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Objective: Thyroid nodules are a common medical problem in China and in other parts of the world. Many guidelines use ultrasound (US) as the first choice for evaluating thyroid nodules. A major limitation of US is operator dependency, resulting in a variety of discrepancies in diagnosing thyroid nodules in the literatures. Risk stratification of thyroid nodules is based on the patterns of US features in the 2015 American Thyroid Association (ATA) management guidelines for adult patients with thyroid nodules. We hypothesize that special training targeting features recognition may increase the inter-observer agreement. Methods: The study was conducted on 52 participants from Peking Union Medical College Hospital (PUMCH) from March to May 2018.The participants were divided into two groups by their own decision for their convenience. Image featuresbased learning (IF-BL) was used to train the participants to learn special features including shape, margin, echo level, internal structure, calcification, vascularity through 10 standard images based on the 2015 ATA guideline. Group A (27 subjects) received IF-BL during the first month, and Group B (25 subjects) received IF-BL during the second month. All participants evaluated US features and risk stratification in 60 US images of 20 thyroid nodules before and after the training. The test results were graded by a teaching assistant according to the rule of 0.5 points assigned to every feature and 2 points assigned to risk stratification, with a total of 100 points. Inter-observer agreements of US features and risk stratification were assessed and compared before and after the training. Results: After the first month, Group A had better scores than Group B, the control group of the month (75.4±9.4 vs 68.7±8.4, p = 0.01). At the end of the second month during which both groups were trained, there was no difference of scores between Group A and Group B (74.5±10.4 vs 75.1±7.4, P = 0.78). Scores of all participants were significantly higher than the initial (74.8±9.0 vs 65.8±13.6, P < 0.01). After the training, the kappa values of US features improved from 0.28-0.43 to 0.43-0.75, and those of risk stratification improved from 0.13 to 0.55. Conclusion: IF-BL can effectively help trainees correctly recognize US features and evaluate the risk stratification of thyroid nodule and can improve the inter-observer agreement.

We document a speculation channel and complement the well-documented collateral channels by offering novel evidence about the effect of curbing housing speculation policies We estimate the positive effect of discouraging housing speculation on household entrepreneurship in China. By exploiting the city-level variations in the stringency of home purchase restrictions between 2011 and 2019 and five waves of China Household Finance Survey (CHFS) data, we find that discouraging housing speculation significantly increases the likelihood of local households starting a business. To address endogeneity concerns, we exploit plausibly exogenous variation using IV estimations and DID research design. The positive effect is stronger for local multiple-home owners, homeowners without mortgage debt, households with previous entrepreneurial experience, households of risk-loving, and households with large assets. This conclusion is robust with city-level evidence. In the mechanism discussion, we find that discouraging housing speculation significantly reduces the likelihood and the plans of local households to purchase new homes and lowers the house price expectations of local households (thus the opportunity cost of starting a business). We also provide evidence supporting the view that discouraging housing speculation increases entrepreneurial opportunities, innovative development, and local households' social network investments, all of which contribute to starting a business. The results imply that policies to curb housing speculation can lead to beneficial spillover on entrepreneurship and the local economy, as well as contribute to the sustainability of economic growth. [ABSTRACT FROM AUTHOR]

Myopia, as the most common disease in ophthalmology, has developed into a serious international public health burden, the development situation is not optimistic. It is necessary to put forward new and effective intervention measures to curb the prevalence of myopia. In recent years, red light intervention to delay the progress of myopia has become a new research hotspot. Starting with the epidemic situation and inducement of myopia, this paper briefly introduces the commonly used clinical treatment methods, summarizes the research status of red light intervention in myopia, and discusses the possible mechanism of red light intervention in improving myopia. Some potential laser safety problems are put forward, hoping to provide reference for related research in the future. [ABSTRACT FROM AUTHOR]

Objective: To explore mechanism of hedyotis diffusa extract attenuating acute pancreatitis (AP) lung injury in rats from 5'-adenosine monophosphate activated protein kinase (AMPK)/autophagy-related protein 5 (ATG5) signaling pathway. Methods: AP lung injury rat model was established, and rats were randomly divided into model group, extract (hedyotis diffusa extract) group, 3-MA (autophagy inhibitor 3-methyladenine) group, AICAR (AMPK activator) group and extract+AICAR group, with 15 rats in each group, and another 15 rats were selected as sham operation group. ELISA was performed to determine levels of serum amylase (AMY), IL-1β, IL-6 and IL-18; amount of ascites and proportion of lung wet/dry (W/D) in rats were determined; HE was performed to observe pathological damage of pancreas and lung tissues; Western blot was performed to determine lysosomal-associated membrane protein 2 (LAMP2), autophagy substrate p62, IL-1β precursor protein (pro-IL-1β), trypsinogen activation peptide (TAP), AMPK, p-AMPK, ATG5, autophagy marker LC3-II/I, ubiquitin-specific protease 10 (UPS10) expressions. Results: Compared with sham operation group, ascites volume, lung W/D, pancreas and lung tissue pathological damage scores, serum AMY, IL-1β, IL-6, IL-18 levels, pancreatic tissue p62, TAP, pro-IL-1β expressions, lung tissue p-AMPK/AMPK, ATG5, LC3-II/I, UPS10, pro-IL-1β expressions of rats in model group were increased (P<0.05), while LAMP2 protein expression in pancreas and lung tissue was decreased (P<0.05); after model rats were intervened by hedyotis diffusa extract or autophagy inhibitor 3-MA, the above indexes were significantly improved (P<0.05), and improvement effect of hedyotis diffusa extract was better than 3-MA (P<0.05); while AMPK activator AICAR could attenuate improvement effect of hedyotis diffusa extract on lung injury in AP rats (P<0.05). Conclusion: Hedyotis diffusa extract can reduce inflammatory response and autophagy level by inhibiting AMPK/ATG5 signaling pathway, and improve lung injury in AP rats. [ABSTRACT FROM AUTHOR]

Recent studies have reported the role of the M3 muscarinic acetylcholine receptor (M3R), a member of the G‐protein coupled receptor superfamily, encoded by the CHRM3 gene, in cardiac function and the regulation of blood pressure (BP). The aim of this study was to investigate the associations of CHRM3 genetic variants with salt sensitivity, longitudinal BP changes, and the development of hypertension in a Chinese population. We conducted a chronic dietary salt intervention experiment in a previously established Chinese cohort to analyze salt sensitivity of BP. Additionally, a 14‐year follow‐up was conducted on all participants in the cohort to evaluate the associations of CHRM3 polymorphisms with longitudinal BP changes, as well as the incidence of hypertension. The single nucleotide polymorphism (SNP) rs10802811 within the CHRM3 gene displayed significant associations with low salt‐induced changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), while rs373288072, rs114677844, and rs663148 exhibited significant associations with SBP and MAP responses to a high‐salt diet. Furthermore, the SNP rs58359377 was associated with changes in SBP and pulse pressure (PP) over the course of 14 years. Additionally, the 14‐year follow‐up revealed a significant association between the rs619288 polymorphism and an increased risk of hypertension (OR = 1.74, 95% CI: 1.06‐2.87, p =.029). This study provides evidence that CHRM3 may have a role in salt sensitivity, BP progression, and the development of hypertension. [ABSTRACT FROM AUTHOR]