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Abstract Objective The objective of this study was to measure and analyze the joint space, condylar morphology, and thickness of the roof of the glenoid fossa (RGF) in patients with unilateral second molar scissor bite using cone beam CT (CBCT). Methods A total of 80 patients were included in this study. Forty patients with a normal posterior occlusal relationship, who attended the Department of Orthodontics at the First Hospital of Shanxi Medical University from December 2021 to August 2023, were selected as the control group. The experimental group consisted of 40 patients with unilateral second molar scissor bite during the same period. All patients underwent CBCT scanning, and the resulting images were analyzed using the NNT viewer software in multiplanar reconstruction (MPR). Axial, coronal, and sagittal adjustments were made for each patient. Results In the control group, the right and left joint spaces (PS, SS, AS), the height of the upper part of the condyle, and the depth of the glenoid fossa did not show statistically significant differences (P > 0.05). When comparing bilateral condylar morphology and joint space in the experimental group, it was found that the posterior joint space on the scissor bite side was greater than that on the normal occlusion side, while the anterior joint space on the scissor bite side was smaller than that on the normal occlusal side. Additionally, the height of the upper condyle and the depth of the glenoid fossa on the scissor bite side were greater than that on the normal occlusal side, with statistically significant differences (P 0.05). The comparison of the minimum thickness of the roof of the glenoid fossa in both the sagittal and coronal directions between the patients in the experimental group and the control group showed no statistically significant difference (P > 0.05). Furthermore, the asymmetry index of the supracondylar height in the control group was significantly smaller than that in the experimental group, displaying a statistically significant difference (P 0.05). When analyzing the position of the condyle in the sagittal direction of the glenoid fossa in the patients of the control group, it was observed that the majority were in the anterior and medial positions, with only 10% and 5% being in the posterior position. However, the analysis of the condyle position in the sagittal direction of the glenoid fossa in the experimental group revealed statistically significant differences (P

Understanding the intention of community residents to seek help from mental health professionals (MHPs) is essential in targeting interventions that promote the prevention and treatment of depression. This study aimed to investigate the current status of Chinese community populations' depression help-seeking intentions from MHPs and explore factors influencing the intentions. Data were used from a survey conducted in a city in central China (n = 919 aged 38.68 ± 17.34, 72.1% female). Help-seeking intentions, help-seeking attitude, depression stigma, family function and depressive symptoms were measured. The total mean score on the intent to seek help from MHPs was 11.01 ± 7.78 and most of respondents were unwilling to seek professional help. Multiple linear regression showed that participants who were students, held a positive help-seeking attitude and had low personal stigma were more likely to have the intention to seek help from MHPs. It is necessary to utilize effective interventions to improve community residents' intention to seek professional help. These include promoting the importance of seeking professional assistance, optimizing the quality of mental health services and altering residents' prejudice to seeking professional help.

Melanoma represents a formidable challenge in dermatological oncology due to its resistance to conventional treatments. The Celandine Alkali Injection Formula (CAIF) offers benefits on clinical internal medicine treatments, within which chelidonine and tetrandrine are recognized as potential quality markers. However, their synergistic mechanisms facilitating their anti-melanoma action remain unveiled. This study embarked on an exploration of CAIF’s therapeutic potential through a multifaceted research design, integrating system pharmacological predictions with empirical molecular biological evaluations. The dual application of chelidonine and tetrandrine within CAIF exhibited a pronounced inhibitory effect on the proliferation of B16F10 cells, surpassing the effectiveness of individual compound administration. Computational predictions identified the top 50 targets, involved in key signaling pathways including cell cycle regulation, and melanogenesis. RNA sequencing further elucidated that the combinatory treatment modulated a broader spectrum of differentially expressed genes, implicating crucial biological processes including cell differentiation, and tyrosinase metabolism. The combination markedly enhanced melanogenesis and apoptotic indices, arrested cell cycle progression, and fostered cellular differentiation. Notably, chelidonine additionally curtailed the migratory capacity of B16F10 cells. Our findings underscore the therapeutic potential of chelidonine and tetrandrine, key components of CAIF, in effectively combating melanoma by targeting cell proliferation, migration, differentiation, and melanogenesis.

AIM: To evaluate the clinical significance of checking episcleral venous fluid wave (EVFW) during gonioscopy-assisted transluminal trabeculotomy (GATT) in patients with open angle glaucoma (OAG). METHODS: This retrospective case series study comprised 30 patients (45 eyes) with OAG underwent GATT. The location and extent of EVFW were examined and graded after intraoperative compression flushing of the anterior chamber angle during the operation. Patients were followed up for 1y. A complete success for surgery is defined as a postoperative intraocular pressure (IOP)

Aims:This study aimed to synthesize the evidence of the comparative effectiveness and safety of Ophiocordyceps sinensis (OS) preparations combined with renin–angiotensin system inhibitors (RASi) for diabetic kidney disease (DKD).Methods:Eight databases were searched from their inception to May 2023. Systematic reviews (SRs) of OS preparations combined with RASi for DKD were identified. Randomized controlled trials (RCTs) from the included SRs and additional searching were performed for data pooling. Cochrane risk-of-bias 2 (RoB 2) tool and AMSTAR 2 were used to evaluate the methodological quality of RCTs and SRs, respectively. A Bayesian network meta-analysis was performed to compare the add-on effect and safety of OS preparations for DKD. The certainty of evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.Results:Fourteen SRs were included, whose methodological quality was assessed as high (1/14) or critically low (13/14). After combining additional searching, 157 RCTs were included, involving 13,143 participants. The quality of the RCTs showed some concerns (155/157) or high risk (2/157). Jinshuibao capsules and tablets, Bailing capsules and tablets, and Zhiling capsules were evaluated. Compared to RASi, adding either of the OS capsular preparations resulted in a decreased 24-h urinary total protein levels. OS preparations ranked differently in each outcome. Jinshuibao capsules plus RASi were beneficial in reducing urinary protein, serum creatinine, serum urea nitrogen, and blood glucose levels, with moderate-certainty evidence. No serious adverse events were observed after adding OS to RASi.Conclusion:Combining OS capsular preparations with RASi appeared to be associated with decreased urinary total protein levels in DKD patients. Further high-quality studies are needed to confirm.Systematic Review Registration:INPASY202350066.

BackgroundPsychological distress is common among patients with acute coronary syndrome (ACS) and has considerable adverse impacts on disease progression and health outcomes. Mindfulness-based intervention is a promising complementary approach to address patients’ psychological needs and promote holistic well-being. ObjectiveThis study aims to examine the effects of a social media–based mindfulness psycho-behavioral intervention (MCARE) on psychological distress, psychological stress, health-related quality of life (HRQoL), and cardiovascular risk factors among patients with ACS. MethodsThis study was a 2-arm, parallel-group randomized controlled trial. We recruited 178 patients (mean age 58.7, SD 8.9 years; 122/178, 68.5% male) with ACS at 2 tertiary hospitals in Jinan, China. Participants were randomly assigned to the MCARE group (n=89) or control group (n=89). The 6-week intervention consisted of 1 face-to-face session (phase I) and 5 weekly WeChat (Tencent Holdings Ltd)–delivered sessions (phase II) on mindfulness training and health education and lifestyle modification. The primary outcomes were depression and anxiety. Secondary outcomes included psychological stress, HRQoL, and cardiovascular risk factors (ie, smoking status, physical activity, dietary behavior, BMI, blood pressure, blood lipids, and blood glucose). Outcomes were measured at baseline (T0), immediately after the intervention (T1), and 12 weeks after the commencement of the intervention (T2). ResultsThe MCARE group showed significantly greater reductions in depression (T1: β=–2.016, 95% CI –2.584 to –1.449, Cohen d=–1.28, P

Abstract Background Dopamine is a neurotransmitter and has been found to regulate lymphocytes by acting on dopamine receptors (DRs). CD4+ T cells express all the five subtypes of DRs, D1R to D5R. Although CD4+ T cells have been involved in pathogenesis of rheumatoid arthritis (RA), roles of DRs expressed on these cells in RA are poorly understood. This study determined whether D2R expressed on CD4+ T cells regulates inflammatory responses and signs in collagen type II (CII)-induced arthritis (CIA), a mouse model of RA. Methods DBA/1 mice and C57BL/6 mice with global D1r or D2r deficiency (D1r –/– or D2r –/– ) or CD4+ T cell-specific D2r deletion (D2r fl/fl /CD4 Cre ) were used to prepare CIA model by intradermal injection of CII. D2R agonist sumanirole was intraperitoneally administered in CIA mice. CD4+ T cells obtained from CIA mice were exposed to sumanirole or/and D2R antagonist L-741,626 in vitro. Arthritic symptoms were assessed by clinical arthritis scores. Flow cytometric assay measured frequencies of CD4+ T cell subsets (Th1, Th2, Th17 and Treg cells). Expression of specific transcription factors for the CD4+ T cell subsets was tested by Western blot. Cytokine production was estimated by quantitative PCR and ELISA. Results CIA mice manifested a bias of CD4+ T cells towards Th1 and Th17 cells. D2r –/– CIA mice showed a stronger bias towards Th1 and Th17 phenotypes than CIA mice, while D1r –/– CIA mice did not show the changes. CD4+ T cell-specific D2r deletion exacerbated both the polarization towards Th1 and Th17 cells and the symptoms of arthritis. Sumanirole administration in CIA mice ameliorated the bias of CD4+ T cells towards Th1 and Th17 phenotypes as well as arthritic symptoms. Sumanirole treatment of in vitro CD4+ T cells obtained from CIA mice promoted the shift to Treg cells, and the effect of sumanirole was blocked by L-741,626. Conclusions D2R expressed on CD4+ T cells is protective against imbalance between pro-inflammatory and anti-inflammatory T cells and arthritic symptoms in CIA.

Abstract Aim To explore whether and to what extent, nurse–patient assessment differences mediate the association between nurse‐to‐patient ratios and readiness for hospital discharge, and examine whether nurse–patient characteristics moderate the indirect and/or direct effect of mediation model. Design A cross‐sectional study was carried out from March 2021 to December 2022. Methods A total of 523 pairs of gastrointestinal cancer patients with PICC and their nurses were recruited. All the participants were invited to complete the general information questionnaire and the Readiness for Hospital Discharge Scale. Outcome measure was patient‐reported readiness for hospital discharge. This study was reported according to the STROBE checklist. Results The patients reported a low level of readiness for hospital discharge. Nurse–patient assessment differences were positively associated with nurse‐to‐patient ratios but negatively associated with readiness for hospital discharge. Furthermore, nurse–patient assessment differences fully mediated the effect of nurse‐to‐patient ratios on readiness for hospital discharge, and age and gender of patients only moderated the indirect path of mediation model.

Background: Recent research in our laboratory shows that CD4+ T cells express the β2 adrenergic receptor (β2-AR), and the sympathetic neurotransmitter norepinephrine regulates the function of T cells via β2-AR signaling. However, the immunoregulatory effect of β2-AR and its related mechanisms on rheumatoid arthritis is unknown.Objective: To explore the effects of β2-AR in collagen-induced arthritis (CIA) on the imbalance of T helper (Th) 17/ regulatory T (Treg) cells.Methods: In DBA1/J mice, collagen type II was injected intradermally at the tail base to prepare the CIA model. The specific β2-AR agonist, terbutaline (TBL), was administered intraperitoneally beginning on day 31 and continuing until day 47 after primary vaccination, twice a day. Magnetic beads were used to sort CD3+ T cells subsets from spleen tissues.Results: In vivo, β2-AR agonist TBL alleviated arthritis symptoms in the CIA mice including histopathology of the ankle joints, four limbs’ arthritis score, the thickness of ankle joints, and rear paws. After TBL treatment, in the ankle joints, the levels of proinflammatory factors (IL-17/22) notably decreased and the levels of immunosuppressive factors (IL-10/TGF-β) significantly increased. In vitro, ROR-γt protein expression, Th17 cell number, mRNA expression and the releasing of IL-17/22 from CD3+ T cells reduced following TBL administration. Moreover, TBL enhanced the anti-inflammatory responses of Treg cells.Conclusion: These results suggest that β2-AR activation exerts anti-inflammatory effects through the amelioration of Th17/Treg imbalance in the CIA disease.

Due to the cold winter, people living in the northwest region of China often eat red or yellow edible herbs to help keep their bodies warm and improve their immunity. Examples of red foods include Chili Peppers and Cinnamon, and examples of yellow foods include Turmeric, Dried Ginger and Carrots. However, the pharmacological properties and warming active compounds of these foods remain unclear. Therefore, an approach combining network pharmacological prediction and experimental validation was adopted to explore the phytochemicals and biological functions of red- and yellow-colored edible herbs for the first time. The results indicated that the warmer Q-markers of red- and yellow-colored edible herbs promoted body heat production and alleviated cold damage by regulating various biological pathways, among which thyroid hormone-mediated thermogenesis was highly correlated. Furthermore, curcumin was indicated to activate the thyroid by upregulating TSHR/TG/TPO/NIS to prolong the survival of mice exposed to −20 °C cold stress.

BackgroundThe alkaline phosphatase-to-albumin ratio (APAR) has been demonstrated to be a promising non-invasive biomarker for predicting prognosis in certain diseases. However, the relationship between APAR and prognosis in non-dialysis chronic kidney disease (CKD) patients remains unclear. This study aims to identify the association between APAR and prognosis among CKD stages 1–4 in China.MethodsPatients with CKD stages 1–4 were consecutively recruited from 39 clinical centers in China from 2011 to 2016. New occurrences of end-stage kidney disease (ESKD), major adverse cardiovascular and cerebrovascular events, and all-cause deaths were the outcome events of this study. Subdistribution hazard competing risk and Cox proportional hazards regression models were adopted.ResultsA total of 2,180 participants with baseline APAR values were included in the analysis. In the primary adjusted analyses, higher APAR level [per 1-standard deviation (SD) increase in natural logarithm transformed (ln-transformed) APAR] was associated with 33.5% higher risk for all-cause deaths [adjusted hazard ratio (HR) 1.335, 95% confidence interval (CI) 1.068–1.670]. In addition, there was evidence for effect modification of the association between APAR and ESKD by baseline estimated glomerular filtration rate (eGFR) (P interaction < 0.001). A higher APAR level (per 1-SD increase in ln-transformed APAR) was associated with a greater risk of ESKD among participants with eGFR ≥ 60 ml/min/1.73 m2 (adjusted SHR 1.880, 95% CI 1.260–2.810) but not in eGFR < 60 ml/min/1.73 m2.ConclusionHigher APAR levels in patients with CKD stages 1–4 seemed to be associated with an increased risk of all-cause death. Thus, APAR appears to be used in risk assessment for all-cause death among patients with CKD stages 1–4.

Abstract Background To observe alterations of fundus microcirculation and retinal thickness in adolescent myopic patients with astigmatism after toric and spherical orthokeratology using optical coherence tomography angiography (OCTA), to explore the effects of orthokeratology on the retinal thickness and choroidal blood flow. Methods A total of 48 patients were enrolled and divided into two group (toric orthokeratology (T) group and spherical orthokeratology (S) group) according to the type of lens design. OCTA was used to measure the superficial and deep retinal vessel densities at the macular region, radial peripapillary capillary (RPC) density, foveal avascular zone (FAZ) area, and choriocapillaris (ChC) perfusion area before and after orthokeratology for 3 months. The data were statistically analyzed by SPSS 19.0 software. Results Compared with before orthokeratology, the superficial vessel density in the fovea and parafovea in the T group significantly increased, and the deep vessel density in the whole area and fovea were significantly elevated after 3 months (P

Abstract Background Mental illness is a major burden of disease worldwide. Community Mental Health Services (CMHS) are key to achieving community-based recovery for people with mental illness. In China, even though the community management of patients with mental illness is improving, the barriers faced by Community Mental Health Workers (CMHWs) are unclear. This study explores the difficulties and challenges in CMHS from the perspective of CMHWs. The results of this study may provide a practical basis for the training of CMHWs. Methods We carried out a qualitative study using an empirical phenomenological approach. Nine CMHWs were recruited from nine communities in Wuhan, Hubei Province, using purposive and snowball sampling. Face to face semi-structured in-depth interviews were conducted with them from December 27 to 28, 2019. Interview recordings were converted to text content by Nvivo 11.0 software and analyzed using Colaizzi’s phenomenological method. Results Three main themes were identified in this study: 1) Lack of role orientation leads to role ambiguity, 2) Failure to establish a therapeutic trust relationship with patients, and 3) Lack of communication and collaboration with various departments and peers. Seven sub themes were also identified. In these themes, CMHWs emphasized the importance of role clarity, therapeutic trusting relationships, and effective communication and coordination mechanisms. Conclusion Although China has made great efforts on the road to improving the quality of CMHS, several salient issues regarding CMHWs must be addressed to optimize the quality of services provided by CMHWs. Community mental health institutions should help CMHWs overcome these difficulties, by maximizing its value and promoting the development of CMHS.

AIM: To analyze the infection characteristics and clinical treatment outcome of patients with fungal keratitis(FK)in Jingzhou area, so as to provide basis for clinical diagnosis and treatment of FK. METHODS: The data of 176 patients with FK diagnosed by etiology in Jingzhou Central Hospital from January 2015 to July 2020 were collected, and the epidemiological characteristics, identification results of fungal strains, drug sensitivity and clinical treatment outcome of the patients were analyzed. RESULTS:Among the 176 patients with FK, 118 were male and 58 were female, and the ratio of male to female is 2.03:1. The age of onset was the largest number of patients in 50-59 years old and 60-69 years old. The peak seasons of onset were April to June and October to December. Risk factors include trauma and possible history of trauma, ocular surface diseases, post ophthalmic surgery, wearing corneal contact lenses and long-term local drug use. The main pathogens were Fusarium(39.8%), aspergillus(30.7%), alternaria(15.9%)and candida(5.1%). The results of drug sensitivity showed that voriconazole and amphotericin B were sensitive, while the drug resistance rate of fluconazole was very high. There were 125 eyes improved or cured after conservative treatment, 12 eyes were injected into corneal stroma, 15 eyes were covered with conjunctival flap or amniotic membrane transplantation, and 21 eyes were treated with corneal transplantation. Enucleation of ocular contents was performed in 8 eyes, including 5 eyes with severe endophthalmitis after conjunctival flap covering. CONCLUSION:The incidence of FK in Jingzhou area is mostly middle-aged and elderly men, mostly caused by corneal trauma in the process of agricultural labor. The main pathogens were fusarium and aspergillus. It is very important to select reasonable antifungal drugs and treatment methods according to the drug sensitivity results.

AIM: To study the protective effect of astragalus-containing serum on cobalt chloride(CoCl2)-induced hypoxia injury of human retinal pigment epithelial cells(ARPE-19), so as to explore whether astragalus can improve diabetic retinopathy(DR)by anti-oxidative stress.METHODS: The ARPE-19 hypoxia model induced by CoCl2 was established and divided into the following 5 groups: normal group(cells were cultured normally without any treatment), hypoxia model group(200μmol/L CoCl2), blank serum group(200μmol/L CoCl2+blank serum), low-dose drug-containing serum group(200μmol/L CoCl2+10% medicated serum)and high-dose drug-containing serum group(200μmol/L CoCl2+20% medicated serum); CCK-8 detects cell viability; Detect the levels of reduced glutathione(GSH)and malondialdehyde(MDA)in the cell supernatant with a kit; ELISA was used to detect the content of hypoxia-inducible factor-1α(HIF-1α)and vascular endothelial growth factor(VEGF)in cell culture medium; Real-time quantitative PCR(qPCR)to detect the mRNA levels of VEGF, HIF-1α and Prolyl hydroxylase-2(PHD-2); The expressions of VEGF, HIF-1α and PHD-2 were detected by Western Blot.RESULTS: Hypoxia model of ARPE-19 can successfully establish by CoCl2 at 200μmol/L. Low-dose and high-dose astragalus-containing serum could inhibit hypoxia-induced ARPE-19 proliferation(P

Primary angle-closure glaucoma(PACG)is the most common type of glaucoma in clinical. It is characterized by progressive and irreversible development with high global incidence and high possibility of blindness. The pathogenesis of PACG is complicated. It is not only associated with the abnormality of the ocular anatomy, such as the small cornea, short eye axis and shallow anterior chamber, but also found that the abnormality of the lens, iris, ciliary body and choroid are related to the pathogenesis of PACG in recent years. Moreover, the occurrence of PACG is also closely related to genetic and psychological stress factors. Our study summarized some literatures and made a brief discussion on the pathogenesis of PACG from the three aspects of anatomical characteristics, genetic factors, and psychological stress. We hope to provide useful theoretical support for the early diagnosis and treatment of glaucoma.

Abstract Background Metabolic syndrome has become a major health threat throughout the world, but there are few studies that focus on the effects of housework on human metabolism. This study explores the association between housework and metabolic markers and examines whether there are gender differences in the relationship of housework intensity on these markers. Methods We obtained data for 2,624 participants from the China Health and Nutrition Survey and used binary logistic regression to analyze the association between housework and metabolic markers (triglycerides, high- and low-density lipoprotein cholesterol, hemoglobin, blood glucose, cholesterol, and blood pressure). Results We observed no association between housework and metabolic markers for men. However, we find that women who engaged in housework had a higher risk of triglycerides than those who did not (OR=1.16, 95% CI: 1.16, 4.25). Compared with low-intensity, we also find that women who performed moderate- and high-housework intensity had a higher risk of triglycerides (moderate-intensity: OR=1.78, 95% CI: 1.14, 2.78; high-intensity: OR=1.91, 95% CI: 1.22, 2.98), MetS (OR=1.54, 95% CI: 0.98, 2.43; OR=1.68, 95% CI: 1.07, 2.66), pre-hypertension (OR=1.68, 95% CI: 1.08, 2.62; OR=1.63, 95% CI: 1.04, 2.55), and obesity (OR=1.65, 95% CI: 1.01, 2.70; OR=1.66, 95% CI: 1.01, 2.72). Conclusion In women, we find that housework is positively associated with the metabolic markers, triglycerides, MetS, and pre-hypertension. However, we did not find evidence that this relationship exists in men, f or any biomarkers we considered. One possible explanation is that people who engage in high-intensity housework are more stressed and sleep less, which could be a mechanism by which housework becomes associated with metabolic disease.

Abstract Background Henoch-Schönlein purpura nephritis (HSPN) is listed as the most common secondary glomerular diseases among children. Approximately 15 to 20% of children eventually could develop into chronic renal failure. Chinese patent herbal medicine Huaiqihuang (HQH) has been widely used in children with HSPN. This study aimed to evaluate the effectiveness and safety of HQH for HSPN in children, so as to provide evidence for clinical use. Methods Randomized controlled trials (RCTs) on HQH for HSPN in children were searched in eight Chinese and English databases from their inception to December 2020. We included children with HSPN received HQH combined with conventional medicine. Cochrane “Risk of bias” tool was used to assess methodological quality, and “Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach” to summarize the certainty of evidence for main findings. Effect estimates were presented as risk ratio (RR), mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI) in meta-analyses using RevMan 5.3. Data not suitable for statistical pooling were synthesized qualitatively. Results In total seven RCTs were identified. Compared with conventional medicine alone, HQH plus conventional medicine showed the better effect in improving clinical cure rate (RR 1.58; 95%CI 1.17 to 2.14; n = 6) and total effective rate (RR 1.34; 1.16 to 1.54; n = 6); reducing urine sediment erythrocyte count (MD -9.23; − 10.76 to − 7.69; n = 3) and urine β2 micro-globulin level (MD -0.09; − 0.12 to − 0.06; n = 2). No serious adverse event was recorded in all included trials. Conclusions Limited evidence showed HQH combined with conventional medicine had a beneficial effect for children with HSPN, and the side effects were mild. HQH may be a promising complementary therapy. However, long term follow-up, high quality and multicenter RCTs are required to confirm the findings.

Abstract Background Moxibustion is a common intervention of Chinese medicine (CM). Systematic reviews (SRs) on moxibustion are increasing. Although the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement provides guidelines for SRs, the quality of moxibustion-related SRs is still not satisfactory. In particular, descriptions of the interventions and the rationale for using moxibustion are insufficient. To address these inadequacies, the working group developed this PRISMA extension for reporting SRs of moxibustion (PRISMA-M 2020). Methods A group of CM clinical professionals, methodologists of SRs, reporting guideline developers, and journal editors developed this PRISMA-M 2020 through a comprehensive process that includes registration, literature review, consensus meetings, Delphi exercises for soliciting comments, and revision, resulting in this final draft. Results Seven of the 27 PRISMA checklist items, namely title (1), rationale (3), eligibility criteria (6), data item (11), additional analyses (16), study characteristics (18), and additional analysis (23), were extended, with specific reference to the application of moxibustion. Illustrative examples and explanations for each item are provided. Conclusion The PRISMA-M 2020 will help improve the reporting quality of SRs with moxibustion. Systematic review registration We have registered it on the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) network, particularly under the item of PRISMA-TCM: http://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-systematic-reviews/#65 .

AIM:To observe the clinical effects of YAG laser ablation in patients with physiological vitreous floaters by A/B ultrasound combined with autofluorescence(AF)of angiography.METHODS: Screening of 30 patients(30 eyes)with physiological vitreous floaters from August 2018 to January 2019 in Hankou Aier Eye Hospital, we used A/B ultrasound to measure the distance from the wall of the ball and the back surface of the lens before operations. Check the patient's best corrected visual acuity, non-contact intraocular pressure, scanning laser fundus photography, A/B ultrasound and autofluorescence(AF)of angiography before treatment, laser ablation was performed by the same skilled doctor using ELLEX YAG laser ablation machine. After treatment, the patients were followed up at the point of 1d, 1wk, and 1mo. The same examination was performed after operation. The Image-J software was used to measure the vitreous opacity in the autofluorescence of angiography pictures before and after treatment.RESULTS:There was no significant difference in the best corrected visual acuity and non-contact intraocular pressure before and after treatment(P>0.05). Of the 30 eyes, 28 eyes underwent laser ablation treatment once, and 2 eyes underwent laser ablation treatment twice. The average number of treatments was 1.06. After treatment, the autofluorescence of angiography showed that the vitreous opacity was obviously reduced or disappeared, and the difference was statistically significant before and after treatment(PCONCLUSION: A/B ultrasound combined with autofluorescence confirmed that Nd:YAG laser is safe and effective in the treatment of physiological vitreous floaters.

Objective: Clinical practice guidelines can improve healthcare processes and patient outcomes; however, the quality of these guidelines varies greatly in China. The aim of this study was to construct a comprehensive instrument for the appraisal of clinical practice guidelines in China (AGREE-CHINA), and to validate its reliability as a tool for helping potential guideline users in assessing guideline quality. Methods: First, an interdisciplinary working group was established for developing the methods. They also created a checklist as a tool according to the Appraisal of Guidelines, Research and Evaluation II (AGREE II) standards, considering the particularity of Chinese clinical practice. Next, the first draft of AGREE-China was developed by vote, modification, preliminary trial, and cross-verification. To ensure the objectivity, credibility, and reproducibility of the draft assessment, all of the checklists and standards were cross-reviewed fairly widely. Finally, AGREE-CHINA and AGREE II were used to assess the Chinese guidelines published in the past five years, and the results were compared. Results: The presented AGREE-CHINA covered five main checkpoints (science and rigor, effectiveness and safety, economy, usability and feasibility, and conflicts of interest) with each point divided into several more specific checkpoints. Definitions and rationales for each main checkpoint appear in the Appendix. The quality ratings based on the total scores of AGREE-China and AGREE II were consistent (r = 0.508, P = 0.020). Compared with AGREE II, the study showed a higher level of interrater-reliability for AGREE-CHINA overall (ICC = 0.957, P < 0.001). The mean time required for AGREE-CHINA was less than that for AGREE II; this was approximately 30 minutes for every assessment. User satisfaction was generally high. Conclusions: This paper has presented the first edition of the AGREE-CHINA appraisal tool for clinical guidelines. It is quick and easy to use; it assesses and performs well in comparison to AGREE II. This first version of AGREE-CHINA will require further development and validation.

BackgroundPeople with suicidal ideation post suicide-related information on social media, and some may choose collective suicide. Sina Weibo is one of the most popular social media platforms in China, and “Zoufan” is one of the largest depression “Tree Holes.” To collect suicide warning information and prevent suicide behaviors, researchers conducted real-time network monitoring of messages in the “Zoufan” tree hole via artificial intelligence robots.ObjectiveTo explore characteristics of time, content and suicidal behaviors by analyzing high suicide risk comments in the “Zoufan” tree hole.MethodsKnowledge graph technology was used to screen high suicide risk comments in the “Zoufan” tree hole. Users' level of activity was analyzed by calculating the number of messages per hour. Words in messages were segmented by a Jieba tool. Keywords and a keywords co-occurrence matrix were extracted using a TF-IDF algorithm. Gephi software was used to conduct keywords co-occurrence network analysis.ResultsAmong 5,766 high suicide risk comments, 73.27% were level 7 (suicide method was determined but not the suicide date). Females and users from economically developed cities are more likely to express suicide ideation on social media. High suicide risk users were more active during nighttime, and they expressed strong negative emotions and willingness to end their life. Jumping off buildings, wrist slashing, burning charcoal, hanging and sleeping pills were the most frequently mentioned suicide methods. About 17.55% of comments included suicide invitations. Negative cognition and emotions are the most common suicide reason.ConclusionUsers sending high risk suicide messages on social media expressed strong suicidal ideation. Females and users from economically developed cities were more likely to leave high suicide risk comments on social media. Nighttime was the most active period for users. Characteristics of high suicide risk messages help to improve the automatic suicide monitoring system. More advanced technologies are needed to perform critical analysis to obtain accurate characteristics of the users and messages on social media. It is necessary to improve the 24-h crisis warning and intervention system for social media and create a good online social environment.

BackgroundA low intention of professional help seeking hinders the effective treatment of depression. The factors are from the perspectives of the social, family, and individual; however, an understanding of how they interact to predict professional help-seeking intention (PHSI) is not clear.ObjectivesThe objectives of the study was to investigate PHSI toward depression in a Chinese community-dwelling population and construct a predictive model of the PHSI to explore the various factors involved.MethodsStratified random sampling and Kish table methods were used to identify 2,000 community residents. Participants completed a series of questionnaires to measure general characteristics, PHSI, professional help-seeking attitude, depression stigma, depression knowledge, family function, and depression symptoms. Analyses included descriptive statistics and Pearson correlation analysis using SPSS 26.0 and a Structural Equation Model using Amos 22.0.ResultsThe score of the PHSI was 14.92 ± 9.574. Professional help-seeking attitude (r = 0.291, p < 0.001) and depression knowledge (r = 0.077, p = 0.002) were positively related to PHSI, while a negative correlation was found between stigma (r = −0.149, p < 0.001) and PHSI. The model of the PHSI indicated a good fit with a CMIN/DF = 2.740 and RESEA = 0.032. The total effect of the influencing factors on the PHSI was listed in the following order: professional help-seeking attitude (0.676) > stigma (−0.143) > depression knowledge (0.088) > depression symptoms (−0.009) > family function (0.005). The total effect of depression knowledge on PHSI included a direct negative effect (Beta = −0.266, p < 0.001) and an indirect positive effect (0.354) through professional help-seeking attitude and stigma. Also, depression knowledge was negatively associated with stigma (Beta = −0.153, p < 0.001). Depression symptoms were negatively associated with family function (Beta = −0.282, p < 0.001), depression knowledge (Beta = −0.252, p < 0.001), and stigma (Beta = −0.102, p < 0.001), indicating that people with less severe depression symptoms had good family function, depression knowledge, and higher stigma. Family function contributed a positive effect on depression knowledge directly (Beta = 0.145, p < 0.001) and a totally positive effect (0.033) on stigma.ConclusionThe PHSI toward depression is low among Chinese community residents. Professional help-seeking attitude, depression knowledge, and family functioning were facilitators of PHSI, and stigma and the severity of depression symptoms were barriers to PHSI. This study provides reference for the development of policies and guidelines to promote community residents to actively seek professional mental health help. Future policies can focus on multicollaboration among the government, mental health services, and families to increase the mental health resources, improve family functioning, enhance mental health literacy (MHL) of the public, and reduce depression stigma to ease the burden of this mental health issue.

ObjectiveTo quantitatively study the effect of the labial inclination of the mandibular central incisors on the surrounding cortical and cancellous-bone morphology among patients with low-angle, skeletal class III malocclusion, by using cone-beam computed-tomography (CBCT) imaging.Materials and methodsThe CBCT images of 60 patients with low-angle, skeletal class III malocclusion were divided into lingual-inclination, upright, and labial-inclination groups. The height of the alveolar bone and the thickness and area of the cortical, cancellous, and total alveolar bone were measured separately on each side of the mandibular central incisors.ResultsThe thickness of the labial cortical bone from 6 mm below the cementoenamel junction (CEJ) to the root apex; the thickness of the labial cancellous bone at the root apex; the total thickness of the alveolar bone at the root apex; the area of labial cortical bone; the total area of labial alveolar bone; and the height of the labial alveolar bone were highest in the labial-inclination group (all P0.05).ConclusionThe morphology of the alveolar bone on the labial but not the lingual side of the mandibular central incisors was statistically significantly correlated with the labial inclination of those teeth in patients with low-angle, skeletal class III malocclusion.

“Zou Fan” is currently the largest “tree hole” on Weibo, where people having suicidal ideation often express their thoughts and use this channel to seek support. Therefore, early suicide monitoring and timely crisis intervention based on artificial intelligence technology are needed for this social media user group. This research was based on the knowledge graph technology, whereby “Tree Hole Intelligent Agent” (i.e., Artificial Intelligence Program) was used to identify “Zou Fan Tree Hole” users at high risk for suicide, and then, the “Tree Hole Action” carried out proactive suicide crisis intervention with them. The “Tree Hole Action” has temporarily prevented 3,629 potential suicides. The “Tree Hole Action” plays a significant role in suicide risk monitoring and crisis intervention for social media users and has been seen to have an important social impact.

Objectives To analyse the relationship between serum uric acid (SUA), all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients to inform clinical practice and future research.Design A systematic review of observational studies.Data sources PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), SinoMed, Chinese Science and Technology Journal Database (VIP) and Wan Fang databases were searched from their inception to January 2021 for cohort and case–control studies reporting SUA and mortality in patients with PD.Methods The Newcastle-Ottawa Quality Assessment Scale was used to appraise quality of cohort and case–control studies. Effect estimates were presented as HRs with 95% CIs in a meta-analysis using STATA V.16.0. Data not suitable for pooling were synthesised qualitatively.Results Fourteen cohort studies with 24 022 patients were included. No case–control studies were identified. For prospective cohort studies, pooled results for the highest SUA category were significantly greater than the lowest for all-cause (one study; 1278participants; HR 1.79; 95% CI 1.17 to 2.75) and CV mortality (one study; 1278 participants; HR 2.63; 1.62–4.27). An increase of 1 mg/dL in SUA level was associated with a 16% increased risk of all-cause mortality (one study; 1278 participants; HR 1.16; 1.03–1.32) and 34% increased CV mortality risk (one study; 1278 participants; HR 1.34; 1.16–1.55). For retrospective cohort studies, the highest SUA category did not demonstrate an elevated all-cause (five studies; 4570 participants; HR 1.09; 0.70–1.70) or CV mortality (three studies; 3748 participants; HR 1.00; 0.44–2.31) compared with the lowest SUA category. Additionally, there was no increase in all-cause (eight studies; 11 541 participants; HR 0.94; 0.88–1.02) or CV mortality (three studies; 7427 participants; HR 0.90; 0.76–1.06) for every 1 mg/dL increase in SUA level.Conclusions Results of prospective and retrospective cohort studies were inconsistent. Consequently, prospective, multicentre, long-term follow-up studies are required to confirm the relationship between SUA and mortality in patients with PD.

Objective: This study aimed to investigate the current status of depression self-management (DSM), and to identify influencing factors of DSM among Chinese community residents.Methods: Stratified random sampling methodology was adopted in this cross-sectional survey. Respondents completed a collection of self-administered questionnairesResults: The majority of participants were female (72.2%), having a mean age of 39 years (SD = 17.3). The total mean score on the DSSM was low (31.63 ± 4.69). Using multiple linear regression analysis, age ranging from 25 to 64 years old (Beta = −0.176, p = 0.008), having personal stigma (Beta = −0.143, p = 0.020) and perceived stigma (Beta = 0.127, p = 0.037), and having a nuclear family structure (Beta = −0.313, p = 0.046), good family function (Beta = 0.278, p < 0.001) and good help-seeking attitude (Beta = 0.159, p = 0.008) were associated with DSSM-knowledge. Older age (≥65 years) (Beta = −0.152, p = 0.034), higher CES-D scores (Beta = −0.162, p = 0.005), having a father with a bachelor's degree or higher level of education (Beta = −0.134, p = 0.047), being female (Beta = 0.147, p = 0.012), indicating a religious preference (Beta = 0.145, p = 0.017) and having good family function (Beta = 0.247, p = 0.001) were significantly associated with DSSM-activities.Conclusions: Reducing stigma related to depression and enhancing help-seeking attitudes may be potential strategies for managing depressive symptoms among Chinese community residents.

Background:: To conduct the bibliometric and visualized analysis of published studies on posttraumatic growth (PTG) based on CiteSpace software and Web of Science, to clarify the research base and research topics in this field, to identify research hotspots and trends in this field. Methods:: A total of 2596 PTG-related references were obtained from the Web of Science Core Collection. The WoS-based literature analysis was used to realize the general information of PTG research. The CiteSpace 5.3.R3 was used to perform the key words co-words and burst detection analysis, reference co-citation analysis and cooperation network analysis. Results:: Present study suggested that more and more researchers started to pay attention to PTG, especially cancer survivors. Research topics in PTG-related field mainly focused on the influencing factors of PTG, coping and intervention measures, and the research objects. Analysis of keywords identified “oncology”, “stage breast cancer”, “perceived benefit” and “adjustment” as terms that may represent emerging trends of research in PTG-related field. Research collaboration is not yet extensive enough between authors, research institutions and countries. Limitations:: Publications with the non-English language were not included. Conclusions:: Bibliometric analysis and visualized analysis of posttraumatic growth could identify new directions for future research and provide innovative insights and references for investigators, which would greatly enhance understandings for PTG and carry out more in-depth researches.

The coexistence of lung cancer and pulmonary tuberculosis (PTB) is uncommon in young patients. We report a case of 22-year-old man who presented with a one-month history of chest pain, cough, slight haemoptysis and weight loss. Following two acid fast bacilli positive sputum samples, a diagnosis of TB was concluded. However, his response to anti-TB therapy was inadequate. A CT scan and further laboratory tests assisted the final diagnosis as c-ros oncogene 1 (ROS1) rearranged lung adenocarcinoma and PTB. Despite severe comorbidities, the patient achieved clinical remission following treatment with the anti-cancer drug, crizotinib and anti- TB therapy. Clinicians should be aware that this comorbidity can occur in all age groups and the clinical and radiological symptoms of the two diseases are similar.

Summary: Background: In the early stages of the outbreak of coronavirus disease 2019 (COVID-19) in Hubei, China, the local health-care system was overwhelmed. Physicians and nurses who had no infectious disease expertise were recruited to provide care to patients with COVID-19. To our knowledge, no studies on their experiences of combating COVID-19 have been published. We aimed to describe the experiences of these health-care providers in the early stages of the outbreak. Methods: We did a qualitative study using an empirical phenomenological approach. Nurses and physicians were recruited from five COVID-19-designated hospitals in Hubei province using purposive and snowball sampling. They participated in semi-structured, in-depth interviews by telephone from Feb 10 to Feb 15, 2020. Interviews were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method. Findings: We recruited nine nurses and four physicians. Three theme categories emerged from data analysis. The first was “being fully responsible for patients' wellbeing—‘this is my duty’”. Health-care providers volunteered and tried their best to provide care for patients. Nurses had a crucial role in providing intensive care and assisting with activities of daily living. The second category was “challenges of working on COVID-19 wards”. Health-care providers were challenged by working in a totally new context, exhaustion due to heavy workloads and protective gear, the fear of becoming infected and infecting others, feeling powerless to handle patients' conditions, and managing relationships in this stressful situation. The third category was “resilience amid challenges”. Health-care providers identified many sources of social support and used self-management strategies to cope with the situation. They also achieved transcendence from this unique experience. Interpretation: The intensive work drained health-care providers physically and emotionally. Health-care providers showed their resilience and the spirit of professional dedication to overcome difficulties. Comprehensive support should be provided to safeguard the wellbeing of health-care providers. Regular and intensive training for all health-care providers is necessary to promote preparedness and efficacy in crisis management. Funding: National Key R&D Program of China, Project of Humanities and Social Sciences of the Ministry of Education in China.

ObjectiveTo explore the attitudes and factors in seeking professional psychological help among a Chinese community-dwelling population in order to promote positive help-seeking behaviors and better utilization of mental health services.MethodsUsing system and simple random sampling with Kish selection table methods, 912 community-dwelling residents were included in this study and asked about their attitudes toward seeking professional psychological help, depression symptoms, family function, depression literacy, help-seeking intention, and stigma.ResultsScores on the Attitudes Toward Seeking Professional Psychological Help scale (ATSPPH-SF) indicated a neutral attitude toward openness to seeking treatment for psychological problems and a negative attitude toward the value and need to seek treatment with a negative total score. Multiple linear regression analysis showed that gender, age, social support (employment status and family function), depression literacy, stigma, and help-seeking intention are significantly associated with attitude toward seeking professional psychological help.ConclusionThe overall attitude toward seeking professional psychological help is not optimistic, thus, more efforts are needed to enhance understanding. Effective interventions including mental health education, training of mental health professionals, and popularizing the use of mental health services are essential, especially for the at-risk population.

Objective: Understanding the general public's beliefs about depression is essential if public education and anti-stigma interventions are to be effective. This study aimed to examine Chinese respondents' personal attitudes towards depression and their perceptions about the attitudes of others regarding depression and to identify the correlates of personal stigma and perceived stigma towards depression. Methods: A community survey was conducted among 1697 residents aged between 16 and 89 years of a large city in central China using the Depression Stigma Scale. Participants completed questionnaires assessing experiences of depression and family functioning. Results: Participants reported high levels of stigma towards depression, with greater perceived stigma than personal stigma. Increasing age was correlated with greater personal stigma and perceived stigma. Higher personal stigma was also significantly correlated with being male, unemployed and good family function. Conclusion: Concerningly high levels of stigmatizing beliefs towards depression were prevalent among the public. This may be a reason why people with mental disorders do not seek assistance. This highlights the importance of the need for health education and promotion activities. Findings from this study suggest that targeted, culturally appropriate education programs are needed to improve knowledge about depression in the broader community. Keywords: Depression, Personal stigma, Perceived stigma, Community attitudes, China

Abstract Background Aberrant CpG island methylation has been increasingly recognized as a common event in myelodysplastic syndrome (MDS). To date, most of the previous studies of miR-124 in MDS have focused on epigenetic changes and little is known about the underlying mechanism through which miR-124 regulates CDK6 expression. Results In the present study, we employed pyrosequencing analysis to quantify the methylation levels of upstream regions of the miR-124 genes (miR-124-1, miR-124-2 and miR-124-3) in 56 primary MDS patients. We found the three miR-124 genes were methylated in MDS patients. Univariate analysis revealed that the World Health Organization (WHO) classification, marrow blast count, karyotype, International Prognostic Scoring System (IPSS), mean corpuscular volume, as well as high methylation of miR-124-1, miR-124-2 and miR-124-3 were significantly related to overall survival. In leukaemia-free survival, patients who were older and had an advanced WHO classification, high marrow blast counts, high IPSS risk and high methylation of miR-124-1 and miR-124-2 progressed rapidly to acute myeloid leukaemia. Multivariate analysis demonstrated that high methylation of miR-124-3 was an independent factor of overall survival. Median survival of patients with high miR-124-3 methylation was significantly shorter (7.6 months) than patients with low methylation (32.7 months; P = 0.010). A functional study revealed that silencing of miR-124 resulted in upregulation of its target gene, cyclin dependent kinase CDK6, which in turn promoted cell proliferation in the MDS cell line SKM-1. Conclusions High methylation of miR-124-3 predicts shorter survival for patients with MDS, which may be a useful prognostic marker in MDS.

Objectives: To explore help-seeking behaviours of Chinese persons managing depressive symptoms and factors that influence these behaviours. Methods: A survey of residents living in communities in Wuhan, China was conducted using stratified random sampling. The Patient Health Questionnaire (PHQ-2), the Actual Help-Seeking Questionnaire (AHSQ) and a socio-demographic questionnaire were completed by participants. Descriptive statistics were analyzed. A multiple linear regression model was used to explore factors associated with help-seeking behaviours. Results: Of the 1785 respondents, 672 (37.6%) reported that they experienced depressive symptoms during the past year, and of these respondents, 517 (76.9%) indicated that they sought assistance. Among help-seeking sources utilized by participants, informal help was sought most frequently (72.9%), followed by hotline/Internet assistance (14.3%), mental health professionals (MHPs) (7.9%) and general physicians (GPs) (3.7%). The results of multilinear regression analysis showed that participants who were adults (aged 25–64 years), attended junior and high school (7–12 years education), and lived in urban areas were more likely to seek additional assistance for their depressive symptoms. Conclusion: Mental health promotion and education efforts are needed to improve the public’s mental health literacy and to promote appropriate utilization of informal sources of assistance in managing depressive symptoms such as a hotline or the Internet. Further interventions need to be considered to reinforce use of social supports and mental health professionals, especially in rural areas. Keywords: Depressive symptoms, Help-seeking behaviour, Social support, Wuhan communities

Through making the analysis of information spread in social networks,the supression of rumors,error information and other negative information was realized.Firstly,by analyzing the structure of social networks and the characteristics of node behavior,a method for the identification of opinion leader nodes was proposed based on the degree of intimacy between nodes in social networks.Then,the rumor propagation model and the analysis of nodes’ state transformation process were made when the rumor spread in social networks.At last,the control method was proposed to suppress the diffusion of rumors with the nodes’ closeness.

AIM: To evaluate the safety and efficacy of Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy. METHODS: Thirty-six patients(36 eyes)with prior failed sequential trabeculectomy who underwent Ahmed glaucoma valve implantation were included. The intraocular pressure(IOP), best corrected visual acuity(BCVA)and complications were ovserved and all the patients were followed up at least for 12mo. RESULTS: Mean preoperative IOP was 35.20±7.28mmHg and reduced to 10.15±3.34, 11.23±3.56, 15.63±5.72, 17.17±5.47, 17.73±6.23,19.76±5.43mmHg at 1, 2wk, 1, 3, 6 and 12mo after surgery, which was significant different from the preoperative level(t=12.643, 11.837, 10.324, 8.839, 8.462, 8.046, all PZ=-0.420, P>0.05). At 12mo after operation, the complete success rate reached 78% and the conditional success rate reached 92%. There were 5 eyes complicated with shallow anterior chamber, 3 eye complicated with anterior chamber hemorrhage, which all recovered after additional treatments. Late complications included valve exposure and encapsulated cystic blebs around the plate. Severe corneal endothelium loss occurred in 1 patient. CONCLUSION: Ahmed glaucoma valve implantation is effective in reducing IOP at 1-year follow-up in refractory glaucoma patients with prior sequential failed trabeculectomy, but we should fully understand and attach great importance to all kinds of complications that may occur.