Epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China:a hospital-based retrospective study

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.

改良经皮原位回针垂直褥式缝合对颏部外伤愈合及瘢痕形成的影响

目的评价改良经皮原位回针垂直褥式缝合(MBVMS)技术对颏部伤口愈合及瘢痕形成的影响。方法选择2017年2月至2023年6月就诊于首都医科大学附属北京安贞医院整形外科急诊的90例颏部外伤患者,按照随机数字表法分为观察组(n=45)和对照组(n=45),清理创面后观察组患者采用改良MBVMS闭合创面,对照组患者采用常规美容缝合闭合创面,2组患者拆线后均外用硅酮凝胶祛疤药膏约3个月。观察2组患者7 d后拆线时的伤口愈合情况,运用温哥华瘢痕量表(VSS)、视觉模拟量表(VAS)、观察者瘢痕评估量表(OSAS)、患者瘢痕评估量表(PSAS)评估2组患者术后3、6个月时的瘢痕形成情况。结果术后7 d拆线,观察组患者伤口甲级愈合44例(97.8%),乙级愈合1例(2.2%);对照组患者伤口均为甲级愈合。观察组与对照组患者甲级愈合比例比较[97.8%(44/45)比100.0%(45/45)],差异无统计学意义(P>0.05)。术后3、6个月,观察组VSS、VAS、OSAS及PSAS评分均低于对照组,差异均有统计学意义(均P<0.05)。结论改良MBVMS技术应用于颏部外伤患者中,可在保证伤口安全愈合的同时,有效改善伤口愈合后瘢痕的性状,减少术后瘢痕增生,达到良好的美容效果。

Genome-Wide Identification and Expression Profiling Suggest that Invertase Genes Function in Silique Development and the Response to Sclerotinia sclerotiorum in Brassica napus

Invertase(INV),a key enzyme in sucrose metabolism,irreversibly catalyzes the hydrolysis of sucrose to glucose and fructose,thus playing important roles in plant growth,development,and biotic and abiotic stress responses.In this study,we identified 27 members of the BnaINV family in Brassica napus.We constructed a phylogenetic tree of the family and predicted the gene structures,conserved motifs,cis-acting elements in promoters,physicochemical properties of encoded proteins,and chromosomal distribution of the BnaINVs.We also analyzed the expression of the BnaINVs in different tissues and developmental stages in the B.napus cultivar Zhongshuang 11 using qRT-PCR.In addition,we analyzed RNA-sequencing data to explore the expression patterns of the BnaINVs in four cultivars with different harvest indices and in plants inoculated with the pathogenic fungus Sclerotinia sclerotiorum.We used WGCNA(weighted coexpression network analysis)to uncover BnaINV regulatory networks.Finally,we explored the expression patterns of several BnaINV genes in cultivars with long(Zhongshuang 4)and short(Ningyou 12)siliques.Our results suggest that BnaINVs play important roles in the growth and development of rapeseed siliques and the defense response against pathogens.Our findings could facilitate the breeding of high-yielding B.napus cultivars with strong disease resistance.

Guideline for the diagnosis and treatment of rheumatoid arthritis with integrated traditional Chinese medicine and Western medicine to increase efficiency and reduce toxicity

Rheumatoid arthritis imposes a huge disease burden.Existing practice guidelines do not meet the needs of integrated traditional Chinese medicine and Western medicine in the treatment of rheumatoid arthritis.We established a guideline working group consists of a steering committee,a secretary group,an evidence evaluation group,a consensus group and a review group and developed a guideline following the guidance of the World Health Organization Handbook and the Chinese Medical Association.The guideline includes 35 recommendations which reached consensus by the two rounds Delphi surveys.These recommendations were formulated to address the following themes of most concern to clinician:diagnostic imaging,disease staging,traditional Chinese medicine syndromes,effectiveness and toxicity of integrated traditional Chinese medicine and Western medicine.

Moderating effect of psychological resilience on the perceived social support and loneliness in the left-behind elderly in rural areas

Objective:To investigate the loneliness and psychological resilience with the perceived social support of the left-behind elderly in rural areas and explore the moderating effect of psychological resilience on the understanding of social support and loneliness of the left-behind elderly in rural areas.Methods:A cross-sectional study was conducted;272 left-behind elderly people in 6 rural villages in the Sichuan Province were investigated by using the General Situation Questionnaire,Perceived Social Support Scale(PSSS),Connor-Davidson Resilience Scale(CD-RISC),and the University of California at Los Angeles Loneliness Scale(UCLA)with a stratified random cluster sampling method.Results:The loneliness score of the left-behind elderly in rural areas was 52.54±7.25,the psychological resilience score was 78(68.87),and the perceived social support score was 57(51.62).The perceived social support and psychological resilience were negatively correlated with loneliness,while the perceived social support was positively correlated with psychological resilience.The moderating effect of psychological resilience on the perceived social support and loneliness of the left-behind elderly in rural areas was−0.102(P<0.001).Conclusions:Higher level resilience is of positive significance to alleviate the negative effect of social support on loneliness.Improving the resilience of the left-behind elderly in rural areas is a beneficial exploration to promote their mental health.

Modeling and Simulation in Spectroscopic Study

Editorial;

基于生物信息数据库分析前列腺癌组织特异性lncRNA表达及临床意义

目的研究前列腺癌组织特异性长链非编码RNA(lncRNA)表达及其临床意义。方法利用生物信息学方法深入分析TCGA及GEO基因组数据库,对数据库收录的492例前列腺癌组织和152例癌旁组织做基因差异分析,筛选出差异表达的lncRNA,并进一步分析上述lncRNA的前列腺组织特异性及对前列腺癌患者预后的影响。结果筛选出差异表达的5个lncRNA包括:前列腺相关转录因子14(PCAT14)、前列腺抗原3(PCA3)、C末端结合蛋白1-AS(CTBP1-AS)、DRAIC、GPC5-AS1。其中,PCAT14、PCA3在前列腺癌组织中特异性表达,二者升高提示与前列腺癌预后相关,且二者与激肽释放酶相关肽酶3(KLK3)、α-甲基酰基辅酶A消旋酶(AMACR)、溶质转运蛋白家族45A3(SLC45A3)等前列腺癌特异抗原相关性好。针对PCAT14、PCA3进行GO功能富集分析和KEGG通路富集分析提示:PCA3差异表达与吞噬作用、细胞识别、对细菌的防御反应、免疫球蛋白复合物、高尔基体、抗原结合、趋化因子受体结合、蛋白质消化吸收、肾素-血管紧张素系统等信号通路等密切相关;PCAT14差异表达与高尔基体、离子通道的活动相关通路,同时与肾素分泌、环磷酸腺苷(cAMP)信号通路、促性腺激素分泌相关信号通路等密切相关。结论PCA3、PCAT14在前列腺癌组织中特异性表达,在正常组织中基本不表达,可以作为前列腺癌诊断的潜在指标。

Microwave-induced thermoacoustic elastic imaging:A simulation study

Microwave-induced thermoacoustic imaging(MTI)has the advantages of high resolution,high contrast,non-ionization,and non-invasive.Recently,MTI was used in the¯eld of breast cancer screening.In this paper,based on the¯nite element method(FEM)and COMSOL Multiphysics software,a three-dimensional breast cancer model suitable for exploring the MTI process is proposed to investigate the in°uence of Young's modulus(YM)of breast cancer tissue on MTI.It is found that the process of electromagnetic heating and initial pressure generation of the entire breast tissue is earlier in time than the thermal expansion process.Besides,compared with normal breast tissue,tumor tissue has a greater temperature rise,displacement,and pressure rise.In particular,YM of the tumor is related to the speed of thermal expansion.In particular,the larger the YM of the tumor is,the higher the heating and contraction frequency is,and the greater the maximum pressure is.Di®erent Young's moduli correspond to di®erent thermoacoustic signal spectra.In MTI,this study can be used to judge di®erent degrees of breast cancer based on elastic imaging.In addition,this study is helpful in exploring the possibility of microwave-induced thermoacoustic elastic imaging(MTAE).

基于BERT模型和图注意力网络的方面级情感分析

方面级情感分析是一项细粒度的情感分析任务,旨在对给定文本中的特定方面进行情感极性分析。当前基于语法分析的方法严重依赖于依存树的单一解析结果,并且大部分研究对于语义和语法特征的融合并不充分。因此,提出了一种基于BERT模型和图注意力网络的方面级情感分析方法。该方法能够充分挖掘句子结构中的语义和语法信息,并通过交互注意力机制融合这些信息,从而获得更精确的情感特征。首先,利用BERT预训练模型得到文本的初始化向量,并使用注意力机制对方面词进行全局的语义信息关联,得到文本的语义特征。其次,利用语法解析器构建短语结构图和依存图,并利用图注意力网络对节点信息进行编码,得到文本的语法特征。最后,通过交互注意力机制结合学习到的语义和语法特征,实现了多个视角的融合,从而全面理解方面-观点关系。实验结果表明,所提方法在多个数据集上的ACC值和F1值均优于现有的多个先进方法。

Implications of 1.5 K climate warming on warm-season ozone exposure and atmospheric oxidation capacity in China

Surface ozone(O_(3))poses significant threats to public health,agricultural crops,and plants in natural ecosystems.Global warming is likely to increase future O_(3)mainly by altering atmospheric photochemical reactions and enhancing biogenic volatile organic compound(BVOC)emissions.To assess the impacts of the future 1.5 K climate target on O_(3)concentrations and ecological O_(3)exposure in China,numerical simulations were conducted using the CMAQ(Community Multiscale Air Quality)model during April-October 2018.Ecological O_(3)exposure was estimated using six indices(i.e.,M7,M24,N100,SUM60,W126,and AOT40f).The results show that the temperature rise increases the MDA8 O_(3)(maximum daily eight-hour average O_(3))concentrations by∼3 ppb and the number of O_(3)exceedance days by 10-20 days in the North China Plain(NCP),Yangtze River Delta(YRD),and Sichuan Basin(SCB)regions.All O_(3)exposure indices show substantial increases.M24 and M7 in eastern and southern China will rise by 1-3 ppb and 2-4 ppb,respectively.N100 increases by more than 120 h in the surrounding regions of Beijing.SUM60 increases by greater than 9 ppm h^(−1),W126 increases by greater than 15 ppm h^(−1)in Shaanxi and SCB,and AOT40f increases by 6 ppm h^(−1)in NCP and SCB.The temperature increase also promotes atmospheric oxidation capacity(AOC)levels,with the higher AOC contributed by OH radicals in southern China but by NO_(3)radicals in northern China.The change in the reaction rate caused by the temperature increase has a greater influence on O_(3)exposure and AOC than the change in BVOC emissions.

山茶油中主要功能性成分研究进展

本文对山茶油的主要功能性成分及其作用作出简要综述,并阐述其检测方法,为山茶油质量品质控制提供参考。

Photoacoustic/ultrasound dual-modal imaging of human nails: A pilot study

Traditional diagnostic techniques including visual examination,ultrasound(US),and magnetic resonance imaging(MRI)have limitations of in-depth information for the detection of nail disorders,resolution,and practicality.This pilot study,for thefirst time,evaluates a dualmodality imaging system that combines photoacoustic tomography(PAT)with the US for the multiparametric quantitative assessment of human nail.The study involved a small cohort offive healthy volunteers who underwent PAT/US imaging for acquiring the nail unit data.The PAT/US dual-modality imaging successfully revealed thefine anatomical structures and microvascular distribution within the nail and nail bed.Moreover,this system utilized multispectral PAT to analyze functional tissue parameters,including oxygenated hemoglobin,deoxyhemoglobin,oxygen saturation,and collagen under tourniquet and cold stimulus tests to evaluate changes in the microcirculation of the nail bed.The quantitative analysis of multispectral PAT reconstructed images demonstrated heightened sensitivity in detecting alterations in blood oxygenation levels and collagen content within the nail bed,under simulated different physiological conditions.This pilot study highlights the potential of PAT/US dual-modality imaging as a real-time,noninvasive diagnostic modality for evaluating human nail health and for early detection of nail bed pathologies.

基于矿物质元素指纹分析技术的浦城大米产地溯源研究

通过分析浦城大米、江西地区大米、湖北地区大米、湖南地区大米和福建地区(除浦城以外)大米中25种矿物质元素质量分数特征,筛选出14种差异显著的矿物质元素,并比较主成分分析(PCA)和正交偏最小二乘判别分析(OPLS-DA)对矿物质元素的降维效果,发现经过PCA降维后的线性判别分析(LDA)结果优于OPLS-DA,进而建立了“差异分析+主成分分析+判别分析”的浦城大米产地溯源模型,筛选出钒(V)、钴(Co)、砷(As)、铷(Rb)、银(Ag)、铯(Cs)等6种特征矿物质元素,判别模型回代检验的整体正确判别率为98.1%,交叉检验的整体正确判别率为97.1%。该模型能准确识别浦城大米,为浦城大米的产地溯源和质量控制提供了参考。

Consensus on rapid screening for prodromal Alzheimer's disease in China

Alzheimer's disease(AD)is a common cause of dementia,characterised by cerebral amyloid-βdeposition,pathological tau and neurodegeneration.The prodromal stage of AD(pAD)refers to patients with mild cognitive impairment(MCl)and evidence of AD's pathology.At this stage,disease-modifying interventions should be used to prevent the progression to dementia.Given the inherent heterogeneity of MCl,more specific biomarkers are needed to elucidate the underlying AD's pathology.Although the uses of cerebrospinal fluid and positron emission tomography are widely accepted methods for detecting AD's pathology,their clinical applications are limited by their high costs and invasiveness,particularly in low-income areas in China.Therefore,to improve the early detection of Alzheimer's disease(AD)pathology through cost-effective screening methods,a panel of 45neurologists,psychiatrists andgerontologistswas invited to establish a formal consensus on the screening of pAD in China.The supportive evidence and grades of recommendations are based on a systematic literature review andfocus group discussion.National meetings were held to allow participants to review,vote and provide their expert opinions to reach a consensus.A majority(two-thirds)decision was used for questions for which consensus could not be reached.Recommended screening methods are presented in this publication,including neuropsychological assessment,peripheral biomarkers and brain imaging.In addition,a general workflow for Screening pAD in China is established,which will help clinicians identify individuals at high risk and determine therapeutic targets.

Determination of Benzoylaconitine Compounds in the Decoctions of Aconiti Lateralis Radix Praeparata(Heishun Pieces),Trichosanthis Fructus and Their Combination

[Objectives]This study was conducted to determine the contents of benzoylmesaconine,benzoylaconitine and benzoylhypacoitine in the decoctions of Heishun pieces,Trichosanthis Fructus and their combination.[Methods]Heishun pieces,Trichosanthis Fructus and their combination were extracted for different time periods,and then grouped.HPLC was performed using an Agilent ZORBAX SB-C 18 chromatographic column(4.6 mm×250 mm,5μm)and acetonitrile-0.02 mol/L sodium dihydrogen phosphate as the mobile phase at a flow rate of 1 mL/min and a column temperature of 30℃,and the sample volume was 20μL.The detection wavelength was 230 nm.[Results]The total amounts of benzoylmesaconine,benzoylaconitine and benzoylhypacoitine in the single decoction group of Heishun pieces were all significantly different from those in the combined decoction group at corresponding time.[Conclusions]The total content of the benzoylaconitine type increased significantly after the combined decoction of Heishun pieces and Fructus Trichosanthis,which proves the scientificity of"eighteen incompatible medicaments,19 counteraction"in traditional Chinese medicine to some extent.

Screening of Long Cowpea[Vigna unguiculata(L.)Walp.ssp.sesquipedialis]Varieties in Autumn in Hunan and Comparison of Various Comprehensive Evaluation Methods

[Objectives]The paper was to screen new varieties of long cowpea that are suitable for autumn cultivation in Hunan,as well as to develop a comprehensive evaluation method to assess their adaptability and performance.[Methods]A total of 48 long cowpea varieties were introduced,and a range of comprehensive evaluation methods was employed to assess these varieties through the collection and analysis of field data.[Results]The square Euclidean distance of 14 allowed for the classification of all varieties into eight distinct groups.Groups II,III,and V belong to the autumn dominant group within this region,while groups I and VIII belong to the intermediate group.Additionally,groups IV,VI,and VII belong to the autumn inferior group in this area.Through a comparative analysis of various comprehensive evaluation methods,it was determined that the common factor comprehensive evaluation,grey correlation method,and fuzzy evaluation method were appropriate for application in the selection of long cowpea varieties.Furthermore,the evaluation outcomes were largely consistent with the cluster pedigree diagram.[Conclusions]Through comprehensive index method,ten varieties demonstrating superior performance in autumn cultivation have been identified,including C20,C42,C29,C40,C3,C14,C18,C25,C15,and C47.The selected varieties exhibit several advantageous traits,such as a reduced growth duration,a lower position of initial flower nodes,a decreased number of branches,predominantly green young pods,elongated pod strips,thicker pod structures,an increased number of pods per plant,and higher overall yields.These characteristics render them particularly valuable for extensive cultivation.

拱肋的不同宽跨比对拱桥屈曲分析的影响

先从拱桥屈曲的相关理论出发,分析拱桥屈曲模态的相关受力特点和失稳特征,以及影响稳定系数的相关因素。再以一座已经建成的上承式拱桥的数据出发,通过有限元分析软件Midas Civil建立有限元分析模型,分析这座桥的屈曲模态以及失稳特征。再改变拱肋的宽度,达到拱肋不同宽跨比的目的。分别建立有限元分析模型,研究不同宽跨比下的拱桥屈曲模态有何特征。在设计拱桥时该如何考虑合理的拱肋宽跨比,从最后屈曲分析的结果表明,拱肋的宽跨比对拱桥的稳定系数的影响不是线性的,而是一种非线性的影响。也就是拱桥的宽跨比存在一个合理的选择范围,这与所设计的桥的相关参数有关。此文旨在做一个基础性的研究,为日后设计拱桥时考虑合理宽跨比时提供一些理论基础。

分次切除荷包缝合在较大面积色素痣切除中的临床应用

目的:探讨分次切除荷包缝合在较大面积色素痣切除中的临床应用效果。方法:选择接受治疗的29例较大面积色素痣(直径20~65mm)患者,术中冰冻排除恶性肿瘤后进行分次切除荷包缝合治疗,每位患者接受两次治疗,间隔约6个月,术后半年观察其临床效果和并发症。结果:本组29例较大面积色素痣患者采用分次切除荷包缝合后,切口均一期愈合,无感染、裂开等并发症发生,术后初期皮损周围皮肤会有放射状的褶皱,6个月后褶皱舒平,瘢痕轻微,患者对效果较为满意。结论:分次切除荷包缝合通过牵拉扩张皮损周围的皮肤,克服了传统手术切口较长、瘢痕明显的缺陷,减小了瘢痕,美容效果较好,值得临床推广。

药源性高尿酸血症临床分析及风险管理

目的从临床实例出发探讨药源性高尿酸血症的发生特点,为临床用药安全及风险管理提供依据。方法检索建库至2022年12月31日医药期刊公开发表的药源性高尿酸血症的病例报道,同时收集我院2010—2022年上报的药源性高尿酸血症不良反应(ADR)报告,提取患者性别、年龄、怀疑药品、药品的用法用量、血尿酸水平、ADR诱导时间、治疗与转归等信息进行统计分析。结果共纳入病例45例,其中文献病例18例,我院ADR病例27例。男性25例,女性20例,年龄14~82岁,平均年龄(53.18±19.45)岁;引起高尿酸血症的药物主要涉及抗结核药、利尿药、抗感染药、复方降压药、抗血小板药、质子泵抑制剂、调节免疫功能药和抗精神病药。用药后血尿酸>420~480μmol·L^(-1)的4例,>480~540μmol·L^(-1)的13例,>540μmol·L^(-1)的28例。高尿酸血症的诱导时间最短为2 d,最长数年。经停药、对症治疗或药物减量后血尿酸水平下降或恢复正常。结论多种药物可引起高尿酸血症,服用易引起高尿酸血症药物的患者,尤其是老年患者,应定期监测血尿酸水平。医务人员应了解易引起高尿酸血症的药物,做好用药风险管理,减少药源性高尿酸血症的发生。

京津冀地区家庭消费升级的动态演化——基于可解释机器学习的新证据

在国内国际双循环相互促进的新发展格局下,加快消费升级对于我国经济高质量发展具有重要战略意义。本文以京津冀地区家庭作为研究对象,采用机器学习模型和可解释机器学习算法,深入分析京津冀地区家庭消费升级的动态演化过程及其作用因素的非线性影响。研究结果表明,机器学习模型可以很好地拟合京津冀地区家庭消费升级,且非日常消费的具体细分支出信息对于家庭消费升级的拟合具有决定性作用。在模型拟合过程中,非日常消费细分支出与家庭经济信息、人口信息以及家庭所在城市信息形成了较好的信息互补关系。可解释性分析结果发现,非日常消费细分支出变量的影响存在非线性变化过程,并且不同细分支出对于家庭消费升级的影响方向存在差别。本文认为,为实现京津冀地区消费驱动经济高质量发展的战略目标,有关部门应在提高家庭收入和财富水平的同时,进一步在对家庭消费升级有正向作用的非日常消费细分领域发力,也应当根据所在地家庭的支出情况及其所处影响曲线的不同位置,制定差异化的激励政策,以便更加有效地推动京津冀地区家庭消费升级。