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Background: The EVEN‐plus syndrome (epiphyseal–vertebral–ear–nose dysplasia plus associated findings) is an extremely rare autosomal recessive inherited disease characterised by specific facial features and skeletal dysplasia. It has a prenatal onset due to defects in the HSPA9 gene. The syndrome has not been reported previously in China. Methods: This study reported the characteristics, examination results, diagnosis and treatment of a female case aged 3 years and 3 months. Results: The patient had global developmental delay and specific facial features, including a prominent forehead, a bilateral auricle deformity, a collapsed nose, a high palatine arch, a short neck and other appearance abnormalities. Her hip joint magnetic resonance imaging (MRI) results showed bilateral femoral head epiphyseal dysplasia with a fork‐shaped malformation at the distal end, and her brain MRI showed white matter myelin dysplasia. HSPA9 compound heterozygous variants c.882_c.883delAG and c.613A>G were identified by exome sequencing. Conclusions: This finding expands the spectra of EVEN‐plus syndrome phenotype and pathogenic variants and suggests that c.882_c.883delAG may have a higher distribution frequency in East Asian populations. [ABSTRACT FROM AUTHOR]

This paper carries out the quasi-natural experiment on China's carbon emissions trading pilot policy to assess the impact of China's carbon emissions trading pilot policy on the export product quality of enterprises in the pilot areas by using the data of listed companies and China Customs, and employing the DDD method. Meanwhile, it analyzes the heterogeneity of the impact under different ownership attributes and energy-intensive attributes of enterprises. The empirical results are as follows. First, due to the implementation of the carbon emissions trading pilot policy, the enterprises in the included industries bear the emission reduction cost. The export product quality of the enterprises in the included industries in the pilot areas is negatively affected compared with that of nonincluded enterprises in the nonpilot areas. Second, the impact of the carbon emissions trading pilot policy on the export product quality of enterprises may be heterogeneous due to the different ownership attributes of enterprises. The carbon emissions trading pilot policy significantly reduces the export product quality of non-state-owned enterprises, but has no significant effect on state-owned enterprises. Third, the impact of the carbon emissions trading pilot policy on the export product quality of enterprises is heterogeneous due to different energy-intensive attributes of enterprises. The carbon emissions trading pilot policy significantly reduces the export product quality of enterprises in energy-intensive industries, but it does not have a significant impact on enterprises in non-energy-intensive industries. [ABSTRACT FROM AUTHOR]

Background: Echinococcosis is highly endemic in western and northern China. Tibet Autonomous Region (TAR) is the most serious prevalent area. Linzhi is located in southeastern part of TAR. Dogs are the primary infection source for the transmission of echinococcosis to humans. A control and prevention campaign based on dog management has been implemented in the past three years. This study aims to evaluate the effects of dog management on the infection rate of dogs. Methods: Data of dog population, registration and de-worming of seven counties/district in Linzhi between 2017 and 2019 were obtained from the annual prevention and control report. Domestic dog fecal samples were collected from each endemic town of seven counties/district in Linzhi in 2019 to determine the infection of domestic dogs using coproantigen enzyme-linked immunosorbent assay (ELISA). Data analysis was processed using SPSS statistics to compare dog infection rate between 2016 and 2019 by chi-square test, and maps were mapped using ArcGIS. Results: In Linzhi, domestic dog population has decreased from 17 407 in 2017 to 12 663 in 2019, while the registration rate has increased from 75.9% in 2017 to 98.6% in 2019. Similarly, stray dog population has decreased from 14 336 in 2017 to 11 837 in 2019, while sheltered rate has increased from 84.6% in 2017 to 96.6% in 2019. Dog de-worming frequency has increased from 4 times per annum in 2017 to 12 times in 2019, indicating that approximately every dog was dewormed monthly. A total of 2715 dog fecal samples were collected for coproantigen ELISA assay. The dog infection rate was 2.8% (77/2715) in 2019, which was significantly lower than 7.3% (45/618) in 2016 (P < 0.05). Conclusions: Increased dog registration, decreased dog population, and increased dog de-worming frequency contributed to significantly decrease the dog infection rate in Linzhi. Control and prevention campaign based on dog management could significantly decrease dog infection with Echinococcus spp. in echinococcosis endemic areas. [ABSTRACT FROM AUTHOR]

In the article, the authors discuss their study on the factors causing the difficulties in the diagnosis and treatment of autism spectrum disorder (ASD) in children in China. Among the factors are the shortage of child psychiatrists and pediatricians and the failure to fully implement early screening. Other topics include the symptoms of ASD like social anxiety disorder and intellectual disability.

Objective: Information about epidemiology on burns is rare in China. The aim of this article is to describe the pattern of burns in East China during a 10-year time period.Method: A retrospective data analysis was performed on all hospitalized patients to the burn center at the Changhai hospital, one of major burn centers in East China, from 2005 to 2014.Results: We included 3376 patients in this study. Among them, 48.1% were from 27 provinces out of Shanghai and nearly 90% were from East China. August saw the most admissions and November saw the fewest. Spring and summer separately dominated in number of female and male patients. Children aged 2-5 and working-age adult were the most commonly treated. Home was the commonest place of injury, followed by industrial-related places, outdoors, public buildings, and vehicles or roads. Scalds remained the primary reason, followed by fire, contact burns, electricity, and chemicals. The average %TBSA of male patients was 14.2±21.3, significantly different from that of female patients (10.4±16.9). Extremities were the most vulnerable body region burned, followed by the trunk, face and hands. The average hospital length of stay in male patients was 25.4±72.4 days, significantly different from that of females' 19.9±27.6 days. The total mortality was 1.8% and the lethal area burned resulting in 50% mortality was 96.5% TBSA.Conclusion: Compared with published data, these result are encouraging, which demonstrate that burn care and treatment has made significant progress. Burn clinicians should bear not only the responsibility to treat and cure burns, but also the popularization of knowledge about burn precautions and emergency treatments. [ABSTRACT FROM AUTHOR]

Abstract: The 105 patients admitted to our Burn Institute from 1st January 1996 to 31st December 2007, with ship fire-related burns were studied retrospectively. The mean age was 30.2±12.6 years with a range of 1–58. One hundred and three patients (98.1%) were men and 2 (1.9%) women. The mean total burn surface area (TBSA) was 46.5%, mostly deep burns. The most common areas of burn were the head, neck and upper limb. Summer months July, August, June and September were times of highest incidence. Fifty-seven (54.3%) patients had inhalation injury, 42 received tracheotomy, and 38 received mechanical ventilation. The treatment was complex, difficult, long, and costly. The interval between burn and start of resuscitation ranged from 2.1 to 67h with a mean of (5.9±4.4)h. Forty-two patients (40%) started intravenous fluid resuscitation 6h after burn. Twenty-four patients (23%) received insufficient fluid resuscitation developed hypotension and severe shock at admission. Ninety-two (87.6%) patients required operations including tracheotomy, debridement and grafting, per patient was 5.2. The mean length of hospital stay was 44.2 days. Pulmonary edema was the most common complication during the early post-burn period (within 7 days), and sepsis during the later period (>7 days). Nine patients died of MODS or sepsis, giving a mortality rate of 8.57%. Conclusion: Caution and preventive measures are needed for persons in ships for fire-related burns. [Copyright &y& Elsevier]

Abstract: Background: This article reports a chemical burn incident that occurred on August 7th, 2005, when a Matsa typhoon hit Shanghai, China. This is the largest chemical burn incident reported in the literature for 20 years in China, involving 118 alkali burn patients who were rescued by the Burn Department of Shanghai Changhai Hospital independently. Methods: The scene of the incident was investigated, and the clinical, emergency and hospitalized data of the patients were summarized. Results: The main injurious chemical was a water solution of sodium hydroxide and ammonium chloride. The 118 victims were mostly young men with 5%TBSA deep thickness burn of both lower extremities, including 31 patients who had additional light coughing. Of 58 patients who were finally hospitalized, 42 patients received surgical treatment. Most of these patients recovered within 1 month. There were no deaths. Discussion: Retrospective analysis of the therapeutic data of the incident demonstrates that pre-designed disaster planning for emergency management of mass burn patients, an effective command group, accurate assessment of pathological conditions, and correct allocation of different casualties are key elements in successful management in a mass casualty even involving burn patients. In addition, it is essential for specialized personnel to take part in emergency treatment of chemical burns. [Copyright &y& Elsevier]

Jin‐Nao‐Ning mixture (JNNm) has been clinically used to treat insomnia in China. However, the major constituents of JNNm were not revealed. In this study, an ultra‐high‐performance liquid chromatography‐tandem mass spectrometry was established and validated for simultaneous quantitation of 19 representative constituents of JNNm. The method had good specificity and adequate sensitivity. The calibration curves of the constituents displayed good linearity (r > 0.990) in appropriate ranges. The intra‐ and inter‐day precision at three quality control (QC) levels ranged from 0.68% to 5.17% and 0.42% to 5.37%, respectively. The recovery ranged from 91.76% to 110.06%, with a precision of less than 5.07%. In addition, the method had good repeatability (relative standard deviation [RSD] < 4.93%). The analytes were all stable for 24 h (RSD < 7.98%) at room temperature. The results of the quantitative analysis showed that salvianolic acid B (495.7–606.3 μg/mL) is the most abundant constituent, followed by betaine (411.3–468.3 μg/mL), salvianic acid A (10.7–34.9 μg/mL), lobetyolin (11.6–14.6 μg/mL), spinosin (4.0–7.6 μg/mL), schisandrol A (1.5–4.1 μg/mL), and schisandrol B (1.2–1.5 μg/mL). Concentrations of other constituents were below 1 μg/mL. This study would be helpful for the QC of JNNm and the revelation of its effective constituents. [ABSTRACT FROM AUTHOR]

Background. There was a remarkable downgrade in China's COVID-19 response strategies in January 2023. The COVID-19 infection rate grew rapidly in the early stages following the management policy shift. This study attempted to explore the associations between SARS-CoV-2 infection and mental or physical health status in pregnant and postpartum women and the role of perceived health risks and family members' SARS-CoV-2 infection status on these associations by capturing the impact of policy shifts in a short period of time. Methods. This cross-sectional study with a random sample from a convenience sample of hospitals was conducted in pregnant and postpartum women in January 2023. Standardized assessment tools were employed to assess anxiety, depressive and physical symptoms, and feelings of hopelessness. Hierarchical multiple logistic regressions were conducted to examine the mechanisms of associations of interests by including a range of sociodemographic factors, self-perceived health, SARS-CoV-2 infection status, and perceived health risks as covariates. Results. Of the 1,013 pregnant and postpartum women aged 32.0 ± 0.3 years, 58.2% (n = 590) were diagnosed with COVID-19, and 49.4% (n = 500) had family members who were infected with SARS-CoV-2. Nearly 98% of the included participants took measures to prevent SARS-CoV-2 infection. A COVID-19 diagnosis was positively associated with feelings of hopelessness (OR = 1.68, 95% CI: 1.20–2.35), probable anxiety (OR = 6.42, 95% CI: 2.18–24.61), possible depression (OR = 2.56, 95% CI: 1.07–6.70), and physical symptoms (OR = 6.28, 95% CI: 1.63–42.03) after adjusting for sociodemographic and health characteristics, while the associations presented no statistical significance when family members' SARS-CoV-2 infection status and perceived health risks were introduced into the models. Conclusions. Our results suggested that pregnant and postpartum women may experience physical and mental health challenges when they or their family members contracted COVID-19 in the context of a considerable shift in COVID-19 management. Early detection of poor health status and its risk factors for vulnerable groups during shifts in health policy and administrative practice is very necessary, and health services, including easy access to psychosocial support and obstetric counselling, should be prioritized. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to conduct a survey of the academic contribution and influence of Chinese scholars in the field of burns.Method: The PubMed database was searched to obtain literature items originating from various countries and Chinese provinces from 1985 to 2014. The citation data were collected through the Google Scholar engine.Results: A total of 1037 papers published in 256 journals were included in this survey. China was second only to the USA in the number of publications on burns since 2010. In addition, the annual number of papers has increased significantly since 2001. The journal Burns published the most number of articles, but its proportion has been decreasing. Of the papers included in the survey, 58.34% were published in journals with a 5-year impact factor between 1 and 2, whereas only 3.66% were published in journals with an impact factor >5. Both total citations and citations per paper have decreased in the past decade. Randomized controlled trials or systematic reviews merely accounted for a small proportion. Twenty-nine provinces including 64 cities contributed one paper at least. The publications from Taiwan, Beijing, Chongqing, Shanghai, and Guangdong were high in both quantity and quality.Conclusion: The Chinese academic contribution to the field of burns is now on a rise. Although the quality of papers is lagging behind quantity, scholars and academies are dedicated to improving China's academic level. [ABSTRACT FROM AUTHOR]

Introduction: Allogeneic and xenogeneic skin are recognized as the best coverings for skin burn wounds, but currently face a supply shortage. To solve this problem, our research group developed a standardized manufactured hydrogel dressing based on a new type of highly bioactive recombinant human collagen.Study Design: Prospective self-controlled trial.Objective: To evaluate the efficacy and safety of recombinant human collagen hydrogel in the treatment of partial burn wounds to the skin compared to those of xenogeneic skin.Methods: This study included twenty-one patients admitted to Shanghai Changhai Hospital within 48 h after receiving partial-thickness skin burns. The wounds were symmetrically separated along the axis and treated with recombinant human collagen hydrogel (RHCH) or a human-CTLA4-Ig gene-transferred pig skin xenotransplant. The condition of the wound surfaces was recorded on days 0 (of enrollment), 5, 10, 15, and 20, and bacterial drug sensitivity testing, hematuria examination, and electrocardiographic tests were conducted on days 0, 10, 20, or on the day of wound healing.Results: There were no statistically significant differences in wound healing time between the two groups. The median number of days to healing was 11.00 ± 0.56 for xenogeneic skin vs. 11.00 ± 1.72 for RHCH.Conclusion: During the observation period, the therapeutic effect of the RHCH developed by our group on partial-thickness burn wounds was not significantly different from that of gene-transferred xenogeneic skin. Thus, our designed RHCH shows potential for clinical use to treat burn wounds on the skin. [ABSTRACT FROM AUTHOR]

Abstract The Song-Nen Plain in northeastern China holds one of the three largest expanses of soda saline-alkali soil in the world. Due to its disadvantageous geotechnical properties, the saline soil in this area is unable to meet the needs of construction projects. This study evaluates the stabilizing effect of adding lime to such soils. Specifically, it investigates how the physicochemical and mechanical properties and microstructure of soda saline-alkali soil are altered by lime and how these changes are affected by both freeze-thaw cycling and the duration of curing. The results reveal that adding lime to saline soil transforms clay particles into sand and silt particles and causes the pore size distribution (PSD) to become bimodal, with small-pore and macropore populations. An increase in lime content leads to an increase in the unconfined compressive strength (UCS) but a gradual decrease in both the cation exchange capacity (CEC) and plastic index. Freeze-thaw cycles break up coarse particles and aggregate finer particles, increasing the diameter of macropores and decreasing the USC; however, the effect on specimens with >9% lime is negligible. It is further shown that the geotechnical properties of the soil change immediately after the addition of lime, indicating that the cation exchange reaction takes place very quickly. Furthermore, the pozzolanic reaction leads to an increase in the percentage of sand-sized particles and a decrease in porosity after 28 days of curing. Overall, these results indicate that it is feasible to use lime to improve the engineering properties of soda saline-alkali soil in this area. Highlights • Using lime to improve soda saline-alkali soil and investigating the influence of lime content. • Considering the effect of freeze-thaw cycles on lime-solidified saline soil and the maximum freeze-thaw cycle is 60 times. • From physicochemical property, mechanical property and microstructure comprehensively studied lime treated saline soil. • The influence of different curing time is also considered. [ABSTRACT FROM AUTHOR]

Background. Copeptin has been implicated as an effective prognostic biomarker of stroke outcome; however, few studies have investigated whether copeptin could be used as an etiological factor for stroke or not. The aim of our study was to evaluate the association of serum copeptin with stroke. Methods. In total, 238 participants including 119 cases (87 ischemic stroke and 32 hemorrhagic stroke) and 119 controls were included in this 1 : 1 matched case-control study. Conditional multivariate logistic regression was conducted to assess the Odds Ratios (ORs) and 95% confidence intervals (CI); restricted cubic spline in logistic regression model was used to evaluate the dose-response association between serum copeptin and total stroke, ischemic stroke, and hemorrhagic stroke. Results. The median serum copeptin was 20.90 pmol/L, 20.90 pmol/L, 6.53 pmol/L, and 8.42 pmol/L for total stroke, ischemic stroke, hemorrhagic stroke, and healthy subjects, respectively. The corresponding ORs (95% CIs) for the highest compared with the lowest quartile were 1.23 (0.62–2.44) for total stroke, 4.01 (1.47–10.96) for ischemic stroke, and 0.13 (0.22–0.69) for hemorrhagic stroke. No nonlinear dose-response relationship was found between serum copeptin and total stroke (Pnonlinear=0.278), ischemic stroke (Pnonlinear=0.362), and hemorrhagic stroke (Pnonlinear=0.314). Compared with the reference copeptin level, a significantly increasing trend was found between serum copeptin and ischemic stroke (Poverall=0.002), and a decreasing trend was found between serum copeptin and hemorrhagic stroke (Poverall=0.007). Conclusions. Elevated serum copeptin levels were positively associated with ischemic stroke and adversely associated with hemorrhagic stroke. Additional prospective studies with larger sample size are needed to confirm the present findings. [ABSTRACT FROM AUTHOR]

Dissolved heavy metals (DHMs) contamination has raised global concern for ecological and human health development. Weathering of sulfide-bearing ore metals can produce acidic, sulfate-rich solutions in the presence of water and oxygen (O 2), and DHMs are released to deprave the river water quality. Sulfur and oxygen isotope signatures (δ 34S SO4 and δ 18O SO4) could identify this pyrite-derived sulfate; however, it is yet not well known whether the δ 34S SO4 and δ 18O SO4 values could limit the DHMs sources and illustrate anthropogenic impacts on DHMs along the river corridor. We tried to solve this problem through field works in the Luohe River and Yihe River, two tributaries of the Yellow River, China, where metal sulfide mine activities mostly occurred upstream, but agricultural and domestic behaviors concentrated in the lower plain reaches. In the Luohe River upper areas, δ 34S SO4 values had negative correlations with concentrations of cadmium (Cd) (p < 0.01), nickel (Ni) (p < 0.05), molybdenum (Mo) (p < 0.01), uranium (U) (p < 0.01), and SO 4 2− (p < 0.01). However, as the δ 34S SO4 values increased downstream in the Luohe River, concentrations of copper (Cu) (p < 0.05), mercury (Hg) (p < 0.05), Ni (p < 0.05), and SO 4 2− (p < 0.01) simultaneously elevated. The Bayesian Isotope Mixing Model (BIMM) results via δ 34S SO4 values demonstrated 64.3%–65.3% of SO 4 2− from acid mine drainage (AMD) in the Luohe River's upper reaches and 63.5%–67.7% in the Yihe River's upper reaches, and about 33% from sewage and industrial effluents in the Luohe River's lower reaches and 27% in Yihe River's lower reaches. Our results confirmed the different anthropogenic impacts on the DHMs concentrations in Luohe River and Yihe River and provided a robust method for DHMs sources appointment and pollution management in river systems. [Display omitted] • Mo and SO 4 2− concentrations had negative relations with δ 34S SO4 values in the upstream. • Sulfide mine drainage contributed 64% to 68% of upstream riverine SO 4 2−. • Sewage and industrial effluents exported 27%–33% of downstream riverine SO 4 2−. • δ 34S SO4 and δ18O SO4 values could be used to distinguish different anthropogenic metal inputs. [ABSTRACT FROM AUTHOR]

Objective: Essential hypertension (EH) is known as the result from the interaction of environmental and genetic factors. We selected tag SNPs of CLCNKA_B genes as gene markers, to elucidate the relationship between CLCNKA_B and EH, and to determine the possible interaction among tag SNPs and dietary factors in island of China.Methods: A case-control study was conducted in Changshan islands of China, blood samples of 806 participants were genotyped, and the general characteristics and dietary habits of them were collected. Unconditional logistic regression (ULR) was used to assess the effects of CLCNKA_B tag SNPs and dietary factors on EH. Generalized multifactor dimensionality reduction (GMDR) was used to test gene–environment interaction for EH risk.Results: Four SNPs were identified as the tag SNPs of CLCNKA_B. Recessive model for rs5253 and rs2275166 were marginal associated with the decrease risk of EH (OR = 0.36, 95% CI = 0.12–1.07 for rs5253; OR = 0.40, 95% CI = 0.16–1.05 for rs2275166). In GMDR, the five-factor interaction model of rs1010069, salt, marine products, meat and edible oil consumption was the best model, with a maximum CVC of 10/10 and a TBA of 0.638 (p = 0.001). In ULR, compared with subjects carried wild genotypes and null dietary risk factor, those with three or more dietary risk factors and mutation genotypes had 5.90-fold EH risk (95% CI:2.24–15.53).Conclusion: Though the single loci of tag SNPs of CLCNKA_B are not enough to significantly increase the EH susceptibility, the combination of CLCNKA tag SNP, salt, marine products, meat and edible oil consumption is associated with elevated risk. [ABSTRACT FROM AUTHOR]

• The water age of Poyang Lake has significant spatiotemporal heterogeneity. • The water stage at Hukou and basin inflow are the main influencing factors. • The proposed Water Conservancy Hub may increase the water age. As an important indicator of pollutant transport and dispersion conditions in lakes, the water exchange capacity of large shallow lakes has always been a focus in research on lake hydrodynamic and water environment. Poyang Lake is a large shallow lake and also the largest freshwater lake in China, which is being given prominent environmental and ecological status. Poyang Lake's hydrological situation fluctuates dramatically and the spatial and temporal characteristics and influencing factors of its water exchange capacity are complicated. In this paper, water age was selected to describe the water exchange capacity of Poyang Lake, and a water age model of Poyang Lake was established. With the water age model, the spatial and temporal characteristics and influencing factors of water age of Poyang Lake were studied and the law of response of the water age to the evolution of River-Lake relationship between Yangtze River and Poyang Lake and the proposed Poyang Lake Water Conservancy Hub was analyzed. The results showed that: (1) The water age of Poyang Lake demonstrates significant spatial and temporal heterogeneity, that is, the water age in summer and autumn is obviously higher than that in winter and spring and the water age in the disc-shaped lake and lake bay area is obviously higher than that in the main river channel and beach; (2) The water stage at Hukou and catchment inflow are the main factors affecting the water age of Poyang Lake and the influence of the water stage at Hukou on the water age of Poyang Lake is greater than that of the catchment inflow, and the higher water stage at Hukou, the higher the water age of Poyang Lake, while the higher the catchment inflow, the lower the water age of Poyang Lake; (3) After 2003, the water age of Poyang Lake decreases with the evolution of River-Lake relationship and the most significant decrease happens in autumn; (4) The proposed Poyang Lake Water Conservancy Hub may increase the water age of Poyang Lake to some extent while it alleviates the problem of low water in Poyang Lake. This study can provide a scientific base for the water environment management of Poyang Lake and provide a reference for research on water exchange capacity of other large shallow lakes. [ABSTRACT FROM AUTHOR]

Background: Many of these therapies have been compared against placebos, but have not been directly compared against each other. To evaluate the efficacy and safety of several commonly used drugs for AIS directly or indirectly. Methods: A systematic literature review was performed to identify randomized controlled trials (RCTs) published prior to April 2013 for AIS therapies. The primary outcome measures were the National Institutes of Health Stroke Scale (NIHSS) scores and the clinical effective rate. A fixed-effects meta-analysis and meta-regression are performed; lastly, performed a mixed treatment comparison was performed through the Bayesian methods. Results: Outcome of Efficacy of therapies for acute ischemic stroke are as followed: All of the therapies mentioned above yielded results a more effective result than placebo, Sodium ozagrel (RR 3.86, 95%CI 3.18–4.61); Sodium ozagrel + edaravone (RR 9.60, 95%CI 7.04–13.06); Edaravone (RR 4.07, 95%CI 3.30–5.01); Edaravone + Kininogenase (RR 15.33, 95%CI 10.03–23.05). The significant difference in efficacy between edaravone monotherapy and Sodium ozagrel + edaravone was evident (RR 0.43, 95%CI 0.08–0.61) and was also significant between efficacy of edaravone + Kininogenase and Sodium ozagrel (RR 4.00, 95%CI 2.47–6.24). The differences between the risk and benefit were not significant when comparing Sodium ozagrel and edaravone or edaravone + Kininogenase and Sodium ozagrel + Edaravone for AIS. Outcome of the defect of neurological function: Placebo served a significant difference in treating the defects of neurological function compared with Sodium ozagrel (WMD = −3.11, 95%CI −4.43 to −1.79), Sodium ozagrel + edaravone (WMD = −6.25, 95%CI −7.96 to −4.54) and Edaravone + Kininogenase (WMD =  −3.47, 95%CI −5.73 to −1.21). Conclusions: It provides that the efficacy of edaravone monotherapy in treatment was not more effective than Sodium ozagrel + edaravone.The efficacy of edaravone + Kininogenase monotherapy in treatment was more effective than Sodium ozagrel. Edaravone + Kininogenase and Sodium ozagrel + Edaravone appeared the most effective treatments. And Sodium ozagrel, Sodium ozagrel + edaravone, Edaravone + Kininogenase can improve the nerve dysfunction. [ABSTRACT FROM AUTHOR]

Background and Aim: Hepatitis B surface antigen (HBsAg) clearance is the closest cure outcome in hepatitis B. The goal of this study was to investigate clinical features in chronic hepatitis B patients achieving seroconversion of HBsAg after treatment with α-interferon (IFN-α) and a nucleos(t)ide analog. Methods: This retrospective study enrolled 38 chronic hepatitis B patients treated with IFN-α plus a nucleos(t)ide analog who achieved HBsAg seroconversion during the period from June 2001 to May 2009. Clinical and laboratory data of the patients were collected before and after treatment every 3 months. All patients with HBsAg seroconversion in this study were followed up for at least 12 months post-treatment. Results: A total of 38 out of 142 patients achieved HBsAg seroconversion after treatment with IFN-α and a nucleos(t)tide analog for a prolonged period of time (medium 31 months). The median time to hepatitis B e antigen seroconversion and to HBsAg seroconversion was 19.5 months (range 3-60 months) and 25.5 months (range 9-63 months), respectively. Thirty-six patients (95%) sustained HBsAg seroconversion during the post-treatment follow up. Three different HBsAg response patterns were observed with classical model accounting for 57.9% (22/38 cases), simultaneous transition mode accounting for 23.7% (9/38 cases), and HBsAg prior transition model accounting for 18.4% (7/38 cases). Conclusions: Extended treatment with IFN-α in combination with a nucleos(t)ide analog in patients with hepatitis-B-e-antigen-positive appears to be a promising approach for achieving a high rate of HBsAg clearance-the closest outcome to cure. [ABSTRACT FROM AUTHOR]

Piedmont alluvial fans have, for a long time, supported clean groundwater for human development worldwide. Rapid urbanization in China has over-exploited groundwater and resulted in severe groundwater nitrate pollution in piedmont alluvial fans, which has led to both human health concerns and clean water shortages, especially in rural residential areas where drinking water is mainly derived from shallow groundwater. However, sources of nitrate in groundwater and their pathways are still unclear. In this study, we hypothesized that untreated manure and domestic sewage are the primary nitrate sources in a residential area, and that an unconfined aquifer would be more vulnerable to nitrate pollution than a confined aquifer due to nitrate infiltration via the vadose zone. To verify this hypothesis, groundwater nitrate pollution in a well-characterized piedmont alluvial fan was studied through hydrochemical composition and multi-isotope (δ 15N NO3 , δ 34S SO4 , δ 18O SO4 , δ 13C DIC) data over four seasons. Seasonal variations for both NO 3 − concentrations and δ 15N NO3 values in unconfined groundwater (UGW) and confined groundwater (CGW) were observed. Mixing of nitrate sourced from manure/sewage, precipitation, soil nitrogen, and synthetic fertilizer controlled the groundwater nitrate level, and manure/sewage contributed 52.4%, 32.4%, and 33.7% nitrate to UGW, CGW, and surface water (SFW), respectively, based on Stable Isotope Mixing Models in R (SIMMR) analysis. Denitrification had a minor effect on groundwater nitrate levels in a residential area, and nitrate pollution in CGW was partly due to nitrate migration through geological faults and fracture zones in a piedmont alluvial fan. Nitrate pollution sources and pathways in residential areas were confirmed through multiple isotopes (δ 15N NO3 , δ 13C DIC , δ 34S SO4 , and δ 18O SO4). Collectively, these results highlight the roles of the hydrogeological setting and anthropogenic activities in groundwater N pollution beneath piedmont alluvial fans. • Hydrogeological controls play a key role in nitrate levels in groundwater. • Elevated nitrate levels in groundwater are closely linked with manure/sewage. • Unconfined groundwater is more vulnerable to nitrate pollution than confined groundwater. • Multiple isotope data confirms nitrate sources and transformations in groundwater. [ABSTRACT FROM AUTHOR]

OBJECTIVE. This review was an effort to systematically examine the nationwide data available on pediatric burns requiring hospitalization to reveal burn epidemiology and guide future education and prevention. METHODS. The China Biomedical Disk Database, Chongqing VIP Database, and China Journal Full-Text Database were searched for articles reporting data on children and their burns from January 2000 through December 2005. Studies were included that systematically investigated the epidemiology of pediatric burns requiring hospitalization in China. Twenty-eight articles met the inclusion criteria, all of which were retrospective analyses. For each study included, 2 investigators independently abstracted the data related to the population description by using a standard form and included the percentage of patients with burn injury who were <15 years old; gender and distribution of age; type of residential area; place of injury; distribution of months and time; reasons for burn; anatomical sites of burn; severity of burn; and mortality and cause of death. These data were extracted, and a retrospective statistical description was performed with SPSS11.0 (SPSS Inc. Chicago, IL). RESULTS. Of the pediatric patients studied, the proportion of children with burn injury ranged from 22.50% to 54.66%, and the male/female ratio ranged from 1.25:1 to 4.42:1. The ratio of children aged ≤3 years to those >3 years was 0.19:1 to 4.18:1. The rural/urban ratio was 1.60:1 to 12.94:1. The ratio of those who were burned indoors versus outdoors was 1.62 to 17.00, and there were no effective hints on the distribution of seasons and anatomical sites of burn that could be found. The peak hours of pediatric burn were between 17:00 and 20:00. Most articles reported the sequence of reasons as hot liquid > flame > electricity > chemical, and scalding was, by far, the most predominant reason for burn. The majority of the studies reported the highest proportion involved in moderate burn, and the lowest proportion was for critical burn. The mortality rate ranged from 0.49% to 9.08%, and infection, shock, and multiple organ dysfunction syndrome were the most common causes of death. CONCLUSIONS. Considering the national proportion of children, a high proportion of hospitalized patients with burn injury were children; those who were male, aged ≤3 years, and lived most of the time indoors were especially susceptible. Great attention should be paid when hot water is used or during suppertime. This compilation and analysis of hospitalization-based information has proved useful in establishing the rational priorities tor prevention; a family-school-factory-government mode of preventive strategy has come into being and was performed effectively. [ABSTRACT FROM AUTHOR]