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This study introduces the concept and characteristics of open access (OA), analyses the status quo and development of OA in foreign countries, and discusses its inspiration to its future development in China.

Objectives: Tracheobronchial foreign body aspiration (TFBA) is a major cause of accidental death in children. Lower respiratory tract infection (LRTI) may be caused by TFBA, but there are few reports about LRTI associated with TFBA. This study collected TFBA cases in our hospital to analyze LRTI and determine its risk factors. Methods: A total of 194 children who underwent tracheobronchial foreign body (TFB) extraction in The Children's Hospital of Zhejiang University School of Medicine from June 2019 to April 2020 were enrolled. CT chest is routinely used in the workup of suspected airway FB at our institution to evaluate for patients, a FB was already highly suspected. The retention time was defined as from the time of TFB inhalation or presentation (if there was no history of TFBA) to the time of TFB removal. General characteristics including weight, clinical symptoms, operative records, cervicothoracic CT, retention time, type of TFB and postoperative hospitalization time were collected. Chi-square tests, rank sum tests and multivariate logistic regression analyses were performed. Results: The incidence of LRTI was 46.6%, 68.6%, and 68.6% when the retention time was within 24 hours, between 24 hours and up to 1 week and more than 1 week, respectively. Postoperative hospitalization time of LRTI group was significantly longer than that of non-LRTI group. Findings for cervicothoracic CT as pneumonia, emphysema, atelectasis meant more serious clinical manifestations and the retention time was longer in the LRTI group than in the non-LRTI group. There was a positive correlation between the retention time of a TFB and LRTI in multivariate logistic regression analysis. Conclusions: The incidence of LRTI caused by TFBA is high. LRTI is association with longer postoperative hospitalization time. The TFB retention time is an independent risk factor for LRTI. If a patient presents with significant LRTI symptoms, a course of steroids and antibiotics maybe a safer approach rather than proceeding immediately with bronchoscopic removal. [ABSTRACT FROM AUTHOR]

Objective: This research aims to analyze the impact of the novel coronavirus pandemic on the hospital visits of patients with acute appendicitis. Methods: The retrospective analysis was designed to look at the treatment of acute appendicitis in the Department of General Surgery in Beijing Jishuitan Hospital before and during the COVID-19 pandemic (2019–2020). Data was analyzed by the numbers of patients, sex, age, onset time, fever or not, laboratory examination, imaging test, and treatment. And we analyzed the differences between the "pre-COVID group" and "during-COVID group". Results: Compared with the year 2019, the number of acute appendicitis patients has diminished substantially during the COVID-19 pandemic (2020), but the number elevated with the control of the pandemic. Even if we did not find the differences of the treatment before and during the pandemic (P = 0.932), the onset time to emergency was significantly longer (P < 0.001), and more patients had showed fever (P < 0.001) during the COVID-19 pandemic. And the total number of white blood cells and C reactive protein level were significantly higher in 2020 than those in 2019 (P = 0.006, 0.003). And the same result was found in patients with appendiceal fecalith (P = 0.047). Conclusion: During the pandemic of the new coronavirus pneumonia, the number of patients with acute appendix treatment dropped significantly, mainly because it took longer than before, and the condition was more severe. It can be seen that the new coronary pneumonia has a great impact on the patients' medical treatment behavior, and the active prevention and treatment of the new coronavirus pneumonia is currently an important and urgent issue. [ABSTRACT FROM AUTHOR]

The Hangzhou Bay New Area is located in a coastal plain area where the groundwater storage environment is relatively fragile and lacks water resources. Recognizing the regularity of groundwater circulation in this area and conducting an analysis of the evolution of groundwater quality can provide support for its potential as an emergency groundwater source. In order to assess the impact of emergency groundwater extraction on the surrounding environment, a 3-D groundwater flow and a solute displacement model were developed to quantify changes in water level, groundwater recovery capacity, salinity, and landing funnel. The numerical model was calibrated by values recorded with the actual observation well and solved by MODFLOW and MT3DMS modules in GMS (groundwater modeling system). The simulation results indicated that under the conditions of emergency grades I, II, and III, the maximum depths of the water level in the half year of mining were 38.5 m, 24 m, and 18.5 m, respectively, the areas of dropping funnel were 53.75 km2, 33.026 km2, and 25.273 km2, respectively, and the widths of saltwater intrusion were 931 m, 585 m, and 413 m, respectively. The numerical simulation provides a reference for the rational allocation, development, and utilization of groundwater resources in the emergency water source area of the Hangzhou Bay New Area. [ABSTRACT FROM AUTHOR]

The Yuyao River Valley is located in the northwest of Ningbo basin, China. The confined aquifers in the study area show obvious spatial distribution characteristics, which are essentially controlled by the evolution and distribution of the paleochannel. Therefore, it is of great significance to determine the spatial geometric characteristics of the paleochannel for finding out the hydrogeological characteristics and establishing a sustainable groundwater management system. In order to confirm the geo-electric parameters (resistivity and thickness) of each geotechnical layer and the spatial geometric characteristics of the paleochannel in the Yuyao River Valley, 77 vertical electric soundings were performed on five profiles perpendicular to the valley. In addition, 13 geological boreholes distributed over the study area were collected, and the borehole-side electrical sounding measurements were carried out near the boreholes. In fact, the interpretations of borehole-side electrical sounding measurements indicate that the resistivity of each geotechnical layer in the survey area varies greatly in the vertical direction. After calibrated by the lithology of the boreholes, the results of the explication of VES and the electrical resistivity profiles demonstrated the existence of the paleochannel. The paleochannel corresponds to the sand gravel or round gravel aquifers whose particle diameter gradually increases from top to bottom. Thus, the buried depth of the paleochannel is about − 70 to − 35 m, and its width is more than 1000 m. This study corroborated the reliability of the VES method through combining electrical resistivity profiles and hydrogeological data to determine the spatial geometric characteristics of the paleochannel in terms of electrical differences. [ABSTRACT FROM AUTHOR]

Chronic exposure to noise is a detrimental environmental factor that can contribute to occupational noise-induced deafness (ONID) in industrial workers. ONID is caused by both environmental and genetic factors, and negatively impacts workers and manufacturing industries in China. Polymorphisms in the paraoxonase 2 gene (PON2) is associated with noise-induced hearing loss, and PON3 expression may modulate oxidative stress in cells and tissues by reducing the levels of reactive oxygen species, which are prominent in ONID. We conducted a matched case-control study to investigate whether PON3 polymorphisms and activity were associated with susceptibility to ONID. We genotyped PON3 single nucleotide polymorphisms (SNPs) using Sanger sequencing and measured the plasma PON3 activity using enzyme-linked immunosorbent assay. Conditional logistic regression models were fitted to evaluate the potential risk factors of ONID. A total of 300 subjects were included (n = 150 ONID and n = 150 control cases) from October 2017 to October 2019. We identified two types of genotypes for the PON3 SNPs. The independent risk factors for ONID were genotype CT and allele C with Odd's ratio (OR) = 2.12 (95% confidence interval [CI]: 1.18–3.84) and OR = 1.68 (95% CI: 1.06–2.66) for SNP rs11767787; AG and allele A with OR = 2.09 (95% CI: 1.25–3.47) and OR = 1.87 (95% CI: 1.19–2.93) for SNP rs13226149; and CT and allele T with OR = 2.59 (95% CI: 1.44–4.67) and OR = 1.95 (95% CI: 1.22–3.14) for SNP rs17882539, respectively. Furthermore, the plasma PON3 level (> 1504 U/L) was observed to be a protective factor associated with the lowest level of ONID (less than 991 U/L) after adjusting for confounding factors (OR = 0.27, 95% CI: 0.13–0.54). In conclusion, the PON3 polymorphisms rs11767787, rs13226149, and rs17882539 and plasma PON3 activity are associated with susceptibility to ONID in the Chinese population. [ABSTRACT FROM AUTHOR]

Thermal storage of sandstone is widely distributed in sedimentary basins in China with a very high degree of exploitation and utilization, while the low recharge rate is the bottleneck of its sustainable development. A new method is proposed to discover the physical and mechanical behaviors of sandstone after thermal cycling and hydro‐thermal cycling treatments in this study. The stress‐strain curves, strength, failure behavior, acoustic emission (AE), P‐wave velocity, density features, X‐ray, and microscope images of specimens are analyzed in detail to investigate and describe the differences of the sandstone after the two different experimental treatments. The results indicate that multiple thermal cycling and hydro‐thermal cycling have an obvious effect on the compaction stage of sandstone at the temperature of 100°C. Meanwhile, strengths and Young's modulus of specimens after hydro‐thermal cycling treatment decrease with cycling times and the reduce degree is greater than that of the thermal cycling treatment on sandstone. The brittleness of the sandstone decreases as the hydro‐thermal cycling number increases from 0 to 15, and the influence of hydro‐thermal cycling is greater than that of thermal cycling on sandstone. In addition, based on the limited cycling experimental results, the action of the thermal cycling leaded the thermal stress of the crystal to nonuniform, which leaded to micronarrow and sharp cracks in specimens. Furthermore, the action of the hydro‐thermal cycling generated thermal stress and ablation coupling effect, which leaded wider and rounder cracks than that of the specimen under thermal cycling condition. Finally, it indicates that hydro‐thermal cycling has a greater effect than that of the thermal cycling treatment on the physical and mechanical properties of sandstone on the macro‐ and microlevels. [ABSTRACT FROM AUTHOR]

Objective: We aim to determine the accuracy of first-trimester ultrasonography in detecting fetal limb abnormalities.Methods: This is a retrospective study of all women undergoing fetal nuchal translucency (NT) assessment and detailed fetal anatomic survey in the first trimester at a single tertiary-care referral center in China. Fetal anatomy scans were repeated in the second trimester. Detection of fetal limb abnormalities was compared between first and second trimester anatomy scans and confirmed at delivery or at autopsy.Results: Analyzed were 9438 fetuses from 9197 women (241 twin pairs). The incidence of fetal limb abnormalities was 0.38% (36/9438). Of these, 28 (77.8%) were diagnosed prenatally: 23 (63.9%) on first trimester scan and 5 (13.9%) on second trimester scan. Limb reduction defects (usually transverse limb deficiencies) were the most common limb defects identified in the first trimester (n = 12), followed by clubfoot (n = 4), skeletal dysplasia (n = 3), sirenomelia (n = 1), limb dysplasia (n = 1), malposition (n = 1), and syndactyly (n = 1). Nine fetuses with isolated limb abnormalities had normal NT, while 74.1% (20/27) of limb abnormalities that were associated with other abnormalities had increased NT.Conclusions: This study demonstrates that the majority of limb abnormalities detected prenatally [23/28 (82%)] can be identified in the first trimester, especially major limb defects; however, our numbers are small and still need larger cases for further investigation. [ABSTRACT FROM AUTHOR]

A scandal can evoke public outrage when it is widely publicized and involves an individual who is perceived to have a high level of cultural representativeness. Two experiments showed that when the scandalous target's moral character was highlighted, emotional responses towards the target were least negative when the scandal was widely circulated and when the target was seen as a representative of his culture. These results suggest that when a cultural symbol is implicated in a widely-circulated scandal, the negative emotions directed towards the scandalous individual can be alleviated when the public remains confident in his or her commitment to morality. [ABSTRACT FROM AUTHOR]

The article comments on several articles related to international law published in Chinese. These include the "Precautionary Principle in the Protection and Preservation of Marine Environment," by Zhu Jiangeng, "The Judicial Review and the Improvement of Legislation of International Commercial Arbitration," by Du Xinli and "Review on Chinese Legislation of "Public Order"," by Xiong Yuhui.

The article discusses several articles related to international law that are published in Chinese as of 2005. The articles include "Study on the Acceptability of Friend-of-the-Court Statements in WTO Dispute-Solving Mechanism," by Cheng Lihu, "Research on the Practice and the Standpoint of the USA in the WTO Disputes Settlement Activities," by Jiang Liyong, and "The Limitation on Intellectual Property in International Trade of Technology," by Gu Zuxue.

Strongly weathered phyllite is a metamorphic soft rock widely distributed in the central and western regions of China. Due to its inadequate engineering properties, the direct use of this material as a roadbed filler is not feasible and requires improvement. In this paper, calcium acetate Ca(CH 3 COO) 2 , magnesium acetate Mg(CH 3 COO) 2 and calcium chloride CaCl 2 are prepared to improve the filler by microbially induced carbonate precipitation (MICP). The effects of different calcium and magnesium sources on porosity, water absorption, uniaxial compressive strength, crack propagation time and failure patterns are investigated. The results show that CaCl 2 and Ca(CH 3 COO) 2 exhibit the most significant enhancement effect in reducing porosity and water absorption, increasing the uniaxial compressive strength by over 30%, delaying the time of failure occurrence and reducing the number of tensile cracks significantly. X-ray diffraction (XRD), scanning electron microscopy (SEM) and pore size distribution analyses reveal disparities among the rock samples. CaCl 2 and Ca(CH 3 COO) 2 have greater efficacy than Mg(CH 3 COO) 2 in terms of improvement, as they generate relatively many carbonate precipitates to bind the phyllite filler and reduce the size and quantity of pores. To avoid the corrosion of Cl- ions when adding reinforcement bars in actual engineering, Ca(CH 3 COO) 2 is an ideal calcium source for improving the strongly weathered phyllite filler. • The physical and mechanical properties of strongly weathered phyllite filler can be improved after modification. • The physical properties and strength of modified sample have a relationship with carbonate content and crystal morphology. • Calcium acetate is suggested for use as the calcium source to improve the strongly weathered phyllite filler. [ABSTRACT FROM AUTHOR]

[Display omitted] • Fracture initiation and breakdown pressures are independent of shale heterogeneity. • Deviating bedding planes from axial direction suppresses tensile cracks. • Shale heterogeneity exerts insignificant impact on deformation than bedding anisotropy. Shales are intrinsically anisotropic and heterogeneous due to the existence of bedding planes and natural microfractures. Although the roles of shale bedding anisotropy and inherent heterogeneity have been well studied, their combined effects remain unclear. To fill this knowledge gap, we performed six hydraulic fracturing tests on shales with varying bedding inclinations (0°, 45° and 90°) collected from Changing (Sichuan) and Lushan (Jiangxi), South China. The mineral components and microstructure of shales collected from these two places were compared. The results indicate that the shale from Lushan is more heterogeneous due to its higher content of microfractures and pores than the shale from Changning. Through hydraulic fracturing analysis, we show that the fracture initiation pressure and breakdown pressure first increase and then decrease with increasing bedding inclination, and a strong linear correlation between the two pressures is found to be independent of shale heterogeneity. Second, we find inconsistency between the high breakdown pressure and large hoop deformation, which can be attributed to the anisotropy effect of shale's bedding strength relative to the maximum principal stress. In addition, the analysis of the amplitudes and frequency of acoustic emission signals suggests that tensile cracks preferentially occur in a short-transverse mode, while deviating the bedding plane from the axial direction suppresses the initiation of tensile cracks. Shale heterogeneity is mainly reflected in reducing the magnitude of critical pressures and deflecting local fracture branch behaviors, which are less significant than the impacts of bedding anisotropy during the hydraulic fracturing process. [ABSTRACT FROM AUTHOR]

Introduction: Severe pneumonia is a crucial issue in the development of acute kidney injury (AKI). This study evaluated the efficacy of early goal-directed renal replacement therapy (GDRRT) for the treatment of severe pneumonia-associated AKI., Methods: In this real-world retrospective cohort study, we recruited 180 patients with severe pneumonia who were hospitalized and received GDRRT in a third-class general hospital in East China between January 1, 2017, and December 31, 2021. Clinical data on baseline characteristics, biochemical indicators, and renal replacement therapy were collected. Patients were divided into Early and Late RRT groups according to fluid status, inflammation progression, and pulmonary radiology. We investigated in-hospital all-cause mortality (primary endpoint) and renal recovery (secondary endpoint) between the two groups., Results: Among the 154 recruited patients, 80 and 74 were in the early and late RRT groups, respectively. There were no significant differences in the demographic characteristics between the two groups. The duration of admission to RRT initiation was significantly shorter in Early RRT group [2.5(1.0, 8.7) d vs. 5.0(1.5,13.5) d, p  = 0.027]. At RRT initiation, the patients in the Early RRT group displayed a lower percentage of fluid overload, lower doses of vasoactive agents, higher CRP levels, and higher rates of radiographic progression than those in the Late RRT group. The all-cause in-hospital mortality was significantly lower in the Early RRT group than in Late group (52.5% vs. 86.5%, p  < 0.001). Patients in the Early RRT group displayed a significantly higher proportion of complete renal recovery at discharge (40.0% vs. 8.1%, p  < 0.001)., Conclusion: This study clarified that early GDRRT for the treatment of severe pneumonia-associated AKI based on fluid status and inflammation progression, was associated with reduced hospital mortality and better recovery of renal function. Our preliminary study suggests that early initiation of RRT may be an effective approach for severe pneumonia-associated AKI.

This study aimed to provide data for the clinical features of invasive pneumococcal disease (IPD) and the molecular characteristics of Streptococcus pneumoniae isolates from paediatric patients in China. We conducted a multi-centre prospective study for IPD in 19 hospitals across China from January 2019 to December 2021. Data of demographic characteristics, risk factors for IPD, death, and disability was collected and analysed. Serotypes, antibiotic susceptibility, and multi-locus sequence typing (MLST) of pneumococcal isolates were also detected. A total of 478 IPD cases and 355 pneumococcal isolates were enrolled. Among the patients, 260 were male, and the median age was 35 months (interquartile range, 12-46 months). Septicaemia (37.7%), meningitis (32.4%), and pneumonia (27.8%) were common disease types, and 46 (9.6%) patients died from IPD. Thirty-four serotypes were detected, 19F (24.2%), 14 (17.7%), 23F (14.9%), 6B (10.4%) and 19A (9.6%) were common serotypes. Pneumococcal isolates were highly resistant to macrolides (98.3%), tetracycline (94.1%), and trimethoprim/sulfamethoxazole (70.7%). Non-sensitive rates of penicillin were 6.2% and 83.3% in non-meningitis and meningitis isolates. 19F-ST271, 19A-ST320 and 14-ST876 showed high resistance to antibiotics. This multi-centre study reports the clinical features of IPD and demonstrates serotype distribution and antibiotic resistance of pneumococcal isolates in Chinese children. There exists the potential to reduce IPD by improved uptake of pneumococcal vaccination, and continued surveillance is warranted.

Objective: Appraisal of cancer survival is essential for cancer control, but studies related to gynecological cancer are scarce. Using cancer registration data, we conducted an in-depth survival analysis of cervical, uterine corpus, and ovarian cancers in an urban district of Shanghai during 2002-2013., Materials and Methods: The follow-up data of gynecological cancer from the Changning District of Shanghai, China, were used to estimate the 1-5-year observed survival rate (OSR) and relative survival rate (RSR) by time periods and age groups during 2002-2013. Age-standardized relative survival rates estimated by the international cancer survival standards were calculated during 2002-2013 to describe the prognosis of cervical, uterine corpus, and ovarian cancers among women in the district., Results: In total, 1307 gynecological cancer cases were included in the survival analysis in the district during 2002-2013. Among gynecological cancers, the 5-year OSRs and RSRs of uterine corpus cancer were highest (5-year OSR 84.40%, 5-year RSR 87.67%), followed by those of cervical cancer (5-year OSR 73.58%, 5-year RSR 75.91%), and those of ovarian cancer (5-year OSR 53.89%, 5-year RSR 55.90%). After age adjustment, the 5-year relative survival rates of three gynecological cancers were 71.23%, 80.11%, and 43.27%, respectively., Conclusion: The 5-year relative survival rate did not show a systematic temporal trend in cervical cancer, uterine cancer, or ovarian cancer. The prognosis in elderly patients was not optimistic, and this needs a more advanced strategy for early diagnosis and treatment. The age structure of gynecological cancer patients in the district tended to be younger than the standardized age, which implies that more attention to the guidance and health education for the younger generation is needed., Competing Interests: Competing interests The authors declare that they have no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Digestive tract cancers are the common cause of cancer deaths in both China and worldwide. This study aimed to describe the burden, recent trends and lifetime risks in the incidence and mortality of digestive tract cancers in an urban district of Shanghai, China. Our study extracted data on stomach, colon, rectum and liver cancers diagnosed in Changning District between 2010 and 2019 from the Shanghai Cancer Registry. We calculated age-standardized incidence and mortality rates, the risks of developing and dying from cancer, and the estimated annual percent changes. Between 2010 and 2019, 8619 new cases and 5775 deaths were registered with digestive tract cancers in the district. The age-standardized incidence rates (ASIRs) of liver cancer decreased steadily, whereas the ASIRs of stomach, colon and rectum cancers remained stable from 2010 to 2019. The age-standardized mortality rates (ASMRs) of stomach and liver cancers showed significant declining changes from 2010 to 2019 in both sexes, but that of colon and rectum cancers remained stable during the entire period. The risks of developing and dying from digestive tract cancers were substantially higher in men than women. The burden of digestive tract cancer and its disparities between sex and age group remain major public health challenges in urban Shanghai. To reduce the burden of digestive tract cancers, the government and researchers should develop and promote a healthy diet, organize a screening, and reduce the prevalence of smoking, alcohol drinking, and hepatitis B virus and hepatitis C virus infections., (© 2022. The Author(s).)

Background: Streptococcus pneumoniae (S. pneumoniae) is a major cause of bacterial meningitis, septicemia and pneumonia in children. Inappropriate choice of antibiotic can have important adverse consequences for both the individual and the community. Here, we focused on penicillin/cefotaxime non-susceptibility of S. pneumoniae and evaluated appropriateness of targeted antibiotic therapy for children with IPD (invasive pneumococcal diseases) in China., Methods: A multicenter retrospective study was conducted in 14 hospitals from 13 provinces in China. Antibiotics prescription, clinical features and resistance patterns of IPD cases from January 2012 to December 2017 were collected. Appropriateness of targeted antibiotics therapy was assessed., Results: 806 IPD cases were collected. The non-susceptibility rates of S. pneumoniae to penicillin and cefotaxime were 40.9% and 20.7% respectively in 492 non-meningitis cases, whereas those were 73.2% and 43.0% respectively in 314 meningitis cases. Carbapenems were used in 21.3% of non-meningitis cases and 42.0% of meningitis cases for targeted therapy. For 390 non-meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were used in 17.9% and 8.7% of cases respectively for targeted therapy. For 179 meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were prescribed in 55.3% and 15.6% of cases respectively. Overall, inappropriate targeted therapies were identified in 361 (44.8%) of 806 IPD cases, including 232 (28.8%) cases with inappropriate use of carbapenems, 169 (21.0%) cases with inappropriate use of vancomycin and 62 (7.7%) cases with inappropriate use of linezolid., Conclusions: Antibiotic regimens for IPD definite therapy were often excessive with extensive prescription of carbapenems, vancomycin or linezolid in China. Antimicrobial stewardship programs should be implemented to improve antimicrobial use., (© 2021. The Author(s).)

Background: Delirium is a common complication in hospitalized elderly patients, yet often remains unrecognized in the clinical care unit. The newly developed 3-Minute Diagnostic Interview for CAM-Defined Delirium (3D-CAM) has high sensitivity and specificity when administered by trained researchers. However, diagnostic characteristics of the 3D-CAM as performed in routine practice are unclear., Objective: To determine the diagnostic characteristics of a Chinese version of the 3D-CAM administered to hospitalized elderly patients by bedside nurses., Design: A prospective cohort study., Setting: A tertiary geriatric hospital in China., Participants: 323 patients and 49 bedside nurses., Methods: This prospective cohort study was conducted at a tertiary geriatric hospital in China. A Chinese version of 3D-CAM was administered by trained bedside nurses and compared against the reference standard performed by experienced neurologists using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. All assessors were blinded to each other's assessment results. Sensitivity and specificity of the 3D-CAM among bedside nurses were analysed by comparing with the reference standard to test the ability of 3D-CAM in detecting delirium., Results: A total of 323 patients were included in the study, of whom 64 were classified as delirium positive by the neurologists. The 3D-CAM had a sensitivity of 92% (95% confidence interval, 82-97%), specificity of 89% (95% confidence interval, 84-92%), respectively., Conclusion: The Chinese version of 3D-CAM demonstrated good performance as a bedside nurse-administered screening tool for delirium detection among hospitalized Chinese geriatric patients. Registration number: ChiCTR-IOR-17,010,368., Competing Interests: Conflict of interest None, (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objectives: To develop a new Chinese medicine (CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome (ARDS) in COVID-19 patients., Methods: A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized, controlled two-arm trial. The two arms of the trial consist of a control therapy (alpha interferon inhalation, 50 µg twice daily; and lopinavir/ritonavir, 400 and 100 mg twice daily, respectively) and a testing therapy (control therapy plus Keguan-1 19.4 g twice daily) by random number table at 1:1 ratio with 24 cases each group. After 2-week treatment, adverse events, time to fever resolution, ARDS development, and lung injury on newly diagnosed COVID-19 patients were assessed., Results: An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events. Based on this result, the study was expanded to include a total of 48 participants (24 cases each arm). The results show that compared with the control arm, the testing arm exhibited a significant improvement in time to fever resolution (P=0.035), and a significant reduction in the development of ARDS (P=0.048)., Conclusions: Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients. (Trial registration No. NCT04251871 at www.clinicaltrials.gov ).

Objective : The main objective of the present study is to evaluate the psychometric properties of the Chinese version of Beliefs about Medicines Questionnaire-specific among asthma patients; and to assess the association between patients' belief and adherence to inhaled corticosteroid therapy. Methods : A cross-sectional survey was carried out in the asthma clinic of Zhongshan Hospital, to Fudan University (Shanghai, China) between April 2016 and March 2018. The Beliefs about Medicines Questionnaire-specific was translated into Chinese according to international guidelines. Internal consistency, test-retest reliability, and confirmatory factor analysis were calculated to validate the Beliefs about Medicines Questionnaire-specific. The relationship between the adherence and the belief subscale were assessed using Kruskal-Wallis test. Results : Two hundred and seventeen patients were recruited in this study. The Beliefs about Medicines Questionnaire-specific was deemed reliable based on the results of Cronbach's alpha coefficient and test-retest intraclass correlation coefficient (ICC, ICC= 0.759). Confirmatory factor analysis showed acceptable model fit for the two-factor model. Patients' compliance was closely related to their belief about inhaled corticosteroid. The adherence rates were highest for the accepting groups, and lowest for the skeptical groups. Higher adherence was significantly associated with higher necessity-concerns differential ( p  = .001) and lower concern ( p  = .004). Conclusions : The Chinese version of the Beliefs about Medicines Questionnaire-specific can be used as a reliable tool by the clinicians to identify beliefs and behaviors of individual to improve adherence in Chinese patients.

Objective: To explore the clinical characteristics and etiology of bacterial meningitis (BM) in Chinese children., Method: BM cases in children 28days to 18 years old were collected from January 2014-December 2016 and screened according to World Health Organization standards. Clinical features, pathogens, and resistance patterns were analyzed., Results: Overall, 837 cases were classified into five age groups: 28 days-2 months (17.0%), 3-11 months (27.8%), 12-35 months (24.0%), 3-6 years (13.9%), and >6years (17.3%). Major pathogens were Streptococcus pneumoniae (S. pneumoniae, n=136, 46.9%), group B Streptococcus (GBS, n=29, 10.0%), and Escherichia coli (E. coli, n=23, 7.9%). In infants <3 months old, GBS (46.5%) and E. coli (23.3%) were most common; in children >3 months old, S. pneumoniae (54.7%), which had a penicillin non-susceptibility rate of 55.4% (36/65), was most frequent. The resistance rates of S. pneumoniae and E. coli to cefotaxime and ceftriaxone were 14.0%/40.0% and 11.3%/68.4%, respectively. All GBS isolates were sensitive to penicillin., Conclusions: The occurrence of BM peaked in the first year of life, while S. pneumoniae was the predominant pathogen in children >3months of old. The antibiotic resistance of S. pneumoniae was a concern., (Copyright © 2018. Published by Elsevier Ltd.)

A diarrhea outbreak caused by porcine epidemic diarrhea virus (PEDV) has been observed in China since December 2010. We report here the complete genome sequence of PEDV strain AJ1102 isolated from a suckling piglet with acute diarrhea, which will help toward understanding the molecular and evolutionary characteristics of the epidemic PEDV in China.

Aim: The risk factors mostly strongly associated with gastric cancer are gastric bacteria Helicobacter pylori and diet. Using a case-control study among residents in Jinan, we examined the association between the salt taste and gastric cancer according to H. pylori infection, smoking and histological type as well as tumor site., Methods: This population-based case-control study included 207 cases and 410 controls. Data on potential risk factors of gastric cancer were obtained by interview of cases and controls with a questionnaire, salt taste preference was measured for all subjects, and IgG antibodies to H. pylori were applied to assess infection. Risk measures were determined using unconditional logistic regression., Results: The proportions of salt taste at intervals of 1.8-7.2 g/L and ≥ 7.2 g/L were significantly higher in cases than controls, with ORs of 1.56 (1.23-3.64) and 2.03 (2.12- 4.11), respectively, subjects with high salt intake having an elevated risk for gastric cancer when infected with H. pylori. Significant modification by smoking and tumor site was observed across the different measures of salt intake, the highest salt taste showed higher cancer risk in ever smokers or with non-cardia cancers., Conclusion: Our study supports the view that high intake of sodium is an important dietary risk factor for gastric cancer, with a synergistic effect found between salt and H.pylori and smoking, dependent on the tumor site.

In 2006, an emerging highly pathogenic strain of porcine reproductive and respiratory syndrome virus (PRRSV), which causes continuous high fever and a high proportion of deaths in vaccinated pigs of all ages, broke out in mainland China and spread rapidly to neighboring countries. To examine the epidemiology and evolutionary characteristics of Chinese PRRSV after the 2006 outbreak, we tested 2,981 clinical samples collected from 2006 to 2010 in China, determined 153 Nsp2 sequences and 249 ORF5 sequences, and analyzed the epidemiology and genetic diversity of Chinese PRRSV. Our results showed that the percentage of PRRSV-positive specimens collected from sick pigs averaged 60.85% in the past 5 years and that the highly pathogenic PRRSV has become the dominant strain in China. Furthermore, a reemerging strain which apparently evolved from the highly pathogenic PRRSV strain in 2006 appeared to be widely prevalent in China from 2009 onwards. Sequence analyses revealed that the hypervariable region of Nsp2 in most of the isolates contained a discontinuous deletion equivalent to 30 amino acids, along with other types of deletions. Extensive amino acid substitutions in the GP5 sequence translated from ORF5 were found, particularly in the potential neutralization epitope and the N-glycosylation sites. Our results suggest that Chinese PRRSV has undergone rapid evolution and can circumvent immune responses induced by currently used vaccines. Information from this study will help in understanding the evolutionary characteristics of Chinese PRRSV and assist ongoing efforts to develop and use PRRSV vaccines in the future.

Objective: To establish reference values of acoustic rhinometry, rhinomanometry and rhinospirometer in healthy adults in Tianjin area, analyze the effects of age,sex and side on the value, investigate the correlation of the measure values, offer the diagnosis date for test nasal ventilation function in Tianjin area., Method: Four hundred and sixty-six healthy adults in Tianjin area were tested. A1 acoustic rhinometry was used to measure the minimum cross-sectional area (MCA), distance of the minimal cross-sectional area to the nostril (DCAN) and the nasal volume from 0-5 cm, 2-5 cm (V5, V2-5); At 150 Pa, 75 Pa and broms, NR6 Rhinomanometry was used to measure unilateral nasal inspiratory resistance (IR)and expiratory resistance (ER), bilateral nasal inspiratory and expiratory resistance (TIR and TER), and differences of the bilateral nasal resistance can be calculated; NV1 Rhinospirometer was used to measure unilateral inspiratory capacity (IC) and expiration capacity (EC), and the nasal partitioning ratio (NPR) can be calculated. Practical measure the distance of nostril to ahead of the inferior turbinate and compare with DCAN. Make the correlational analysis on different index of three exam., Result: Reference values of acoustic rhinometry: MCA was (0.45 +/- 0. 16) cm2 for male, (0.44 +/- 0.16) cm2 for female; V2-5 was (3.52 +/- 1.38) cm3 for male, (3.36 +/- 1.22) cm3 for female, V5 was (5.10 +/- 1.47) cm3 for male, (4.86 +/- 1.12) cm3 for female; DCAN have two distance, (2.22 +/- 0.398, 0.53 +/- 0.625) cm was for male, (2.10 +/- 0.37, 0.67 +/- 0.15) cm was for female. No significant gender, side and age differences were shown in MCA, V5, V2-5. Significant gender differences were shown in DCAN but no side and age differences. Reference values of rhinomanometry: Significant gender but no side and age differences were shown in IR, ER, TIR, TER. Reference values of rhinospirometer: IC was (2.06 +/- 1.10) L/20 s for male, (1.37 +/- 0.34) L/20 s for female, EC was (2.15 +/- 1.23) L/20 s for male (1.39 +/- 0.58) L/20 s for female. NPRi was 0.11 [0.05, 0.23],NPRe was 0.11 [0.05, 0.19]. Significant gender but no side and age differences were shown in IC and EC. No gender and age differences were shown in NPRi and NPRe. There was significant correlation found between MCA and IR/ER/IC/EC, IR and IC, ER and EC, Rlr and NPRi/ NPRe., Conclusion: Acoustic rhinometry,rhinomanometry and rhinospirometer can be useful reference values to evaluate nasal ventilation function, more value will be found if use the three together.