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Background Hypertension is a growing public health problem in China. In recent years, more and more studies have begun to focus on the quality of life of hypertensive older adults, and explore the factors affecting their quality of life, which is of great significance for the development of effective health management programs for hypertension. Objective To measure the health state utility (HSU) of hypertensive older adults in Northwest China using the EQ-5D-5L scale and the 15D scale, evaluate the health-related quality of life (HRQoL) of them, and explore the main factors affecting HRQoL in the elderly. Methods A total of 2 000 older adults were randomly recruited in Lanzhou City, Gansu Province in 2021, the clinical data were collected through questionnaires, basic physical examination and laboratory tests, and HSU was measured using the EQ-5D-5L and 15D scales. Subgroup analysis, Tobit regression analysis and multiple linear regression analysis were used to evaluate the factors affecting HRQoL. Results A total of 1 784 older adults participated in this study, 50.9% of them had normal blood pressure, 676 (37.9%) had stage 1 hypertension, 152 (8.5%) had stage 2 hypertension, 48 (2.7%) had stage 3 hypertension, the HSU of these older adults were 0.949, 0.942, 0.933, and 0.921 in the EQ-5D-5L, and 0.875, 0.863, 0.851, and 0.840 in the 15D scale, respectively. Tobit regression analysis showed that gender, age, years of education, occupational status, and annual income were associated with HSU in older adults in the EQ-5D-5L scale (P

Obstructive sleep apnea (OSA) is one of the most common sleep disorders, which is closely related to a variety of cardiovascular diseases, and has become one of the key directions for the control and prevention of cardiovascular disease risk factors. In recent years, many clinical studies have confirmed that OSA is closely related to the initiation and evolution of acute coronary syndrome (ACS). Therefore, this article summarized the status quo of clinical studies on OSA and ACS, the shortcomings of current studies, and prospects for future research directions.

Background Metabolic syndrome (MS) has become a global health problem, and most studies have focused on the correlation of MS and its components with alanine aminotransferase (ALT) and aspartate aminotransferase (AST), but whether there is a dose-response relationship of ALT and AST with MS needs to be further explored. Objective To explore the relationship of ALT and AST with the risk of MS in the elderly, and provide a reference basis for the prevention and control of MS. Methods A health examination with multi-stage sampling method was conducted to residents (≥60 years) from 162 townships (streets) under jurisdiction of 18 cities of Henan Province in 2022. The investigation was performed with physical examination and laboratory test. Logistic regression model combined with restricted cubic spline model was recruited to analyze the relationship of ALT and AST with the risk of MS. Results Totally, 112 605 research participants were enrolled, of whome the prevalence of MS was 18.6% (20 935/112 605), ALT abnormality was 5.4% (6 132/112 605), and AST abnormality was 6.8% (7 661/112 605). The MS group showed a higher level of ALT and a lower level of AST than the non-MS group (P0.05), and a nonlinear dose-response relationship between AST and the risk of MS (P for overall

Objective To compare the disinfection effect of three different disinfectants for oral dental chair water lines (DUWLs). Methods Selection of seven independent water source integrated treatment tables in the Stomatology Department of Beijing No. 2 Hospital before opening of the clinic in 2019, divided into 4 groups (3 experimental + 1 control). The experimental group used 500mg/L chlorine-containing disinfectant respectively (2 integrated treatment chairs in group A)、3% hydrogen peroxide (Group B, 2 comprehensive treatment chairs)、60 g/L silver ion peroxide disinfectant (2 comprehensive treatment chairs in group C) and purified municipal water purified water (1 comprehensive treatment chair in control group D). The DUWLs were disinfected by three different disinfectants, and then water samples from each group of triple lances and high-speed hand pieces were collected for bacterial cultures. To compare the total number of bacterial colonies in each group of DUWLs before disinfection and immediately, 1d, 3d, and 7d after disinfection. Results The bacterial colony counts of pre-disinfection DUWLs had exceeded the standard ( all＞4500 cfu/mL). The total number of bacterial colonies of the three disinfectants immediately after disinfection and 1 day after disinfection decreased remarkably, and were lower than that of the pre-disinfection and control group. Three days after disinfection, except for experimental group C, the total number of bacterial colonies in experimental groups A and B exceeded the standard for oral healthcare water as stipulated in the Beijing "Technical specification for the disinfection of water circuits in comprehensive oral treatment tables (DB11_T 1703-2019)". The total number of bacterial colonies in groups A, B and C were close to or exceeded the pre-disinfection level 7 days after disinfection. Conclusion Short duration of time to maintain the effect of 500 ml/L chlorine disinfectant and 3% hydrogen peroxide disinfectant on waterway disinfection. Long-term use causes irreparable damage to the inner wall of the pipeline. Silver ionic disinfectant with 60 g/L hydrogen peroxide was optimal in controlling the total number of bacterial colonies and inhibiting bacterial growth time in oral dental chair water lines (DUWLs). (目的 比较3种不同消毒剂对口腔综合治疗台水路(DUWLs)的消毒效果。方法 选取本院2019年装修后待开诊前7台采用独立水源的综合治疗台, 分为4组(3组实验组+1组对照组), 实验组分别采用500 mg/L含氯消毒剂(A组2台综合治疗椅)、3%过氧化氢(B组2台综合治疗椅)、60 g/L过氧化氢银离子消毒剂(C组2台综合治疗椅)和净化后市政用水纯水(D组对照组1台综合治疗椅), 通过3种不同的消毒剂对DUWLs进行消毒, 然后收集各组三用枪和高速手机水样进行细菌培养, 比较各组DUWLs消毒前及消毒后即刻、1d、3d、7d细菌菌落总数。结果 消毒前DUWLs各组细菌菌落总数均严重超标(均＞4500 cfu/mL)。3种消毒剂消毒后即刻和消毒后1 d细菌菌落总数明显下降, 低于消毒前及对照组。消毒后3 d, 除实验C组外, 实验A、B两组细菌菌落总数均超过北京市《口腔综合治疗台水路消毒技术规范(DB11/T 1703-2019)》规定的口腔医疗卫生用水标准。消毒后7 d, A、B、C三组细菌菌落总数均接近或超过消毒前水平。结论 500 mg/L含氯消毒剂和3%过氧化氢消毒剂对水路消毒效果维持时间短, 长期使用对管路内壁造成不可修复的危害。60g/L过氧化氢银离子消毒剂在控制口腔牙椅水路(DUWLs)细菌落数总数和抑制细菌生长时间方面效果最优。)

Background It is hard to make an early and accurate diagnosis of developmental delay (DD) /mental retardation (MR) in children due to complex etiology, diverse and heterogeneous clinical manifestations of the disease. There are few large-sample analyses of the clinical and genetic test data of these children in China. Objective To perform an analysis of genetic test results of children with DD/MR, providing evidence for genetic diagnosis, treatment plan formulation and prognosis assessment in such children. Methods Ninety-three children with DD/MR of unknown origin were selected from Department of Rehabilitation, Kunming Children's Hospital from September 2017 to September 2021. Whole-exome sequencing (WES) was performed to explore pathogenic gene mutations associated with clinical manifestations. Copy number variation (CNV) detection was conducted to examine the characteristics of pathogenic CNVs. The detection of gene mutations was analyzed. Results The DD/MR in the children was mainly manifested by motor or global DD, or MR, and with a developmental level falling behind normal developmental milestones. Seventy-four cases (79.6%) were detected with genetic variants, and the detection rate was 79.6%, among whom 40 (43.0%) with pathogenic gene mutations, 13 (14.0%) with gene CNVs, and 21 (22.6%) with mutations of uncertain significance. The genetic test results involved more than 50 pathogenic genes in total. The most prevalent disease caused by gene mutation was spinal muscular atrophy caused by mutations in the SMN1 gene (10.0%, 4/40), followed by Bethlem myopathy-1 caused by mutations in the COL6A2 gene (7.5%, 3/40) and Joubert syndrome-21 caused by mutations in CSPP1 (5.0%, 2/40) . Conclusion Pathative gene mutations and gene copy number variants may be main causes of DD/MR. SMN1, COL6A2, and CSPP1 are common mutated genes in DD/MR patients. WES combined with CNV detection may greatly contribute to the exploration of the etiology of DD/MR, especially for DD/MR manifested by atypical phenotypes and clinical manifestations.

[Objective] Water infiltration characteristics at the ridge, furrow, and film hole interface under furrow seeding and sprinkling irrigation on double ridges of inland area of Hexi Corridor at Minqin County, Gansu Province were determined, and the relationship between water transfer and the utilization of agricultural water-saving and farm technology coupling were discussed in order to provide a theoretical basis for the development of efficient agricultural water-saving technologies. [Methods] Four sprinkler irrigation treatments of 24 mm (G1), 30 mm (G2), 36 mm (G3), and 42 mm (G4) were established in a field experiment, and the HYDRUS-2D model was used to simulate the soil moisture at different positions of the double-ridge and furrow-sowing sprinkler irrigation ridge film hole. Differences and two-dimensional distribution characteristics of soil moisture were determined. [Results] The accuracy of the HYDRUS-2D model to simulate soil moisture for the sprinkler irrigated double-ridge and furrow-sowing system at the film hole was high (average relative error was 6.46%—9.08%, and the coefficient of determination was 0.85—0.95. One day after irrigation, the saturated and humid soil area was mainly concentrated in the 0—30 cm soil layer, and the saturated area of the G1 treatment was the smallest of all of the treatments due to water deficit. In the 0—20 cm soil layer, the saturated area increased with increasing irrigation amount (i.e., G2>G3>G4). However, there was no significant difference in water content between different treatments below the 50 cm soil depth. [Conclusion] Sprinkler irrigation of farmland at the inland arid area of Hexi Corridor mainly affected the upper soil layer. Simulations of soil water distribution by the HYDRUS-2D model were acceptable and the parameters were reliable. The model can be used to formulate sprinkler irrigation system technology for the double-ridge production system.

【Background】 Agriculture is the largest water-consuming sector in China, but how to estimate agricultural water use is an issue that remains extremely difficult despite its importance in improving water measurement. Considering that moving water for irrigation needs power, an alternative method emerging over the past decades is to estimate it based on the electricity reading on the national grid. The purpose of this paper is to investigate how to estimate the conversion coefficient of this method. 【Method】 We took Horqin District at Tongliao City in Inner Mongolia as an example. We calculated the conversion coefficient using the multiple linear regression model and the BP neural network model respectively, with the standard average method taken as the control (CK). For each method, the average relative error (MRE), root mean square error (RMSE) and decisive coefficient (R2) were selected as indicators to compare the above models. 【Result】 The error of the standard average method was 7.40%. In contrast, the relative error of the multiple linear regression model and the BP neural network models was 2.40% and 1.65%, respectively. These results indicated that it is feasible to estimate agricultural water consumption using the electricity consumption read from the national grid. Among the three methods we compared, the BP neutral network was most accurate for estimating the conversion coefficient. 【Conclusion】 The MRE, RMSE and R2 of the multiple linear regression model were 0.024, 0.175 and 0.923 respectively, compared with their associated values in the BP neural network model, which were 0.018, 0.131 and 0.957. The BP neural network can thus be used as a robust method to estimate the conversion coefficient in converting electricity consumption to agricultural water consumption.

As the supporting region for ecological barrier in the Yellow River Basin, it is of profound significance for Henan Province to explore the relationship between land use and ecosystem service value (ESV) for promoting ecological protection and high-quality development in the basin. In this paper, the ESV equivalent table proposed by Xie Gaodi et al was revised and the ecological value of construction land was also incorporated into the table. Combined with the FLUS model, the ESV of Henan from 2000 to 2050 was calculated. The historical evolution characteristics of ESV and the impact of different land use scenarios on ESV were analyzed. The results are shown as follows. (1) The ESV of Henan showed a trend of rising, falling and rising again from 2000 to 2020. The spatial distribution pattern was high in the West and low in the East. The distribution range of low value areas and sub-high value areas was enlarged. (2) The ESV in each city of Henan showed an upward trend from 2000 to 2010, and first decreased and then increased from 2010 to 2020. The ESV and its variation in Nanyang, Xinyang and Luoyang were higher, contributing to about 50% ESV in Henan. (3) The ESV ratios of cultivated land, forest land and water area were relatively high. During the study period, the growth of ESV mainly benefited from the expansion of water area and forest land, while the reduction of cultivated land and the disorderly expansion of construction land were the key factors leading to the decline of ESV. (4) From 2025 to 2050, the ESV in Henan will be the highest under the cultivated land protection scenario and the lowest under the natural scenario. It is very important to protect farmland, forest, grass, water area and reduce the disorderly expansion of construction land for maintaining and improving ecosystem service value in the next 30 years. [ABSTRACT FROM AUTHOR]

Objective To investigate the effects of hyperbaric oxygen combined with ulinastatin on choline acetyltransferase (ChAT), malondialdehyde (MDA), and myocardial function in rats with acute organophosphorus pesticide poisoning. Methods 50 specific-pathogen-free (SPF) male SD rats were randomly divided into five groups of ten each: normal group (N), model group (M), hyperbaric oxygen group (H), and ulinastatin group (U), and hyperbaric oxygen combined ulinastatin (O) group. The model of acute organophosphorus pesticide poisoning was established in the M, H, U, and O groups via cumulative subcutaneous injections on the neck back, and the N group did not set up the model. After the success of the modeling, the H group was treated with hyperbaric oxygen therapy, and the U group was intraperitoneally injected with ulinastatin at a dose of 100 000 U/kg.The O group received a combination of hyperbaric oxygen and ulinastatin treatment, whereas the N and M groups were gavaged with an equivalent volume of saline. The rats' myocardial function was assessed through cardiac echocardiography, brain tissue pathology was examined using hematoxylin and eosin (HE) staining and Nissl staining, cardiomyocyte apoptosis was evaluated by TUNEL assay, and ChAT and acetylcholine (Ach) content in rat brain tissues were determined through histochemical methods. Serum levels of MDA and superoxide dismutase (SOD) were measured using the thiobarbituric acid reactive substances (TBARS) assay. Statistical analysis was performed by SPSS 22.0. Results Compared with Group N, the left ventricular end systolic dimension (LVSD) and left ventricular end diastolic dimension (LVDD) in Group M were both enlarged, with increased interventricular septum (IVS) thickness, aggravated left ventricular strain (LVS), increased number of apoptotic cardiomyocytes, and elevated Ach and MDA levels (P<0.05). Additionally, the left ventricular ejection fraction (LVEF) decreased, while ChAT and SOD levels also decreased (P<0.05). When compared to Group M, both Groups H and U exhibited reduced LVSD and LVDD, thinner IVS, decreased LVS, and fewer apoptotic cardiomyocytes. Furthermore, Ach and MDA levels were lower (P<0.05), while LVEF, ChAT, and SOD levels were higher (P<0.05). No statistically significant difference was observed between Groups U and H (P>0.05), while Group O showed more pronounced changes compared to Group U (P<0.05). Rats in Group N exhibited normal brain tissue pathological morphology, while those in Group M suffered severe damage to brain tissue structure. Compared to Group M, significant improvements in symptoms were observed in Groups H, U, and O. Conclusions Hyperbaric oxygen combined with ulinastatin has a significant effect on acute organophosphorus pesticide poisoning rats, which can significantly increase ChAT content, decrease MDA content, and effectively improve myocardial function. [ABSTRACT FROM AUTHOR]

The microcrystalline cellulose/thermoplastic starch (MCC/TPS) film was prepared by melt extrusion method, and the MCC/TPS film was combined with paper by hot pressing method. The results show that the SEM images show that the interface layer of paper-plastic composite has good adhesion. When the addition a-mount of MCC is 5wt%, the mechanical properties of TPS film are improved, and the path of water vapor through TPS film is extended, resulting in the water vapor transmittability of MCC/TPS/paper composite is reduced, and the barrier properties of paper-plastic composite are improved. TPS/paper composites and MCC/ TPS/paper composites have better physical properties (i.e. smoothness, flexibility and folding resistance) than paper alone. Therefore, the addition of MCC can improve the barrier properties and mechanical properties of paper-plastic composite materials to meet the requirements of the food packaging industry for low water sensitive materials. [ABSTRACT FROM AUTHOR]

With the rapid development and wide application of big data technology, users' unauthorized access to resources becomes one of the main problems that restrict the secure sharing and controlled access to big data resources. The ReBAC (Relationship-Based Access Control) model uses the relationship between entities to formulate access control rules, which enhances the logical expression of policies and realizes dynamic access control. However, It still faces the problems of missing entity relationship data and complex relationship paths of rules. To overcome these problems, a link prediction model LPMDLG based on GNN dual-source learning was proposed to transform the big data entity-relationship prediction problem into a link prediction problem with directed multiple graphs. A topology learning method based on directed enclosing subgraphs was designed in this modeled. And a directed dual-radius node labeling algorithm was proposed to learn the topological structure features of nodes and subgraphs from entity relationship graphs through three segments, including directed enclosing subgraph extraction, subgraph node labeling calculation and topological structure feature learning. A node embedding feature learning method based on directed neighbor subgraph was proposed, which incorporated elements such as attention coefficients and relationship types, and learned its node embedding features through the sessions of directed neighbor subgraph extraction and node embedding feature learning. A two-source fusion scoring network was designed to jointly calculate the edge scores by topology and node embedding to obtain the link prediction results of entity-relationship graphs. The experiment results of link prediction show that the proposed model obtains better prediction results under the evaluation metrics of AUC-PR, MRR and Hits@N compared with the baseline models such as R-GCN, SEAL, GraIL and TACT. The ablation experiment results illustrate that the model's dual-source learning scheme outperforms the link prediction effect of a single scheme. The rule matching experiment results verify that the model achieves automatic authorization of some entities and compression of the relational path of rules. The model effectively improves the effect of link prediction and it can meet the demand of big data access control relationship prediction. [ABSTRACT FROM AUTHOR]

Aiming at the problem of complex multi-step attack detection, the method of attack scenario construction oriented to cloud computing environment was studied. Firstly, a dynamic probabilistic attack graph model was constructed, and a probabilistic attack graph updating algorithm was designed to make it update periodically with the passage of time and space, so as to adapt to the elastic and dynamic cloud computing environment. Secondly, an attack intention inference algorithm and a maximum probability attack path inference algorithm were designed to solve the uncertain problems such as error and fracture of attack scenarios caused by false positive or false negative, and ensure the accuracy of attack scenario. Meanwhile, the attack scenario was dynamically evolved along with the dynamic probability attack graph to ensure the completeness and freshness of the attack scenario. Experimental results show that the proposed method can adapt to the elastic and dynamic cloud environment, restore the penetration process of attacker's and reconstruct high-level attack scenario, and so provide certain references for building supervised and accountable cloud environment. [ABSTRACT FROM AUTHOR]

Estimation of panicle blast level plays an important role in high-quality production of rice. It helps to quantitatively assess the level of blast resistance and severity in the field to make appropriate decisions in gauging cultivar resistance in rice breeding or precisely controlling blast epidemic. However, it is difficult to evaluate the blast disease degree automatically and accurately. In this study, a novel grading method for panicle blast severity based on hyperspectral imaging technology is proposed. The method defines a bag of spectrum words (BoSW) model for hyperspectral image data representation. The BoSW model based on hyperspectral image data representation is used as the input of a Chi-square kernel support vector machine (Chi-SVM) classifier for predicting the rice panicle blast level. More precisely, dense grids are firstly extracted over the spatial X- and Y-axes across the whole spectral Z-axis. The average spectrum curve of all the pixels within a grid cube is calculated. Then, K-Means clustering would be performed on the large collection of average spectrum curves from the training samples to form the dictionary of spectrum words. Next, each spectrum curve on the grid cube is quantized into one of spectrum words. Each hyperspectral image of rice panicle is transformed into a map of spectrum words. All the spectrum words are distributed evenly on the spatial XY-axis plane. BoSW model for each hyperspectral data cube is then formed by means of histogram statistics of spectrum word occurrences. Finally, a Chi-SVM classifier is trained using the BoSW representations of rice panicle hyperspectral images for predicting panicle blast infection levels. The proposed BoSW method uses both the image and full-spectrum information by means of regular grid cube extraction, which utilizes the full potential of the imaging sensing system. Meanwhile, the representation dimension for each hyperspectral image is significantly reduced, i.e. 100 here, and thus relieving modeling difficulty. The procedure of clustering helps to find the representative spectrum curves and quantizing helps to transform all the continuous-state spectrum curves into one of representative spectrum curve. Thus the proposed BoSW method is invariant to complicated noise and robust to rice cultivars. To verify the proposed BoSW method, a total of 170 fresh rice panicles covering more than 50 cultivars are collected from an experimental field for the performance evaluation. The experimental field is located in regional testing area for evaluating rice cultivars in Guangdong province. Therefore, all the rice plants in this area are naturally inoculated as the area is a typical source of rice blast fungus. The hyperspectral images of all the rice panicles are acquired using HyperSIS-VNIR-QE imaging spectrometer and then are transformed into 100-dimension BoSW representation for the construction of Chi-SVM classifier. Four-class label of hyperspectral image sample is determined by plant protection expert according to description of blast infection levels. Two thirds of the labeled BoSW representations are randomly selected for training and the rest for testing. Experimental results show that the proposed BoSW based method achieved high classification accuracy of 94.72%. This result is much better than traditional hyperspectral image analysis methods such as Principal component analysis (PCA), sensitive bands selection and etc. Moreover, the proposed BoSW demonstrates strong robustness to rice cultivars, which is vital for the wide and practical application. This research improves the classification accuracy of rice panicle blast grading and provides a reference to evaluate other disease level grading as well. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the regulatory role of nucleotide-bound oligomerized domain-like receptor containing pyrin-domain protein 6 (NLRP6) in liver lipid metabolism and non-alcoholic fatty liver disease (NAFLD)., Methods: Mouse models with high-fat diet (HFD) feeding for 16 weeks ( n =6) or with methionine choline-deficient diet (MCD) feeding for 8 weeks ( n =6) were examined for the development of NAFLD using HE and oil red O staining, and hepatic expressions of NLRP6 were detected with RT-qPCR, Western blotting, and immunohistochemical staining. Cultured human hepatocytes (LO2 cells) with adenovirus-mediated NLRP6 overexpression or knock-down were treated with palmitic acid (PA) in the presence or absence of compound C (an AMPK inhibitor), and the changes in cellular lipid metabolism were examined by measuring triglyceride, ATP and β-hydroxybutyrate levels and using oil red staining, RT-qPCR, and Western blotting., Results: HFD and MCD feeding both resulted in the development of NAFLD in mice, which showed significantly decreased NLRP6 expression in the liver. In PA-treated LO2 cells, NLRP6 overexpression significantly decreased cellular TG content and lipid deposition, while NLRP6 knockdown caused the opposite effects. NLRP6 overexpression in PA-treated LO2 cells also increased mRNA and protein expressions of PGC1A and CPT1A, levels of ATP and β-hydroxybutyrate, and the phosphorylation level of AMPK pathway; the oxidative decomposition of lipids induced by Ad-NLRP6 was inhibited by the use of AMPK inhibitors., Conclusions: NLRP6 overexpression promotes lipid oxidation and decomposition through AMPK/CPT1A/PGC1A to alleviate lipid deposition in hepatocytes.

Objective: To investigate the therapeutic effect of SVF-gel in unilateral vocal cord paralysis. Methods: his investigation presented a retrospective study of SVF-gel auto-transplantation in 22 patients with unilateral vocal cord paralysis from June 2017 to December 2018 in otolaryngology head and neck surgery of Nanjing Tongren Hospital. Under the general anesthesia support laryngoscope, the medial thigh was selected as the fat supply area. SVF-gel was obtained by SVF-gel technology. The SVF-gel was transplanted into the vocal cord muscle and the paraglottic space. The laryngography was performed before and after the operation. The voice was analyzed and compared to evaluate the therapeutic effect. Results: SVF-gel was successfully transplanted in all 22 cases. The stroboscopic laryngoscopy showed that the vocal cords vibrated well and the glottis closed normally. The results of GRBAS showed that the voice quality of the patients at 12 and 18 months after the operation was significantly improved. The voice analysis showed that the maximum phonation time of the patients at 12 and 18 months after the operation increased. The basic frequency increased. The basic frequency perturbation, amplitude perturbation and standardized noise energy decreased significantly（ P <0.05）. Conclusion: SVF-gel auto-transplantation can effectively improve the voice quality of unilateral vocal cord paralysis and the long-term effect is stable., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Early recognition and treatment for early warning electrocardiogram (ECG) of sudden death are very important to prevent and treat malignant arrhythmia and sudden death. Previous studies have found that R-on-T and T wave alternation, and QT interval prolongation are closely related to malignant arrhythmia or sudden death, which are included in the critical value of ECG.By analyzing the ECG characteristics of 4 patients with sudden death, we found that although the causes of the patients were different, there were transient prolongation of QT interval after premature contraction in 12 lead ECG, followed by malignant arrhythmia or sudden death. Thus, we thought that the transient prolongation of QT interval after premature contraction had a high value for warning malignant arrhythmia or sudden death. This phenomenon should be paid enough attention to reduce the risk of sudden death.

Objective: To investigate the value of ventricular tachycardia (VT) score in diagnosing pre-excited tachycardia.
 Methods: Twelve-lead electrocardiograph results were obtained from 30 patients at pre-excited tachycardia attacking stage who were diagnosed by electrophysiology. We scored pre-excitation tachycardia based on the VT score. To analyze the electrocardiogram of pre-excited tachycardia using 7 diagnostic indicators of the VT score and calculate the specificity of 7 diagnostic indicators and right superior axis (-90º to ±180º), the differences were compared among VT score of 2 points and brugada, Wellens, and Vereckei algorithms in diagnosing pre-excited tachycardia. According to the specificity of Vereckei, Wellens, and Brugada algorithms, and VT scores from low to high, their prediction value and differences were analyzed.
 Results: Single indicator such as atrioventricular (AV) dissociation or right superior axis (-90º to ±180º) showed the highest specificity (100%) for identifying pre-excited tachycardia. No patient with VT score was ≥3 points, and the specificity was 100%. The specificity of VT score of 2 point was higher than that of Brugada, Wellens, or Vereckei algorithms in the diagnosing pre-excited tachycardia (76.7% vs 50.0%, 23.3% or 20.0%, P<0.05). The specificity of Vereckei, Wellens, and Brugada algorithms and VT score were gradually increased after each of stepwise individually eliminated VT (20.0%, 40.0%, 66.7%, 83.3%, P<0.05). However, there was no significant difference in the specificity in the remaining false positive cases between the 4 methods and VT score.
 Conclusion: VT score ≥3 points can identify pre-excited tachycardia and VT with 100% specificity. VT score of 2 points cannot completely distinguish pre-excited tachycardia from VT, but specificity of VT score with 2 points is obviously higher than that of Brugada, Wellens, and Vereckei algorithms.

Objective: To observe the effects of electroacupuncture (EA) on postoperative cognitive dysfunction (POCD) and AngⅡ/AT1R in the hippocampus in D-galactose-induced aging rats which received hepalobectomy, and to explore the possible mechanism of EA on POCD., Methods: Eighty male Sprague-Dawley rats were randomly divided into a young control group (10 rats), a D-Galactose-induced aged (Da) group (10 rats), a Da+hepatolobectomy group (30 rats) and an EA group (30 rats). The rats in the Da+hepatolobectomy group and EA group were further randomly divided into a 1 d subgroup, 3 d subgroup and a 7 d subgroup, 10 rats in each subgroup. The rats in the EA group were treated with EA at "Baihui" (GV 20) and "Dazhui" (GV 14) with continuous wave (15 Hz in frequency and 1 mA in intensity), and rats in each subgroup were treated for 1 d, 3 d and 7 d, respectively. The rats in the remaining groups were treated with immobilization, once a day. The Y-maze was used to observe the behavior change of rats, and ELISA was applied to measure the level of hippocampal AngⅡ, and RT-PCR and immunohistochemistry method were performed to detect AT1R mRNA expressions and AT1R positive expression in the hippocampus., Results: The number of rat initiative avoidance in the Da group was significantly less than that in the young control group ( P <0.05), and the mRNA expression and positive percentage of AT1R in the hippocampus in the Da group were significantly higher than those in the young control group (both P <0.01). Compared with the Da group, the number of rat initiative avoidance in each subgroup of Da+hepatolobectomy group and EA group were significantly reduced (all P <0.01), and the expression of AngⅡ, AT1R mRNA and AT1R positive cells percentage in the hippocampus were significantly increased ( P <0.05, P <0.01). The number of rat initiative avoidance in each subgroup of EA group was higher than that in the subgroup of Da+hepatolobectomy group ( P <0.05, P <0.01); and the expression of AngⅡ, AT1R mRNA, and AT1R positive percentage in the EA group were significantly less than that in the Da+hepatolobectomy group ( P <0.05, P <0.01)., Conclusions: EA at "Baihui" (GV 20) and "Dazhui" (GV 14) could improve POCD in D-galactose-induced aging rats which received hepalobectomy, and it is likely to be related with the inhibition of AngⅡ, AT1R positive expression and AT1R mRNA in the hippocampus.

Objective: To observe the effects of electroacupuncture (EA) pretreatment on the intestinal function, inflammatory reaction and blood lactic acid in the patients of colorectal cancer surgery., Methods: Sixty patients of colorectal cancer laparotomy at selective period, aged from 18 to 59 years old were selected. According toⅠ-Ⅲ grade of American Society of Anesthesiologists (ASA), the patients were randomized into group A (total intravenous anesthesia), group B[total intravenous anesthesia combined with EA pretreatment at Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) on the right side] and group C[total intravenous anesthesia combined with EA pretreatment at Zhongwan (CV 12), Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) on the right side], 20 cases in each one. The total intravenous anesthesia was applied to all of the three groups. EA pretreatment was used one day before surgery and 30 min before surgery at corresponding acupoints in the group B and group C separately, 30 min each time. After surgery, the recovery time of bowel sound, the recovery time of flatus, the recovery time of defecation, the duration of diet fasting, the time of peritoneal drainage tube withdrawal and the total peritoneal drainage volume were observed in the three groups. The venous blood was collected to determine white blood cell count (WBC) and neutrophil count (NEUT) before surgery (T 0 ), 24 h after surgery (T 1 ) and on the 5th day after surgery (T 2 ) separately. The arterial blood was collected to determine the level of lactic acid before surgery (T Ⅰ ), after peritoneal douching (T Ⅱ ) and 24 h after surgery (T Ⅲ )separately., Results: The recovery time of bowel sound, the recovery time of flatus, the duration of diet fasting and the time of peritoneal drainage tube withdrawal in the group C were apparently earlier than those in the group A (all P <0.05). WBC and NEUT at T 1 in the group C were apparently less than those in the group A (both P <0.05). The differences in lactic acid at T Ⅰ , T Ⅱ and T Ⅲ were not significant statistically in comparison of the three groups (all P >0.05)., Conclusions: The total intravenous anesthesia combined with EA pretreatment at Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Tianshu (ST 25) and Zhongwan (CV 12) reduce the recovery time of bowel sound, the recovery time of flatus, the duration of diet fasting and the time of peritoneal drainage tube withdrawal so as to improve the recovery of intestinal function, reduce WBC in 24 h after surgery and alleviate inflammatory reaction. This therapy has no influence on blood lactic acid.

Objective: To develop a brief version scale with good validity and reliability to evaluate self-management knowledge, attitude and behavior (KAB) of diabetes patients in a shorter time., Methods: 20 authority experts who specialized in the field of diabetes clinical and non-communicable disease self-management, and familiar with the relevant content of diabetes self-management were selected. Face to face and Email consultation methods were applied in two rounds delphi expert consultations to choose items from the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB, total scale, 98 items). In the first round of expert consultation, experts were asked to select the core items from every dimension and score the extent of familiarity and basis of judgment. In the second round of expert consultation, the significance of the core items which were selected by experts in first round, were graded. The items which entered into the brief scale were determined by harmonious condition of expert opinions., Results: Two rounds of consultation reclaimed 16 and 15 responses respectively, Positive coefficients of experts were 80% and 94% respectively, and both authoritative coefficients were 0.90. In the first round of consultation, experts selected 44.3 ± 6.2 items on average, 42 items were selected according to the integrity of the scale for measuring dimension and content at last. In the second round of consultation, experts thought that the 42 items could measure the important contents of each dimension comprehensive and representative, the item importance scores of knowledge, attitude, and behavior subscale were 8.42 ± 1.17, 8.61 ± 1.24, 8.61 ± 1.02 respectively, and the coordination coefficients of the three subscale were 0.36, 0.20, 0.49 (χ(2) were 89.74, 11.13, 96.03, P<0.05). The total coordination coefficient was 0.38 (χ(2) =199.36, P<0.001), which indicated the concentration of experts(')opinion was acceptable, showed the brief scale with good face validity and content validity., Conclusion: The brief scale could evaluate Diabetes Self-management KAB Scale rapidly and relatively comprehensive in groups or individuals diabetes with good face validity and content validity.

Objective: To develop The Diabetes Self-management Knowledge, Attitude, and Behavior Scale (DSKAB) with Chinese population social culture character in a good validity and reliability after Delphi method and pilot study., Methods: This study based on former knowledge, attitude, and behavior questionnaires, an index list was established through literature search, group discussion, and expert in-depth interviews. Then we identified the core indexes and developed a primary scale through the Delphi. We selected 24 experts who specialized in the field of diabetes related clinical medicine, non-communicable diseases self-management, non-communicable diseases control and prevention, and public health. The consultation tables were delivered by EMS and Email. All the experts were asked to grade the evaluation indexes based on overall consideration finality, scientificity, importance, applicability, and to explain the extent of similarity and the basis of judgment. The core indexes of the scale were determined through the positive coefficient, the degree of concentration, the harmonious coefficient, the authoritative coefficient. We selected 27 diabetes patients from the community, and interviewed them face to face. After finishing the field survey, we organized the staff who investigated the patients to participate the panel discussion, to modify and adjust the items formed the scale knowledge attitude behavior of self-management for patients with diabetes mellitus., Results: Two rounds of Delphi both reclaimed 20 experts(') responses, the positive coefficients were 83% and 100% respectively, the authoritative coefficients were 0.85 ± 0.10 and 0.87 ± 0.09, the harmonious coefficients were 0.16 and 0.23 (χ(2) were 283.49 and 398.00, P<0.001) respectively. We identified 75 core indexes through two-round Delphi, 86.30% (63/75) indexes had the importance of full marks than in 0.50 above, it developed the primary scale which included 100 items. Based on the pilot study, we increased 2 items, deleted 4 items, recomposed 2 items and reserved 96 items, the scale consisted of 98 items that were made of three subscales which were the knowledge subscale, the attitude subscale and the behavior subscale., Conclusion: For DSKAB through Delphi method and pilot study, the active coefficients, the authoritative coefficients, the harmonious coefficients fulfilled the scientific requires, it also laid the foundation for the good performance of the scale.

Scale is the basis and quality assurance of investigation research, and a rigorous process is needed to develop a scale. The establishment of the item pool is the first step, then screening these items by using Delphi expert consultation method or statistical methods to establish the scale. At last, the acceptability, validity, reliability and sensitivity of scale should be evaluated. A scale can be widely applied only if it has a good acceptability, validity, reliability and sensitivity. China National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention have developed "the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB)" and "the brief version of Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB-SF) ". These scales provide a set of scientific evaluation tools to diabetes self-management of Type 2 Diabetes with excellent reliability, validity, sensitivity and acceptability.

Objective: To evaluate the validity and reliability of Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB)., Methods: We selected 460 patients with diabetes in the community, used the scale which was after two rounds of the Delphi method and pilot study. Investigators surveyed the patients by the way of face to face. by draw lots, we selected 25 community diabetes randomly for repeating investigations after one week. The validity analyses included face validity, content validity, construct validity and discriminant validity. The reliability analyses included Cronbach's α coefficient, θ coefficient, Ω coefficient, split-half reliability and test-retest reliability., Results: This study distributed a total of 460 questionnaires, reclaimed 442, qualified 432. The score of the scale was 254.59 ± 28.90, the scores of the knowledge, attitude, behavior sub-scales were 82.44 ± 11.24, 63.53 ± 5.77 and 108.61 ± 17.55, respectively. It had excellent face validity and content validity. The correlation coefficient was from 0.71 to 0.91 among three sub-scales and the scale, P<0.001. The common factor cumulative variance contribution rate of the scale and three sub-scales was from 57.28% to 67.19%, which achieved more than 50% of the approved standard, there was 25 common factors, 91 items of the total 98 items held factor loading ≥0.40 in its relevant common factor, it had good construct validity. The scores of high group and low group in three sub-scales were: knowledge (91.12 ± 3.62) and (69.96 ± 11.20), attitude (68.75 ± 4.51) and (58.79 ± 4.87), behavior (129.38 ± 8.53) and (89.65 ± 11.34),mean scores of three sub-scales were apparently different, which compared between high score group and low score group, the t value were - 19.45, -16.24 and -30.29, respectively, P<0.001, and it had good discriminant validity. The Cronbach's α coefficient of the scale and three sub-scales was from 0.79 to 0.93, the θ coefficient was from 0.86 to 0.95, the Ω coefficient was from 0.90 to 0.98, split-half reliability was from 0.89 to 0.95.Test-retest reliability of the scale was 0.51;the three sub-scales was from 0.46 to 0.52, P<0.05., Conclusion: The validity and reliability of the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale are excellent, which is a suitable instrument to evaluate the self-management for patients with diabetes.

Objective: To investigate the values of CD64 and CD11b indices of peripheral white blood cells in the early diagnosis of acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) in older adults., Methods: The study enrolled 86 aged AE-COPD patients, 82 stable-COPD patients admitted in the affiliated hospital of Jiujiang University from March 2011 to December 2013, and simultaneously 84 healthy aged volunteers as a control group. All the subjects were examined in white blood cells, hypersensitive C-reactive protein (hs-CRP), mean fluorescence intensity (MFI) of CD64 and CD11b from peripheral white blood cells within 24 hours after admission. CD64 and CD11b MFI were converted into CD64 and CD11b indices by conversion formula. The significant indicators for the diagnosis of AE-COPD were screened and the receiver operating characteristic (ROC) curve was drawn for calculating the area under the curve, critical value, sensitivity and specificity., Results: Compare with stable-COPD group, the CD11b index decreased and CD64 index increased. There existed statistical difference in CD11b and CD64 indices between the AE-COPD group and the stable-COPD group (P<0.01), but not between the stable-COPD group and the healthy control group (P>0.05). Critical values of CD11b and CD64 indices were respectively less than 0.94 and more than 1.83. Their sensitively and specificity for the diagnosis of AE-COPD were 62.65% and 77.11% for CD11b and 79.52% and 98.80% for CD64., Conclusion: Increased CD64 index and decreased CD11b index are the credible laboratory markers in the early diagnosis of AE-COPD, and the dynamic monitoring of them may facilitate the evaluation of therapeutic outcomes of AE-COPD.

Objective: To study the relationship between body mass index (BMI) and cardiovascular risk factors among Chinese adult population., Methods: 98 271 subjects aged 18 years or over were recruited from 162 surveillance points around 31 provinces in China's mainland in 2010, under a complex multistage stratified sampling method. The survey included face-to-face interview, physical measurement and laboratory testing, to collect information related to the prevalence of risk factors as smoking, drinking, diet and physical activities as well as the prevalence of main chronic disease as hypertension, diabetes and dyslipidemia. 24 kg/m(2)≤BMI<28 kg/m(2) was defined as overweight and BMI≥28 kg/m(2) was defined as obese. After a complex weighting on the sample, level and proportion of cardiovascular risk factors in groups of different BMI were analyzed., Results: The overall prevalence rates of overweight and obesity were 30.6% (95%CI:29.5%-31.7%) and 12.0% (95%CI:11.0%-12.9%) and were significantly higher in men for overweight (χ(2) = 16.09, P < 0.001) and those aged 45-65 years old for both overweight and obesity (χ(2) values were 485.17 and 112.23 both P < 0.001), respectively. The levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), fasting plasma glucose (FPG) and fasting blood insulin (FBI) showed a significantly increase on BMI and were seen higher in overweight (F values were 4 056.19, 6 860.70, 3 898.91, 1 624.73, 2 337.21, 2 558.01, 1 049.01 and 1 665.52, with both Ps< 0.001)respectively and obese participants (F values were 5 628.68, 9 949.81, 5 508.77, 1 656.34, 2 452.05, 2 365.92, 1 441.72 and 6 081.27, respectively; all Ps<0.001). The prevalence rates of hypertension, dyslipidemia, diabetes, insulin resistance and clustering of cardiovascular disease showed a significantly increase on BMI and were higher in overweight (χ(2) values were 704.70, 521.86, 431.35, 449.13 and 686.83, both Ps<0.001), and obese participants (χ(2) values were 113.45, 645.03, 1 063.30, 1 547.86 and 1 909.66, both Ps<0.001), respectively. After adjustment for age and gender, participants with 24 kg/m(2) ≤BMI<28 kg/m(2) and BMI≥28 kg/m(2) increased the risks of hypertension, dyslipidemia, diabetes, insulin resistance and clustering of cardiovascular disease by 2.5/5.5, 2.2/3.4, 1.8/2.9, 2.9/8.2 and 3.3/8.9 times than participants with BMI<28 kg/m(2), respectively., Conclusion: The risk of cardiovascular disease parallelly increased with BMI among Chinese adults. Rational control on BMI should be viewed as priority on chronic disease prevention and control.

Objective: To detect the expressions of CXCR4 and Nrf2 in non-small cell lung cancer (NSCLC) tissues and analyze their association with the clinicopathological features of NSCLC., Methods: We investigated the expressions of CXCR4 and Nrf2 in 66 NSCLC and corresponding distant normal tissue specimens using immunohistochemistry and real-time PCR., Results: The expressions of CXCR4 protein and mRNA were significantly higher in NSCLC tissue specimens than in the distant normal tissues, while the expression of Nrf2 protein and mRNA increased significantly in NSCLC tissues compared to those in the distant normal tissues (P<0.01). A high expression level of CXCR4 was positively correlated with a large tumor size (P=0.048), poor differentiation (P=0.024), advanced TNM stage (P=0.018), lymph node metastasis (P=0.004), and distant metastasis (P=0.016). The expression of Nrf2 protein was positively correlated with a large tumor size (P=0.008), advanced TNM stage (P=0.028), lymph node metastasis (P=0.038), and distant metastasis (P=0.023). A strong correlation was found between CXCR4 and Nrf2 expressions in NSCLC tissues (r=0.324, P<0.01), and the co-expression of CXCR4 and Nrf2 was strongly correlated with lymph node metastasis and distant metastasis., Conclusion: Abnormal expressions of CXCR4 and Nrf2 may contribute to the progression and malignant biological behavior of NSCLC.

Pyogenic granuloma also known as granulomatous type capillary hemangioma, telangiectatic granuloma, lobular capillary hemangioma, is not really a tumor, its nature is still controversial. A rare clinical entity. I Division in treating facial pyogenic granuloma in 1 cases, the report is as follows.

Objective: To investigate the genotoxicity of acrylamide and to determine its genotoxic target organs., Methods: DNA damage was detected by using comet assay. Lung, liver, spleen, kidney, testicle, bone marrow and peripheral lymphocytes of mice were isolated at 0, 3, 6, 12 and 24h after 50 mg/kg acrylamide intraperitoneal injection., Results: Significant increase in comet tail length, tail DNA% and tail moment in the cells of liver, spleen, testicle, bone marrow and peripheral lymphocytes were induced at different sampling time after treatment of acrylamide. The indexes decreased more or less as time extended. No obvious increase in DNA damages was observed in the lung and kidney with the same treatment., Conclusion: Acrylamide could cause DNA damage to multiple organs of mice. The DNA damage caused by acrylamide could be repaired to a certain degree.

Objective: Discussion on utility and purposed value of obesity and abdomen obesity when body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) used as indexes predicting hypertension, hyper-blood glucose, and both clusters, to provide scientific basis for the decision on the indexes and their cut-off points of obesity and abdomen obesity in Chinese people., Methods: Using the data of diabetes mellitus (DM) from epidemiological studies carried out in 11 provinces/autonomous regions/municipalities of China from July 1995 to June 1997. Partial relative analysis, logistic multi-factors regression analysis, interaction analysis were used. Relative risk (RR), attributable risk proportion (ARP) and population attributable risk proportion (PARP) of hypertension, hyper-blood glucose, and the both cluster as BMI, WC, WHR with the different cut off points were analysed., Results: 1) The correlations between BMI, WC and blood pressure, blood glucose were better than the WHR. 2) After adjusted by age, sex, occupation leisure physical activity, education degree and the family history of DM, the results suggested that BMI, WC, WHR were important predictive factors, with relative importance as BMI > WC > WHR. 3) There were augment interactions on BMI, WC and WHR with hypertension, hyper-blood glucose, with the interaction of BMI and WC in particular. Their pure attributable interaction proportion were from 5.95% to 29.34%. 4) The values of RR were about 2.5 when BMI >/= 23, >/= 24 and >/= 25, suggesting the relationship with exposure factors and diseases were with medium and high maleficent extent. Their ARP were from 0.580 to 0.623 with PARP from 0.259 to 0.425. The values of RR were from 2.06 to 3.08 as WC >/= 85 cm in males, WC >/= 80 cm in females while WC >/= 90 cm in males, WC >/= 80 cm in females, which suggested that the relationship with exposure factors and diseases were in medium and high maleficent extent. Their ARP were from 0.515 to 0.676 while PARP from 0.241 to 0.431., Conclusions: Since the maleficent extent of exposure factors to diseases, the acceptability for overweight and obesity in population, and the prevention and care for overweight and obesity were just in the introduction stage in China. The utility value of predicted hypertension, hyper-blood glucose in BMI and WC seemed to be better then in WHR. We suggested that BMI used as the obesity index, with the diagnostic cut-off point BMI >/= 24. WC as the abdomen obesity index. The diagnostic cut-off points are suggested to be WC >/= 85 cm in males, and WC >/= 80 cm in females.