Abstract:Objective To explore the protective effect and mechanism of hydrogen (H₂) on ionizing radiation injury of mouse spermatogonia. Methods Mouse spermatogonia GC-1 cells were divided into 4 groups:control group, H₂ group, irradiation group and irradiation plus H₂ group. The cells in the irradiation group and the irradiation plus H₂ group were given single ⁶⁰Co γ ray irradiation with a cumulative dose of 8 Gy (dose rate 0.897 Gy/min). The cells in the H₂ group and the irradiation plus H₂ group were cultured in a H₂ cell culture system (75% H₂, 20% O₂ and 5% CO₂) for 1 h before irradiation. Cell counting kit 8 (CCK-8) and flow cytometry were used to detect the effects of irradiation and H₂ treatment on viability and apoptosis of GC-1 cells 24 h after irradiation. The 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) and mitochondrial membrane potential JC-1 fluorescence probes were used to detect the effects of irradiation and H₂ treatment on intracellular reactive oxygen species (ROS) and mitochondrial membrane potential of GC-1 cells 2 h after irradiation. Western blotting was used to detect the effects of irradiation and H₂ treatment on the expression of mitochondrial apoptosis pathway proteins (B-cell lymphoma-associated protein x[Bax], cytochrome c[Cyt-c] and cleaved caspase 3[an activation product of caspase 3]) in GC-1 cells 24 h after irradiation. Results CCK-8 results showed that H₂ significantly increased the viability of GC-1 cells after irradiation (P<0.01), and flow cytometry showed that H₂ significantly reduced the apoptosis rate (P<0.01). The results of specific fluorescent probe staining showed that H₂ reduced the increase of intracellular ROS and inhibited the decrease of mitochondrial membrane potential after irradiation (P<0.01 or P<0.05). Western blotting results showed that H₂ inhibited the expression of mitochondrial apoptotic proteins (Bax, Cyt-c and cleaved caspase 3) in GC-1 cells after irradiation (P<0.01 or P<0.05). Conclusion H₂ can protect mouse spermatogonia from ionizing radiation injury of ⁶⁰Co γ ray irradiation by reducing ROS production, protecting mitochondrial membrane potential, and inhibiting mitochondrial apoptotic pathway.

Abstract:Objective To explore the mechanism of microRNA (miRNA)-340-5p in regulating inhibitors of DNA binding/differentiation 3 (ID3) and its effect on the biological function of esophageal squamous cell carcinoma (ESCC) cells. Methods The effect of miRNA-340-5p on ID3 expression in human ESCC Eca109 cells was preliminarily confirmed using bioinformatics analysis, quantitative real-time polymerase chain reaction and Western blotting. The expression levels of miRNA-340-5p and ID3 were detected in 12 pairs of ESCC tissues and adjacent normal tissues. The regulatory effect of miRNA-340-5p on ID3 was verified by dual-luciferase reporter assay. The effects of miRNA-340-5p on the proliferation, migration and invasion of Eca109 cells were evaluated using cell counting kit 8, colony formation assay and Transwell assay. Results Eleven miRNAs that most likely to bind to ID3 gene were identified through bioinformatics analysis and experimental verification, of which miRNA-340-5p had the most significant effect on ID3 expression at the transcriptional and translation levels. Dual luciferase reporter assay confirmed that miRNA-340-5p could directly bind to ID3 gene. The expression of miRNA-340-5p was significantly lower and the expression of ID3 mRNA was significantly higher in the ESCC tissues compared with the adjacent normal tissues (both P<0.01), and the expression of miRNA-340-5p was negatively correlated with the expression of ID3 mRNA in the ESCC tissues (r=-0.71, P<0.01). Cell function experiments showed that miRNA-340-5p could inhibit the proliferation, migration and invasion of Eca109 cells (all P<0.01). Conclusion miRNA-340-5p can inhibit the proliferation, migration and invasion of ESCC cells by targeting ID3 gene.

Abstract:Objective To observe the clinical efficacy and safety of circulating tumor cell (CTC) drug sensitivity-guided chemotherapy in the treatment of advanced biliary tract cancer. Methods Twenty-six patients with advanced biliary tract cancer treated in the Department of Oncology Biotherapy, Eastern Hepatobiliary Surgery Hospital, Naval Medical University (Second Military Medical University) from Jul. 2018 to Apr. 2020 were included. The CTCs were isolated and enriched from the peripheral blood. The drug sensitivity was tested with the fixed chemotherapy regimen commonly used in biliary tract cancer, and the best regimen was selected for chemotherapy (CTC group). Nineteen patients with advanced biliary tract cancer treated with GEMOX regimen (gemcitabine+oxaliplatin) during the same period were selected as the controls (GEMOX group). The objective response rate (ORR), disease control rate (DCR), progress-free survival (PFS), overall survival (OS) and safety of the 2 groups were observed. Results The efficacy and safety were evaluated in all the patients: 1 case achieved complete remission (CR), 4 cases achieved partial remission (PR), 12 cases had stable disease (SD) and 9 cases had progressive disease (PD) in the CTC group; and 1 case reached PR, 10 cases had SD and 8 cases had PD in the GEMOX group. The ORRs of the CTC group and GEMOX group were 19.2% (5/26) and 5.3% (1/19), and the DCRs were 65.4% (17/26) and 57.9% (11/19), respectively. The median PFS was 5.8 months (95% confidence interval[CI] 4.5-7.2 months) in the CTC group and 5.1 months (95% CI 4.6-6.4 months) in the GEMOX group, showing no significant difference (P=0.313). The median OS was 13.6 months (95% CI 10.8-16.3 months) in the CTC group and 7.9 months (95% CI 5.5-10.3 months) in the GEMOX group, showing significant difference (P=0.003). In all patients, the main adverse events were anemia, neutropenia, thrombocytopenia, fatigue and anorexia, all of which were tolerable, and there was no treatment-related death. Conclusion CTC drug sensitivity-guided chemotherapy improves the tumor response rate of advanced biliary cancers, prolongs the overall survival of the patients, and the adverse events are tolerable. CTC drug sensitivity test is convenient, and is valuable for accurate clinical selection of individualized chemotherapy regimens, so it is worthy of further promotion.

Abstract:Objective To observe the efficacy of oral Houpo Tongbi decoction combined with pirarubicin intravesical chemotherapy in the treatment of postoperative patients with non-muscle-invasive bladder cancer (NMIBC). Methods Ninety-five NMIBC patients who underwent transurethral resection of bladder tumor (TURBT) in Shanghai General Hospital of Shanghai Jiao Tong University from Jan. 2018 to Dec. 2019 were randomly divided into observation group (n=49) and control group (n=46). The control group only received pirarubicin intravesical chemotherapy, while the observation group received oral Houpo Tongbi decoction combined with pirarubicin intravesical chemotherapy. The total course of treatment was 1 year. All patients were followed up for 1 year. The recurrence, improvement of traditional Chinese medicine (TCM) symptoms, quality of life, urine routine, blood routine, liver and kidney function and adverse events were compared between the 2 groups. Results After 1 year of adjuvant treatment, the recurrence rate in the observation group (18.37%, 9/49) was significantly lower than that in the control group (36.96%, 17/46) (P<0.05). The overall improvement rate of TCM symptoms was significantly higher in the observation group (79.59%, 39/49) than in the control group (41.30%, 19/46) (P<0.05). The quality of life results showed that the emotional function, fatigue, pain, general health status and urinary tract symptom were significantly better in the observation group compared with the control group (all P<0.05). The peripheral white blood cell count and alanine aminotransferase level in the observation group were significantly lower than those in the control group (both P<0.05), and there were no significant differences in other blood routine or liver and kidney function indexes between the 2 groups (all P>0.05). There were no significant differences in the levels of white blood cell or red blood cell in urine (both P>0.05), while the urine protein level of the observation group was significantly lower than that of the control group (P<0.05). During the treatment period, the total incidence of adverse events in the observation group (36.73%, 18/49) was significantly lower than that in the control group (60.87%, 28/46) (P<0.05). Conclusion Houpo Tongbi decoction combined with pirarubicin intravesical chemotherapy can reduce the postoperative recurrence of NMIBC, alleviate TCM symptoms caused by tumor, improve quality of life, and reduce chemotherapy-related adverse events.

Abstract:Objective To construct prediction models for the clinical outcomes of coronavirus disease 2019 (COVID-19) patients using machine learning algorithms, and explore the outcome-related factors. Methods The clinical indexes and outcomes (in-hospital mortality and receiving tracheal intubation) of COVID-19 patients who were admitted to Wuhan Huoshenshan Hospital or Guanggu Branch of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from Feb. 5 to Apr. 15, 2020 were collected. The prediction models for the clinical outcomes were constructed using artificial neural network (ANN), naive Bayes, logistic regression and random forest algorithms. Results A total of 4 804 COVID-19 patients were included, of whom 100 (2.08%) patients died and 87 (1.81%) patients received tracheal intubation during the hospitalization. White blood cell (WBC), albumin, calcium, blood urea nitrogen, creatine kinase-myocardial band (CK-MB) and age were the most correlated variables with in-hospital mortality. WBC, lymphocyte, hypersensitivity C reaction protein (hs-CRP), total bilirubin, calcium and age were the most correlated variables with in-hospital tracheal intubation. With the above variables and based on the 4 machine learning algorithms, the prediction models for in-hospital mortality and tracheal intubation were constructed. In the 4 prediction models, the model constructed based on naive Bayes algorithm had the best performance in predicting in-hospital mortality (area under curve[AUC]=0.952, 95% confidence interval[CI] 0.925-0.979) and tracheal intubation (AUC=0.948, 95% CI 0.896-0.965) versus the models constructed based on ANN, logistic regression and random forest algorithms (the AUC[95% CI] values for predicting in-hospital mortality were 0.938[0.882-0.993], 0.926[0.865-0.987] and 0.867[0.780-0.954], and the AUC[95% CI] values for predicting in-hospital tracheal intubation were 0.932[0.814-0.980], 0.935[0.817-0.981] and 0.936[0.921-0.972], respectively). Conclusion The 4 machine learning algorithms have good performance in predicting the clinical outcomes of COVID-19 patients. WBC, albumin, calcium, blood urea nitrogen, CK-MB and age can be used to predict the in-hospital mortality of COVID-19 patients; while WBC, lymphocyte count, hs-CRP, total bilirubin, calcium and age can be used to predict the in-hospital tracheal intubation.

Abstract:Objective To analyze the clinical characteristics and prognostic factors of patients with traumatic cardiac laceration. Methods The clinical data of adult patients diagnosed with cardiac trauma in 2012 were collected from the American National Trauma Data Bank (NTDB) database, and the clinical characteristics and prognosis of cardiac laceration patients and other cardiac trauma patients were compared. The influencing factors of in-hospital death in cardiac laceration patients were determined using univariate and multivariate analyses. Results Among all 830 785 trauma patients in NTDB database in 2012, cardiac trauma patients accounted for 0.41% (3 387 cases), including 1 437 (42.43%) patients with cardiac laceration and 1 950 (57.57%) patients with other cardiac trauma. Compared with other cardiac trauma patients, cardiac laceration patients were characterized with younger age, less White race, less comorbidities, more males, more uninsured, more admitted to level Ⅰ trauma designation and teaching hospitals, more firearm or explosive injury and cutting or piercing instrument injury, more penetrating injury of the cardiac cavity, more associated penetrating injury of the chest wall, traumatic hemothorax/pneumothorax and lung contusion, more surgery treatment, and more serious vital signs and higher trauma scores on admission (all P<0.01). Of the 1 437 patients, 467 were dead on arrival, 507 died in hospital, and the remaining 463 survived and discharged from hospital. Multivariate logistic regression analysis showed that age ≥ 50 years, uninsured, comorbidities, injury due to motor vehicle, injury severity score ≥ 25, severe arrhythmia, associated lung contusion, systolic blood pressure< 90 mmHg (1 mmHg=0.133 kPa), oxygen saturation< 90% and core temperature< 36℃ on admission, and exploratory thoracotomy were independent risk factors for in-hospital death of cardiac laceration patients (all P<0.01). Cutting or piercing instrument injury, respiratory rate on admission ≥ 20 min^-1 and cardiac or pericardial repair were independent protective factors for in-hospital death in adult patients with cardiac laceration (all P<0.01). Conclusion The proportion of traumatic cardiac laceration is high and the survival rate is low in cardiac trauma patients. Cardiac laceration is more critical than other cardiac traumas. There are many influencing factors for its prognosis, and more attention should be given to cardiac laceration research.

Abstract:Objective To explore the risk factors affecting the prognosis of young and middle-aged patients with cerebral infarction, and establish a clinical prognostic prediction model for its prognosis and individualized treatment. Methods A total of 294 young and middle-aged patients with cerebral infarction hospitalized in Wusong Branch of Zhongshan Hospital, Fudan University from Jan. 1, 2018 to Jan. 1, 2020 were included. The baseline data such as age, gender, past history, National Institutes of Health stroke scale (NIHSS) score and blood indexes were collected. The gene polymorphisms of ring finger protein 213 (RNF213) gene (rs112735431), histone deacetylase 9 (HDAC9) gene (rs2107595, rs2240419, rs2389995) and methylenetetrahydrofolate reductase (MTHFR) gene (C677T) were detected. According to the clinical outcomes at 1-year follow-up, 294 patients were divided into non-progression group (177 cases, 60.20%) and progression group (117 cases, 39.80%). The above indexes were compared between the 2 groups. The patients were divided into training set and test set by a ratio of 7:3. With the above indexes as independent variables and the clinical outcome at 1-year follow-up as dependent variable, the data of the training set were used for logistic regression analysis to identify the risk factors of prognosis and to establish a prognostic prediction model. The data of the training set and test set were used for receiver operating characteristic (ROC) curve analysis to evaluate the value of the model. Results The NIHSS score and levels of serum creatinine, total bilirubin and homocysteine in the progression group were significantly higher than those in the non-progression group (all P<0.05); and the distribution of MTHFR (C677T) gene polymorphism was different between the 2 groups (P<0.01). Logistic regression analysis showed that the risk of disease progression increased by 76.8% with every 1 point increment of NIHSS score (odds ratio[OR]=1.768, 95% confidence interval[CI] 1.479-2.112); the risk of disease progression in patients with TT genotype of MTHFR (C677T) gene was 4.128 times higher than that in patients with CC genotype (OR=4.128, 95% CI 1.497-11.383); and the risk of disease progression in patients with hypertension was 3.421 times higher than that in patients without hypertension (OR=3.421, 95% CI 1.353-8.645). The area under curve (AUC) of ROC curve in the training set was 0.856 (95% CI 0.806-0.906), and that in the test set was 0.847 (95% CI 0.756-0.937), indicating good prediction ability of the model. Conclusion NIHSS score, MTHFR (C677T) gene polymorphism and hypertension are risk factors for the progression of cerebral infarction in young and middle-aged patients. The clinical prognostic model based on NIHSS score, MTHFR (C677T) gene polymorphism and hypertension is helpful in evaluating prognosis of young and middle-aged patients with cerebral infarction.

Abstract:Objective To search for the prognostic factors of young patients with gastric cancer, and construct a prognostic prediction model nomogram, so as to provide a more accurate tool for the individualized prognostic evaluation of patients. Methods The information of 2 673 young gastric cancer patients aged 18-44 years diagnosed from 2004 to 2015 was collected from the Surveillance, Epidemiology, and End Results (SEER) database client SEER*Stat 8.3.8. The patients were randomly divided into training set (1 873 cases) and validation set (800 cases) in a ratio of about 7:3 using R 4.0.3 software. Focusing on the cancer-specific survival (CSS) rate, univariate and multivariate analyses were performed using Fine-Gray competitive risk model in the training set to find the influencing factors of CSS in young gastric cancer patients. According to the influencing factors, the prognosis prediction model was established and the nomogram was drawn. Receiver operating characteristic (ROC) curve and calibration curve were used to verify the prediction effect of the model in the training set and validation set. Results The results of multivariate analysis in the training set showed that tumor grade, T stage, N stage, M stage, primary surgery, regional lymph node surgery and chemoradiotherapy were the independent influencing factors of CSS in young patients with gastric cancer. The cumulative 1-, 3- and 5-year CSS rates of young gastric cancer patients in the training set were 54.56%, 29.70% and 23.96%, respectively. The area under curve (AUC) values of ROC curves of 1-, 3- and 5-year CSS rates of nomogram constructed based on independent prognostic factors were 0.817, 0.864 and 0.887 in the training set, respectively, while those were 0.820, 0.899 and 0.890 in the validation set, respectively. The calibration curves showed that the prediction probabilities of the 1-, 3- and 5-year CSS rates in the training set and validation set were basically consistent with the observed probabilities. Conclusion The Fine-Gray competitive risk model can effectively identify the prognostic factors of young patients with gastric cancer, and the prognostic prediction model can effectively predict the CSS of patients, which can help clinicians to make treatment decisions.

Abstract:Objective To investigate the value of serum C reactive protein (CRP), apolipoprotein A1 (ApoA1), and CRP to ApoA1 ratio (CRP/ApoA1) in evaluating coronary artery disease. Methods A total of consecutive 533 patients who were hospitalized due to chest pain and examined by coronary angiography in the No. 904 Hospital of Joint Logistics Support Force of PLA from Dec. 2018 to Dec. 2019 were retrospectively included. According to the Gensini score and coronary angiography results, the patients were divided into normal coronary artery group (Gensini score of 0, n=118), coronary atherosclerosis group (Gensini score of 1-18 but not meeting the diagnostic criteria of coronary heart disease[CHD], n=109) and CHD group (Gensini score of 1-180 and meeting the diagnostic criteria of CHD, n=306). According to the Gensini score, the CHD patients were divided into mild CHD group (Gensini score of 1-<30, n=177) and severe CHD group (Gensini score of 30-180, n=129). According to the lesion vessel number, the CHD patients were divided into single-vessel lesion group (n=147), double-vessel lesion group (n=90) and 3 or more vessel lesion group (n=69). The hematological indexes such as serum CRP, ApoA1 and albumin were recorded in each group, and CRP/ApoA1 was calculated. Multivariate logistic binary regression analysis was used to determine the independent risk factors of CHD and severe CHD. Receiver operating characteristic (ROC) curve was used to analyzed the predictive value of CRP/ApoA1 on CHD, severe CHD and 3 or more vessel lesions, and the differences from CRP to albumin ratio (CAR), CRP and ApoA1 were observed. Results The CRP/ApoA1 of the CHD group was significantly higher than that of the normal coronary artery group (P<0.01), and the CRP/ApoA1 of the severe CHD group was significantly higher than that of the mild CHD group (P<0.01). Multivariate logistic binary regression analysis suggested that CRP/ApoA1 was an independent risk factor of CHD and severe CHD (odds ratio[OR]=2.171, 95% confidence interval[CI] 1.293-3.647, P<0.01; OR=6.306, 95% CI 3.591-11.073, P<0.01). Spearman correlation analysis showed that CRP/ApoA1 was positively correlated with Gensini score (r=0.419, P<0.01) and lesion vessel number (r=0.431, P<0.05). ROC curve analysis showed that CRP/ApoA1 had good predictive value for CHD, severe CHD and 3 or more vessel lesions (area under curve[AUC]=0.704, 0.796 and 0.820), and was significantly better than that of CAR, CRP and ApoA1 (AUC=0.684, 0.783, 0.806; 0.682, 0.778, 0.800; and 0.641, 0.669, 0.687) (all P<0.05). Conclusion CRP/ApoA1 is related to CHD and its severity, and its diagnostic value is higher than that of CAR, CRP and ApoA1. It can be used in the diagnosis and evaluation of CHD.

Abstract:Objective To explore the feasibility of low-load hepatitis B virus (HBV) DNA S-gene amplification and optimize the experimental conditions, so as to provide a basis for the detection of HBV DNA S-gene mutation in occult HBV infection (OBI) patients. Methods HBV DNA S-gene in serum samples of 6 cases with low-load HBV DNA (100-200 IU/mL) and 22 cases with lower-load HBV DNA (20-99 IU/mL) was amplified by traditional nested polymerase chain reaction (PCR) and self-built 2-round PCR. The experimental conditions, such as primer sequences, primer amount, the dilution ratio of PCR product templates, annealing temperature, the number of PCR reaction cycles, and PCR reaction system, were optimized. The PCR amplification product was observed by agarose gel electrophoresis, the target band gel was cut for cloning and sequencing, and then the cloned sequencing result was confirmed by BLAST comparison of nucleic acid sequence. Results Three pairs of primers (P1-P3) for nested PCR were designed, and the amplified products theoretically contained the whole HBV DNA S-gene. After optimization of PCR amplification conditions, only 2 of the 6 serum samples with low-load HBV DNA were amplified by nested PCR, and 22 samples with low-load HBV DNA were failed to amplify any fragments. Twelve pairs of primers (P4-P15) were designed for the self-built 2-round PCR, and the amplified products theoretically contained the whole HBV DNA S-gene. After PCR amplification conditions were optimized and P13 was selected as the best primer, all 6 serum samples with low-load HBV DNA and 15 (15/22, 68.18%) samples with lower-load HBV DNA were amplified successfully. The PCR products were confirmed as the HBV DNA S-gene specific target sequences by cloning and sequencing. Among the 15 samples, the minimum HBV DNA load was 20.1 IU/mL. Conclusion The self-built 2-round PCR based on the primer P13 is more suitable for the amplification of low-load HBV DNA S-gene. The amplification efficiency and specificity are much better than traditional nested PCR. The amplified products can be further applied to analyze HBV DNA S-gene mutation in OBI patients.

Abstract:In diving practice, divers who are suspected of suffering decompression illness (DCI) in locations remote from a recompression chamber and cannot be immediately transported to eligible settings for further treatment are sometimes treated with in-water recompression (IWR) when the equipment and technique are available. However, not all diving-related diseases require IWR, compression therapy is not feasible in all conditions. At the same time, IWR has certain risks. Therefore, at the diving site, various factors should be taken into account when IWR is chosen, and the pros and cons of IWR should be weighed for decision making. This paper briefly summarizes the conditions, risks, treatment schedules and requirements of IWR.

Abstract:Cancer management involves the whole process of disease diagnosis and treatment, including early detection, tumor diagnosis, determination of tumor margins, tracking tumor evolution, prediction of tumor recurrence, and evaluation of clinical outcomes. As a traditional discipline aiming to explore the etiology, pathogenesis, morphological structure, function and metabolism of diseases, pathology is the gold standard for tumor diagnosis and participates in the whole process of cancer management. The application of artificial intelligence in pathology provides a powerful tool for cancer management, and will play an important role in disease diagnosis/auxiliary diagnosis, precision medicine and life exploration.

Abstract:Objective To investigate the incidence and treatment effect of motion sickness of island-reef personnel during navigation, so as to provide data support for guiding the army to carry out motion sickness management, prevention and control. Methods A total of 132 island-reef garrison personnel with similar time on island, times to sea, taking warships, and sea conditions experienced and conditions of residence were selected. Basic information, severity and concomitant symptoms of seasickness, treatment history, eating and sleeping conditions were collected using questionnaires, and the factors associated with seasickness were analyzed. Results A total of 132 questionnaires were sent out and all were valid. Of the 132 respondents, 24 were females and 108 were males, and 6 (4.55%) had received vestibular function training to prevent seasickness before the navigation. Sixteen (12.12%) had no seasickness symptoms, 116 (87.88%) had seasickness symptoms, 91 (68.94%) had vomiting symptoms, and 90 (68.18%) accompanied by walking instability during the navigation. Totally 101 patients (76.52%) received treatment during seasickness, of which 38 (28.79%) were ineffective, 55 (41.67%) were partially relieved, and 8 (6.06%) were effective; while 31 (23.48%) did not receive any treatment. During the navigation, 34 (25.76%) could eat normally, while 98 (74.24%) could eat less or could not eat; 72 (54.55%) had normal sleep, while 60 (45.45%) had reduced sleep or insomnia. There was significant difference in the incidence of seasickness among respondents with different eating and sleeping conditions (all P<0.05), and incidence of seasickness was higher in respondents with reduced food intake or inability to eat, decreased sleep or insomnia. Conclusion There is a high incidence of seasickness among island-reef personnel during defense rotation navigation. Training for seasickness prevention should be strengthened before navigation, and drugs for sickness prevention, stomach protection and sleep aid should be given during navigation.

Abstract:Objective To investigate the relationship between tea and coffee use and sleep status among navy officers and soldiers. Methods With cluster sampling, 1 149 navy officers and soldiers were investigated using self-compiled demographic questionnaire, substance use items and Pittsburgh sleep quality index (PSQI) scale. The association between tea and coffee use and sleep was analyzed using Spearman correlation analysis. The effects of general demographic information and tea and coffee use on sleep were analyzed using multiple linear regression. Results Among the 1 149 navy officers and soldiers, 38.8% (446 cases) seldom drank tea, 49.9% (573 cases) drank tea sometimes, and 11.3% (130 cases) drank tea almost every day; 60.8% (699 cases) seldom or never drank coffee, 36.0% (414 cases) drank coffee sometimes, and 3.1% (36 cases) drank coffee almost every day. Tea use was positively correlated with sleep time, sleep disorders and daytime dysfunction (P<0.05 or P<0.01), and negatively correlated with hypnotic drugs (P<0.01). Coffee use was positively correlated with sleep quality, time to fall asleep, sleep time, sleep disorders, daytime dysfunction and total PSQI scale score (P<0.05 or P<0.01). After controlling the general demographic factors (gender, age, education level, marital status and personnel category), it was found that more frequent use of coffee was associated with poor sleep quality. Conclusion Long-term use coffee has an adverse effect on the sleep of naval officers and soldiers.

Abstract:Objective To explore the mental health status of rural residents in Southwest Anhui province and its influencing factors during the coronavirus disease 2019 (COVID-19) epidemic. Methods A total of 766 rural residents in Southwest Anhui province completed the self-made general information questionnaire and symptom checklist 90 (SCL-90) online from Feb. 1 to Feb. 5, 2020. The mental health status was compared among the residents with different demographic information. Multivariate logistic regression analysis was used to screen the influencing factors of mental health. Results A total of 887 online questionnaires were sent out, and 766 valid questionnaires were collected, with an effective rate of 86.4%. The incidence of psychological problems in the rural residents in Southwest Anhui province was 23.3% (178/766) during the COVID-19 epidemic. The main manifestations were compulsion (15.1%, 116/766), interpersonal sensitivity (9.0%, 69/766), and sleep and diet problems (8.5%, 65/766). All factor scores of SCL-90 of the rural residents were lower than the national norm, and the scores for somatization, compulsion, interpersonal sensitivity, depression, anxiety, hostility, paranoia, psychotic, and "other" factors were significantly different from the norm (all P<0.01). Multivariate logistic regression analysis showed that age (odds ratio[OR]=0.977, 95% confidence interval[CI] 0.965-0.989), education level (OR=0.693, 95% CI 0.497-0.966), family structure (OR=1.934, 95% CI 1.223-3.059) and the knowledge about the epidemic (OR=0.948, 95% CI 0.914-0.983) were the influencing factors of mental health (all P<0.05). Conclusion During the COVID-2019 epidemic, the mental health of the rural residents in Southwest Anhui province is good. It is important to pay more attention to the susceptible population and further popularize the knowledge about COVID-19 epidemic and maintain good mental health of rural residents during the epidemic.

Abstract:Objective To explore the clinical value of transabdominal gastric ultrasonography in the diagnosis of gastric cancer. Methods The data of 129 gastric cancer patients diagnosed and treated in Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Kongjiang Hospital of Yangpu District, and Jiading Central Hospital of Shanghai University of Medicine & Health Science from Jan. 2010 to May 2020 were retrospectively analyzed. All patients were diagnosed with gastric lesions on the first examination of transabdominal gastric ultrasonography, then underwent gastroscopy, and were finally pathologically proven with gastric cancer by gastric mucosal biopsy. McNemar method was used to compare the detection rates of suggestive lesions, the overall qualitative diagnosis accuracy and the qualitative diagnosis accuracy of different gastric parts between gastroscopy and ultrasonography. Results Advanced gastric cancer accounted for 93.0% (120/129) and early gastric cancer accounted for 7.0% (9/129). With the histopathological diagnosis as the gold standard, no false positive cases were detected by transabdominal gastric ultrasonography, and the detection rate was 100.0% (129/129); 128 cases of gastric lesions were detected by gastroscopy, and the detection rate was 99.2% (128/129). For the one misdiagnosed case by gastroscopy, ultrasonography showed significant thickening of gastric antrum wall, while gastroscopy showed hyperemia, edema and coarse folds of gastric mucosa without other obvious abnormalities, but it was confirmed as poorly differentiated adenocarcinoma by postoperative pathology. The sonographic features of gastric cancers showed that thickened, excavated and protruded lesions accounted for 46.5% (60/129), 41.1% (53/129) and 12.4% (16/129), respectively. The maximum thickness and diameter of the lesions were (13.5±5.1) mm and (56.8±24.9) mm, respectively. The diagnostic accuracy of ultrasonography and gastroscopy for gastric cancer was 74.4% (96/129) and 82.2% (106/129), respectively, showing no significant difference (P>0.05). There was no significant difference in the diagnostic accuracy for cancers in the gastric antrum, gastric body, gastric angle, gastric fundus, cardia or gastric stump between ultrasound and gastroscopy (all P>0.05). Conclusion Transabdominal gastric ultrasonography has a good ability to detect gastric wall lesions, and its application can further improve the detection rate and diagnostic accuracy of gastric cancer.

Abstract:Objective To explore the effects of chest scanning parameters of 2 Philips computed tomography (CT) models on image quality under free breathing. Methods Eighty patients examined on Philips 256-multislice CT (40 cases using conventional scan mode and 40 cases using fast scan mode) and 80 patients examined on Philips 16-multislice CT (40 cases using conventional scan mode and 40 cases using fast scan mode) were prospectively enrolled. In the 256-and 16-multislice CT conventional scan groups, the conventional spiral mode was selected under the control of breathing after deep inhalation, and the pitch was 0.977 and 1, respectively. In the 256-and 16-multislice CT fast scan groups, the fast spiral mode was selected under free breathing, and the pitch was 1.473 and 1.472, respectively. The objective evaluation indexes of image quality were compared among the 4 groups. The image quality was evaluated and scored by 2 senior chest diagnostic physicians, and the consistency of subjective scores between the 2 physicians was analyzed. Results The objective evaluation results of image quality showed density resolution:256-multislice CT fast scan group > 16-multislice CT fast scan group > 16-multislice CT conventional scan group > 256-multislice CT conventional scan group; spatial resolution:16-multislice CT conventional scan group > 16-multislice CT fast scan group > 256-multislice CT fast scan group > 256-multislice CT conventional scan group; and background noise:16-multislice CT conventional scan group > 16-multislice CT fast scan group > 256-multislice CT conventional scan group > 256-multislice CT fast scan group. The subjective evaluation results of image quality showed that the consistency of image quality score between the 2 physicians was good (Kappa=0.91). Conclusion The 256-multislice CT fast scan can effectively reduce image respiratory artifacts under free breathing.

Abstract:Objective To analyze the efficacy of levetiracetam combined with lamotrigine in the treatment of gestational epilepsy and its effect on pregnancy outcomes. Methods A total of 76 patients with gestational epilepsy in the outpatient or inpatient departments of Suzhou Municipal Hospital Affiliated to Nanjing Medical University from Jan. 2017 to Feb. 2021 were included, including 20 cases in levetiracetam monotherapy group, 22 cases in lamotrigine monotherapy group and 34 cases in combined treatment group (levetiracetam combined with lamotrigine). The epilepsy frequency, pregnancy-related complications and adverse pregnancy outcomes were compared among the 3 groups. Results The proportions of patients with no epilepsy, no change in epilepsy frequency, increase in epilepsy frequency and decrease in epilepsy frequency during pregnancy were 82.3% (28/34), 2.9% (1/34), 5.8% (2/34) and 8.8% (3/34) in the combined treatment group, 45.0% (9/20), 25.0% (5/20), 15.0% (3/20) and 15.0% (3/20) in the levetiracetam monotherapy group, and 45.5% (10/22), 13.6% (3/22), 18.2% (4/22) and 22.7% (5/22) in the lamotrigine monotherapy group, respectively, and the differences were significant among the 3 groups (P<0.05). There were no significant differences in pregnancy-related complications or adverse pregnancy outcomes among the 3 groups (all P>0.05). Conclusion The efficacy of levetiracetam combined with lamotrigine in the treatment of gestational epilepsy is better than that of monotherapy. It can reduce the frequency of gestational epilepsy without increasing the incidence of pregnancy-related complications and adverse pregnancy outcomes.

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