To examine the cross-sectional association between the problematic smartphone use(PSU) and mental health and the mediating role of academic pressure in the association between them among junior and senior high school students in Shanghai, China.
A two-stage sampling method was employed in Dec 2018.Students from 13 (5 junior and 8 senior) high schools participated in a survey assessing demographic characteristics, academic stress, PSU and mental health.A total of 2 867 valid questionnairs were collected, and the effective response rate was 92.5%.Problematic Smartphone Use Classification Scale (PSUCS) for primary and high school students was used to evaluate the PSU. Academic Pressure Subscale (APS) for Chinese high school was used to evaluate the academic pressure.World Health Organization Five-Item Well-Being Index (WHO-5) was used to evaluate the mental health.Bivariate correlation and regression analysis were used to analyze the relationship among PSU, academic pressure and mental health. Mediating effect models were conducted to explore the mediating role of academic stress in the relationship between PSU and mental health.
The PSU was significantly positively associated with academic pressure among junior (r=0.27, P < 0.01) and senior (r=0.22, P < 0.01) high school students.The academic pressure was significantly negatively associated with mental health among junior (r=-0.52, P < 0.01) and senior (r=-0.49, P < 0.01) high school students.Among junior high school students, the PSU on social networking (r=-0.08, P < 0.05) and PSU on entertainment (r=-0.13, P < 0.01) were significantly negatively associated with mental health respectively.Among senior high school students, the PSU on information collection was significantly positively associated with mental health (r=0.08, P < 0.01).Among both junior and senior high school students, the association between PSU on social networking and mental health was suppressed by academic pressure, while academic pressure mediated the negative association between PSU on entertainment and mental health.
The PSU is associated with mental health among junior and senior high school students, and academic pressure mediates the association between them.But there are different associations between different PSU types and mental health.
To investigate the relationship between Alzheimer's disease (AD) and olfactory dysfunction by comparing the olfactory identification ability (OI) in patients with different degrees of cognitive impairment, including health controls, patients with mild cognitive impairment (MCI), and patients with AD.
In order to obtain literature from case-control or cross-sectional studies published between Jan 2010 and Nov 2021 relating to "olfactory function of AD and MCI patients", three English-based databases (Web of Science, PubMed, and EMBASE) and four Chinese-base databases (CBM, CNKI, VIP, and Wanfang) were systematically screened.The records were screened according to the inclusion and exclusion criteria, and study screen and selection were carried out by two researchers and cross-checked.The records were evaluated qualitatively using the Newcastle-Ottawa Scale.The standardized mean difference (SMD) of OI scores between individual study groups were calculated using Cohen's d method, and the combined SMD were calculated using either a random effect model or a fixed effect model based on heterogeneous size.
We eventually included 20 literatures, all of which were medium- and high-quality literatures.And these studies covered a total of 1 717 people with MCI and 1 322 people with AD in nine countries.The results showed that the OI score in the MCI group was significantly lower than that of the healthy controls (SMD=-0.80, 95%CI: -0.94, -0.67).And the OI score of the AD group was significantly lower than that of the MCI group(SMD=-0.74, 95%CI: -0.94, -0.54).There was no significant difference in SMD between people in East Asia and in Europe/the United States.
The decline in OI ability with the deepening of cognitive impairment suggests that the decline of olfactory function may associated with the decline in cognitive function in AD patients.
To construct family service needs index system (FSNIS) and their weights in public health events, and establish a systematic, scientifically feasible and popular family service evaluation index system.
We invited 21 domestic experts in the fields of public health, safety and emergency to participate in the Delphi expert consultation during Sept 2020.Then we adjusted the index according to the consultation results and adopted the analytic hierarchy process to determine the final index weights.
The needs index system was constructed according to the consultation results of Delphi experts included 4 first-level indicators, 14 second-level indicators, and 32 third-level indicators. The weights of index at all levels were obtained by using the analytic hierarchy process.Among them, the weight of the first-level indicators: "family safety needs (FSN)" was 0.268, "family health needs (FHN)" was 0.257, "family life needs (FLN)" was 0.252, and "family spiritual and cultural needs (FSCN)" was 0.221.The top five three-level indicator weights: "ventilation" was 0.034, "special supplies during emergencies" was 0.034, "public opinion guidance and information transparency" was 0.033, "public equipment and facilities" was 0.033, and "food source" was 0.033.
The evaluation index and weights of family services in public health events constructed in this study were objective and credible, which can provide a scientific reference and basis for policymakers to promote the construction of family services at the community level.
To observe whether region cerebral blood flow (rCBF) is altered in brain before surgery in postoperative cognitive dysfunction (POCD) patients, and whether there is a correlation with the score of neuropsychiatric scale in elderly patients.
A total of 83 elderly (≥65 years) patients scheduled for spinal stenosis surgery during 2017-2020 were enrolled in the study.All the participants accomplished a battery of neuropsychological tests by well-trained neuropsychologist 1 day before and 1 week after surgery.Pulsed arterial spin-labeling (ASL) MRI was scanned at least one day before surgery.POCD was defined as≥2 neuropsychological test Z-scores > 1.96.The patients were devided into POCD and NPOCD group.The ASLtbx toolkit and SPM8 were applied to preprocess and correct the images, which were then standardized to the MNI brain template space to obtain standardized cerebral perfusion images.ALS in the two groups were compared.
POCD was identified in 11 of 50 patients (22%).The CBF of the right middle cingulate gyrus in POCD group was lower than that in NPOCD group (P < 0.001).The correlation coefficient r of CBF with Z score of JLOT, BVMT-D and DST-B was -0.631, -0.480 and -0.533(P < 0.05), respectively, which was statistically significant.
Patients' preoperative MRI cingulate gyrus local CBF may contribute to the prediction of early POCD in elderly patients, and there is a good correlation between cingulate gyrus local CBF and neuropsychiatric scales.
To investigate the effect of intrahepatic veno-venous shunt (IHVS) on the measurement of hepatic venous pressure gradient (HVPG) in patients with sinusoidal cirrhotic portal hypertension.
A retrospective analysis was performed for the clinical data of 259 patients with cirrhotic portal hypertension who underwent transjugular intrahepatic portosystemic shunt (TIPS) in Zhongshan Hospital, Fudan University from Jan 2015 to Nov 2020.Angiographic parameter imaging (API) software was used to color-code each pixel of an anterior-posterior digital subtraction angiography (DSA) series according to time-intensity curve to quantitatively analyze IHVS.Compared with direct portal venous pressure (PVP), the impact of IHVS on hepatic venous pressure gradient (HVPG) was evaluated.
There were 36.3% of patients (94/259) with varying degrees of IHVS: mild IHVS accounted for 11.6% (30/259), moderate IHVS accounted for 10.0% (26/259), and severe IHVS accounted for 14.7% (38/259). Compared with patients without IHVS, patients with IHVS had lower mean wedged hepatic venous pressure (WHVP) and hepatic venous pressure gradient (WHVP: P < 0.001;HVPG: P < 0.001).Meanwhile, the impact on WHVP and HVPG was dependent upon the severity of IHVS.The average WHVP and HVPG were 7 mmHg lower in patients with mild IHVS (WHVP: P=0.027;HVPG: P=0.039), 10 mmHg lower in patients with moderate IHVS (WHVP: P=0.022;HVPG: P=0.013) and 15 mmHg lower in patients with severe IHVS (WHVP: P < 0.001;HVPG: P < 0.001) than mean PVP and portal venous pressure gradient (PPG).
For patients with IHVS, the actual portal vein pressure may be seriously underestimated by HVPG measurement, and should be measured directly by portal catheterization.
To evaluate and compare the effect of flurbiprofen axetil, parecoxib sodium and propacetamol on postoperative analgesia in patients undergoing otoendoscopic surgery under general anesthesia.
A total of 140 patients scheduled for ear endoscopic surgery from Oct 2019 to Oct 2020 in Eye, Ear, Nose and Throat Hospital, Fudan University were recruited.The patients were randomly divided into 4 groups (n=35 each): flurbiprofen axetil group (Group Flu), parecoxib sodium group (Group Par), propacetamol group (Group Pro) and sufentanil group(Group Suf) by random number table.In the non steroidal drug groups, flurbiprofen axetil (50 mg), parecoxib sodium (40 mg) or propanthamol (2 g) were given intravenously 15-30 minutes before the end of the operation; Group Suf was given 0.2 μg/kg sufentanil 15-30 minutes before the end of operation.We measured visual analogue scale (VAS) of patients in static state at post anesthsia care unit (PACU) interval, postoperative 6 and 24 h.The recovery profiles, incidence and severity of side-effects (nausea, vomiting, dizzy, drowsiness and respiratory depression) were evaluated.
Postoperative analgesia in this study was effective with the median value of VAS score < 2 at 3 time points in the 4 groups.There were no significant difference in VAS scores between the whole Non-steroidal groups(Group Flu, Par, Pro) and Group Suf at PACU (H=2.160, P=0.540) and postoperative 24 h (H=3.493, P=0.322);While the VAS scores at postoperative 6 h of Group Par was lower than Group Pro (P=0.039) and Group Suf (P=0.015);The extubation time in Group Suf [(23.83±5.73) min] was longer than Group Flu [(18.71±5.99)min, P=0.001] and Group Pro [(19.69±6.97)min, P=0.009];The incidence of all adverse reactions in the 4 group was not statistically significant (χ2=6.269, P=0.099).
The simple application of nonsteroidal drugs can provide adequate pain relief for patients undergoing otoendoscopic surgery with no impact on duration of recovery and side-effect incidence.
To investigate the surgical effect of intractable epilepsy originating from insular lobe confirmed by stereoelectroencephalography (SEEG).
Eleven patients with refractory epilepsy diagnosed insular epilepsy were monitored by SEEG in the Epilepsy Center of Shanghai Deji Hospital from Apr 2017 to Oct 2020.Their clinical data (symptomatology, scalp EEG, neuroimaging, SEEG results, pathological diagnosis and surgical outcomes, etc.) were analyzed retrospectively to evaluate and explore the surgical effect on refractory epilepsy originating from insular lobe.
A total of 148 electrodes were implanted without any electrode-related complications, including 69 electrodes implanted within insular lobe. All patients accepted surgery according to respective resection plan, and the follow-up period was 6-42 months.Nine patients had no seizures (Engel grade Ⅰ), 1 case had only mild seizures (Engel grade Ⅱ), and 1 case still had frequent seizures (Engel grade Ⅳ).Histopathological diagnosis includes 6 cases of glial hyperplasia, 3 cases of focal encephalomalacia, 1 case of tuberous sclerosis and 1 case of inflammation (the patients who had meningitis history).After operation, two patients suffered contralateral hemiplegia, one patient had mixed aphasia, one patient suffered severe vomiting and one patient had intracranial infection.All of them recovered within 1 month except one patient with long-term unilateral limb paresis.
The intractable epilepsy originating from insular lobe which is confirmed by SEEG can be treated by surgery safely, and satisfactory results of epilepsy control can be obtained.
Congenital heart disease (CHD) is the most common congenital malformation in China. The dual-index screening method (i.e. pulse oximetry plus cardiac murmur auscultation) has been promoted nationwide in China.At present, pulse oximetry has many commercial equipments, but there are shortcomings in low perfusion, anti-interference and dual-index integration. Meanwhile, the auscultation of cardiac murmur is mostly judged by examiner through the stethoscope so far, which is greatly affected by subjective factors.However, the intelligent ausculation technology introduced in recent years has defects in practicability, consistency, precision and database and can't be applied to cogenital cardiac murmur ausculation directly.Besides, related matured commercial products are also lack. Therefore, the degree of integration, automation, intelligence and homogenization in the process of promotion of the "dual-index method" is low, which affects the efficiency and accuracy of neonatal CHD screening.This paper reviews the current situation and intelligent trend of the screening technology for neonatal CHD, as well as the progress of the dual-index intelligent CHD screening device developed by our research group.
Behcet's disease (BD) is a systemic inflammatory disorder characterized by orogenital ulcerations and uveitis. Pathology of BD suggests a vasculitis with mixed-cellular perivascular infiltrates and thrombotic tendency. Its pathogenesis is obscure.Environmental agent, genetic predisposition and immune-dysregulation involving T cells are reported to have a role in the pathogenesis of BD, which includes γδT cells featuring innate immunity, recognition of specific antigens, antigen presenting, CD4+ T cells and CD8+ T cells featuring adaptive immunity.Th1/Th17 expansion and Treg impairment are the central futures of altered T-cell homeostasis.All of those have been suggested to be responsible for inducing and/or maintaining the proinflammatory environment characteristic of BD.Here, we review the features of the phenotypes of T cell subsets in BD, by which modify the immune conducted inflammation, and the transformation of treatment and future target therapy.
Neuroblastoma (NB) is an embryonic tumor originating from the sympathetic nervous system. It occurs in the fetal period or early postnatal period and is one of the most common extracranial solid malignant tumors in children. Cytokines are pleiotropic proteins that effectively activate tumor cells and/or counteracts immunosuppression so as to inhibit tumors.Cytokine immunotherapy provides more possibilities for the application of immunotherapy through its own induction and activation of the immune system.This review describes several common cytokines and research advances in the treatment of NB children with cytokine-based immunotherapy.
Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique that affects brain metabolism and neuroelectrical activity by applying pulsed magnetic fields to the brain to induce neuronal excitation or inhibition.In recent years, TMS has been widely used in the assessment and treatment of post-stroke motor, speech, swallowing, cognitive and other dysfunctions, which is a hot topic in brain modulation research.However, its mechanism seems still unclear.As measurable and objective indicators, biomarkers are often used to analyze treatment effects.In this review, we firstly introduce the theoretical basis of TMS application, and then use the changes of biological markers before and after treatment as an entry point to explore the efficacy mechanism of TMS in stroke treatment.We summarize and generalize the mechanism of TMS treatment in stroke from four perspectives: neurophysiology, functional MRI, tissue cytokines and functional near infrared spectroscopy.
Stem cell-like memory T cells (TSCM) is a group of newly discovered pluripotent stem cells that have the capability of self-renewal, long-term survival, and differentiation into other types of T cells. These characteristics make it an important weapon for adoptive cell immunotherapy.However, as TSCM is extremely rare in human body, this has become a major obstacle to its clinical translation.In recent years, more and more evidences have revealed that modulation of WNT, mTORC or Notch signaling pathways can facilitate the production of TSCM.Small molecule drugs can induce and facilitate the production of pluripotent stem cells.Meanwhile, cytokines and APC also play crucial roles in the production of TSCM cells.This review will focus on the recent research progresses of acquiring TSCM through signaling modulation by small-molecule drugs and cytokines, as well as the underlying mechanisms of TSCM generation.
Loeys-Dietz syndrome (LDS) is a rare autosomal dominant connective tissue disorder characterized by the clinical trial of hypertelorism, bifid uvula/cleft palate and aortic/arterial aneurysms and tortuosity. Compared to MFS or other inheritable connective tissue disorder, LDS were more widespread arterial involvement and progressive vascular process.The average life expectancy of patients without surgery is only 26 years.However, little is known about the pathogenesis and underling precise mechanisms.This review intends to discuss the progress on the diagnosis and treatment of LDS, in order to promote early identification and diagnosis as well as the standardized treatment so as to improve the long-term prognosis.
The infection of Zika virus (ZIKV) can be detrimental to host nervous system, leading to fetal microcephaly and Guillain-Barré syndrome.Researches are focusing on the development of vaccines and drugs targeting flaviviruses including ZIKV.This paper reviewed the present research status of the host factors which facilitates the infection of ZIKV so as to uncover the mechanism of ZIKV infection.
We reported a case of hypoxia-inducible factor prolyl hydroxylase inhibitor(HIF-PHI) in the treatment of thalassemia combined with renal anemia.The patient was an elderly female with β-thalassemia, heterozygous for the mutant gene CD41-42, and progressed to uremia due to hypertension and diabetes.After treatment with erythropoietin, the patient's renal anemia could not be corrected, and she relied on blood transfusion for a long time. HIF-PHI Roxadustat is effective in treating this patient.
Tamoxifen (TAM) is a selective estrogen receptor modulator, which is widely used in endocrine therapy of postoperative breast cancer.TAM inhibits the growth of breast cancer by competitive antagonism at the estrogen receptor level.TAM has partial agonist on the uterus, which promote benign and malignant uterine pathology, such as endometrial hyperplasia, endometrial polyps, endometrial invasive cancer, and uterine sarcomas.High-risk factors for endometrial disease in patients treated with TAM include genetic factors, postmenopausal, obesity, diabetes, hypertension, and receiving unopposed estrogen.Hence, routine endometrial surveillance is important for these patients.Ultrasonography is significant for endometrial thickness monitoring despite its high false positive rate.Endometrial biopsy is the golden standard for diagnosis.However, the current endometrial thickness threshold for the TAM-related endometrial lesions is not clear, and there is no unified opinion on the indications for hysteroscopy or diagnostic curettage.Therefore, we reviewed the effects of TAM on the endometrium and summarized its progress in diagnosis and treatment of postoperative breast cancer.
