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Background: Studies have shown that pharmacological and psychological treatments are effective for children and adolescents with obsessive-compulsive disorder (OCD). However, few network meta-analyses have examined whether pharmacological or psychological treatments on their own, or combined, are most effective. Methods: We conducted a database search and selected randomized controlled trials of pharmacological or psychological treatments, alone or in combination, for children and adolescents with OCD. The primary outcome was change in symptom severity as a result of treatment, as assessed using the Yale-Brown Obsessive Compulsive Scale (BOCS) or Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) . Findings: We included 18 studies with 1353 participants and 12 kinds of treatments. In terms of efficacy, all pharmacological and psychotherapy treatments were more effective than placebo. Among the 12 treatments, the efficacy of pharmacological treatment combined with cognitive behavioral therapy (CBT) was better than pharmacological treatment alone. When pharmacological treatment was used alone, escitalopram was significantly better than clomipramine(CY-BOCS average change 3.42; 95% CI 2.11, 4.65), fluvoxamine(CY-BOCS average change 3.59; 95% CI 1.09, 6.20), paroxetine(CY-BOCS average change 2 .80; 95% CI 0.01, 5.64) and sertraline(CY-BOCS average change 3.49; 95% CI 1.53, 5.64). Interpretation: The available evidence suggests that the combination of pharmacological and psychological treatment is likely to be most effective for children and adolescents with OCD. Funding: The National Nature Science Foundation of China (81801357, 81801350), the Science and Technology Education Program of the Sichuan Province (2020JDKP0013), the Key R&D Projects of the Science and Technology Department of Sichuan Province(2020YFS0259 ), and the Chengdu Key Technology R&D Program (2019-YF05– 00284-SN). Declaration of Interest: None to declare.

Type 2 diabetes mellitus (T2DM) is known as a complex genetic disease characterized by genetic and environmental factors. The imbalanced intestinal flora and intestinal mucosal barrier are considered to be related to T2DM. Curcumin has been proved to affect the progression of T2DM. T2DM animal was established by low-dose streptozotocin intraperitoneal injection combined with high-fat diet (HFD) feeding. Hematoxylin and eosin (HE) staining and transfer electron microscopy (TEM) were used to observe morphological changes of intestinal tissues of T2DM rats. Insulin and glucose tolerance tests were performed to investigate the influence of curcumin on blood glucose. Curcumin significantly improved the intestinal integrity, hyperglycemia and insulin resistance in diabetic rats. The metabolic endotoxemia induced by HFD in diabetic rats was inhibited remarkably. Curcumin reversed gut microbiota dysbiosis in diabetic rats caused by HFD. We demonstrated that curcumin could protect intestinal mucosal barrier, improve insulin resistance and reduce blood glucose in diabetic rats. This study might provide experimental evidence for the prevention and treatment in T2DM.

Relying on the entrance section of a high-speed railway tunnel blasting project, the fluid-solid coupling algorithm based on ANSYS/LS-DYNA was used to optimize the parameters of wedge cut blasting, and the vibration could be reduced on the basis of ensuring the blasting effect. Through the combination of visual numerical simulation results and rock-breaking mechanism of wedge cut blasting, the maximum vibration velocity of different monitoring points in the model under different segmented time delay was analyzed. The results show that the best method for detonation is dividing the blastholes into three segments from upper to lower and dividing the left and right symmetrical blastholes into one segment. When the delay time is 10 ms, the average vibration reduction ratio is the best, which is reduced by 18% compared with the six-hole simultaneous blasting. In addition, the actual surrounding rock stress has a clamping effect on the cut blasting area. The wedge cut blasting footage obtained by numerical simulation was basically consistent with the field results, which proved that the model is reasonable and effective. This study intuitively and accurately demonstrated the process of cut blasting, the superposition curve of vibration velocity and the vibration reduction results under different delay times, and the effect of cut blasting. The results can be directly applied to similar projects, and the optimal blasting parameters and related issues can be solved more accurately with the help of this engineering analysis method.

In recent years, deep neural networks have been extensively applied in various fields, and face recognition is one of the most important applications. Artificial intelligence has reached or even surpassed human capabilities in many fields. However, while artificial intelligence application provides convenience to the human lives, it also leads to the risk of privacy leaking. At present, the privacy protection technology for human faces has received extensive attention. Research goals of face privacy protection technology mainly include providing face anonymization and data availability protection. Existing methods usually have insufficient anonymity and they are not easy to control the degree of image distortion, which makes it difficult to achieve the purpose of privacy protection. Moreover, they do not explicitly perform diversity preservation of attributes such as emotions, expressions and ethnicities, so they cannot perform data analysis tasks on non-identity attributes. This paper proposes a diverse privacy face image generation algorithm based on machine learning, called DIVFGEN. This algorithm comprehensively considers image distortion, identity mapping distance loss and emotion classification loss; transforms the privacy protection target into the problem of generating adversarial examples based on the recognition model; and uses an adaptive optimization algorithm to generate anonymity and diversity of privacy images. The experimental results show that on the Cohn-Kanade+ dataset, our algorithm can reduce the probability of facial recognition by the neural network when it accurately classifies sentiment, from 98.6% to 4.8%.

Objective: The resonance frequency (Fr) of twelve meridians was observed by means of sweep frequency of weak constant current, and a method of evaluating Fr was explored. Method: Four-electrode bioimpedance spectroscopy was used in the study. Constant current of 1~100Hz was applied from a phase-locked amplifier through the excitation electrode to the twelve meridians of 30 healthy subjects. Data were collected by the test electrode and the Fr of the twelve meridians was obtained by data fitting in Matlab. Result: Among the twelve meridians, the Fr of the small intestine meridian is the lowest, and the gallbladder meridian is the highest, which are 23.18±0.99Hz and 28.27±1.39 Hz, respectively. The mean resonance frequencies of meridians of the same name on hand and foot are 24.80±1.34Hz and 26.22±1.17Hz, respectively. The Fr of the Shao Yin meridian of the hands and feet is basically equal, the other five pairs of foot meridians are all higher than the hand meridian, and the difference of the Yang meridian of the same name is greater than the Yin meridian of the same name, the Fr of hand Shao Yang meridian, hand Tai Yang meridian and hand Yang Ming meridian were lower than those of foot meridians. The mean value of 6 pairs of yin and yang meridians are 25.59 ± 1.97Hz and 25.42 ± 0.70Hz, respectively. Conclusion: The resonance frequencies of the twelve meridians ranged from 23 to 28Hz approximately.

T cell receptor excision circles (TRECs) are small circularized DNA elements produced during rearrangement of T cell receptor (TCR) genes. Because TRECs are fairly stable, do not replicate during mitosis, and are not diluted during division of naïve T cells (Dion et al. [1]), they are suitable for assessing the number of newly formed T cells (Ping and Denise [2]). In this study, we detected TRECs in 521 healthy Chinese children aged 0-18 years in different clinical settings. The TRECs decrease with aging and show lower levels in preterm and low birth weight (BW) babies compared to those in full-term infants, while the preterm babies can also show comparable levels of TRECs when they have a gestation age (GA)-matched BW. We found a strong correlation between TRECs and peripheral CD4 naïve T cell numbers, which was age-related. We also analyzed the TRECs in different PIDs. Since T cell defects vary in PIDs, TREC levels change inconsistently. For example, in Wiskott-Aldrich syndrome (WAS), combining the level of TREC with lymphocyte subsets can help to distinguish subtypes of disease.Conclusion: We established the reference value range for TRECs by evaluating children below 18 years old in China, which could be used to screen for PIDs during early life. What is Known: • The TREC levels are decreased with age, and there is a positive correlation between TRECs and the numbers of naïve T cells. What is New: • This is the largest study to determine TREC reference levels in healthy Chinese pediatric, we provide solid data showing a correlation between CD4 naïve T cell counts and TREC levels according to age. We point out the GA matched BW is need to be considered during the SCID newborn screening. We are the first group showed that TREC levels can help clinician distinguish different WAS phenotype.

We recently showed that inhibition of hypoxia-induced factor-1α (HIF-1α) decreased acute ischemic stroke-induced blood-brain barrier (BBB) damage. However, factors that induce the upregulation of HIF-1α expression remain unclear. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase played a critical role in reperfusion-induced BBB damage after stroke. However, the role of NADPH oxidase in BBB injury during the acute ischemia stage remains unclear. This study is aimed at investigating the role of NADPH oxidase in BBB injury and the expression of HIF-1α after acute ischemic stroke. A sutured middle cerebral artery occlusion (MCAO) model was used to mimic ischemic stroke in rats. Our results show that the inhibition of NADPH oxidase by apocynin can significantly reduce the BBB damage caused by 2 h ischemic stroke accompanied by reducing the degradation of tight junction protein occludin. In addition, treatment with apocynin significantly decreased the upregulation of HIF-1α induced by 2 h MCAO. More importantly, apocynin could also inhibit the MMP-2 upregulation. Of note, HIF-1α was not colocalized with a bigger blood vessel. Taken together, our results showed that inhibition of NADPH oxidase-mediated HIF-1α upregulation reduced BBB damage accompanied by downregulating MMP-2 expression and occludin degradation after 2 h ischemia stroke. These results explored the mechanism of BBB damage after acute ischemic stroke and may help reduce the associated cerebral hemorrhage transformation after thrombolysis and endovascular treatment after ischemic stroke.

We present a case report of a patient with incomplete Susac syndrome. He had cognitive impairment, corpus callosum lesions, and vestibulocochlear dysfunction on brainstem auditory evoked responses. He was treated with methylprednisolone and plasmapheresis, improved, and then, also received rituximab. His improvement has been lasting as of this writing. This case shares our experience with a successful treatment of this rare condition that is incompletely understood and lacks well-established treatment guidelines.

Background. It is often tricky to differentiate cystic pituitary adenoma from Rathke cleft cyst with visual inspection because of similar MRI presentations between them. We aimed to design an MR-based radiomics model for improving differential diagnosis between them. Methods. Conventional diagnostic MRI data (T1-,T2-, and postcontrast T1-weighted MR images) were obtained from 215 pathologically confirmed patients (105 cases with cystic pituitary adenoma and the other 110 cases with Rathke cleft cyst) and were divided into training ( n = 172 ) and test sets ( n = 43 ). MRI radiomics features were extracted from the imaging data, and semantic imaging features ( n = 15 ) were visually estimated by two radiologists. Four classifiers were used to construct radiomics models through 5-fold crossvalidation after feature selection with least absolute shrinkage and selection operator. An integrated model by combining radiomics and semantic features was further constructed. The diagnostic performance was validated in the test set. Receiver operating characteristic curve was used to evaluate and compare the performance of the models at the background of diagnostic performance by radiologist. Results. In test set, the combined radiomics and semantic model using ANN classifier obtained the best classification performance with an AUC of 0.848 (95% CI: 0.750-0.946), accuracy of 76.7% (95% CI: 64.1-89.4%), sensitivity of 73.9% (95% CI: 56.0-91.9%), and specificity of 80.0% (95% CI: 62.5-97.5%) and performed better than multiparametric model ( AUC = 0.792 , 95% CI: 0.674-0.910) or semantic model ( AUC = 0.823 , 95% CI: 0.705-0.941). The two radiologists had an accuracy of 69.8% and 74.4%, respectively, sensitivity of 69.6% and 73.9%, and specificity of 70.0% and 75.0%. Conclusions. The MR-based radiomics model had technical feasibility and good diagnostic performance in the differential diagnosis between cystic pituitary adenoma and Rathke cleft cyst.

Summary Background Preterm birth rates have increased significantly worldwide over the past decade. Few epidemiological studies on the incidence of preterm birth and temporal trends are available in China. This study used national monitoring data from China's National Maternal Near Miss Surveillance System (NMNMSS) to estimate the rate of preterm birth and trends between 2012 and 2018 in China and to assess risk factors associated with preterm birth. Methods In this observational study, data were sourced from the NMNMSS between Jan 1, 2012, and Dec 31, 2018. Pregnancies with at least one livebirth, with the baby born at 28 weeks of gestation or more or 1000 g or more birthweight were included. We estimated the rates of overall preterm, very preterm (born between 28 and 31 weeks’ gestation), moderate preterm (born between 32 and 33 weeks’ gestation), and late preterm (born between 34 and 36 weeks’ gestation) births in singleton and multiple pregnancies and assessed their trends over time. We used logistic regression analysis to examine the associations between preterm birth and sociodemographic characteristics and obstetric complications, considering the sampling strategy and clustering of births within hospitals. Interrupted time series analysis was used to assess the changes in preterm birth rates during the period of the universal two child policy intervention. Findings From Jan 1, 2012, to Dec 31, 2018, 9 645 646 women gave birth to at least one live baby, of whom 665 244 (6·1%) were born preterm. In all pregnancies, the overall preterm birth rate increased from 5·9% in 2012 to 6·4% in 2018 (8·8% increase; annual rate of increase [ARI] 1·3 [95% CI 0·6 to 2·1]). Late preterm births (8·8%; ARI 1·5% [0·9 to 2·2]) and very preterm births (13·3%; ARI 1·8% [0·5 to 3·0]) significantly increased from 2012 to 2018, whereas moderate preterm births did not (3·8%; ARI 0·3% [95% CI –0·9 to 1·5]). In singleton pregnancies, the overall preterm birth rate showed a small but significant 6·4% increase (ARI 1·0% [0·4 to 1·7]) over the 7 year period. In multiple pregnancies, the overall preterm birth rate significantly increased from 46·8% in 2012 to 52·7% in 2018 (12·4% increase; ARI 1·9% [1·2 to 2·6]). Compared with women who gave birth in 2012, those who gave birth in 2018 were more likely to be older (aged ≥35 years; 7·4% in 2012 vs 15·9% in 2018), have multiples (1·6% vs 1·9%), have seven or more antenatal visits (50·2% vs 70·7%), and have antepartum complications and medical disease (17·9% vs 35·1%), but they were less likely to deliver via caesarean section (47·5% vs 45·0%). Compared with the baseline period (January, 2012 to June, 2016), a higher increase in preterm birth was observed after the universal two child policy came into effect in July, 2016 (β=0·034; p=0·03). Interpretation An increase in preterm births was noted for both singleton and multiple pregnancies between 2012 and 2018 in China. China's strategic investment in maternal and neonatal health has been crucial for the prevention of preterm birth. Due to rapid changes in sociodemographic and obstetric factors related to preterm birth—particularly within the context of the universal two child policy—such as advanced maternal age at delivery, maternal complications, and multiple pregnancies, greater efforts to reduce the burden of preterm birth are urgently needed. Funding National Key R&D Program of China, National Health Commission of the People's Republic of China, China Medical Board, WHO, and UNICEF.

Ultra-light electromagnetic (EM) wave absorbers with strong absorption bandwidth are highly desired in reducing EM pollution. Herein, a series of nanocomposites with ZnO nanoparticles decorated nanoscale reduced graphene oxide (NRGO) were synthesized via a simple and efficient hydrothermal process. The characterizations reveal that NRGO with layered structure possesses intensive folds and the ZnO nanoparticles are well attached on the surface of NRGO. The EM parameters demonstrate that the EM wave absorption properties of ZnO/NRGO nanocomposite are closely related to the amount of NRGO. The minimum reflection loss (RL) values of ZnO/NRGO-10, ZnO/NRGO-15 and ZnO/NRGO-20 are − 44.4 dB with a thickness of 4.5 mm, − 39.6 dB with a thickness of 2.5 mm and − 18.8 dB with a thickness of 2.0 mm, respectively. The largest effective absorption bandwidths of ZnO/NRGO-10, ZnO/NRGO-15 and ZnO/NRGO-20 are 5.5 GHz at 2.5 mm, 5.2 GHz at 2.5 mm and 5.5 GHz at 2.0 mm, respectively. These outstanding EM wave absorption properties resulting from the multiple reflection, various polarization relaxation processes and synergistic effects between ZnO and NRGO. It is believed that as-synthesized ZnO/NRGO nanocomposite could be used as promising EM wave absorber.

Background The outbreak of Coronavirus Disease 2019(COVID-19) caused psychological stress in Chinese adults population. But we are unaware of whether the pandemic causes psychological stress on children. Methods We used the Children’s Impact of Event Scale questionnaire (CRIES-13) to investigate the degree of Post-traumatic Stress (PTSD) symptoms caused by the pandemic in students selected from schools in Sichuan, Jiangsu, Henan, Yunnan, and Chongqing provinces of China. Results A total of 7769 students(3692 male and 4077 female), aged 8–18 years, were enrolled in the study, comprising 1214 in primary schools, 2799 in junior high schools and 3756 in senior high schools. A total of 1639 students (21.1%) had severe psychological stress reactions. A large proportion of senior high school students (23.3%) experienced severe psychological stress, and they had the highest median total CRIES-13 score. Female students were more likely to experience severe psychological stress and had higher median CRIES-13 total scores than males. Conclusion COVID-19 has placed psychological stresses on primary and secondary school students in China. These stresses are more likely to reach severe levels among female students and senior high school students.

Monolayer MoS2 is a typical transition metal dichalcogenides (TMDs), which is similar to graphene. However, MoS2 is a direct band gap semiconductor material. Based on the density functional theory, the changes of band structure, densities of states, phonon dispersion relations, and Raman spectrum of 2H monolayer MoS2 under ab biaxial strain are studied in this paper. The results show that the band gap, the structural stability, and the peak value of Raman spectrum of monolayer MoS2 are obviously changed under the biaxial strain. At compressive strain of 4%, monolayer MoS2 changed from direct band gap semiconductor to indirect band gap semiconductor, and at tensile strain of 10%, it changed from semiconductor material to metal material. During compressive strain above 4%, imaginary frequency appears in the phonon dispersion curve, and it means that the structure becomes unstable.

Background Few studies have focused on the association between lifestyle and subclinical hypothyroidism (SCH). The purpose of this study was to investigate the association between lifestyle and thyroid function in SCH. Methods This study was a part of a community-based and cross-sectional study, the Epidemiological Survey of Thyroid Diseases in Fujian Province, China. A total of 159 participants with SCH (81 males and 78 females) and 159 euthyroid (87 males and 72 females) participants without any missing data were included in the analysis. General information and lifestyle information including sleep, exercise, diet and smoking habits of the participants was collected by questionnaire and Pittsburgh sleep quality index scale (PSQI) was collected. Thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TgAb) and urine iodine concentration (UIC) were tested. Thyroid homeostasis parameter thyroid’ s secretory capacity (SPINA-GT), Jostel’s TSH index (TSHI), thyrotroph T4 sensitivity index (TTSI) were calculated. Logistic regression and multiple linear regression were performed to assess associations. Results Compared with euthyroid subjects, patients with SCH were more likely to have poor overall sleep quality (15.1 vs.25.8 %, P = 0.018) and l less likely to stay up late on weekdays (54.7 vs. 23.9 % P β= -0.224, P = 0.004), thyroid secretory capacity (β = 0.244, P = 0.006) and thyrotropin resistance (β = 0.206, P = 0.009). Iodine excess was the influencing factor of thyroid secretory capacity (β = 0.209, P = 0.001) and pituitary thyroid stimulating function (β = 0.167, P = 0.034). Smoking was the influencing factor of pituitary thyroid stimulating function (β = 0.161, P = 0.040). Staying up late on weekends was the influencing factor of thyroid secretory capacity (β = 0.151, P = 0.047). After adjusting for possible confounders, logistic regression showed that those with poor overall sleep quality assessed by PSQI and iodine excess had an increased risk of SCH (OR 2.159, 95 %CI 1.186–3.928, P = 0.012 and OR 2.119, 95 %CI 1.008–4.456, P = 0.048, respectively). Conclusions Lifestyle including sleep, smoking, diet and exercise was closely related to thyroid function especially thyroid homeostasis in SCH.

At present, the Chinese government is encouraging people to learn calligraphy; however, an automatic evaluation method for the results is not available. Calligraphy evaluation is challenging, because calligraphic characters are complex graphics composed of strokes as basic units. Therefore, it is necessary to consider not only the structure of the whole character but also the details of each stroke. To address this problem, we propose an automatic stroke segmentation method for calligraphic images as the foundation for the subsequent evaluation task. Specifically, we treat the stroke segmentation problem as an image to image translation problem and propose the stroke segmentation generative adversarial network (SSGAN) algorithm. Unlike the existing approaches that do not exhibit a satisfactory performance or are not suitable for use in practical projects, the proposed approach can efficiently obtain accurate results. The SSGAN enables the simultaneous generation of all the strokes of a calligraphic image, based on a multistroke tensor training strategy. Moreover, we specifically design a ResU-Net structure with embedded attention modules to enhance the accuracy of the results. The experimental results demonstrate the superiority of the proposed method over the existing state of the art models.

The research analyzes and improves upon the concept of ventilation safety subregions in coal mines and proposes a partition method based on the breadth-first search algorithm for assessing the quality of the ventilation. This involves the analysis of the function of ventilation subregions and of ventilation gas-monitoring data. Then, using the so-called ventilation sensitivity matrix as the analysis method, we confirm the consistency of considering safety subregions, which are associated with air consumption places as the core concept and the objective positioning of the safety subregions within the ventilation analysis. This allows us to establish the validity and practicability of employing regional characteristic information of mine ventilation and gas concentrations in the mine’s air. Finally, based on the characteristics of the ventilation subregions, ventilation air quantity network maps with safety subregions are proposed and their application is demonstrated. The advantages and characteristics of using these maps to replace ventilation network maps for ventilation analysis are demonstrated.

Upcycle of waste fabrics has been a promising project since it can reduce textile pollution and provide a prospect to waste management. In this work, a multiple recyclable transparent functional film was fabricated through ionic liquid (IL) assisted regeneration process with a higher yield of 90.40 %, compared with other polymer regeneration process using IL. Fourier Transfer Infrared Spectroscopy (FTIR), X-ray diffraction (XRD), UV–vis Spectrophotometer, as well as tensile strength test were carried out to explore the performance of the regenerated jute film. This transparent renewable jute film can be made into many functional materials, like packaging materials, electrically conductive films or information storage devices. Furthermore, it can be dissolved in IL and regenerate new films for multiple cycles, which can still maintain a relatively high transparency and a considerable mechanical property. Compared to other fabric recycle process, the solvent and production both can be effectively recycled, which can be considered as a green and sustainable tool to manage waste fabrics.

To evaluate the correlation between “hot cross bun” sign (HCBs) and disease severity in multiple system atrophy (MSA). We recruited patients with probable and possible MSA with parkinsonism (MSA-P) or the cerebellar ataxia (MSA-C) subtypes. Clinical and imaging characteristics were collected and comparison was performed between MSA-C and MSA-P cases. Spearman test was used to evaluate the correlation between HCBs and other variables. Curve estimate and general linear regression was performed to evaluate the relationship between HCBs and the Scale for Assessment and Rating of Ataxia (SARA). Unified Multiple System Atrophy Rating Scale (UMSARS) IV was used to assess the severity of disease. Multinomial ordered logistic regression was used to confirm the increased likelihood of disability for the disease. Eighty-one MSA with HCBs comprising of 50 MSA-C and 31 MSA-P were recruited. We demonstrated that the severity of HCBs showed a positive linear correlation with SARA scores in MSA-C. Multinomial ordered logistic regression test revealed that the increase in the HCBs grade may be associated with an increased likelihood of disability for the disease severity in MSA, especially in those with cerebellar ataxia subtype. We demonstrated that HCBs is a potential imaging marker for the severity of cerebellar ataxia. The increase in the HCBs grade may be associated with an increased likelihood of disability in MSA-C, but not MSA-P cases, suggesting that it may be a useful imaging indicator for disease progression in Chinese patients with MSA-C.

Introduction: This systematic review aims to update the evidence for moxibustion for essential hypertension. Methods: Randomized controlled trials (RCTs) comparing moxibustion versus lifestyle intervention or moxibustion plus antihypertensive drugs versus antihypertensive drugs alone were searched in 9 databases up to March 29, 2020. In meta-analyses, mean difference (MD) and proportional odds ratio (pOR) with 95% confidence intervals (CIs) was pooled for continuous and ordinal outcomes, respectively. Results: Eighteen RCTs were included, involving 1,460 patients. Moxibustion decreased systolic (MD –7.85 mm Hg, 95% CI –9.69 to –6.00, p < 0.00001, I2 = 46%) and diastolic (MD –4.09 mm Hg, 95% CI –5.45 to –2.73, p < 0.0001, I2 = 56%) blood pressures and improved the response to hypotensive treatment (pOR 2.37, 95% CI 1.49–3.75, p = 0.0003, I2 = 57%) significantly more than did the control treatment. Moxibustion also significantly relieved headache and dizziness but the effects changed to be statistically nonsignificant after excluding RCTs with a high risk of bias. Moxibustion did not significantly relieve insomnia and anxiety. No adverse events were reported. Conclusions: Based on the current low to moderate quality evidence, our study suggests that moxibustion may have effects on reducing blood pressure. The effects of moxibustion on typical hypertension symptoms and the long-term safety of moxibustion remain uncertain.

BackgroundAccidental drowning of children under five is a serious problem in China. The present study analyzed data on environmental and sociodemographic factors and on primary caregivers of drowned children to understand factors that may contribute to this problem.MethodsThe present study collected information on 563 cases of drowning in children under five from October 1, 2015, to September 30, 2016, in 334 sampling districts in China. Primary caregivers were interviewed individually using the Drowning Mortality among Children under 5 Questionnaire.ResultsMost drowned children under 5 years old were boys, and 71.6% lived within 100 m of a body of water. The drownings primarily occurred in ponds, canals, rivers, and wells, and over 90% of these water bodies had no safety measures. There were 28.1% of primary caregivers who did not provide full-time care for the children, and 83.1% of them had no knowledge of first aid skills for drowning.ConclusionEncouraging kindergarten enrollment and providing safety education for children may reduce drowning in children under 5 years of age. Public water body protection measures should be strengthened to prevent children from drowning. Encouraging primary caregivers to care full-time for the children and learning first aid skills for drowning may also help reduce fatalities.

Purpose Lymph node metastasis is one of the important prognostic factors of colorectal cancer, and an important index of individualized treatment. The purpose of this study is to use metabonomics to identify potential molecular markers of lymph node metastasis in colorectal cancer (CRC). Patients and methods Peripheral blood samples of 223 CRC patients were collected. The metabolic levels of amino acids and carnitine in peripheral blood of CRC patients, with and without lymph node metastasis, were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results The results show that there were significant differences in the levels of serum amino acids and carnitine between lymph node metastatic patients and lymph node non-metastatic patients. The diagnostic model that was constructed by 9 types of serum metabolites has a high diagnostic ability. Conclusion LC-MS/MS is a detection method that has a broad application in predicting CRC prognosis, individualized treatment, and in studying the mechanism of lymph node metastasis.

With the popularization of intelligent transportation system, the demand for vision-based algorithms and performance becomes more and severe. Vehicle detection techniques have made great strides in the past decades; however, there are still some challenges, such as the classification of tiny vehicles. The images of distant vehicles are generally blurred and lack detailed information due to their low resolutions. To solve this problem, we propose a novel method to generate high-resolution (HR) images from fuzzy images by employing a generative adversarial network (GAN). In addition, the dataset used for training standard GAN is generally constructed by down-sampling from the neutral HR images. Unfortunately, the effect of reconstruction is more modest. To cope with this trouble, we first construct our dataset by using three fuzzy kernels. Then, the exposure of the low-resolution (LR) image is adjusted randomly. Furthermore, a hybrid objective function is designed to guide the model to restore image details. The experimental results on the KITTI data set verify the effectiveness of our method for tiny vehicle classification.

There are limited data on vascular, inflammatory, metabolic risk factors of dementia in Parkinson's disease (PD) with type 2 diabetes mellitus (DM) (PD-DM). In a study of 928 subjects comprising of 215 PD with DM (including 31 PD-DM with dementia, PD-DMD), 341 PD without DM (including 31 PD with dementia, PDD) and 372 DM without PD (including 35 DM with dementia, DMD) patients, we investigated if vascular, inflammatory, metabolic, and magnetic resonance imaging (MRI) markers were associated with dementia in PD-DM. Lower fasting blood glucose (FBG15μmol/L, OR=3.131; 95%CI: 1.243-7.888; p=0.015) and hyperlipidemia (OR=3.075; 95%CI: 1.142-8.277; p=0.026), increased age (OR=1.043; 95%CI: 1.003-1.084; p=0.034) were the most significant risk factors in PDD patients. Lower low-density lipoprotein cholesterol (LDL-C4g/L, OR=4.066; 95%CI: 1.467-11.274; p=0.007) were the most significant risk factors in PD-DMD patients. The area under the curve (AUC) for fibrinogen and LDL-C was 0.717 (P=0.001), with a sensitivity of 80.0% for the prediction of PD-DMD.In summary, we identified several factors including LDL-C and fibrinogen as significant risk factors for PD-DMD and these may have prognostic and treatment implications.

A new coronavirus, severe acute respiratory syndrome coronavirus 2, was first discovered in Wuhan, China, in December 2019. As of 7 April 2020, the new coronavirus has spread quickly to 184 countries and aroused the attention of the entire world. No targeted drugs have yet been available for intervention and treatment of this virus. The sharing of academic information is crucial to risk assessment and control activities in outbreak countries. In this review, we summarize the epidemiological, genetic and clinical characteristics of the virus as well as laboratory testing and treatments to understand the nature of the virus. We hope this review will be helpful to prevent viral infections in outbreak countries and regions.

This article presents a brief introduction of Beijing plan, namely the Beijing’s Brain Health Examination (dementia risk screening) project initiated by Beijing municipal government in early 2019, which is a successful exploration and practicality of brain health examination for the community residences and dementia risk screening system construction. Slowing down the incidents of dementia and reducing eventually its prevalence in the population has been one of the main targets highlighted in Healthy China Initiative 2030 , by Chinese government. As a welfare to its elderly residents, Beijing municipal government initiated the brain health examination (dementia risk screening) project, aiming to provide brain health examination service for 96000 permanent residences over 65 years old at six districts in Beijing before the end of 2019 and gradually make the service available city-wide. This project is a first yet crucial step that governments, central or local, take the lead and concrete measure to organize and implement brain health examination for the aged on a large scale, and to make the nation’s strategy of healthy China a reality by 2030. Through the early detection and reduction of dementia prevalence, the project would make optimal allocation of medical resources possible and bring enormous social and economic benefit. For example, it will save an estimated cost of 23.36 billion yuan for healthcare in five years only in Beijing area. As an institute involved in the early conceptualization and initiation of this project, the Center for Beijing Aging Brain Rejuvenation Initiative (BABRI) and State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University have been working on AD risk longitudinal research (BABRI project) primarily community-cohort based and later with the added clinical-based cohort since 2008. Based on our ten-year basic research and technology advancement, we built a state-of-art mobile platform with innovative cognitive and mental tests as well as the well-known standard ones. It also includes dementia risk screening system and has been used for the Brain Health Examination (Dementia Risk Screening) project successfully. This platform endows the advantages of high screening efficiency, uses shorter time and is designed for its convenience for the elderly. In addition, it is also a platform for basic scientific research by providing comprehensive data managements, and curative effect assessment of cognitive rehabilitation training. And it’s a technological answer to problems faced by large-scale community-based dementia risk screening. In summary, the Beijing’s Brain Health Examination project not only lays the foundation for carrying out the citywide screening for the aged as a social welfare, but also plays a trend-leading role for the establishment of a government sponsored system for brain health in major provinces and cities of China.

Background Geographical distribution of endemic species and its multiple scale drivers are an important topic in biodiversity conservation, because these species are especially vulnerable to climate change and habitat degradation, and therefore have high conservation priority. Here, for the first time, we simultaneously linked glacial-interglacial climate change, contemporary climate, plant species richness and altitudinal range with endemic bird distribution in China. Methods Ordinary least squares models and simultaneous autoregressive models were used to assess the associations between endemic bird richness, endemic bird ratio and each explanatory variable. Structural Equation Models were also performed to test the direct and indirect effects of these variables on endemic bird richness and endemic bird ratio. Results Higher endemic bird richness and endemic bird ratio occurred in regions with stable glacial-interglacial temperature, i.e., southwest China. Plant species richness and altitudinal range were also positively correlated with endemic bird richness and endemic bird ratio. Glacial-interglacial temperature change, contemporary precipitation, plant species richness and altitudinal range were all included in the best combination of variables for endemic bird richness. Importantly, glacial-interglacial temperature change had strong direct effects on both endemic bird richness and endemic bird ratio, while plant species richness only had a direct effect on endemic bird richness. Conclusions Our results indicate that endemic birds in China concentrate in southwest regions where there are stable glacial-interglacial temperature, more plant species and larger altitudinal range. Notably, while stable climate has strong direct effects on both endemic bird richness and endemic bird ratio, plant species may affect endemic bird richness through its effect on overall bird species richness. Importantly, the recent anthropogenic activities have also significantly intensified in this region, which would pose huge challenge for biodiversity conservation in China.

Background More attention should be paid to communicable disease-specific infant mortality rate (CD-IMR) in rural China. However, few studies have examined specific geographic patterns and trends in CD-IMR in these areas. Our aims were to assess the epidemiological distribution and trends in CD-IMR in rural China for the period 1996–2015. Methods We used data from China’s Under-5 Child Mortality Surveillance System (U5CMSS). The time trends in communicable disease-specific IMR (CD-IMR) were assessed by Poisson regression model, and the proportion of total infant deaths due to communicable disease was assessed by the Cochran Armitage trend test. Differences in CD-IMR among and within geographic regions were assessed for significance using the Cochran–Mantel–Haenszel test. Results The overall CD-IMR fell by 86.0% from 1444.3 to 201.5 per 100,000 live births in rural mainland China from 1996 to 2015. The proportion of total infant deaths related to communicable disease fell from 33.4 to 19.7%. Using eastern rural areas as the reference, rate ratios (RRs) of IMR due to all communicable diseases ranged between 1.7 and 3.1 in central rural areas and between 4.4 and 9.8 in western areas during the four study intervals. Acute respiratory infection (ARI) accounted for 71% of deaths, followed by diarrhea and septicemia. Conclusions IMR due to communicable disease remains a major public health issue. ARI is the leading cause of mortality, followed by diarrhea. A regional gap remains in the risk of infant exposure to communicable disease in rural China. More attention should be paid to western rural areas.

The electron transport properties in bis[2-(2-hydroxyphenyl)-pyridine] beryllium (Bepp2) doped 8-hydroxyquinolinolatolithium (Liq) are investigated by impedance spectroscopy (IS). The Nyquist curve...

Background Prostate cancer (PC) is the most commonly diagnosed solid tumor in men. A major challenge in PC immunotherapy is the lack of an animal model that resembles human adenocarcinoma and allows for manipulation or monitoring of the immune response. Mouse models are needed for preclinical testing of new immunotherapies, whether used alone or in combination with established drugs, and to develop companion biomarkers that can be validated in clinical trials. Methods To develop a syngeneic prostate adenocarcinoma model with a well-defined tumor antigen, murine RM1 PC cells were transfected with the endogenous mouse melanoma protein, gp100 (RM1-gp100). Gp100 was attractive because it is a self-protein and it instantly allowed us to use the large trove of immune research tools developed for melanoma research. A dendritic cell (DC) vaccine was used as model immunotherapy to demonstrate that adoptive immunotherapy against gp100 decreases the growth of RM1-gp100 but not RM1. Results Expressing gp100 did not change the growth of RM1 cell in vitro or in vivo. The DCs pulsed with RM1-gp100 could be used to stimulate Pmel-1 lymphocyte proliferation and activation. Pmel-1 lymphocytes could be adoptively transferred into C57Bl/6 mice that were treated with DCs pulsed with RM1-gp100. The resulting Pmel-1 lymphocytes were monitored to assess the primary cellular immune response and memory response. Conclusion We describe a murine model for prostate adenocarcinoma with a well-characterized antigen that can be used in an immunologically intact mice to monitor the temporal CD8+ lymphocyte-mediated antitumor immunity.

Background: Glial-derived neurotrophic factor (GDNF) has been demonstrated to promote the therapeutic effect of mesenchymal stem cells on ameliorating renal injury. The mechanism may involve the transfer of endogenous molecules, but these factors remain unknown. Methods: GDNF was transfected into human adipose mesenchymal stem cells via a lentiviral transfection system and exosomes were isolated (GDNF-AMSC-exos). Using unilateral ureteral obstruction (UUO) mouse models and human umbilical vein endothelial cells (HUVECs) against hypoxia/serum deprivation (H/SD) injury models we investigated whether GDNF-AMSC-exos ameliorate peritubular capillary (PTC) loss in tubulointerstitial fibrosis, and whether this effect is meditated by SIRT1 signaling pathway. Additionally, by using SIRT1 activators or siRNA, the roles of the candidate mRNA and its downstream gene in GDNF-AMSC-exo-induced regulation of endothelial cell function were assessed. Findings: GDNF-AMSC-exos resulted in significantly decreased PTC rarefaction and renal fibrosis scores in mice with UUO. In vitro studies revealed that GDNF-AMSC-exos exert cytoprotective effects on HUVECs against H/SD injury by stimulating migration, angiogenesis and conferring apoptosis resistance. Mechanistically, GDNF-AMSC-exos enhanced SIRT1 signaling, which accompanied by increased protein levels of phosphorylated eNOS (p-eNOS). In addition, we have confirmed the SIRT1-eNOS interaction in HUVECs by immunoprecipitation. Interpretation: Our study unveils a mechanism by which exosomes ameliorate renal fibrosis: GDNF-AMSC-exos may activate an angiogenesis program in surviving PTCs after injury by activating the SIRT1/eNOS signaling pathway. This finding suggests that inhibition of chronic kidney disease (CKD) progression requires long-term suppression of fibrosis via renal microvascular repair and angiogenesis and that GDNF-AMSC-exos therapy is a promising strategy for achieving this goal. Funding Statement: This work were supported by projects of the National Natural Science Foundation of China (81270769 and 81803473); a project of the Jiangsu Provincial Natural Science Foundation (BK20161172); a project of the Jiangsu Provincial Commission of Health and Family Planning (H201628); projects of the Jiangsu Provincial Post Graduate Innovation Plan (KYCX18-2178, KYCX17-1708, SJCX17-0560, SJCX18-0715); the Municipal Key Research and Development Project of Xuzhou (KC18212); the “Liu ge yi Gong Cheng” project of Jiangsu High-Level Personnel (LGY2016043); a school class project of Xuzhou Medical University (2017KJ13); and the Xuzhou Science and Technology Bureau Applied Basic Research Program( KC18041 and KC 19069). Declaration of Interests: All the authors declared no competing interests. Ethics Approval Statement: Approval of all research involving human participants was obtained from the Institutional Review Board of the Affiliated Hospital of Xuzhou Medical University (permit number: xyfylw2013032). All experiments involving animals followed the animal use protocol enacted by the Institutional Animal Care and Use Committee of Xuzhou Medical University.

Using survey data from 208 Chinese manufacturing firms, this paper empirically explores whether servitization facilitates or hinders radical product innovation performance. On the basis of organizational knowledge creation theory, we argue that servitization enables manufacturers to identify latent customer needs that are valuable in searching for radical product innovation opportunities. However, according to social structural embeddedness theory, a firm with a high level of servitization becomes overembedded in customer relationships, which prevents it from seizing such opportunities. We integrate these two theories and find an inverted U-shaped relationship between servitization and radical product innovation performance. Our research enriches the servitization literature by identifying and integrating the two roles of servitization for radical product innovation performance.

Background Intellectual Disability (ID) is a characterized by significantly impaired adaptive behavior and cognitive capacity. Currently, high throughput sequencing approaches have led to the identification of genetic causes for ID in 25-50% of cases, while the causes of inherited ID are less well known. Here, we have investigated the genetic cause for non-syndromic ID in a Han Chinese family. Methods Whole genome sequencing was performed on identical twin sisters diagnosed with ID, their respective children as well as their asymptomatic parents. Data was filtered for rare variants and in silico prediction tools used to establish pathogenic alleles. Candidate mutations were validated by Sanger sequencing. Molecular modelling was conducted to establish the effects of the mutation on the protein encoded by a candidate coding gene. Results A novel heterozygous variant in the ZBTB18 gene c.1323C>G (p.His441Gln) was identified. This variant co-segregated with affected individuals in an autosomal dominant pattern and was not detected in asymptomatic family members. Molecular studies reveal that a p.His441Gln substitution disrupts the coordination of a zinc ion within the second zinc finger and disrupts the capacity for ZBTB18 to bind DNA. Conclusions c.1323C>G mutation in ZBTB18 gene on 1 chromosome may be related with the phenotype of intellectual disability in this family. WGS is an efficient method to perform molecular diagnosis for hereditary ID. This is the first report of an inherited ZBTB18 mutation for ID and suggests that mutations that disrupt C2H2 motifs underlie human neurodevelopmental disorder.

Purpose: There is a need for strategies to prevent prostate cancer. Cholesterol-lowering interventions are employed widely and safely to reduce risk of cardiovascular disease and has been proposed for chemoprevention. Using preclinical models and a window-of-opportunity clinical trial, we describe an adaptive antitumor immunity resulting from cholesterol lowering. Experimental Design: Statins do not reliably lower serum cholesterol in mice. Therefore, oral ezetimibe was administered to mice to lower serum cholesterol to clinically relevant levels and evaluated the final adaptive immune response. T-lymphocytes-specific mTORC2 knockout mice were used to evaluate mTOR signaling and antitumor immunity. Pretreatment and posttreatment prostate tumors and lymphocytes were examined from a window-of-opportunity clinical trial where men with prostate cancer were treated with 2 to 6 weeks of aggressive cholesterol-lowering intervention prior to radical prostatectomy. Results: Mice treated with oral ezetimibe exhibited enhanced antitumor immunity against syngeneic cancers in a CD8+ lymphocyte-dependent manner, produced immunity that was transferrable through lymphocytes, and had enhanced central CD8+ T-cell memory. In mice and in patients undergoing prostatectomy, lowering serum cholesterol inhibited mTORC2 signaling in lymphocytes and increased infiltration of CD8+ lymphocytes into prostate tumors. T-lymphocyte-specific mTORC2 knockout mice demonstrated enhanced CD8+ lymphocyte function and antitumor capacity. In patients, cholesterol-lowering intervention prior to prostatectomy decreased the proliferation of normal prostate and low-grade adenocarcinomas. Conclusions: Lowering serum cholesterol decreased signaling through mTORC2 and enhanced antitumor CD8+ T-cell memory. We provide a rationale for large-scale clinical testing of cholesterol lowering strategies for prostate cancer chemoprevention.

The ingestion of foreign bodies is not uncommon in clinical settings. In most cases, foreign objects will pass through the gastrointestinal tract without causing any damage (1,2). However, a few articles have reported that foreign bodies can perforate the stomach or intestines, leading to liver abscesses (3-5). As patients rarely remember the history of ingestion of foreign bodies and the clinical manifestations are not specific, diagnoses can be challenging (1,3). This case report describes a patient who experienced unexplained abdominal pain without obvious infection symptoms, which was found to be caused by a bamboo toothpick in the liver. Due to a lack of any special medical history and based on the patient’s symptoms, the presence of a foreign body was finally diagnosed by liver ultrasound and computed tomography (CT). The patient’s condition had been stable. This type of situation is rare.

The novel COVID-19 pandemic spread quickly and continuously influenced global societies. As a vulnerable population that accounted for the highest percentage of deaths from the pandemic, older adults have experienced huge life-altering challenges and increased risks of mental problems during the pandemic. Empirical evidence is needed to develop effective strategies to promote preventive measures and mitigate the adverse psychological impacts of the COVID-19 pandemic. This study aimed to investigate the behavioral responses (i.e., preventive behaviors, physical activity, fruit and vegetable consumption) and mental responses (i.e., depression and loneliness) towards the COVID-19 pandemic among Chinese older adults. A further aim was to identify the associations among demographics, behavioral responses, and mental responses. Using a convenience sampling approach, 516 older adults were randomly recruited from five cities of Hubei province in China. Results of the cross-sectional survey showed that 11.7% of participants did not adhere to the WHO recommended preventive measures, while 37.6% and 8.3% of participants decreased physical activity and fruit–vegetable consumption respectively. For mental responses, 30.8% and 69.2% of participants indicated significantly depressive symptoms and severe loneliness, respectively. Participants’ behavioral and mental responses differed significantly in several demographics, such as age group, living situation, marital status, education levels, household income, medical conditions, and perceived health status. Demographic correlates and behavioral responses could significantly predicate the mental response with small-to-moderate effect sizes. This is the first study to investigate the characteristics of behavioral and mental responses of Chinese older adults during the COVID-19 pandemic. Research findings may give new insights into future developments of effective interventions and policies to promote health among older adults in the fight against the pandemic.

BackgroundThis retrospective study aimed to determine the epidemiological features of deaths caused by unintentional suffocation among infants in China.MethodsThe data used in this study were obtained from China’s Under 5 Child Mortality Surveillance System (U5CMSS) from October 1, 2015, to September 30, 2016. A total of 377 children under 1 year of age who died from unintentional suffocation were included in the survey. Primary caregivers were interviewed individually using the Unintentional Suffocation Mortality among Children under 5 Questionnaire. EpiData was used to establish the database, and the results were analysed using SPSS 22.0.ResultsMost (85.9%) unintentional infant suffocations occurred in rural areas, and 67.5% occurred in infants 0 to 3 months old. Among the primary caregivers of the infants, most (82.7%) had a junior middle school education or below, and 83.1% of them lacked unintentional suffocation first aid skills. Of the 377 unintentional suffocated-infant deaths, the causes of death were accidental suffocation and strangulation in bed (ASSB) (193, 51.2%), inhalation suffocation (154, 40.8%), other unintentional suffocation (6, 1.6%), and unknown (24, 6.4%). Among the infant deaths due to ASSB, overlaying (88.6%) was the most frequently reported circumstance. A total of 93.8% of cases reported occurred during co-sleeping/bed sharing with parents, and in 72.8% of the cases, the infants were covered with the same quilt as their parents. In our study, most inhalation suffocation deaths (88.3%) involved liquid food (such as breast milk and formula milk). A total of 80.5% of infant deaths reportedly occurred after eating; in 28.2% of those cases, the infants were held upright and patted by their caregivers, and 57.2% of them were laid down to sleep immediately after eating.ConclusionsTo reduce the occurrence of unintentional suffocation, local government should strengthen knowledge and awareness of unintentional suffocation prevention and safety among parents and caregivers. Additionally, health care providers should educate parents and caregivers about safety issues of unintentional suffocation, and relevant policies should be introduced to provide environments and activities that reduce the risk of suffocation, such as promoting the Safe to Sleep Campaign. It is important to enhance the focus on infant unintentional suffocation as a health issue.

Background: Mild cognitive impairment (MCI) is an important stage between the normal cognitive decline of aging and dementia. The aim of this study was to compare and harmonize the recommendations for the diagnosis and treatment of MCI based on current clinical practice guidelines.Methods: We searched the PubMed, EMBASE, China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, and Chinese Biological Medicine Database from their inception date to April 24, 2021 to identify all published guidelines on MCI. The qualities of the eligible guidelines were appraised by two reviewers using the Appraisal of Guidelines for Research and Evaluation II instrument.Results: Thirteen guidance documents (four guidelines and nine consensus statements) with specific recommendations were included. Nine guidelines and consensus statements covered the screening and diagnosis of MCI. The evaluation of the documents showed that neuropsychological testing and biomarker assessments were the most common recommendations for the diagnosis of MCI. Nine of the 13 guidance documents covered the treatment and management of MCI. The recommendations for the treatment and management were classified into four categories, namely: intervention for risk reduction, pharmacologic interventions, non-pharmacologic interventions, and counseling. Regarding pharmacological interventions, three guidelines recommend no pharmacologic intervention. The use of cholinesterase inhibitors for MCI is contraindicated in three guidance documents, whereas one proposes that cholinesterase inhibitors and memantine should be deprescribed. EHb761®, Chinese herbal decoctions, and Chinese traditional patent medicine are recommended in two documents. A total of seven guidance documents recommend non-pharmacological interventions, including physical activity interventions, cognitive interventions, dietary and nutritional interventions, and acupuncture.Conclusion: An updated search for possible evidence on the diagnosis and treatment of MCI is needed. Potentially effective diagnoses and treatments, either conventional or complementary, and alternative therapies should be highly valued and addressed in correlation with the supporting evidence.

Background Cryptococcosis is a major opportunistic invasive mycosis in immunocompromised patients, but it is also increasingly seen in immunocompetent patients. In the early stages of cryptococcosis, limitations of the detection method may hinder the diagnosis. A molecular diagnostic technique based on nucleic acid sequence-based amplification (NASBA) method was developed to fulfil the need for efficient diagnosis of cryptococcosis. Methods We compared the diagnostic performance of NASBA, PCR and cryptococcal antigen (CrAg) test (colloidal gold method) in clinical samples from 25 cryptococcosis patients (including 8 cryptococcal meningoencephalitis and 17 pulmonary cryptococcosis) who were categorized as proven cases (n = 10) and probable cases (n = 15) according to the revised EORTC/MSG definitions. 10 patients with non-Cryptococcus infection and 30 healthy individuals were categorized as control group. Results The lowest detection limit of NASBA was 10 CFU/mL, and RNA of non-target bacteria or fungi was not amplified. The sensitivity of NASBA, PCR and colloidal gold method was 92.00% (95% CI 72.50–98.60%), 64.00% (95% CI 42.62–81.29%), 100.00% (95% CI 83.42–100.00%), and the specificity was 95.00% (95% CI 81.79–99.13%), 80.00% (95% CI 63.86–90.39%) and 82.50% (95% CI 66.64–92.11%) respectively. The highest specificity (97.50%), accuracy (95.38%) and k value (0.90) were achieved when both NASBA and colloidal gold results were positive. Conclusions NASBA is a new alternative detection method for cryptococcosis which is both accurate and rapid without expensive equipment and specialised personnel. It may be used as a tool for confirming current infection as well as monitoring the effectiveness of antifungal treatment. The use of NASBA to detect Cryptococcus RNA in blood samples is of great significance for the diagnosis of pulmonary cryptococcosis. The combination of NASBA and colloidal gold can improve the diagnostic accuracy of cryptococcosis.

Background We explored the associations between chronic stress and dynamic working patterns of the whole brain using resting state MRI data in drug-naive, first-episode adolescents with major depressive disorder (MDD). Methods We compared dynamic functional connectivity (dyn-FC) and screen out networks with difference in whole brain between 45 healthy controls (HC) and 60 adolescent MDD patients using dynamic independent components analysis. In each of these networks with difference between groups, hub brain regions were selected as functionally connected to more than 30 brain regions at the same time. Then we extracted the dyn-FC coefficients of each hub brain region with other brain regions in each component at different time points and calculated the average value of the entire scan time. Finally, we explored correlations between these average values of the entire scan time and scores on the Childhood Chronic Stress Questionnaire (CCSQ). Results We found three networks as well as some hub brain regions with different dyn-FC patterns between adolescent MDD and HC. Scores on the CCSQ were found to correlate with dynamic FC between hub brain areas and certain other brain areas in MDD patients. Limitations our cross-sectional study design does not allow us to speculate about causality between chronic stress and depression. Prospective cohort studies should explore in detail how the changes in dynamic FC appear and evolve during MDD. Conclusions Chronic stress is related with the brain dynamic working patterns in adolescent MDD.

3D reconstruction has raised much interest in the field of CSAR. However, three dimensional imaging results with single pass CSAR data reveals that the 3D resolution of the system is poor for anisotropic scatterers. According to the imaging mechanism of CSAR, different targets located on the same iso-range line in the zero doppler plane fall into the same cell while for the same target point, imaging point will fall into the different positions at different aspect angles. In this paper, we proposed a method for 3D point cloud reconstruction using projections on 2D sub-aperture images. The target and background in the sub-aperture images are separated and binarized. For a projection point of target, given a series of offsets, the projection point will be mapped inversely to the 3D mesh along the iso-range line. We can obtain candidate points of the target. The intersection of iso-range lines can be regarded as voting process. For a candidate, the more times of intersection, the higher the number of votes, and the candidate point will be reserved. This fully excavates the information contained in the angle dimension of CSAR. The proposed approach is verified by the Gotcha Volumetric SAR Data Set.

Background As reported, 27-93 % of pregnant women take at least one drug during pregnancy. However, drug exposure during pregnancy still lacks sufficient foetal safety evidence of human origin. It is urgent to fill the knowledge gap about medication safety during pregnancy for optimization of maternal disease treatment and pregnancy drug consultation. Methods and analysis The China Teratology Birth Cohort (CTBC) was established in 2019 and is a hospital-based open-ended prospective cohort study with the aim of assessing drug safety during pregnancy. Pregnant women who set up the pregnancy health records in the first trimester or who seek drug consultation regardless of gestational age in the member hospitals are recruited. Enrolled pregnant women need to be investigated four times, namely, 6–14 and 24–28 weeks of gestational age, before discharge after hospital delivery, and 28–42 days after birth. Maternal medication exposure during pregnancy is the focus of the CTBC. For drugs, information on the type, name, and route of medication; start and end time of medication; single dose; frequency of medication; dosage form; manufacturer; and reason for medication is collected. The adverse pregnancy outcomes collected in the study include birth defects, stillbirth, spontaneous abortion, preterm birth, post-term birth, low birth weight, macrosomia, small for gestational age, large for gestational age and low Apgar score. CTBC uses an electronic questionnaire for data collection and a cloud system for data management. Biological samples are collected if informed consents are obtained. Multi-level logistic regression, mixed-effect negative binomial distribution regression and spline function regression are used to explore the effect of drugs on the occurrence of birth defects. Discussion The findings of the study will assist in further understanding the risk of birth defects and other adverse pregnancy outcomes associated with maternal drug exposure and developing the optimal treatment plans and drug counselling for pregnant women. Trial registration This study was approved by the Research Ethics Committee of the West China Second Hospital of Sichuan University and registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn/index.aspx, registration number ChiCTR1900022569).

BackgroundColorectal cancer (CRC) is among the most common malignancies worldwide. M2 macrophages and regulatory T cells (Tregs) are immunosuppressive cells that can promote tumor progression via inhibiting anti-tumor immunities. However, the significance and correlation of the two types of cells in colorectal cancer are still inconclusive. The purpose of this study is to detect the number of M2 macrophages and Tregs in colorectal cancer and lymph nodes and to explore the clinical and pathological significance of their existence.MethodsThe pathologic specimens and clinical data of 197 patients with Colorectal cancer after radical resection were collected. Immunohistochemical methods were used to detect the expression of M2 macrophages and Tregs in colorectal cancer tissues, adjacent tissues, and lymph node tissues in each group.ResultsCompared with adjacent tissues and non-metastatic lymph node tissues, M2 macrophages and Tregs not only increased significantly in cancer tissues and metastatic lymph node tissues (P ConclusionM2 macrophages are involved in the formation of lymph node immunosuppressive environment and promote the development of CRC and lymph node metastasis together with Tregs. Upregulation of M2 macrophages and Tregs expression is a prognostic marker for monitoring the condition of colorectal cancer and judging the prognosis.