Assessment of Cancer Therapy for Breast Cancer (p < 0.001) were lower in the infected group than the non-infected group, the Hospital Anxiety and Depression Scale (HADS) anxiety scale (p < 0.001) and HADS depression scale (p < 0.001) were considerably higher in the infected group than the non-infected group. @*Conclusion@#With timely treatment and effective medical management, SARS-CoV-2 does not appear to affect the efficacy of NAC; however, it can significantly affect the QOL of patients and increase their psychological distress. Therefore, in addition to a timely assessment of the efficacy of NAC, it is necessary to dynamically understand the patient's psychological state and QOL.

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Fusobacterium nucleatum is an opportunistic pathogenic bacterium that can be enriched in colorectal cancer tissues, affecting multiple stages of colorectal cancer development. The two-component system plays an important role in the regulation and expression of genes related to pathogenic resistance and pathogenicity. In this paper, we focused on the CarRS two-component system of F. nucleatum, and the histidine kinase protein CarS was recombinantly expressed and characterized. Several online software such as SMART, CCTOP and AlphaFold2 were used to predict the secondary and tertiary structure of the CarS protein. The results showed that CarS is a membrane protein with two transmembrane helices and contains 9 α-helices and 12 β-folds. CarS protein is composed of two domains, one is the N-terminal transmembrane domain (amino acids 1-170), the other is the C-terminal intracellular domain. The latter is composed of a signal receiving domain (histidine kinases, adenylyl cyclases, methyl-accepting proteins, prokaryotic signaling proteins, HAMP), a phosphate receptor domain (histidine kinase domain, HisKA), and a histidine kinase catalytic domain (histidine kinase-like ATPase catalytic domain, HATPase_c). Since the full-length CarS protein could not be expressed in host cells, a fusion expression vector pET-28a(+)-MBP-TEV-CarScyto was constructed based on the characteristics of secondary and tertiary structures, and overexpressed in Escherichia coli BL21-Codonplus(DE3)RIL. CarScyto-MBP protein was purified by affinity chromatography, ion-exchange chromatography, and gel filtration chromatography with a final concentration of 20 mg/ml. CarScyto-MBP protein showed both protein kinase and phosphotransferase activities, and the MBP tag had no effect on the function of CarScyto protein. The above results provide a basis for in-depth analysis of the biological function of the CarRS two-component system in F. nucleatum.

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Five new spirostanol saponins (1-5) and seven known compounds (6-12) were isolated from the n-butanol fraction of 75% ethanol extract of Allii Macrostemonis Bulbus. The identification and structural elucidation of all the isolates were performed through extensive 1D and 2D NMR experiments, HR-ESI-MS data analysis and comparisons with literature values. Antioxidant evaluation showed that compounds 6-11 exhibited certain scavenging effects on ABTS radical, where compounds 6, 7 and 11 had IC50 values of 0.208, 0.057 and 0.014 mg·mL-1, respectively.

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Objective:To explore the teaching resources innovation and the teaching quality improvement for international students in clinical medicine based on the bilingual test question database of digitalized systematic anatomy.Methods:The test question database was set up and applied to Batch 2018 international students of clinical medicine (experiment group). The results of the usual test, final theory, and experimental examination of Batch 2017 international students (control group) were compared to verify the application value of the test question database. Questionnaires were used to get feedback from international students, and the feasibility of developing the test question database and the driving effect of teaching reform were further evaluated. SPSS 20.0 was used for data analysis, and the examination achievements of the two groups were compared with independent-samples t test and the measurement data were expressed by (mean ± standard deviation). Results:There was no significant difference between the two groups in the usual test results ( P>0.05), and in the experimental group, the results of final theory and experimental examination were significantly higher than those in the control group ( P<0.05). According to the questionnaire, more than 89.55%(155) of the international students highly appraised the test question database in terms of learning resources, quality of questions, examination mode and experience evaluation, while only 52.02%(90) of them recognized the bilingual form of the test questions. Conclusion:The bilingual test question database of digital systematic anatomy has effectively expanded the teaching resources and promoted the teaching reform of international students.

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Objective:To implement the teaching activities for cultivating the four characteristics (innovation, development, integration, and ecology) and the four abilities (political ability, learning ability, cross-border ability, and driving force), and to provide a reference for improving the capability of service-based education in basic teaching organizations.Methods:The basic teaching organization in School of Basic Medical Sciences, Qiqihar Medical University, was selected for research, and the action research method and the focus group interview method were used to carry out characteristic teaching activities around the cultivation of the four characteristics and the four abilities. After the implementation of these activities, Sojump, a questionnaire platform, was used to conduct a survey among full-time and part-time teachers and teaching administrators, and the effect of each activity on the cultivation of the four characteristics and the four abilities was analyzed. The strategies to enhance abilities were improved based on the results of the above analyses. SPSS 25.0 software was used for data processing, and categorical data were expressed as frequency and percentage.Results:The data analysis showed that through cultivation of the four characteristics and the four abilities, each designed activity had a remarkable effect on improving the capability of service-based education in the basic teaching organization, with a mean value of 80.77%(63/78)- 91.03%(71/78), and only the activities centered on "integration" had a relatively low value of "obvious effect", which accounted for 64.10%(50/78).Conclusion:Under the guidance of the new concept of "New Medicine" and with the opportunity of capacity building, a series of teaching activities focusing on the four characteristics and the four abilities can effectively improve the capability of service-based education in basic teaching organizations in colleges and universities through targeted ability training.

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Objective:To construct an evidence-based phased swallowing training program for patients after partial laryngectomy applying the Delphi method.Methods:Evidence was screened systematically applying evidence-basing principles to construct a first draft of a phased swallowing training program for patients after partial laryngectomy. After two rounds of Delphi expert consultation a final draft was formed.Results:The protocol was composed of 27 items covering 5 aspects of the gastrointestinal decompression period, the first- and second-stage continuous tube feeding periods, trial feeding of the intermittent tube feeding period and the oral feeding stage.Conclusion:The phased swallowing training program is scientifically sound and feasible in clinical practice. It can provide references for clinic staff to improve swallowing management.

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Objective:To observe the distribution characteristics of fungi, bacteria and Demodex in the eyelid margin of patients with blepharitis and without blepharitis at different ages. Methods:A cross-sectional study was conducted.A total of 98 patients diagnosed with anterior blepharitis and 99 patients diagnosed with posterior blepharitis in Henan Eye Hospital from March 2021 to June 2022 were enrolled as anterior blepharitis group and posterior blepharitis, respectively.Additionally, 100 patients with an initial diagnosis of refractive error and 200 patients with vitreous opacity were enrolled during the same period as a non-blepharitis group.All patients underwent examinations for lid margin fungi, bacteria and eyelash Demodex, as well as fungal spores and ciliary Demodex count.The differences in the positive rate and load of palpebral fungi, bacteria and eyelash Demodex were compared between anterior and posterior blepharitis groups, as well as across different ages in non-blepharitis group.This study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2019[18]).All patients were informed about the purpose and methods of the study.Written informed consent was obtained from each patient. Results:There were significant differences in the positive rates of bacteria, fungi and Demodex and the load of Demodex in the non-blepharitis group at different ages ( χ2=28.34, 10.36, 51.57, H=35.66; all at P<0.01).The positive rates of palpebral bacteria and ciliary Demodex and the load of Demodex were significantly higher and the palpebral fungi positive rate was significantly lower in the ≥60 years old than in the <60 years old (all at P<0.05).There were significant differences in the positive rates of bacteria and fungi among anterior blepharitis, posterior blepharitis and non-blepharitis groups ( χ2=18.99, 6.36; all at P<0.01).The palpebral bacteria positive rate was significantly higher in anterior blepharitis group than in posterior blepharitis and non-blepharitis groups, and the palpebral fungi positive rate was significantly higher in anterior blepharitis and posterior blepharitis groups than in non-blepharitis group (all at P<0.05).There was no significant difference in the ciliary Demodex detection rate among the three groups ( χ2=0.16, P=0.74).The number of palpebral fungi spores and eyelash Demodex counts were higher in anterior and posterior blepharitis groups than in non-blepharitis group, and the differences were statistically significant (all at P<0.05).The positive rate of palpebral margin bacteria in ciliary Demodex-positive group was 45.7%(156/341), which was significantly higher than 25.6%(40/156) in ciliary Demodex-negative group ( χ2=17.20, P<0.01), and there was no significant difference in the positive rate of palpebral margin fungi between them ( χ2=0.11, P=0.70). Conclusions:In the population with normal eyelid margin, the infection of Demodex and bacteria in lid margin increases and fungal infection decreases in the ≥60 years old.Fungal and bacterial infections are the main sources of palpebral infection in patients with blepharitis, and positive detection of Demodex increases the chance of bacterial infection.

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Objective To observe the regulatory effect of roxadustat on lipid metabolism while correcting anemia in hemodialysis patients.Methods Sixty patients with chronic kidney disease(CKD)receiving hemodialysis treatment at Nanjing Drum Tower Hospital and combined with concurrent renal anemia were selected.These included 30 patients receiving erythropoietin(EPO)therapy at a dose of 10 000 U per week,and 30 patients receiving roxadustat treatment at a dose based on body weight.The patients'hemoglobin levels were measured,and data on lipid and iron metabolism-related indicators were collected for statistical analysis.Results After 6 months of treatment,the mean hemoglobin levels of both groups of patients were significantly higher than the baseline levels.The mean hemoglobin level in the roxadustat group was higher than that in the EPO group(114.1±7.88 vs.122.23±10.33,P<0.05),but there was no significant difference in the achievement rate between the two groups(77%vs.93%,P>0.05).The total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and triglycerides(TG)in the roxadustat group decreased significantly(P<0.05),while there was no significant change in the EPO group.Compared with the EPO group,roxadustat showed an improvement in iron metabolism indicators.Conclusion Roxadustat has been shown to improve lipid metabolism while correcting anemia.

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Objective:To investigate the changes of podocyte circadian rhythm in the high-glucose environment and diabetic nephropathy (DN) mouse model and the protective effect of melatonin on podocyte injury in DN.Methods:Primary podocytes were cultured in vitro and divided into 3 groups: control group, high glucose (30 mmol/L) group and high glucose (30 mmol/L) treated with melatonin (0.1 mmol/L or 0.5 mmol/L) group. The podocytes were collected every 4 hours for 24 hours, synchronized with dexamethasone (100 nmol/L) for 2 hours, which was recorded as zeitgeber time 0 point. Male C57BL/6J mice aged 6-8 weeks and weighing about 20 g were randomly (randomized block) assigned to three groups: control group, DN (high-fat diet+streptozotocin 120 mg/kg intravenously injected) group, and DN (high-fat diet+streptozotocin 120 mg/kg intravenously) treated with melatonin (20 mg/kg intragastric treatment) group (melatonin group). Real-time quantitative PCR was used to detect the mRNA levels of rhythm genes in podocytes. Western blotting was used to detect the protein expression levels of circadian clock genes (Clock and Bmal1), podocyte marker proteins (Nephrin, Synaptopodin, WT1, and Desmin) and autophagy-related proteins (Beclin1, LC3Ⅱ/Ⅰ and P62). Immunofluorescence staining was used to detect the protein expression level of WT1, and immunohistochemistry was used to analyze the protein expression levels of P62 and cleaved-caspase-3 in renal tissues of mice. The pathological changes of renal glomerulus were observed under electron microscope. Results:(1) Dexamethasone reseted the expression and rhythmic oscillation of circadian clock genes in podocytes. The circadian rhythmic oscillations of Clock and Ck1e mRNA in the high glucose group were flattened compared to the control group, and the circadian rhythmic oscillations in Clock and Ck1e mRNA expression were partial recovery in high glucose treated with melatonin group (all P<0.05). (2) Compared with the control group, the protein expression levels of Nephrin, Synaptopodin and WT1 were lower while Desmin was higher in the high glucose group (all P<0.05). The protein expression levels of Nephrin, Synaptopodin and WT1 were higher and the protein expression level of Desmin was lower in the high glucose treated with melatonin (0.5 mmol/L) group compared with the high glucose group (all P<0.05). (3) The invivo experimental results showed that compared with the DN group, melatonin group had higher protein expression levels of glomerular Nephrin and WT1, and lower urinary albumin/creatinine ratio, width of foot process and thickness of glomerular basement membrane (all P<0.05). The protein expression levels of Beclin1 and LC3Ⅱ/Ⅰ in the DN group were lower than those in the control group, and the protein expression level of P62 was higher than that in the control group (all P<0.05). Compared with the DN group, the protein expression levels of Beclin1 and LC3Ⅱ/Ⅰ in the melatonin group were significantly higher, and the protein expression level of P62 was lower (all P<0.05). Conclusions:Melatonin can partially restore the circadian rhythm of clock genes in high-glucose environment, improve autophagy and alleviate injury in podocytes.

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ObjectiveTo explore the mechanism of Shaoyaotang （SYT） in the treatment of ulcerative colitis （UC） based on network pharmacology and experimental verification. MethodThe core components， target genes， and main pathways of SYT were predicted based on network pharmacology， and UC-related components， target genes， and pathways were screened. Dextran sodium sulfate （DSS） was used to induce the UC model in mice， and the effect of SYT on UC mice was observed， followed by mechanism verification. ResultNetwork pharmacology indicated that 174 active components and corresponding 159 target genes of SYT were screened， and the related pathways were those mediated by 5-hydroxytryptamine （5-HT） degredation and 5-HT receptor 3. The results of animal experiments showed that compared with the model group， the SYT group showed increased body weight and colon length（P<0.01）， reduced disease activity index （DAI） score （P<0.01）， improved histopathological manifestations， reduced concentrations of 5-HT in the colonic tissues and serum （P<0.05， P<0.01）， and increased mRNA expression of monoamine oxidase A （MAOA）， monoamine oxidase B （MAOB）， sodium-dependent serotonin transporter （SLC6A4）， and 5-HT receptor 3A （5-HTR3A） related to 5-HT metabolism in the colon （P<0.01）. ConclusionSYT can alleviate the local inflammatory response of the intestinal tract in UC by regulating 5-HT degredation pathways.

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OBJECTIVE@#To explore the genetic basis for four Chinese pedigrees affected with Waardenburg syndrome (WS).@*METHODS@#Four WS probands and their pedigree members who had presented at the First Affiliated Hospital of Zhengzhou University between July 2021 and March 2022 were selected as the study subjects. Proband 1, a 2-year-and-11-month female, had blurred speech for over 2 years. Proband 2, a 10-year-old female, had bilateral hearing loss for 8 years. Proband 3, a 28-year-old male, had right side hearing loss for over 10 years. Proband 4, a 2-year-old male, had left side hearing loss for one year. Clinical data of the four probands and their pedigree members were collected, and auxiliary examinations were carried out. Genomic DNA was extracted from peripheral blood samples and subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing.@*RESULTS@#Proband 1, with profound bilateral sensorineural hearing loss, blue iris and dystopia canthorum, was found to have harbored a heterozygous c.667C>T (p.Arg223Ter) nonsense variant of the PAX3 gene, which was inherited from her father. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as pathogenic (PVS1+PM2_Supporting+PP4), and the proband was diagnosed with WS type I. Proband 2, with moderate sensorineural hearing loss on the right side and severe sensorineural hearing loss on the left side, has harbored a heterozygous frameshifting c.1018_1022del (p.Val340SerfsTer60) variant of the SOX10 gene. Neither of her parents has harbored the same variant. Based on the ACMG guidelines, it was classified as pathogenic (PVS1+PM2_Supporting+PP4+PM6), and the proband was diagnosed with WS type II. Proband 3, with profound sensorineural hearing loss on the right side, has harbored a heterozygous c.23delC (p.Ser8TrpfsTer5) frameshifting variant of the SOX10 gene. Based on the ACMG guidelines, it was classified as pathogenic (PVS1+PM2_Supporting+PP4), and the proband was diagnosed with WS type II. Proband 4, with profound sensorineural hearing loss on the left side, has harbored a heterozygous c.7G>T (p.Glu3Ter) nonsense variant of the MITF gene which was inherited from his mother. Based on the ACMG guidelines, the variant was classified as pathogenic (PVS1+PM2_Supporting+PP4), and the proband was diagnosed with WS type II.@*CONCLUSION@#By genetic testing, the four probands were all diagnosed with WS. Above finding has facilitated molecular diagnosis and genetic counseling for their pedigrees.

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Objectives:This study aimed to evaluate the predictive value of the CHA 2DS 2-VASc score for in-hospital outcomes of patients with acute myocardial infarction (AMI). Methods:Data of 23 728 patients from the China patient-centered Evaluative Assessment of cardiac Events (China PEACE)Retrospective Acute Myocardial Infarction Study were analyzed retrospectively. The patients were categorized into 3 groups according to the CHA 2DS 2-VASc scores: the low score group (score 1-3), the middle score group (score 4-6) and the high score group (score 7-9). The in-hospital outcomes included major adverse cardiovascular events (MACE), death, death or withdrawal from treatment, reinfarction, ischemic stroke,etc. The CHA 2DS 2-VASc score was incorporated into multivariate Cox regression analyses to determine its independent impact on in-hospital outcomes. Receiver operating Characteristic (ROC) curves were constructed, and the area under the curve (AUC) was used to evaluate the predictive value of the CHA 2DS 2-VASc score for in-hospital mortality and death or withdrawal from treatment, respectively. Results:The patients had a median age of 66 (56,75) years, and 30.7% of them were females. Patients with higher CHA 2DS 2-VASc scores had a higher in-hospital mortality and more in-hospital complications (all P<0.001). After adjustment of baseline covariates, the subjects in the high score group were associated with high risks of in-hospital mortality ( OR=6.13, 95% CI 4.77-7.87, P<0.001), death or treatment withdrawal ( OR=6.43, 95% CI 5.16-8.00, P<0.001) and MACE ( OR=4.94, 95% CI 4.06-6.01, P<0.001). The AUCs of the CHA 2DS 2-VASc score were comparable with those of the mini-global registry of acute coronary events(mini-GRACE)score in evaluation of in-hospital mortality (0.699 vs. 0.696, P=0.752) and the death or treatment withdrawal risk (0.708 vs. 0.713, P=0.489). Conclusions:The CHA 2DS 2-VASc score is an independent predictor of in-hospital outcomes for patients with AMI. Its predictive value was comparable with the mini-GRACE score, which could be used as a simple tool for early and rapid outcome evaluation for AMI patients.

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Objective:To explore the effects of self-made bilingual anatomy micro-lecture on the comprehensive ability training of nursing students, such as autonomous learning, medical English and knowledge expression.Methods:The study group was set up, and the micro-lectures were independently completed by the students under the guidance of teachers. The nursing medical students of Batch 2017 and Batch 2018 were recruited as control group and experimental group, respectively. Micro-lectures were applied in experimental group teaching and students' autonomous learning. The effect of self-made micro-lectures on cultivating students' comprehensive ability was verified by comparing examination results and analyzing questionnaire. SPSS 20.0 was used to conduct t-test. Results:A total of 53 micro-lectures were produced. Compared with the control group, the final theoretical and experimental examination scores of the experimental group were significantly improved ( P < 0.05), and the excellence rate of study group members was 31.25% (10/32); the questionnaire results showed that the satisfaction rate in classroom teaching of using micro-lectures in the experimental group was 90.24%(74/82), and 85.37% (70/82) of the students wanted to participate in the production of micro-lectures; 100.00% (40/40) of the study group members thought that the production of micro-lectures promoted them to perform autonomous learning, more than 82.50%(33/40) of the students indicated that the knowledge expression was effectively trained, and 67.50%(27/40) of the members improved their medical English. Conclusion:The self-made bilingual micro-lectures of anatomy is an effective means to achieve the goal of comprehensive ability training for medical students majoring in nursing.

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Objective:To observe any curative effect of combining hydraulic dilatation with radial extracorporeal shock waves on scapulohumeral periarthritis.Methods:A total of 132 patients with scapulohumeral periarthritis were randomly divided into a hydraulic dilatation group, a shock wave group and a combination group. The three treatments were applied for 3 weeks, before and after which shoulder range of motion was evaluated. Shoulder function was quantified using the Japanese Orthopaedic Association′s (JOA′s) shoulder function scoring, pain was reported using a visual analogue scale (VAS), and ability in the activities of daily living (ADL) was also quantified. Serum prostaglandin E2 (PGE2), β-endorphin (β-EP), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were assayed.Results:The treatment response rate of the combination group (95%) was significantly higher than those of the hydraulic dilatation group (70%) and the shock wave group (82%). After the treatment, the average shoulder range of motion, JOA and ADL scores, and β-EP level in all 3 groups had improved significantly, while the average VAS score, and the PGE2, IL-6 and TNF-α levels had decreased significantly, but in each case the improvement in the combination group′s average was significantly greater than those of the other 2 groups. During the treatment there were no such adverse events as intra-articular infection, skin redness, numbness or palpitations.Conclusions:Combining hydraulic dilatation with radial extracorporeal shock waves significantly improves the treatment of scapulohumeral periarthritis. It can effectively promote the recovery of shoulder function and improve quality of life. Its greater effectiveness may be related to improving levels of PGE2, β-EP, IL-6 and TNF-α, and relieving pain and inflammation.

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Objective:To evaluate perioperative coagulatory parameters and transfusion rates of lung transplantation recipients.Methods:Clinical data were retrospectively reviewed for 178 lung transplant recipients at China-Japan Friendship Hospital from March 2017 to July 2019. According to whether extracorporeal membrane oxygenation(ECMO)was used during perioperative period, they were divided into two groups of ECMO(131 cases)and without ECMO(47 cases). Clinical data, laboratory examinations and blood transfusion status of two groups were compared. In ECMO group, excluding secondary thoracotomy for hemostasis(7 cases)and incomplete data(2 cases), the remainders were divided into the groups of no red blood cell transfusion(63 cases), red blood cell transfusion(59 cases), plasma transfusion <1 000 ml(99 cases)and plasma transfusion≥1 000 ml (23 cases), no platelet transfusion(93 cases)and platelet transfusion(29 cases). Clinical data, laboratory examinations and ECMO-related parameters of recipients were analyzed by Bary Logistic regression.Results:Statistically significant inter-group differences existed in body mass index(BMI), disease course, primary disease, bilateral lung transplantation, laboratory examinations, postoperative blood transfusion volume, postoperative red blood cell and plasma transfusion ratio between groups with and without ECMO( P<0.05). Bilateral lung transplantation, ASA grade, differences in BMI, disease course, postoperative hemoglobin<100 g/L, postoperative PT/APTT/INR abnormalities and postoperative PLT count <100×10 9/L were independent risk factors for postoperative transfusion during ECMO. Conclusions:The application of ECMO during lung transplantation may affect the perioperative transfusion volume and demand.Fully assessing blood transfusion requirements, optimizing coagulation monitoring and identifying the independent influencing factors of postoperative blood transfusion facilitate clinical scientific and rational blood transfusions.

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Objective@#This study aimed to investigate the impact of polycystic ovary syndrome (PCOS) on fertility-sparing treatment in young patients with atypical endometrial hyperplasia (AEH) or endometrioid endometrial cancer (EEC). @*Methods@#A total of 285 patients with EEC (n=76, FIGO stage IA, without myometrium invasion) or AEH (n=209) who received progestin-based fertility-sparing treatment were evaluated retrospectively. Among the 285 patients, 103 (36.1%), including 70 AEH cases and 33 EEC cases, were diagnosed with PCOS. General characteristics, cumulative 16- and 32-week complete response (CR) rate, pregnancy outcome and recurrence were compared between patients with or without PCOS. @*Results@#The cumulative 16-week CR rate was lower in the PCOS group than in the non-PCOS group (18.4% vs. 33.8%, p=0.006). Patients with PCOS took longer treatment duration to achieve CR (7.0 months vs. 5.4 months, p=0.006) and shorter time to relapse after CR (9.6 months vs. 17.6 months, p=0.040) compared with non-PCOS group. After adjusting for patient age, body mass index, PCOS, homeostasis model assessment-insulin resistance index, and serum testosterone levels, we found that body mass index ≥25 kg/m2 (HR=0.583; 95% CI=0.365–0.932; p=0.024) and PCOS (HR=0.545; 95% CI=0.324–0.917; p=0.022) were significantly correlated with lower 16-week CR rate. @*Conclusion@#PCOS was associated with lower 16-week CR rate, longer treatment duration and shorter recurrence interval in patients with AEH or EEC receiving fertility-preserving treatment.

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Adverse childhood experience (ACE) is potentially negative experience that occurs between 0 and 18 years old. The ACE adolescents have prominent mental health problems such as emotional regulation disorder, unstable interpersonal relationship, poor coping ability, and cognitive dysfunction. Until now, the factors affecting the mental health of ACE adolescents are not clear, but it is certain that the ecosystem in which ACE adolescents life affects their mental health. Specifically, the parent-child relationship, the school environment, the peer relationship in the micro-system, and the interaction between the parent-child relationship and other interpersonal relationship in the meso-system have been confirmed to be significantly related to the mental health of ACE adolescents. In the appearance system, the neighborhood cohesion, the level of family income, the educational level of parents and the different social and cultural background in the macro-system all have different degrees of impact on the development of ACE adolescents' psychological behaviors. In the diachronic system, the time and frequency of suffering from ACE have different effects on the mental health regarding the ACE adolescents.

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