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Jiaying Lao,1,2,&ast; Hang Tan,3,&ast; Yuyu Wu,2,&ast; Ting Ding,4 Xinqian Liu,1 Lanrong Sun,2 Xiyi Chen,2 Chongrong Zhu,2 Yiming Kang,5 Yu-Hsin Chen,2,6 Chonghui Tang,1 Fan Wang,7 Yanlong Liu2,6 1Department of Neurosurgery, Affiliated Cixi Hospital, Wenzhou Medical University, Ningbo, People’s Republic of China; 2School of Mental Health, Wenzhou Medical University, Wenzhou, People’s Republic of China; 3Department of neurosurgery, Hangzhou Mingzhou Brain Rehabilitation Hospital, Hangzhou, People’s Republic of China; 4Department of Infectious Diseases, The Affiliated Xiangshan Hospital of Wenzhou Medical University, Ningbo, People’s Republic of China; 5Psychosomatic Medicine Research Division, Inner Mongolia Medical University, Huhhot, People’s Republic of China; 6Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, People’s Republic of China; 7Beijing Hui−Long−Guan Hospital, Peking University, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yanlong Liu, School of Mental Health, Medical University, Wenzhou, 325035, People’s Republic of China, Email benjaminlyl@wmu.edu.cn Chonghui Tang, Department of Neurosurgery, Affiliated Cixi Hospital, Wenzhou Medical University, Ningbo, 315300, People’s Republic of China, Email tangegg@163.comObjective: Cigarette smoking and low peripheral nitric oxide synthase (NOS) levels are strongly associated with sleep disorders. However, whether cerebrospinal fluid (CSF) NOS relates to sleep disorders and whether CSF NOS mediates the relationship between cigarette smoking and sleep disorders is unclear.Methods: We measured CSF levels of total NOS (tNOS) and its isoforms (inducible NOS [iNOS] and constitutive NOS [cNOS]) in 191 Chinese male subjects. We applied the Pittsburgh Sleep Quality Index (PSQI).Results: The PSQI scores of active smokers were significantly higher than those of non-smokers, while CSF tNOS, iNOS, and cNOS were significantly lower (all p < 0.001). CSF tNOS, iNOS, and cNOS were negatively associated with PSQI scores in the general population (all p < 0.001). Mediation analysis suggested that CSF tNOS, iNOS, and cNOS mediate the relationship between smoking and PSQI scores, and the indirect effect accounted for 78.93%, 66.29%, and 81.65% of the total effect, respectively.Conclusion: Cigarette smoking is associated with sleep disorders. Active smokers had significantly lower CSF levels of tNOS, iNOS, and cNOS. Furthermore, tNOS, iNOS, and cNOS mediate the relationship between cigarette smoking and sleep quality. This study provides insights into how cigarette smoke affects sleep disorders.Keywords: cerebrospinal fluid nitric oxide synthase, cigarette smoking, Pittsburgh Sleep Quality Index, sleep disorders, mediation

Jingyi Lao,1,&ast; Yijie Zeng,1,&ast; Zhangying Wu,1 Gaohong Lin,1 Qiang Wang,1 Mingfeng Yang,1 Si Zhang,1 Danyan Xu,1 Min Zhang,1 Kexin Yao,1 Shuang Liang,1 Qin Liu,1 Jiafu Li,1 Xiaomei Zhong,1 Yuping Ning1– 4 1Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China; 2The First School of Clinical Medicine, Southern Medical University, Guangzhou, People’s Republic of China; 3Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, People’s Republic of China; 4Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuping Ning; Xiaomei Zhong, The Affiliated Brain Hospital of Guangzhou Medical University, No. 36, Mingxin Road, Liwan District, Guangzhou, Guangdong, People’s Republic of China, Email ningjeny@126.com; lovlaugh@163.comBackground: Late-life depression (LLD) is characterized by disrupted brain networks. Resting-state networks in the brain are composed of both stable and transient topological structures known as microstates, which reflect the dynamics of the neural activities. However, the specific pattern of EEG microstate in LLD remains unclear.Methods: Resting-state EEG were recorded for 31 patients with episodic LLD (eLLD), 20 patients with remitted LLD (rLLD) and 32 healthy controls (HCs) using a 64-channel cap. The clinical data of the patients were collected and the 17-Item Hamilton Rating Scale for Depression (HAMD) was used for symptom assessment. Duration, occurrence, time coverage and syntax of the four microstate classes (A-D) were calculated. Group differences in EEG microstates and the relationship between microstates parameters and clinical features were analyzed.Results: Compared with NC and patients with rLLD, patients with eLLD showed increased duration and time coverage of microstate class D. Besides, a decrease in occurrence of microstate C and transition probability between microstate B and C was observed. In addition, the time coverage of microstate D was positively correlated with the total score of HAMD, core symptoms, and miscellaneous items.Conclusion: These findings suggest that disrupted EEG microstates may be associated with the pathophysiology of LLD and may serve as potential state markers for the monitoring of the disease.Keywords: late-life depression, microstate, electroencephalogram, resting-state networks

Shuo Wu,1,2 Jiahong Lao,1 Feitong Jian1 1E.N.T. Department, the 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 2School of Biomedical Engineering, Sun Yat-Sen University, Shenzhen, People’s Republic of ChinaCorrespondence: Shuo Wu, E.N.T. Department, the 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China, Tel +86-20-85252239, Email wush68@sysu.edu.cnPurpose: This study aimed to determine indices to diagnose and predict eosinophilic chronic rhinosinusitis (ECRS) during the initial clinic visit.Patients and Methods: We retrospectively analyzed 116 patients with chronic rhinosinusitis who underwent endoscopic sinus surgery and were classified according to the postoperative pathological diagnosis. General data and various clinical indicators were analyzed, and indicators with statistically significant differences between groups were further incorporated into a multivariate logistic regression to establish a comprehensive prediction model. The receiver operating characteristic (ROC) curve was used to compare the two significant valuable single factors from previous studies, the difference in CT scores between the ethmoid sinus and the sum difference of the maxillary sinus (EM difference) and the absolute value of peripheral blood eosinophil (bEOS), with a comprehensive prediction model.Results: There were significant differences in history of allergic asthma (p < 0.001), visual analog scale (VAS) score (p=0.005), sino-nasal outcome test-22(SNOT-22) scale score (p=0.004), Lund-Mackay scale score (p=0.017), EM difference (p=0.002), percentage of bEOS (%)(p=0.001), and absolute value of bEOS (× 109/L) (p=0.000) between the two groups (p< 0.05). The history of allergic disease, VAS and bEOS were screened out and included in the comprehensive prediction model. The area under the curve (AUC) of the comprehensive prediction model (0.804)> the AUC of the absolute value of the bEOS (0.764)>the AUC of the EM difference (0.655). The AUC of the EM difference and the comprehensive prediction model were statistically different (P=0.025). There was no statistical difference between the absolute value of bEOS and the AUC of the comprehensive prediction model.Conclusion: The comprehensive prediction model covering the three aspects of allergic asthma history, VAS score, and bEOS count had the highest AUC compared to the other predictors and had good predictive power for the diagnosis of ECRS.Keywords: eosinophilic chronic rhinosinusitis, non-eosinophilic chronic rhinosinusitis, prediction model, the difference of the CT scores between the ethmoid sinus and maxillary sinus, European position paper on rhinosinusitis and nasal polyps 2020

Cheng Huang,1 Peiming Zhang,2 Yu Dong,1 Ruchun Chang,2 Jinxiong Lao,2,3 Ziyong Li,2,3 Danchun Lan2 1Acupuncture and Rehabilitation Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 2Department of Acupuncture and Moxibustion, Foshan Hospital of Traditional Chinese Medicine, Foshan, People’s Republic of China; 3The Eighth Clinical School of Medicine, Guangzhou University of Chinese Medicine, Foshan, People’s Republic of ChinaCorrespondence: Danchun Lan, Email Danchun2013@aliyun.comObjective: To systematically evaluate the efficacy of acupuncture in the treatment of schizophrenia.Methods: We searched China National Knowledge Infrastructure (CNKI), Wanfang Database, Chongqing VIP Chinese Science and Technology Periodical Database (VIP), China Biology Medicine Database (CBM), PubMed, Embase, Web of Science, Cochrane Library for relevant literature on the acupuncture treatment of schizophrenia published from database inception to May 17, 2023. The evaluation criteria included total effective rate, incidence of adverse reactions, TESS scale, PANSS scale, BPRS scale, SANA scale, SAPS scale. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. The RevMan 5.4 software was used for meta-analysis, risk of bias (ROB) evaluation tool was used to evaluate the risk of bias of the studies, and the GRADE evaluation tool was used to evaluate the quality of evidence. The study was registered on PROSPERO, CRD42023416438.Results: A total of 38 RCTs involving 3143 patients were included in the meta-analysis. The results showed that acupuncture can improve the total effective rate [OR=3.43 (95% CI: 2.71, 4.35), moderate credibility], reduce the incidence of adverse reactions [OR=0.45 (95% CI: 0.32, 0.63), moderate credibility], reduce the TESS score (side effect scale) [MD=− 1.83 (95% CI: − 2.94, − 0.71), very low credibility]. Acupuncture also reduced the PANSS total score [MD=− 5.75 (95% CI: − 8.08, − 3.42), very low credibility], SANA score [MD=− 2.66 (95% CI: − 6.84, 1.51), very low credibility], SAPS score [MD=− 1.26 (95% CI: − 2.55, − 0.02), very low credibility], and BPRS score [MD=− 7.02 (95% CI: − 10.59, − 3.46), very low credibility].Conclusion: Existing evidence indicates that acupuncture as an adjunctive therapy can improve the total effective rate of SZ patients, reduce the incidence of adverse reactions, improve clinical symptoms, and alleviate depression and anxiety in SZ patients. However, more high-quality clinical research evidence is still needed to support these findings.Keywords: acupuncture, meta-analysis, schizophrenia

Sirou Han,1,2 Min Xu,1 Jiahui Lao,3 Zhanming Liang4 1Hospital Administration Department, The Second Affiliated Hospital of Shandong First Medical University, Taian, People’s Republic of China; 2School of Public Health, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan, People’s Republic of China; 3Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, People’s Republic of China; 4College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, AustraliaCorrespondence: Min Xu, Hospital Administration Department, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian, Shandong Province, 271000, People’s Republic of China, Tel +86-137-9112-0603, Email 13791120603@139.com Zhanming Liang, College of Public Health, Medical and Veterinary Sciences, James Cook University, JCU Townsville Campus, Douglas, Building 41, Room 217, Townsville, QLD, 4870, Australia, Tel +61-7-4781-5040, Email zhanming.liang@jcu.edu.auPurpose: Patient feedback plays a significant role in hospital service improvement. However, how to encourage patient feedback that can guide hospital service improvement is still being explored. By examining patient feedback data related to a tertiary hospital in China that was collected from the “ 12345” Government Service Convenience Hotline (GSCH), the paper discusses the learnings from GSCH in encouraging patient feedback and how quality improvement initiatives have effected the number and types of complaints made by patients and their families via GSCH.Methods: The study retrospectively collected and analyzed complaints on a Tertiary General University-affiliated hospital made via GSCH between 2016 and 2020. Patient care process-related complaints were coded using the health care complaint analysis tool (HCAT) and other complaint data were categorized based on the nature of the complaints. The autoregressive integrated moving average (ARIMA) models and mosaic plots were used to observe complaints trends and different complaint variables, respectively. The relationship between various quality improvement initiatives introduced since 2018 and patient complaints was also tested.Results: Close to 67% (n=2688) of calls made to the GSCH hotlines about the hospital were classified as a complaint including 60.6% vs 39.4% related to patient care process and nonpatient care process, respectively. For patient care process-related complaints, specifically against departments and personnel, 57.72% (n=961) were on clinical departments and 55.87% (n=471) were on doctors. Comparing the proportion of the complaint data in different categories in the two-year period of 2017– 2018 and 2019– 2020, an increase in management problems (47.73% vs 58.50%, P< 0.001) and decrease in relationship problems (33.65% vs 25.69%, P=0.002) were recorded.Conclusion: A unified, transparent, and impartial GSCH platform greatly encourages feedback from patients and families. Feedbacks provide evidence to guide health care organizations in improving the overall experience of patients and the quality of services that they provide.Keywords: patient feedback, medical service, hospital management, hotline, quality improvement, hospital services

Jian-Yao Wang,1,&ast; Jing Lao,2,&ast; Yu Luo,3 Jing-Jie Guo,2 Hao Cheng,2 Hong-Yan Zhang,2 Jun Yao,4 Xiao-Peng Ma,1 Bin Wang1 1Department of General Surgery, Shenzhen Children’s Hospital, Shenzhen, 518026, Guangdong Province, People’s Republic of China; 2Shenzhen Children’s Hospital of China Medical University, Shenzhen, 518026, Guangdong Province, People’s Republic of China; 3Zhuhai Campus of Zunyi Medical University, Zhuhai, 519090, Guangdong Province, People’s Republic of China; 4Department of Gastroenterology, Jinan University of Medical Sciences, Shenzhen Municipal People’s Hospital, Shenzhen, 518020, Guangdong Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiao-Peng Ma; Bin Wang Tel +86-075583008073Email 1345012907@qq.com; szwb1967@126.comPurpose: This study aimed to identify novel methylation-regulated genes as diagnostic biomarkers and therapeutic targets for hepatoblastoma (HB).Materials and Methods: The DNA methylation data of 19 HB tumor samples and 10 normal liver samples from the GSE78732 dataset and gene expression profiling data of 53 HB tumor samples and 14 normal liver samples from the GSE131329 dataset and 31 HB tumor samples and 32 normal liver samples from the GSE133039 dataset were downloaded form the Gene Expression Omnibus database. Next, differentially methylated genes (DMGs) and differentially expressed genes (DEGs) were identified. Venn diagrams were used to identify methylation-regulated genes. The VarElect online tool was selected to identify key methylation-regulated genes, and a protein–protein interaction (PPI) network was constructed to show the interactions among key methylation-regulated genes and DEGs. Finally, Gene Ontology annotation and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were performed to investigate the potential regulatory mechanisms of key methylation-regulated genes.Results: A total of 457 DMGs and 1597 DEGs were identified between the HB and normal liver samples. After DMGs and DEGs overlapping, 22 hypomethylated and upregulated genes and 19 hypermethylated and downregulated genes in HB were screened. Survival analysis revealed that 13 methylation-regulated genes were associated with the prognosis of liver cancer. Moreover, SPP1, UHRF1, and HEY1 were selected as the key DNA methylation-regulated genes. The PPI network revealed that all of them could affect TP53, while both UHRF1 and HEY1 could influence BMP4. Enrichment analysis suggested that the DEGs were involved in TP53-related pathways, including the cell cycle and p53 signaling pathway. Finally, SPP1, UHRF1, and HEY1 were hypomethylated and upregulated in the HB samples compared with those in the normal liver samples.Conclusion: SPP1, UHRE1, and HEY1 may play important roles in HB and be used as biomarkers for its diagnosis and treatment.Keywords: DNA methylation, gene, hepatoblastoma, biomarker, tumor

Yonghong Tan,1,* Xiaobao Bi,1,* Qiong Wang,1 Yu Li,1 Na Zhang,1 Jianxin Lao,1 Xiaoping Liu21Department of Anesthesiology, Guangzhou Women and Children’s Medical Center, Guangzhou, Guangdong 510623, People’s Republic of China; 2Department of Hematology, Guangzhou Women and Children’s Medical Center, Guangzhou, Guangdong 510623, People’s Republic of China*These authors contributed equally to this workBackground: Understanding of lidocaine-induced neurotoxicity is not complete, resulting in the unsuccessful treatment in some clinical settings. Dexmedetomidine (DEX) has been shown to alleviate lidocaine-induced neurotoxicity in our previous cell model. However, the rationale for DEX combined with lidocaine to reduce lidocaine-induced neurotoxicity in the clinical setting remains to be further clarified in the detailed molecular mechanism.Methods: In this study, we established a cellular injury model by lidocaine preconditioning. Cell Counting Kit-8 (CCK-8) and 5-ethynyl-2ʹ-deoxyuridine (EdU) proliferation assay kit were used to analyze cell proliferation. Cell apoptosis was measured by flow cytometry and Hoechst 33342 staining. Cell cycle progression was detected by flow cytometry. The protein expression levels were detected by Western blotting and immunofluorescence staining.Results: Our results showed that DEX dose-dependently restored impaired proliferation of PC12 cells induced by lidocaine，as reflected by the increased cell viability and EdU positive cells, which were consistent with the decreased expression of tumor suppressor protein p21 and increased expression of cell cycle-related cyclin D1 and CDK1. In addition, DEX dose-dependently reduced apoptotic PC12 cells induced by lidocaine，as reflected by the decreased expression of apoptosis-related Bax, caspase-3 and caspase-9 and increased expression of anti-apoptotic Bcl-2 compared to the cells only treated with lidocaine. Mechanistically, with gain-or-loss-of-function of STMN1, we showed that DEX-mediated neuroprotection by lidocaine-induced damage is associated with downregulation of STMN1 which might be an upstream molecule involved in regulation of mitochondria death pathway.Conclusion: Our results reveal that DEX is likely to be an effective adjunct to alleviate chronic neurotoxicity induced by lidocaine.Keywords: dexmedetomidine, lidocaine, STMN1, neurotoxicity, proliferation, apoptosis

Chong Meng,1–3 Xun Yang,1–3 Yuzhou Liu,1–3 Yingjie Zhou,1–3 Jing Rui,1–3 Shenqian Li,1–3 Ce Xu,1–3 Yongqing Zhuang,4 Jie Lao,1–3 Xin Zhao1–31Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People’s Republic of China; 2Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai 200032, People’s Republic of China; 3Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai 200032, People’s Republic of China; 4Hand Surgery Department, Shenzhen People’s Hospital, Shenzhen 518020, People’s Republic of ChinaPurpose: Neuropathic pain (NP) is a challenging clinical problem due to its complex pathogenesis. In our previous study using microarray, we found that the levels of lncRNA Malat1 were decreased in the spinal cord of NP rat after brachial plexus avulsion, but its contribution to NP remain unclear. The purpose of this study was to investigate its role in the pathogenesis of NP.Methods: In the NP model of complete brachial plexus avulsion rat, spinal cords were harvested, and fluorescence in situ hybridization (FISH) was used to test the spatial expression of Malat1 and qRT-PCR was used to confirm the quantitative expression of Malat1. In primary cultured neurons, Malat1 expression interfered with adenovirus. Spontaneous electric activities of neurons were tested using multi-electrode arrays and apoptosis of neurons was tested using TUNEL method. The change of intracellular calcium concentration was analyzed using calcium imaging method.Results: Decreased Malat1 expression was confirmed using qRT-PCR, and Malat1 was identified in the cytoplasm of neurons in spinal cord, but not in glia. In vitro, the decrease of Malat1 resulted in an increase in the frequency of spontaneous electric activity in neurons but had no effect on neuronal apoptosis. Further analysis indicated during glutamate stimulation, the change of intracellular calcium concentration in neurons with downregulated Malat1 expression was significantly greater than that in normal neurons.Conclusion: Reduced Malat1 expression may induce NP by increasing neuronal excitability in the spinal cord via regulation of calcium flux.Keywords: neuropathic pain, lncRNA, Malat1, spinal cord, neuron, multielectrode array, brachial plexus avulsion

In response to the issue of corrosion prevention in offshore wind farms，by collecting existing industry standards and specifications，combined with the characteristics of Chinese marine environment，a comparison and applicability analysis of relevant standards were conducted.The more applicable corrosion prevention standards for offshore wind farms were summarized and discussed from the following aspects: First，the current mainstream anti-corrosion technologies and their applications situation，including metal surface treatment and anticorrosive coatings，were examined；second，the characteristics of the operating environment of offshore wind power plants in coastal and ocean-going areas，as well as their differentiated needs on corrosion prevention technologies，were analyzed，and applicable corrosion prevention standards for different regions were put forward；third，the selection principles and performance evaluation indexes of anti-corrosion materials，including the assessment methods for the anti-corrosion performance of single materials and composite materials，were analyzed；fourth，the need to strengthen the performance evaluation of anti-corrosion materials and the formulation and updating of standards for ocean-going wind farms was emphasized.The research results were of great significance in promoting the sustainable development of offshore wind farms in China and improving the level of anti-corrosion protection technology.

OBJECTIVE: Our aim is to investigate the incidence and risk factors of acute kidney injury (AKI) in hospitalized patients who received aminoglycoside antibiotics. MATERIALS AND METHODS: A retrospective analysis was performed on the electronic medical record information of inpatients who received aminoglycoside (AG) antibiotics in our center from January 2018 to December 2020. The diagnosis of AKI was based on serum creatinine changes. Several statistical methods, including chi square test and two sample Wilcoxon rank sum test, were used to evaluate the epidemiological characteristics of aminoglycosides associated AKI. The multivariate logistic regression analysis was used to screen the risk factors. RESULTS: Finally, 8,040 patients who received AGs were included in the study. Among them, 494 patients (6.14%) were judged as incidence with AKI, while only 29 patients were diagnosed with AKI in the medical record. The multiple logistic regression analysis suggested that admission to ICU, complicated with diabetes mellitus, heart failure, anemia, shock, combined use of diuretics, β-lactam antibiotics, proton pump inhibitors were independent risk factors for AKI related to aminoglycosides. CONCLUSIONS: It is urgent to improve the understanding and attention of AKI for medical workers, and the assessment of risk factors before the use of aminoglycosides should be contributed to the early prevention, diagnosis, and treatment of AKI. [ABSTRACT FROM AUTHOR]

M. Sandoval (1), N. N. Okuhama (1), X.-J. Zhang (1), L. A. Condezo (2), J. Lao (2), F. M. Angeles (1), R. A. Musah (3), P. Bobrowski (4), and M. [...]