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Objective: To propose a scoring system based on laryngoscopic characteristics for the differential diagnosis of benign and malignant vocal fold leukoplakia. Methods: Laryngoscopic images from 200 vocal fold leukoplakia cases were retrospectively analysed. The laryngoscopic signs of benign and malignant vocal fold leukoplakia were compared, and statistically significant features were assigned and accumulated to establish the leukoplakia finding score. Results: A total of five indicators associated with malignant vocal fold leukoplakia were included to construct the leukoplakia finding score, with a possible range of 0–10 points. A score of 6 points or more was indicative of a diagnosis of malignant vocal fold leukoplakia. The sensitivity, specificity and accuracy values of the leukoplakia finding score were 93.8 per cent, 83.6 per cent and 86.0 per cent, respectively. The consistency in the leukoplakia finding score obtained by different laryngologists was strong (kappa = 0.809). Conclusion: This scoring system based on laryngoscopic characteristics has high diagnostic value for distinguishing benign and malignant vocal fold leukoplakia. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the trajectory and predictors of family function in caregivers of stroke survivors during the first 6 months after the first episode of stroke. Design: Longitudinal study. Methods: A total of 288 primary caregivers of patients with first‐time stroke were recruited from seven tertiary hospitals in China between July 2020 and March 2021. The following characteristics were assessed by caregivers at hospitalization (T0) and at 1 month (T1), 3 months (T2) and 6 months (T3) after the stroke: family function, general self‐efficacy, social support, coping style, caregiver burden, and sociodemographic and clinical data. Results: Family function scores among caregivers of stroke survivors were highest in the resolve dimension and lowest in the growth and adaptation dimensions within the first 6 months. The percentages of families with low functioning were 34.7%, 33.3%, 24.8% and 17.7% at T0, T1, T2 and T3, respectively. The generalized estimating equation model revealed that family function in caregivers increased over the first 6 months (Exp(B) = 1.415–2.689, p <.05). The following factors were identified as predictors of family functioning: caregiver's age, education, residential district, self‐efficacy, social support utilization and caregiver burden. Conclusions: Family function of caregivers of stroke survivors gradually increased during the first 6 months after stroke. However, some families demonstrated poor functioning. Caregivers' age, education, caregiver burden, self‐efficacy and social support utilization could predict family function over time. Impact: Empirical data on family function in families of stroke survivors are important for developing psychosocial interventions that can help families adapt to stroke. This study found that families of stroke survivors were likely to be dysfunctional in the first 6 months after stroke, particularly in family growth and adaptation. Therefore, reducing caregiver burden and promoting self‐efficacy and social support utilization can help restore family functioning early after stroke. Patient or Public Contribution: Stroke caregivers from seven hospitals in China were involved in this study and had the right to be informed of the main findings. A few patients were informed of the research results, who contributed to the dissemination. [ABSTRACT FROM AUTHOR]

The formation of peer attachment is vitally important for the mental health of adolescents. Additionally, converging evidences show that childhood emotional trauma leads to poor peer attachment during adolescence. However, little is known about the underlying mechanism accounting for the link between early emotional trauma and adolescent peer attachment. Therefore, the present study is intended to examine the relationship between childhood psychological maltreatment (CPM) and peer attachment among Chinese adolescents and reveal its underlying mechanism. In total, we collected data from 670 adolescents (36.5% males and 63.5% females, M age = 16.44 years, SD = 0.78) attending two Chinese high schools. These participants completed measurement scales for CPM (emotional abuse and neglect), peer attachment, and emotion regulation strategies, including cognitive reappraisal (CR) and expressive suppression (ES). The multiple mediation models showed that emotional neglect negatively predicted adolescent peer attachment but that emotional abuse did not. Furthermore, the two emotion regulation strategies, CR and ES, completely mediated the relationship between emotional abuse and peer attachment and partially mediated the relationship between emotional neglect and peer attachment. These findings extend the existing studies on adolescent peer attachment and elucidate how childhood emotional trauma negatively influences adolescent peer attachment. In addition, the present results provide implications for improving the peer attachment of adolescents. On one hand, appropriate family intervention should be implemented to reduce CPM. On the other hand, schools can focus on improving the peer attachment of adolescents by enhancing their emotion regulation. Specifically, adolescents should be taught how to use adaptive strategies, such as CR, to regulate negative emotions. [ABSTRACT FROM AUTHOR]

Background: Delirium is one of the most common complications in critically ill children. Once delirium occurs, it will cause physical and psychological distress in children and increase the length of their ICU stay and hospitalization costs. Understanding the risk factors for delirium in critically ill children can help develop targeted nursing interventions to reduce the incidence of delirium. Aims: To investigate the incidence and the risk factors of delirium in the paediatric intensive care unit (PICU). Study design: We performed a prospective observational study in critically ill patients in the PICU between February and July 2020. Delirium was diagnosed by the Cornell Assessment of Paediatric Delirium (CAPD) and the Richmond Agitation Sedation Scale and analysed via univariate analysis and multivariate logistic regression to determine the independent risk factors of delirium in critically ill children. Results: The study enrolled 315 patients ranging in age from 1–202 (65.3–54.3) months, with 56.2% (n = 177) being male. The incidence of delirium was 29.2% (n = 92) according to CAPD criteria. Among them, 33 cases (35.9%) were of hyperactive delirium, 16 cases (17.4%) were of hypoactive delirium, and 43 cases (46.7%) were of mixed delirium. By using stepwise logistic regression, the independent risk factors of delirium included mechanical ventilation (odds ratio [OR], 11.470; 95% confidence interval [CI], 4.283–30.721), nervous system disease (OR, 5.596; 95%CI, 2.445 to 12.809), developmental delay (OR, 5.157; 95% CI, 1.990–13.363), benzodiazepine (OR, 3.359; 95% CI 1.278–8.832), number of catheters (OR, 1.918; 95% CI, 1.425 to 2.582), and age (OR, 0.985; 95% confidence interval CI, 0.976–0.993). Conclusions: Delirium is a common complication in the PICU. The independent risk factors include mechanical ventilation, nervous system disease, developmental delay, benzodiazepines, higher number of catheters, and younger age. This study may help develop intervention strategies to reduce the incidence of delirium in critically ill children by targeting modifiable risk factors. Relevance to Clinical Practice: Recommendations for practice include paying attention to high‐risk children in the ICU who are prone to delirium, removing influencing factors as soon as possible, and providing targeted nursing interventions. [ABSTRACT FROM AUTHOR]

Objectives. Primary central nervous system lymphoma (PCNSL) usually has a poor prognosis. Cerebrospinal fluid (CSF) interleukin (IL)-10 has shown diagnostic, prognostic, and monitoring value in our previous studies. Cell-free circulating tumor DNA can be detected in the CSF of refractory/relapse cases and has also shown monitoring value. However, information about its monitoring value in newly diagnosed PCNSL patients and comparisons of CSF IL-10 and CSF cell-free DNA (cfDNA) are scarce. Methods. We performed next-generation sequencing on paraffin-embedded tissue and the serial CSF cfDNA of 10 newly diagnosed PCNSL patients and on the baseline CSF cfDNA of 11 other central nervous system lymphoma patients. We also monitored the CSF IL-10 levels of the 10 newly diagnosed PCNSL patients. Results. In seven newly diagnosed PCNSL patients with sufficient baseline CSF cfDNA, six had ≥1 mutated genes in their CSF cfDNA. The most common were MYD88(4/7), PIM1(3/7), MLL2(3/7), and ETV6(2/7). We also identified multiple somatic mutations, most commonly in PIM1. MYD88L265P can be detected in both tumor tissue and CSF cfDNA. The genomic profiles of CFS cfDNA were similar in PCNSL and PIOL patients. Newly diagnosed PCNSL patients with persistently positive cfDNA and negative IL-10 progressed quickly, while those with negative cfDNA and negative IL-10 were in maintenance therapy for more than 18 months. Two patients without cfDNA had increased CSF IL-10 concentrations before disease relapse. These results indicate that negative CSF cfDNA predicts better results, and persistently positive CSF cfDNA predicts disease progression earlier than conventional magnetic resonance imaging. Conclusion. In conclusion, CSF cfDNA is a potential predictor of relapse and progression, which complements the monitoring value of CSF IL-10 in newly diagnosed PCNSL patients. [ABSTRACT FROM AUTHOR]

Background. To evaluate the associations between long-term oral Chinese herbal medicines (CHMs) and recurrence and metastasis (R&M) in patients with stage II and III colorectal cancer (CRC). Furthermore, we aimed to determine the correlation between different syndrome patterns and prognosis and summarized the regularities among CHMs prescriptions, providing reference for clinical practice. Methods. An ambispective cohort study was conducted. All CRC patients who sought evaluation and treatment at Xiyuan Hospital and Beijing Cancer Hospital from August 2014 to August 2016 were included. In this study, "whether patients voluntarily take CHMs" was taken as the exposure factor, and the exposure degree was "the duration of CHM use." Stratification was performed according to the duration of TCM use to determine the relationship with R&M of CRC. The primary outcome was disease-free survival. Patients who had R&M of CRC after taking CHMs for ≥6 months were defined as "worst patients." R software was used for statistical analysis. The Kaplan–Meier method and Cox regression analysis were used to determine the prognosis. IBM SPSS was used to model a priori association rules; drug use rules were analyzed on this basis. Results. A total of 186 patients with stage II and III CRC after radical resection were enrolled. All patients reached the study endpoint by August 2021. The difference in disease-free survival between the two groups was most significant when the cutoff value for CHMs was 18 months (P = 0.0012). Multivariate analysis showed that 18 CHMs were independent protective factors for R&M of CRC (P = 0.001 , HR = 0.20, 95% CI = 0.08–0.53). The ratio of Pi (spleen) and Shen (kidney) deficiency in the worst cases was higher than patients without R&M (P = 0.018). Sijunzi and Liuwei Dihuang decoctions were the most frequently used prescriptions in the anti-R&M phase. Conclusion. CHMs complying with the "Jianpi Bushen" principle may attenuate the risk of R&M in patients with stage II and III CRC. Pi (spleen) and Shen (kidney) deficiency in patients receiving TCM intervention for the first time within 6 months of radical resection may be associated with a higher CRC R&M rate. Further research is warranted to validate these findings and elucidate underlying biological mechanisms. [ABSTRACT FROM AUTHOR]

Background: Since the outbreak of COVID-19 in 2019, the global economy, culture, politics, and people's lives and health have been severely damaged and threatened. Although western modern medical treatment has made great efforts, the treatment of COVID-19 has not achieved ideal clinical efficacy with severe sequelae. Qingfei Paidu (QFPD), an important herbal prescription for COVID-19 treatment, has shown remarkable therapeutic effects in China's fight against the epidemic. Materials and methods: We searched seven databases up to 7 September 2022, including PubMed, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, World Scientific and SpringerLink. We used the Cochrane Risk of Bias tool to assess the quality of randomized controlled trials. All analysis results were conducted by RevMan 5.4.1 to carry out a meta-analysis. Results: Fifteen studies with 10390 patients were included. QFPD could not only significantly improve the cure rate and lung CT of COVID-19, reduce the number of patients turning to critical condition and death, shorten the time for nucleic acid conversion and the length of hospital stay, but change laboratory indexes and relieve body symptoms quickly without adverse effects. Conclusions: Compared with patients only treated by conventional western treatment (CWM), QFPD combined with CWM could be more effective for patients. It is worth spreading to other countries in the global battle against COVID-19. [ABSTRACT FROM AUTHOR]

Objectives: Limited information is known about preventive dental visits (PDVs) before seven years of age among children in China. This study aimed to examine the early PDV rate, identify the impact of PDV on dental caries and untreated dental caries, and explore the factors related to PDV among Chinese sampled children under seven years old. Methods: A cross-sectional survey was conducted in five selected primary health care facilities in Chengdu, China, from May to August 2021. Parent–child dyads during regular systematic medical management were recruited to participate. Children's dental caries were identified through dental examinations and documented as decayed, missing and filled teeth index (dmft) by trained primary care physicians. Dental-related information was collected through a questionnaire. Zero-inflated negative binomial (ZINB) regression was used to test the effect of early PDV on the dmft value, and logistic regression was used to analyse impact factors on the early PDV. Results: A total of 2028 out of 2377 parent–child dyads were qualified for analysis. Half of the children (50.4%) were male, with a mean age of 4.8 years. Among all the children, 12.1% had their first dental visit for preventive purposes, 34.4% had their first dental visit for symptomatic purposes, and more than half had never visited a dentist. The results showed that a lower dmft value (adjusted OR: 0.69, 95% CI: 0.48–0.84), a higher rate of caries-free (aOR: 6.5, 95% CI: 3.93–10.58), and a lower rate of untreated dental caries (aOR: 0.40, 95% CI: 0.21–0.76) were associated with early PDV utilization. Children who had a higher rate of PDV were positively associated with living in a family with better parental behaviours (aOR: 2.30, 95% CI: 1.71–3.08), better parental oral health perception (aOR: 1.23, 95% CI: 1.06–1.32), fathers who had no untreated caries (aOR: 0.68, 95% CI: 0.47–0.97), families with higher socioeconomic status (aOR: 1.09, 95% CI: 1.04–1.16), and dental health advice received from well-child care physicians (aOR: 1.47, 95% CI: 1.08–2.00). Conclusions: Early PDV was associated with a lower rate of dental caries prevalence and untreated dental caries among sampled children younger than seven in Western China. Underutilization and social inequities existed in PDV utilization. Public health strategies should be developed to increase preventive dental visits and eliminate social disparities that prevent dental care utilization. [ABSTRACT FROM AUTHOR]

Aim: To examine whether various aspects of adverse childhood experiences (ACEs) are associated with comorbid cardiovascular diseases (CVDs) and diabetes among middle‐aged and old adults in China. Methods: Using the 2018 China Health and Retirement Longitudinal Study survey and the 2014 Life History survey, in total, 17 115 respondents aged ≥45 years were included. Logistic regressions were applied to estimate the relationship between aspects of ACEs and diagnosis of both CVDs and diabetes while adjusting for adulthood demographics, health and health behaviors. Results: Childhood hunger (OR = 1.75, P < 0.01), childhood socioeconomic status (OR = 1.45, P < 0.05) and abuse from father (OR = 1.50, P < 0.05) were significantly associated with greater odds of comorbid CVDs and diabetes above and beyond adulthood characteristics. In addition, the effects of these ACEs on comorbidity were stronger than their effects on the single chronic condition. Conclusions: Our findings suggest that, for middle‐aged and old Chinese adults, ACEs could have long‐lasting impacts on multiple chronic conditions in later life. Public health interventions should focus on the early life stage as the protective childhood conditions might help in warning of later clustering chronic diseases. Geriatr Gerontol Int 2022; 22: 12–18. [ABSTRACT FROM AUTHOR]

Being victimized online and through social media is a prevailing phenomenon among adolescents, and has been shown to be associated with later internalizing and externalizing problems. However, there is insufficient understanding of how the experience of cybervictimization is associated with these problems and when these associations are strongest. Guided by general strain theory, we proposed that cybervictimization is associated with internalizing and externalizing problems through different mechanisms, and that emotion regulation strategies moderate these processes. Questionnaire data were collected from 810 high school students in southern China (54.3% girls, mean age = 16.8, SD = 0.79). As hypothesized, path analysis results showed that the positive association between cybervictimization and internalizing problems was mediated by psychological insecurity, whereas the positive association between cybervictimization and externalizing problems was mediated by moral disengagement. In addition, adolescents' emotion regulation strategies moderated these mediation processes. Cognitive reappraisal buffered the effect of psychological insecurity on internalizing problems but aggravated the effect of cybervictimization on moral disengagement. Expressive suppression buffered the effect of moral disengagement on externalizing problems. Our results provide a novel perspective for understanding the negative impacts of cybervictimization on adolescents, and have practical implications for interventions to reduce these impacts. • Cybervictimization is associated with adolescents' internalizing and externalizing problems. • Moral disengagement and psychological insecurity mediated these two pathways, respectively. • Cognitive reappraisal and expressive suppression play a moderating role in the above relationships. • The results have practical implications for developing targeted prevention and intervention programson cybervictimization. [ABSTRACT FROM AUTHOR]