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To investigate the changes in relevant anatomical parameters of posterolateral protrusion of the vertebral artery (VA) between head-neck rotational and neutral positions using low-dose three-dimensional computed tomography angiography (3D-CTA).Low-dose 3D-CTA images obtained for various craniocervical diseases in 36 non-dominant VA side patients with neutral, left and right head-neck rotational positions were evaluated. The relevant parameters from superior and inferior views, including external diameter (ED), internal diameter (ID), transverse diameter (TD), heights and diameters of posterolateral protrusion of the VA over the posterior arch of the atlas in the neutral and rotational positions, were recorded and compared.There was no significant differences in the rotational angle (left/right: 31.23 ± 6.60/29.94 ± 6.09°, p0.05). There were no significant differences in heights and diameters of bilateral VA between rotational and neutral positions (all p0.05). The contralateral ID, ED, and TD of the rotational positions were significantly shorter than those of the neutral position (all p0.05), while there were no significant differences in the three ipsilateral diameters (all p0.05).Posterolateral protrusion of the VA is not uncommon in the population, and surgeons should be aware of its presence, especially the increased possibility of injury to the VA caused by head-neck rotation, during the operation; thus, preoperative evaluation by low-dose 3D-CTA should be considered.

A family with nanophthalmos was genetically investigated. The proband of this family was a 34-year-old male, who was diagnosed as binocular glaucoma two years ago and was admitted to Beijing Tongren Eye Center due to impaired vision in his right eye for 2 months. The intraocular pressure was controlled with two anti-glaucoma medications, the range of the angle closure was300 degrees, and the cup-disk ratio was significantly increased in both eyes. The axial length of the right and left eyes was 17.45 mm and 17.36 mm, respectively. A heterozygous missense variant of the TMEM98 gene was detected by gene sequencing (C. 602GC, P.R201p). Both eyes were diagnosed with nanophthalmos and secondary angle-closure glaucoma. The father of the proband was found to carry a homozygous variant in the same gene, while the daughter of the proband carried the same heterozygous variant as the proband. Both of them were diagnosed as binocular nanophthalmos in combination with clinical manifestations.先证者为34岁右眼视力下降2个月男性患者，双眼青光眼2年，双眼眼压在正常范围（使用2种抗青光眼药物），双眼房角关闭范围300°，双眼视杯视盘直径比明显增大，眼轴长度右眼为17.45 mm，左眼为17.36 mm，基因测序检出TMEM98基因杂合错义突变（c.602GC，p.R201P），诊断为双眼真性小眼球和双眼继发性闭角型青光眼。家系中发现先证者父亲携带相同基因纯合错义突变，先证者女儿携带与先证者相同基因杂合错义突变，综合临床表现均诊断为双眼真性小眼球。.

Our aim is to characterize patients with pruritus in type 2 diabetes, determine independent risk factors and explore the impact of the psychological condition of these patients.This is a retrospective study. From October 1, 2020, to September 30, 2021, 944 individuals with T2DM who had medical treatment were identified from the database. Electronic medical record information including patient characteristics, complications, laboratory data, and medication usage was obtained from the database. Propensity score matching, univariate analysis and a multivariable logistic regression model were used in this study. Based on observation, we discussed the psychological impact of pruritus on these patients.There were 97 patients with T2DM who suffered from pruritus. After propensity score matching based on age, gender, and family history of diabetes etc., 97 pairs of subjects were matched. 97 patients were categorized as the Pruritus group and 97 patients as the Non-pruritus group. In univariate analysis, there were 5 variables significantly related to pruritus, including BMI, absolute eosinophils, percentage of eosinophils, diabetic kidney disease, diabetic retinopathy. After multivariable logistic regression, BMI (OR 1.094, 95%CI 1.010-1.185) and diabetic retinopathy (OR 2.440, 95%CI 1.229-4.847) were considered significant. Patients with pruritus in T2DM suffer greatly in psychological condition in many ways.For patients with pruritus complicated by T2DM, BMI and diabetic retinopathy may be independent risk factors. Mental health problems such as anxiety and depression might exacerbate by pruritus. The intimate partner relationship was also challenged due to the restless sleep caused by their partner. Frequent monitoring of BMI and diabetic retinopathy and psychological assessment may be warranted in these patients.

COVID-19 has impacted all spheres of life massively. Among the emerging studies on the psychosocial impact of the pandemic, few studies look specifically at how social workers are impacted. To understand this gap, this study surveyed 337 social workers. The findings showed that changes experienced in the workplace were enormous and caused secondary traumatic stress while engendering compassion satisfaction among social workers, but the presence of social support moderated to keep the secondary traumatic stress at bay. Resilience mediated association between social and workplace support and compassion fatigue. Social support seemed to have the largest effect on reducing stress through resilience. Workplace support also helped mitigate burnout. In conclusion, continued social and workplace support will be key to supporting social workers during a pandemic.

With the increasing detection rate of early upper gastric cancer and adenocarcinoma of esophagogastric junction, the safety of proximal gastrectomy with clear indications has been verified, and function-preserving proximal gastrectomy has been widely used. However, proximal gastrectomy destructs the normal anatomical structure of esophagogastric junction, resulting in severe postoperative gastroesophageal reflux symptoms and seriously affecting the quality of life. Among various anti-reflux surgery methods, reconstruction of "cardiac valve" has always been the focus of relevant scholars because its similarity with the mechanism of normal anti-reflux. After years of development, evolution and optimization, the designed seromuscular flap anastomosis includes tunnel muscle flap anastomosis, Hatafuku valvuloplasty, single muscle flap anastomosis and double muscle flap anastomosis. The double muscle flap anastomosis has become a research hotspot because it shows good anti-reflux effect in clinical application. This paper reviews the history, research status and hot issues of seromuscular flap anastomosis of esophageal remnant stomach at home and abroad.随着早期胃上部癌及食管胃结合部腺癌的检出率逐渐增高，近端胃切除术的安全性得到验证，保功能的近端胃切除术逐步得到广泛应用。然而，近端胃切除破坏了食管胃结合部的正常解剖结构，导致患者术后胃食管反流症状较重，严重影响生活质量。在各种抗反流术式中，重建"贲门-阀门"因与正常抗反流原理类似，一直是相关学者探索的热点。经过多年的发展及演进优化，目前设计的浆肌瓣吻合包括隧道式肌瓣吻合、Hatafuku设计的瓣膜成形术、单肌瓣吻合和双肌瓣吻合等。其中，双肌瓣吻合因其在临床应用中显示出良好的抗反流效果，已成为目前的研究热点。本文将对食管胃结合部抗反流的机制、食管残胃浆肌瓣吻合的历史和国内外研究现状及其热点问题进行综述。.

Background Minimal erythema dose (MED) has substantial inter- and intraindividual variations, reflecting the influence of very diverse factors. However, related studies showed little consistency probably because of their limited sample size. Objective To identify the factors associated with MED variations in a large-scale population study. Methods The MED test was performed by following the international standard procedure on 22 146 subjects. The results were analysed in adjusted multivariable linear and logistic regression models. Results This large-scale study revealed that lower MED was consistently associated with lighter skin [β-coefficient = -0.33, 95% confidence interval (CI) -0.36 to 0.30, P = 6.41 × 10-84 ]. Females had significantly higher MED than male (β = 0.91, 0.32-1.50, P = 2.93 × 10-3 ). Stratified analyses showed that MED was not associated with age [female: odds ratio (OR) = 0.99, 0.98-1.01; male: OR = 0.99, 0.97-1.00]. MED was lower in summer than in other seasons (spring: OR = 1.08, 1.06-1.11; autumn: OR = 1.11, 1.08-1.13; winter: OR = 1.20, 1.18-1.22). Furthermore, MED was associated with air temperature (β = -0.36, -0.49 to 0.23, P = 4.81 × 10-8 ) and air pressure (β = -0.64, -0.82 to 0.46, P = 8.01 × 10-12 ) in summer only while not in other seasons. Conclusions This study provides unprecedented evidence that MED is associated with skin colour, sex, season and meteorological factors, but not with age.

Kaempferol has been reported to play an anti-tumor role in various human cancers, while its role in gallbladder cancer (GBC) is unclear.We found that kaempferol significantly inhibited the growth, invasion and migration, meanwhile induced apoptosis through cells arrested at G0/G1 phase of GBC cell lines, including GBC-SD and SGC996 cells in vitro.Kaempferol promoted the release of cytochrome C from the mitochondria to cytoplasm, the activation of c-caspase-3 and c-caspase-9 and increased the expression levels of pro-apoptotic factor Bax, meanwhile decreased the expression levels of anti-apoptotic factor Bcl-2. In addition, the expression levels of CDK4, CDK6 and cyclin D1, which are members of the CDK4/CDK6/cyclin D1 signaling pathway, were also decreased by kaempferol. Moreover, kaempferol could efficiently prevent tumor progression of GBC in the xenograft in vivo.Our results demonstrated that kaempferol suppressed GBC progression through activation of the CDK4/CDK6/cyclin D1 signaling pathway, suggesting that it might be a potential anti-tumor agent for clinical treatment of GBC.

Wilson Disease is kind of an autosomal recessive genetic disease. Early diagnosis and timely treatment are very important for prognosis. This article reviews the treatment of Wilson Disease, focusing on penicillamine, sodium dimercaptopropane sulfonate, ammonium tetrathiomolybdate and zinc, liver transplantation and gene therapy. At the same time, the problems of medication adherence and follow-up evaluation in patients with Wilson Disease are also discussed.肝豆状核变性是一种常染色体隐性遗传病，早期诊断和及时治疗对预后至关重要。现就肝豆状核变性的治疗现状进行综述与展望，重点介绍青霉胺、二巯基丙磺酸钠、四硫代钼酸铵和锌剂等药物治疗、肝移植以及基因疗法的现状及进展，同时也讨论了肝豆状核变性患者用药依从性和随访评估等方面的问题。.

The purpose of this study was to elucidate the regulatory role of microRNA-324-5p (miRNA-324-5p) in inhibiting inflammatory response of diabetic vessels by regulating CPT1A level, thus alleviating the development of type 2 diabetes mellitus (T2DM).Arterial vessels (splenic artery) and serum exosomes were extracted from 30 T2DM patients and 30 non-T2DM subjects treated in Binzhou People's Hospital from 2015 to 2019. Relative levels of miRNA-324-5p and CPT1A in each subject were detected. Then, VSMCs were induced with high-glucose, followed by detection of inflammatory factor levels. Next, the regulatory effects of miRNA-324-5p and CPT1A on viability, 5-Ethynyl-2'-deoxyuridine (EdU)-positive ratio, and release of inflammatory factors in VSMCs were determined. Finally, Dual-Luciferase reporter assay was conducted to verify the interaction between miRNA-324-5p and CPT1A.The results revealed that compared with non-T2DM subjects, miRNA-324-5p was downregulated in splenic arteries and exosomes in T2DM patients. High-glucose treatment in VSMCs triggered the release of the inflammatory factors. In addition, the overexpression of miRNA-324-5p in VSMCs reduced viability and inflammatory factor levels, and the inhibited trends were partially reversed by overexpression of CPT1A. CPT1A was indicated to be the target gene binding miRNA-324-5p.MiRNA-324-5p exerts an inhibitory effect on T2DM-induced inflammation in blood vessels by negatively regulating CPT1A level and reducing the release of inflammatory factors. MiRNA-324-5p might be a promising therapeutic target for T2DM.

Recently, metabolic-associated fatty liver disease has become the world's highest prevalence of chronic liver disease. Moreover, it is closely related to metabolic syndrome and related diseases, bringing a huge disease burden. Previously, the global expert consensus on renaming for non-alcoholic fatty liver disease and the diagnostic criteria for metabolic-associated fatty liver disease has increased the certainty of further clinical research and practice. Presently, the research on metabolic-associated fatty liver disease is progressing rapidly, and the opinions and data based on clinical evidence are constantly updated. Hepatology international has published the "Asian Pacific Association for the Study of liver diseases' clinical guidelines on the management of metabolic-associated fatty liver disease" , which aims to promote clinical practice and improve the efficiency of clinical research. Here, we have translated the published recommendations into Chinese language, hoping to help most health professionals make clinical decisions.代谢相关脂肪性肝病已成为目前全球患病率最高的慢性肝病，与代谢综合征及相关疾病关系密切，带来了巨大的疾病负担。先前全球相关专家就非酒精性脂肪性肝病更名以及代谢相关脂肪性肝病的诊断标准达成共识，为进一步的临床研究和实践增加了信心。目前，代谢相关脂肪性肝病相关研究进展迅速，基于临床证据的观点和数据不断更新。

Vestibular migraine (VM) has emerged as one of the major vestibular syndromes. Although probiotics have exhibited beneficial effects on migraine headache, its effect on VM is not clear. This trial aimed to investigate the treatment efficacy of the probiotic

Nonalcoholic fatty liver disease is the leading cause of chronic liver disease worldwide. Non-alcoholic fatty liver disease has a wide spectrum of diseases including simple fatty liver, steatohepatitis, liver fibrosis, and cirrhosis. The clinical manifestations and disease outcomes of patients with non-alcoholic fatty liver disease vary widely, and are related to the heterogeneity of risk factors, such as heredity, epigenetics, race, gender, age, diet, exercise, alcohol drinking, intestinal microecology, coexisting diseases, and hormone and metabolic status. Emphasizing the study of pathogenesis and clinical heterogeneity of patients with non-alcoholic fatty liver disease will help to layer the management of disease and improve the effectiveness of clinical trials.非酒精性脂肪性肝病是全球慢性肝病的首要原因。非酒精性脂肪性肝病的疾病谱广泛，主要包括单纯性脂肪肝、脂肪性肝炎、肝纤维化及肝硬化。非酒精性脂肪性肝病患者的临床表现和疾病转归差异巨大，与遗传、表观遗传、种族、性别、年龄、饮食、运动、饮酒、肠道微生态、并存疾病，以及激素和代谢状态等危险因素的异质性有关。重视非酒精性脂肪性肝病患者发病机制和临床异质性的研究，有助于该病的分层管理和提高临床试验的效果。.

To analyze the evaluation results of malaria elimination and summarize the experience in Jiujiang City, so as to provide the evidence for formulating the surveillance work plan post-malaria elimination.According to the requirements and arrangements ofIn Jiujiang City, the last local malaria case was reported in 2008. From 2010 to 2016, there were 20 imported malaria cases reported, including 12 cases of falciparum malaria, 7 cases of vivax malaria, and 1 case of mixed infection. Totally 67 501 fever patients were tested forAll 13 counties (cities and districts) of Jiujiang City have passed the city level evaluative criteria of malaria elimination, and the key work should be the prevention and surveillance of imported malaria in the future.

Hepatocellular carcinoma (HCC) is a major disease with a high degree of malignancy, and poor prognosis, which seriously endangers human health. Chronic viral hepatitis (HBV, HCV)-cirrhosis-liver cancer patterns of pathogenesis has been widely accepted. However, the relationship between non-infectious liver disease and HCC is not completely clear; thereby how various non-infectious liver diseases develop through precancerous lesions has attracted widespread attention to HCC. A full understanding of these precancerous lesions is likely to provide new ideas and strategies for the prevention and treatment of non-infectious liver disease-related HCC.肝细胞肝癌（HCC）是恶性程度很高、预后极差、严重危害人类健康的重大疾病。慢性病毒性肝炎（乙型、丙型肝炎）-肝硬化-肝癌的发病模式已为大家广泛接受。然而，非感染性肝病与HCC的关系尚不完全清晰，各种非感染性肝病如何经过癌前病变进展为HCC引起广泛关注。充分认识这些癌前病变可望为非感染性肝病相关HCC的防治提供新的思路和策略。.

BACKGROUND AND PURPOSE: 3D reconstruction of a targeted area (“safe” triangle and Kambin triangle) may benefit the viability assessment of transforaminal epidural steroid injection, especially at the L5/S1 level. However, manual segmentation of lumbosacral nerves for 3D reconstruction is time-consuming. The aim of this study was to investigate the feasibility of deep learning–based segmentation of lumbosacral nerves on CT and the reconstruction of the safe triangle and Kambin triangle. MATERIALS AND METHODS: A total of 50 cases of spinal CT were manually labeled for lumbosacral nerves and bones using Slicer 4.8. The ratio of training/validation/testing was 32:8:10. A 3D U-Net was adopted to build the model SPINECT for automatic segmentations of lumbosacral structures. The Dice score, pixel accuracy, and Intersection over Union were computed to assess the segmentation performance of SPINECT. The areas of Kambin and safe triangles were measured to validate the 3D reconstruction. RESULTS: The results revealed successful segmentation of lumbosacral bone and nerve on CT. The average pixel accuracy for bone was 0.940, and for nerve, 0.918. The average Intersection over Union for bone was 0.897 and for nerve, 0.827. The Dice score for bone was 0.945, and for nerve, it was 0.905. There were no significant differences in the quantified Kambin triangle or safe triangle between manually segmented images and automatically segmented images (P > .05). CONCLUSIONS: Deep learning–based automatic segmentation of lumbosacral structures (nerves and bone) on routine CT is feasible, and SPINECT-based 3D reconstruction of safe and Kambin triangles is also validated.

Worldwide increasing prevalence of obesity and lifestyle changes has put nonalcoholic fatty liver disease (NAFLD) as the most prevalent liver disease of the coming decade. NAFLD not only causes cirrhosis and hepatocellular carcinoma, but also acts as a component of metabolic syndrome together with obesity, type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), and dyslipidemia. Consequently, its mutual cause-and-effect interactions have brought a huge clinical and financial burden to patients and society.随着肥胖的流行和生活方式的改变，全球非酒精性脂肪性肝病(NAFLD）已成为第一大肝病，在接下来的10多年中其患病率仍将进一步增高。NAFLD不仅导致肝硬化和肝细胞癌，还与肥胖、2型糖尿病、动脉硬化性心血管疾病和血脂异常等一起作为代谢综合征的组分，互为因果，相互影响，给患者和社会带来了巨大的临床负担和经济负担。.

AIM To compare bone mineral density (BMD) measurement accuracy by dual-energy spectral computed tomography (CT) and quantitative CT (QCT) using an anthropomorphic European spine phantom (ESP). MATERIALS AND METHODS An ESP containing three hydroxyapatite inserts with densities of 50, 100, and 200 mg/cm3 was scanned 10 times each using spectral CT and QCT protocols. Their BMD values were measured using hydroxyapatite-based spectral CT material decomposition images and QCT images and compared with the true values in ESP. RESULTS Both protocols had good repeatability in BMD measurement with low coefficient-of-variance (spectral CT: CONCLUSION BMD can be accurately measured using either QCT or spectral CT, and spectral CT has smaller bias than QCT.

The survival advantage of radiotherapy (RT) for patients with metastatic esophagus cancer has not been adequately evaluated. This study aims to find out the role of RT for metastatic esophagus cancer and to find the different effect for RT to esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). This study included 5,970 metastatic esophagus cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database, registered from January 2004 to December 2013. Propensity score (PS) analysis with 1:1 nearest neighbor matching method was used to ensure well-balanced characteristics of all comparison groups by histological types. The Kaplan-Meier and Cox proportional hazardous models were used to evaluate the overall survival (OS), cancer-specific survival (CSS), and corresponding 95% confidence interval (CI). Generally speaking, EAC did not get survival benefit from RT (median OS for RT group vs. no-RT group-8.0, 7.6-8.4 vs. 9.0, 8.5-9.5, P = 0.073), whereas RT for metastatic ESCC did significantly improve OS (median OS for RT group vs. no-RT group-8.0, 7.4-8.6 vs. 7.0, 6.4-7.6, P = 0.044). Therefore, compared with adenocarcinoma, ESCC could get more survival benefit from RT.

Chronic hepatitis B and fatty liver disease are two most common chronic liver diseases in China, and with the increasing prevalence of obesity, chronic hepatitis B complicated by fatty liver disease is more and more common in clinical practice. The influence of chronic hepatitis B virus infection on fatty liver disease and lipid metabolism has gradually become a hot topic in clinical research, as well as the influence of fatty liver disease and metabolic factors on the course and treatment of chronic hepatitis B.慢性乙型肝炎和脂肪肝是我国目前最常见的慢性肝病，而随着肥胖人群的增多，慢性乙型肝炎合并脂肪肝越来越常见。乙型肝炎病毒的慢性感染对脂肪肝、脂代谢的影响，以及合并脂肪肝、代谢因素对慢性乙型肝炎病程和治疗的影响逐渐成为关注与研究的热点。.

This is one of the largest multicentered, cohort studies conducted to evaluate the proinflammatory biomarkers associated with cognitive impairment in breast cancer patients. While elevated interleukin (IL)-6 and IL-1β were observed in patients with poorer response speed performance and perceived cognitive disturbances, IL-4 may be protective against chemotherapy-associated cognitive impairment., Background Existing evidence suggests that proinflammatory cytokines play an intermediary role in postchemotherapy cognitive impairment. This is one of the largest multicentered, cohort studies conducted in Singapore to evaluate the prevalence and proinflammatory biomarkers associated with cognitive impairment in breast cancer patients. Patients and methods Chemotherapy-receiving breast cancer patients (stages I–III) were recruited. Proinflammatory plasma cytokines concentrations [interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, granulocyte–macrophage colony-stimulating factor, interferon-γ and tumor necrosis factor-α] were evaluated at 3 time points (before chemotherapy, 6 and 12 weeks after chemotherapy initiation). The FACT-Cog (version 3) was utilized to evaluate patients' self-perceived cognitive disturbances and a computerized neuropsychological assessment (Headminder™) was administered to evaluate patients' memory, attention, response speed and processing speed. Changes of cognition throughout chemotherapy treatment were compared against the baseline. Linear mixed-effects models were applied to test the relationships of clinical variables and cytokine concentrations on self-perceived cognitive disturbances and each objective cognitive domain. Results Ninety-nine patients were included (age 50.5 ± 8.4 years; 81.8% Chinese; mean duration of education = 10.8 ± 3.3 years). Higher plasma IL-1β was associated with poorer response speed performance (estimate: −0.78; 95% confidence interval (CI) −1.34 to −0.03; P = 0.023), and a higher concentration of IL-4 was associated with better response speed performance (P = 0.022). Higher concentrations of IL-1β and IL-6 were associated with more severe self-perceived cognitive disturbances (P = 0.018 and 0.001, respectively). Patients with higher concentrations of IL-4 also reported less severe cognitive disturbances (P = 0.022). Conclusions While elevated concentrations of IL-6 and IL-1β were observed in patients with poorer response speed performance and perceived cognitive disturbances, IL-4 may be protective against chemotherapy-associated cognitive impairment. This study is important because cytokines would potentially be mechanistic mediators of chemotherapy-associated cognitive changes.

Synopsis Objective To understand the habits of Chinese women applying leave-on skincare products (LOSCP) and to improve female facial evenness of anti-ageing cosmetics through modifying facial skincare smear ways. Methods A questionnaire on the method of applying LOSCP was distributed to 60 women with habit of using LOSCP. Their facial images before and after applying LOSCP were taken, and their positioning and grey value were used to analyse the effects of different applying methods on the uniformity of facial LOSCP. Results LOSCP including anti-ageing cosmetics have been widely used among Chinese women for a long time. However, some women do not concern how to properly apply LOSCP. In our survey, the main focal points of the face are forehead, malar region, cheek, mouth corners and chin when they looking into the mirror, and mouth corners and inner canthus are often overlooked when applying cosmetic products. The image analysis found that after applying the LOSCP, the greyscale of the forehead, glabella, malar region, upper lip region and jaw changed significantly whereas that of canthus, mouth corners and lateral cheek region was not significantly different. Applying an improved smear method (11-point method)could significantly increase the grey values of various facial areas. Conclusion The way of Chinese women applying LOSCP may result in facial unevenness of skin products. By improving facial skincare smear method, one can make the products even in all facial areas, thereby ensuring the efficacy of anti-ageing cosmetics. Thus, further improvement and education regarding skincare is required. Resume Objectif Pour comprendre les habitudes des femmes chinoises qui appliquent des produits de soins de la peau (LOSCP) non rinces et d'ameliorer la regularite du visage feminin par des produits cosmetiques anti-âge grâce a une modification de la procedure de leur application sur le visage. Methodes Un questionnaire sur la methode de l'application des LOSCP a ete distribue a 60 femmes ayant l'habitude d'utiliser LOSCP. Leurs images faciales avant et apres application des LOSCP ont ete prises et leur positionnement et leurs valeurs de gris ont ete utilisees pour analyser les effets des differentes methodes d'application sur l'uniformite de LOSCP au visage. Resultats Les LOSCP y compris les cosmetiques anti-âge ont ete largement utilises chez les femmes chinoises pendant une longue periode. Cependant, certaines femmes ne se soucient pas de la facon d'appliquer correctement LOSCP. Dans notre enquete, les principaux points focaux de la face sont front, region malaire, joue, des levres et le menton quand elles regardant dans le miroir; les coins de la bouche et le canthus interne sont souvent negliges lors de l'application de produits cosmetiques. L'analyse d'image a constate que, apres l'application des LOSCP, l'echelle de gris du front, la glabelle, region malaire, region de la levre superieure et la mâchoire a change de maniere significative tandis que celle du canthus, des coins de la bouche et de la region de la joue laterale n'a pas ete significativement differente. L'application d'une methode d'etalage amelioree (11 Methode Point) pourrait augmenter de maniere significative les valeurs de gris de differentes zones du visage. Conclusion La maniere d'application des femmes chinoises qui utilisent des LOSCP peut entrainer des inhomogeneites des produits sur le visage. En ameliorant la methode de l'etalage des produits, on peut appliquer les produits dans toutes les zones du visage de maniere homogene, assurant ainsi l'efficacite de la cosmetique anti-âge. Ainsi une amelioration de l'education en matiere de soins de la peau est necessaire.

Recent studies have found that non-alcoholic fatty liver disease(NAFLD) has great impact on the development of biliary tract diseases. Here in this review, we summarized the relationship between NAFLD and the occurrence and development, risk factors and severity of cholestasis, gallstones, intrahepatic cholangiocarcinoma, primary biliary cirrhosis and bile microbiota, so as to further illuminate the pathogenesis of NAFLD and biliary tract diseases, obtain better diagnostic and therapeutic outcomes on NAFLD and biliary tract diseases.近年的研究发现非酒精性脂肪性肝病（NAFLD）与胆道疾病的发生和发展具有相关性。现对NAFLD与胆汁淤积、胆结石、胆管细胞癌、原发性胆汁性胆管炎以及胆道微生态的发生和发展，危险因素及严重程度之间的相互关系和可能的联系进行综述，以便进一步探究NAFLD和胆道疾病的发病机制，更好地预防和治疗NAFLD和胆道相关疾病。.

Nonalcoholic fatty liver disease (NAFLD) is a multi-system disease, and metabolic syndrome, type 2 diabetes, and NAFLD interact as both cause and effect. Deaths caused by cardiovascular diseases and malignant tumors are the adverse outcome of patients with NAFLD and nonalcoholic steatohepatitis (NASH), and increased deaths caused by liver disease is mainly seen in NASH patients. There is a causal relationship between NASH and hepatocellular carcinoma, and almost 50% of patients with NASH-associated hepatocellular carcinoma do not have liver cirrhosis. At present, cohort studies on the natural history of NAFLD in China should be enhanced in order to provide a basis for the development of health strategies and prevention and treatment measures. This editorial elaborates on the association of NAFLD with diabetes, cardiovascular disease, liver cirrhosis, and hepatocellular carcinoma from the perspective of clinical epidemiology, in order to emphasize the importance of the natural history of NAFLD.非酒精性脂肪性肝病（NAFLD）是一种多系统性疾病，与代谢综合征和2型糖尿病互为因果。心血管疾病和恶性肿瘤相关死亡是非酒精性脂肪肝和非酒精性脂肪性肝炎（NASH）患者共同的不良结局，肝病病死率显著增加主要见于NASH患者。NASH与肝细胞癌之间存在因果关系，NASH相关肝细胞癌一半左右发生于没有肝硬化的患者。当前亟需加强我国NAFLD患者自然史的队列研究，从而为制定卫生策略和防治对策提供依据。现主要从临床流行病学角度阐述NAFLD与糖尿病、心血管疾病以及肝硬化和肝细胞癌的重要关联，以提醒大家对NAFLD自然史的重视。.

BACKGROUND Although tremendous efforts have been made to reduce rubella incidence, there are still 300 new cases of congenital rubella syndrome daily; thus, rubella infections remain one of the leading causes of preventable congenital birth defects. An effective surveillance system, which could be achieved and maintained by using an external quality assessment program, is critical for prevention and control of this disease. METHODS Armored RNAs, which are noninfectious and RNase-resistant, were used for encapsulation of the E1 gene of rubella virus and for preparation of a 10-specimen panel for external quality assessment. Thirty-two laboratories across mainland China that used nucleic acid tests for rubella virus RNA detection were included in the external quality assessment program organized by the National Center for Clinical Laboratories of China. RESULTS Different kinds of commercial kits were used by the laboratories for nucleic acid extraction and TaqMan real-time reverse-transcription PCR for rubella virus RNA detection; 99.2% sensitivity and 100% specificity were achieved in this external quality assessment program. CONCLUSIONS Most of the participating laboratories obtained accurate results for rubella nucleic acid tests, thereby achieving the quality required for regional rubella and congenital rubella syndrome elimination.

INTRODUCTION The optimal strategy of percutaneous coronary intervention (PCI) for patients with ST-elevation myocardial infarction (STEMI) and multivessel disease (MVD) still remains controversial. This study sought to explore the optimal PCI strategy for those patients. EVIDENCE ACQUISITION Medline, EMBASE and the Cochrane Controlled Trials Registry were searched for relevant studies. We analyzed the comparison of major adverse cardiac events (MACEs) as the primary end point between the preventive PCI strategy and the culprit only PCI strategy (CV-PCI). The further analysis of two subgroups described as the complete multivessel PCI strategy during primary procedure (CMV-PCI) and the staged PCI strategy (S-PCI) was also performed. EVIDENCE SYNTHESIS Nine randomized trials were identified. The risk of MACEs was reduced significantly regarding to preventive PCI strategy (OR=0.41, 95% CI: 0.31-0.53, P

Some studies have suggested that prenatal paracetamol exposure might associate with the risk of child asthma. However, other studies have not confirmed this result. Therefore, we conducted a meta-analysis to investigate their relationship.Two authors searched Pubmed and Embase databases up to June 2016. The strength of the association was calculated with the OR and respective 95% CIs. The random-effects model was chosen to calculate the pooled OR.A total of 13 articles of more than 1,043,109 individuals were included in the meta-analysis. A statistically significant association between prenatal paracetamol exposure and child asthma risk was found. The data showed that prenatal paracetamol exposure could increase the risk of child asthma (OR=1.19; 95% CI, 1.12-1.27; P0.00001) in a random-effect model. Six studies reported paracetamol exposure during the first trimester of pregnancy. We found that paracetamol exposure during the first trimester of pregnancy was associated with increased risk of child asthma (OR=1.21; 95% CI, 1.14-1.28; P0.00001). Furthermore, we observed that paracetamol exposure during the 2-3 trimesters of pregnancy was also associated with child asthma risk (OR=1.13; 95% CI, 1.04-1.23; P=0.005).This study suggested that prenatal paracetamol exposure was significantly associated with the increased risk of child asthma.

Nonalcoholic fatty liver disease (NAFLD) is a pathological manifestation of obesity and metabolic syndrome involving the liver. It can cause disability and mortality related to liver disease, and it is closely associated with the high incidence rates of type 2 diabetes and cardiovascular diseases. At present, NAFLD has become the most common chronic liver disease worldwide, and the development and implementation of the clinical guideline for the diagnosis and treatment of NAFLD help to improve patients' prognosis. This article provides an interpretation of the latest Europeans guidelines through a comparative analysis of the previous and latest Europeans guidelines.

To investigate the differential expression profiles of long non-coding RNAs (lncRNAs) in human liver cell line LO2 with stable expression of hepatitis B x (HBx) gene, and to screen out the lncRNAs which play an important role in HBV-related liver cancer.The lncRNA microarray was used to establish the differential expression profiles of lncRNAs, and the methods such as scatter plots and cluster analysis were used to obtain the HBx-related lncRNAs with differential expression. The qRT-PCR was used to verify some lncRNAs with differential expression. The t-test was used to compare the expression of lncRNAs between the two microarray groups, and hierarchical cluster analysis was used for the original data of lncRNAs with differential expression.Compared with the control group transfected with blank plasmids (L02/pcDNA3.0), LO2/HBx cells had 323 lncRNAs with2-fold upregulation and 421 lncRNAs whose expression was reduced by more than 50% (P0.05). The results of qRT-PCR verified 4 upregulated lncRNAs (TCONS_00006195, ENST00000557524, NR_037597, and ENST00000539975) and 3 downregulated lncRNAs (ENST00000508424, ENST00000447433, and uc001lva.4), which were consistent with the results of microassay.HBx-related lncRNAs are successfully screened out, which lays a foundation for further investigation of the role of lncRNAs in the pathogenesis of liver cancer.

To investigate the value of a two-step approach with cytokeratin-18 (CK-18) and controlled attenuation parameter (CAP) in the noninvasive diagnosis of nonalcoholic steatohepatitis (NASH).A total of 65 patients with biopsy-proven nonalcoholic fatty liver disease were enrolled, including 30 patients with NASH. The M30 and M65 enzyme-linked immunosorbent assay kits were used to measure serum CK-18, and FibroScan was used to measure CAP. The receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUROC) was used to determine the value of noninvasive diagnosis. The binary logistic regression model was used to calculate the predicted probability of combined diagnosis. The maximum Youden index, a sensitivity of90%, and a specificity of90% were used to determine the optimal cut-off value, the low value, and the high value, respectively.The results of the multivariate analysis showed that M65 (OR = 1.004, 95% CI 1.002-1.007, P = 0.003) and CAP (OR = 1.017, 95% CI 1.001-1.033, P = 0.036) were independent predictors of NASH. The AUROC of M65+CAP was 0.851 (95% CI 0.761-0.942), higher than 0.808 (95% CI 0.702-0.913) of M65 and 0.677 (95% CI 0.545-0.808) of CAP alone. A two-step approach with high (820.8 U/L) and low (527.7 U/L) values for M65 and the optimal cut-off value (293.5 dB/m) for CAP was used for the differential diagnosis of NASH, with a positive predictive value of 85.7%, a negative predictive value of 100%, and a coincidence rate of 92.0%.A two-step approach with M65 and CAP can improve the value of noninvasive diagnosis of NASH, and a high negative predictive value can avoid unnecessary liver biopsy.

To analyze the current research status of evidence-based nursing of burn in the mainland of China, in order to provide basis for the improvement of scientificity of burn nursing practice.Chinese scientific articles on evidence-based nursing of burn in the mainland of China published from January 1997 to December 2015 were retrieved from Chinese Biology Medicine disc, Chinese Journals Full-text Database, Wanfang Database, and VIP Database. From the results retrieved, date with regard to publication year, region of affiliation of the first author, journal distribution, literature type, literature quality assessment, topic of evidence-based research, fund program support, implementation of evidence-based practice steps, and language and quantity of reference. Data were processed with Microsoft Excel software.A total of 50 articles conforming to the criteria were retrieved. (1) Articles about evidence-based nursing of burn arose in 2004. Compared with that in the previous year, there was no obvious increase in the number of relevant articles in each year from 2004 to 2011. The number of literature in 2012 was obviously increased than that in each year from 2004 to 2011, while the number of literature in each year from 2012 to 2015 was not obviously increased compared with that in the previous year. (2) The regions of affiliation of the first author were distributed in 13 provinces, 3 minority autonomous regions, and 3 municipalities, with the largest distribution in East China, and Northwest China and Southwest China in the follow. (3) The articles were published in 32 domestic journals, with 9 (28.12%) nursing journals, 5 (15.62%) burn medical related journals, and 18 (56.25%) other journals. Twenty (40%) articles were published in Source Journal for Chinese Scientific and Technical Papers. (4) Regarding the literature type, 31 (62%) articles dealt with clinical experiences, 17 (34%) articles dealt with scientific research, and 2 (4%) articles dealt with case report. (5) There were 21 quantitative study articles and 29 narrative study articles, all with low quality. (6) The topics of evidence-based research in these articles were mainly burn rehabilitation, burn nursing technology, pediatric burn, inhalation injury and airway management, and complications of burn injury. Only one study was supported by fund program. (7) Only one article described complete evidence-based practice steps. (8) The literature cited 57 English articles as references, with an average of 1.14, and 316 Chinese articles, with an average of 6.32.The concept of evidence-based nursing of burn has been initially formed in the mainland of China. The number of relevant articles is on the rise, but the quality needs to be further improved. There is an urgent need to improve nurses' understanding of evidence-based nursing and their command of the method of evidence-based practice through on-job training, so as to improve the scientificity and effectiveness of burn nursing.

Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in developed and developing countries. NAFLD is considered to be the manifestation of metabolic syndrome in the liver and an important risk factor for cardiovascular diseases as well. Studies have shown that NAFLD patients have significantly increased the prevalence rates of the diseases including ischemic heart disease and heart failure. Therefore, whether the changes in cardiac structure and impaired cardiac function occur before the development of organic heart diseases in NAFLD patients has attracted scholars' attention. With reference to the published literature, this article reviews the research advances in the association between NAFLD and cardiac changes in adults, children, and patients with diabetes and hypertension.

The objective of this study was to determine whether an association exists between certain single nucleotide polymorphisms (SNPs), which have previously been linked with adverse normal tissue effects resulting from radiotherapy, and the development of radiation injury resulting from radiotherapy for prostate cancer. A total of 135 consecutive patients with clinically localized prostate cancer and a minimum of 1 year of follow-up who had been treated with radiation therapy, either brachytherapy alone or in combination with external-beam radiotherapy, with or without hormone therapy, were genotyped for SNPs in SOD2, XRCC1 and XRCC3. Three common late tissue toxicities were investigated: late rectal bleeding, urinary morbidity, and erectile dysfunction. Patients with the XRCC1 rs25489 G/A (Arg280His) genotype were more likely to develop erectile dysfunction after irradiation than patients who had the G/G genotype (67% compared to 24%; P=0.048). In addition, patients who had the SOD2 rs4880 T/C (Val16Ala) genotype exhibited a significant increase in grade 2 late rectal bleeding compared to patients who had either the C/C or T/T genotype for this SNP (8% compared to 0%; P=0.02). Finally, patients with the combination of the SOD2 rs4880 C/T genotype and XRCC3 rs861539 T/C (Thr241Met) genotype experienced a significant increase in grade 2 late rectal bleeding compared to patients without this particular genotypic arrangement (14% compared to 1%; P=0.002). These results suggest that SNPs in the SOD2, XRCC1 and XRCC3 genes are associated with the development of late radiation injury in patients treated with radiation therapy for prostate adenocarcinoma.

Aim To explore the presence of symptom clusters in patients with brain metastases. Materials and methods Patients with brain metastases referred to an outpatient palliative radiotherapy clinic were asked to rate their symptom distress using the Edmonton Symptom Assessment Scale (ESAS). Baseline demographic data were obtained. To determine interrelationships between symptoms, a principal component analysis with ‘varimax rotation' was carried out on the nine ESAS items. Follow-up was carried out by telephone 1, 2, 4, 8 and 12 weeks after radiation. Results Between January 1999 and January 2002, 170 patients with brain metastases provided complete baseline data on the ESAS. The most common primary cancer sites were lung, breast and gastrointestinal. Fatigue was the highest scored symptom, followed by a poor sense of well-being, anxiety, drowsiness and poor appetite. The four most prevalent symptoms were fatigue (91.7%), a poor sense of well-being (88.1%), drowsiness (82.2%) and anxiety (82.1%). Three symptom clusters were found at baseline. Cluster 1 included fatigue, drowsiness, shortness of breath and pain. Cluster 2 included anxiety and depression. Cluster 3 included poor appetite, nausea and a poor sense of well-being. Fatigue, nausea, drowsiness and poor appetite showed an overall increase in symptom severity over time; whereas fatigue, drowsiness and poor appetite were experienced to some extent by a greater proportion of patients at week 12 compared with baseline. Symptom clusters emerged in all weeks of follow-up, but consisted of different symptoms in each week. Conclusion Symptom clusters seemed to exist in patients with brain metastases before and after whole brain radiotherapy. However, different symptoms clustered at various time points. The effectiveness of whole brain radiotherapy in providing palliative relief to patients with brain metastases needs to be explored with regards to symptom clusters.

Purpose The ATM gene product is a central component of cell cycle regulation and genomic surveillance. We hypothesized that DNA sequence alterations in ATM predict for adverse effects after external beam radiotherapy for early breast cancer. Methods and Materials A total of 131 patients with a minimum of 2 years follow-up who had undergone breast-conserving surgery and adjuvant radiotherapy were screened for sequence alterations in ATM using DNA from blood lymphocytes. Genetic variants were identified using denaturing high performance liquid chromatography. The Radiation Therapy Oncology Group late morbidity scoring schemes for skin and subcutaneous tissues were applied to quantify the radiation-induced effects. Results Of the 131 patients, 51 possessed ATM sequence alterations located within exons or in short intron regions flanking each exon that encompass putative splice site regions. Of these 51 patients, 21 (41%) exhibited a minimum of a Grade 2 late radiation response. In contrast, of the 80 patients without an ATM sequence variation, only 18 (23%) had radiation-induced adverse responses, for an odds ratio of 2.4 (95% confidence interval, 1.1–5.2). Fifteen patients were heterozygous for the G→A polymorphism at nucleotide 5557, which causes substitution of asparagine for aspartic acid at position 1853 of the ATM protein. Of these 15 patients, 8 (53%) exhibited a Grade 2-4 late response compared with 31 (27%) of the 116 patients without this alteration, for an odds ratio of 3.1 (95% confidence interval, 1.1–9.4). Conclusion Sequence variants located in the ATM gene, in particular the 5557 G→A polymorphism, may predict for late adverse radiation responses in breast cancer patients.