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Background and Purpose: Most patients cannot receive intravenous thrombolytic therapy in the early stage of stroke onset, and the application of mobile stroke unit (MSU) in prehospital intravenous thrombolytic therapy of acute stroke may change this situation. The first MSU in China was put into use in 2017. Herein, we aimed to explore the preliminary experience of MSU in prehospital thrombolysis of acute stroke. Methods: Patients who received prehospital intravenous thrombolytic therapy using MSU were classified to the MSU thrombolysis group, and the control group consisted of stroke patients admitted by regular ambulances, who were transferred to hospital for intravenous thrombolytic therapy. The feasibility, safety, and duration of procedures were compared. Results: There were 14 patients received prehospital intravenous thrombolysis on the MSU, and 24 patients underwent intravenous thrombolysis in the emergency center, who were transferred by the ordinary ambulance during the same period. The median call-to-needle time was 59.5 min in the MSU thrombolysis group, while it was 89 min in the control group; the difference between the 2 groups was statistically significant (p = 0.001). The median time from onset to thrombolysis was 70 and 102.5 min, respectively, in the 2 groups (p = 0.002). The percentages of good clinical outcome (modified Rankin Scale score ≤ 2) at 90-day follow-up were 79 and 67%, respectively (p = 0.488). The rate of symptomatic intracranial hemorrhage and mortality during the perioperative period did not differ significantly between 2 groups. Conclusion: Despite the small sample size, our preliminary experience of the application of MSU in the prehospital thrombosis therapy seems to indicate a significant reduction in time from call to needle, the efficacy of MSU in the treatment of acute stroke needs further experiment and larger sample size to confirm. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to explore customer satisfaction towards the celebrated Tong Ren Tang (TRT) Chinese corporate heritage brand (established in 1669). This paper examines the multiple role identities of the corporate brand and, in particular, the enduring imperial identity (role identity) of the corporate brand. The study examines whether the corporate heritage brand's imperial associations are still meaningful. Design/methodology/approach: A indicative, survey-based case study methodology undertaken with Chinese customers informs this research. Findings: TRT's corporate heritage brand identity and, moreover, its imperial role identity were salient in terms of customer satisfaction. TRT's augmented imperial role identity not only was highly salient but also, moreover, meaningfully enhanced the organisation's corporate reputation in terms of customer satisfaction. Research limitations/implication: This study lends further support for the utility of the notion of corporate heritage/corporate heritage brands and in particular the saliency of the theoretical notion of augmented role identity within the corporate heritage marketing field. Practical implication: Corporate heritage brand managers should be appraised of which corporate role identities are meaningful for customers. At a practical level, senior corporate marketing managers of corporate heritage organisations should accorded importance to the additional P of Provenance apropos the corporate marketing mix. Social implication: At a time, when China is reappraising its relationship with its past - including its imperial past (of which much has been destroyed) - this paper's focus on TRT's unsurpassed augmented role identity is pertinent and propitious. Seemingly, this corporate heritage brand's imperial association provides a living and tangible link with China's long and momentous imperial provenance and erstwhile imperial polity. In short, the corporate heritage brand is part of China's patrimony and enjoys a unique place in this regard. Originality/value: This paper is one of the first empirical studies examining a Chinese corporate heritage brand entity. The study marks new ground in examining customer satisfaction from the theoretical perspectives of corporate heritage brand and augmented role identity. It is believed that this is the first study to consider corporate heritage in the pharmaceutical sector and marks new ground in considering the saliency of China's imperial legacy on an extant, highly successful and high profile-Chinese corporate heritage brand. [ABSTRACT FROM AUTHOR]

Adakitic rocks in continental settings are commonly considered to be formed by partial melting of thickened or delaminated lower crust. Investigations on this kind of rocks can provide important information about crustal evolution complementary to information from other rocks. This paper reports adakitic granodiorite of the Lingxi pluton in the interior of the Cathayisa Block. LA-ICP-MS zircon U-Pb dating shows that it was formed in the late Early Cretaceous (100±1 Ma). The granodiorite has geochemical features of adakitic rocks derived from partial melting of the thickened lower crust, e.g., high SiO (mainly ranging from 64.4 to 68.9 wt.%) and Sr (624-894 ppm) contents, Sr/Y (49.9-60.8) and La/Yb (23.4-42.8) values, low Y (10.3-17.1 ppm), Ni (5.62-11.8 ppm) and MgO (mostly from 0.86 wt.% to 1.57 wt.%) contents and weak Eu anomaly. It has initial Sr/Sr ratios of 0.7086-0.7091, ε ( t) values of −6.2 to −5.9 and zircon ε ( t) values mostly of −10.1 to −7.6. Based on the geochemical characteristics and simple modelling, it is suggested that the most likely generation mechanism of the Lingxi granodiorite is partial melting of a thickened Proterozoic lower continental crust at a pressure ≥12 kbar (or crust thickness ≥40 km), leaving a garnet-bearing amphibolite residue. Combining our results and previous studies of the tectonic evolution of the Cathaysia Block, we propose that the crust was thickened to over 40 km by a compressive event occurring during the late Early Cretaceous, which is supported by the observation that there is an angular unconformity between the Upper Cretaceous Series and the early Lower Cretaceous or the Jurassic rocks. After this event, the Cathaysia Block experienced a lithospheric extension and thinning probably driven by the high-angle paleo-Pacific subduction. With the attenuation of lithosphere, the lower crust was heated to partial melting by upwelling asthenospheric materials, resulting in generation of the Lingxi granodiorite and other coeval granitoids in the Cathaysia Block. This study provides new information on the crustal evolution of the Cathaysia Block during the Early Cretaceous. [ABSTRACT FROM AUTHOR]

Purpose This paper aims to examine the attractiveness of the Tong Ren Tang (TRT) as a Chinese corporate heritage tourism brand and consider the significance of TRT for Chinese national identity. The study considers the saliency of Balmer’s augmented role identity notion vis-à-vis corporate heritage institutions/corporate brands. Insights are made from and for corporate heritage, heritage tourism and national identity literature.Design/methodology/approach A conceptual model comprising five hypotheses was developed and this informed a survey-based questionnaire administered to domestic tourists/customers visiting Tong Ren Tang’s flagship shop in Beijing.Findings The attractiveness to domestic Chinese tourists/customers of the TRT corporate heritage tourism brand was found to be attributable to its multiple role identities: national, corporate, temporal, familial and imperial. As such, this study lends credence to Balmer’s augmented role identity notion. Chinese domestic tourists/customers – as members of an ethnic Chinese community – in visiting TRT not only consume an extant corporate heritage by tangible and intangible means but can also be seen to express, and reaffirm, their sense of Chinese national identity.Practical implications For TRT’s managers, there should be an appreciation that the attractiveness of TRT as a corporate heritage tourism brand rests not only on what it sells but also in what it symbolises in national and cultural terms. This finding is applicable to the managers of many other corporate heritage/corporate heritage tourism brands.Social implications Adopting a primordial perspective, the TRT pharmacy was found to be of singular significance to China’s national identity. Traditional Chinese Medicine, Confucian and Daoist religious/philosophical and China’s erstwhile Imperial polity are significant and enduring precepts of Chinese national identity. As such the TRT flagship shop/brand is of singular importance, as China has eviscerated much of its cultural heritage – particularly in relation to its corporate heritage brands.Originality/value This is the first empirical study to focus on corporate heritage tourism brands and one of the first studies to examine a Chinese corporate heritage/corporate heritage tourism brand. Also significant in focussing on the TRT corporate heritage brand. Established in 1669, TRT’s history spans five centuries: a corporate provenance which is exceptional within the People’s Republic of China. The study links the corporate brand notion with the nascent corporate heritage brand domain and the established area of heritage tourism. [ABSTRACT FROM AUTHOR]

The main contributions of this article include (i) the identification of different modes of brand development with five dimensions being identified: home-grown, corporate heritage, acquisition, association, joint-venture and alliance and (ii) the introduction of a distinct Chinese corporate brand total communications framework (consisting of six dimensions: primary, secondary, tertiary, family, guanxi and party (communist party) communications). This article identifies seven reasons why there has been a growth of interest in brands in China and also provides an overview of the main themes contained in the literature on China's brands and brand management in China. Taking a historical perspective, it examines the use and significance of brands in China and identifies similarities between the importance accorded to China and the situation that existed in Great Britain during the industrial revolution. It notes the factors that have led to the exponential growth of interest in brands in China. [ABSTRACT FROM AUTHOR]

This study breaks new ground because it (i): considers a non-western (Chinese) corporate heritage brand and (ii) for the first time within the corporate heritage brand/corporate heritage canon, adopts an explicit consumer perspective. Significantly - taking an overt corporate heritage/corporate heritage brand stance - this empirical study reveals why a corporate heritage brand such as Tong Ren Tang (TRT) - founded in 1669 - is highly meaningful to consumers from one generation to another. The researchers marshal the first four of Balmer's criteria of corporate heritage entities in order to verify their corporate heritage credentials and explain their attractiveness to customers. As such, it was found that TRT is meaningfully linked to the past, present and prospective future (Balmer's criterion of omni temporality); has durable and constant organisational traits (Balmer's criterion of institutional trait consistency); has customer and stakeholder faithfulness for a minimum of three generations (Balmer's criterion of tri-generational loyalty); and has acquired meaningful non-corporate role identities vis-à-vis Chinese national identity and China's imperial identity (Balmer's criterion of augmented role identities). TRT was found to be attractive to consumers owing to its core and augmented role identities following Balmer's 2013 augmented role identity theoretical perspective. These findings explain why TRT has endured and flourished from one generation to another and accounts for its celebrated status within China and the wider Chinese diaspora. [ABSTRACT FROM AUTHOR]

The Miaoershan uranium (U) ore field in northeastern Guangxi is one of the important granite-related U deposits in south China and is closely related to the Douzhashan U-bearing granite. The Douzhashan granite contains primary U-rich accessory minerals, including monazite (UO 2 = 0.98–1.75 wt%) and xenotime (UO 2 = 1.48–6.14 wt%). Primary monazite and xenotime yield chemical ages of 231 ± 28 Ma and 230 ± 38 Ma by electron microprobe analysis and U-Pb isotopic ages of 220±6 Ma and 211±7 Ma by laser ablation-inductively coupled-mass spectrometry respectively. These ages demonstrate that the Douzhashan granite formed during the period of Indosinian magmatic activity. Back scattered electron imaging shows that monazite and xenotime are commonly altered to assemblages of low-U synchisite and apatite, which was associated with loss of U to hydrothermal fluids. U-Th-Pb analyses of secondary apatite yielded a chemical age of 136 ± 17 Ma, which corresponds to the timing of Cretaceous-Tertiary crustal extension in south China. We suggest that the heat and CO 2 required for mineralization was the result of Yanshanian crustal extension, and that this triggered the breakdown of U-rich accessory minerals in the Douzhashan U-bearing granite. Uranium remobilization from the Douzhashan granite provided materials for mineralization within the granite and/or surrounding country rocks. Therefore, a combination of Indosinian compression and Yanshanian extensional overprint produced the hydrothermal U deposits associated with the Douzhashan granite. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to investigate the organisational changes (OCs) and the development of Chinese reformed township and village enterprises (RTVEs), their marketing and R&D strategies, and the impact of changes in terms of overall performance. Design/methodology/approach – A case study methodology involving semi-structured interviews is adopted. The unit chosen is the Guotai International Group (GTIG) in Zhangjiagang, Suzhou, Jiangsu province, China, in which the organisational changes over a period of over 40 years are analysed. Findings – OCs in Chinese RTVEs are found to be driven by a combination of local government plans and market forces. Considering the hybrid nature of the organisation and ownership structures, changes in Chinese RTVEs follow a very much "top-down" approach. Research limitations/implications – The findings imply that managers appointed by the state in RTVEs usually lack the necessary skills in marketing and business management, and can be resistant to organisational changes, such as the willingness to undertake risks. As a result, RTVEs may become stuck in a cycle of low-cost, low-tech products, inhibiting any breakthrough in developing their own quality brands. Originality/value – This is one of few papers studying change over a long span of time to arrive at research findings that will be useful to academic researchers in their future work. The qualitative findings from this paper would also enrich the literatures on organisational change in Chinese RTVEs. [ABSTRACT FROM AUTHOR]

This article sets out to investigate the critical factors of Knowledge Management (KM) which are considered to have an impact on the performance of Chinese information and communication technology (ICT) firms. This study confirms that the cultural environment of an enterprise is central to its success in the context of China. It shows that a collaborated, trusted, and learning environment within ICT firms will have a positive impact on their KM performance. [ABSTRACT FROM AUTHOR]

Damage to concrete structures with gypsum-contaminated aggregate occurs frequently. Aggregates in much of the southern part of China are contaminated with gypsum. Therefore, in this study, the effects of using different quantities of gypsum-contaminated aggregate on the expansion and compressive strength of concrete were investigated over a period of one year. Two groups of concrete were designed with the gypsum-contaminated aggregate containing different parts of fine and coarse aggregate, respectively. The SO3 contents were 0%, 0.5%, 1%, 1.5%, 3%, 5%, and 7% by weight of aggregate. X-ray diffraction (XRD), thermogravimetry (TG), and differential scanning calorimetry (DSC) were used to analyze the change in mineral composition over time. The microstructure was also studied by scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS). The results showed that significant expansion and great loss in compressive strength did not occur in concrete if the content of SO3 lay below 1.5% and 3% in fine and coarse aggregates, respectively. The concentration of sulfate ions in concrete was not enough to form new a phase of gypsum. During the process of internal sulfate attack, the content of gypsum decreased and the content of ettringite increased. Ettringite was the main reason for the expansion damage of concrete. Additionally, the fracture mode of internal sulfate attack on concrete was the crack extension from gypsum to paste; finally, the aggregate separated from the paste. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics such as corporate brand image and luxury goods branding in Chinese markets.

[Display omitted] • Two fluids were involved in the U mineralization process in the Shazhou U deposit. • These two fluids show distinct U content and Br/Cl, Rb/Na, K/Na, and Rb/Cs ratios. • The U-poor fluid was derived from mafic magma that formed mafic dikes in wall rocks. • The U-rich fluid was from basinal brines sourced from meteoric water. The volcanic-related type U mineralization in South China has been associated with the crustal extension occurred since the late Cretaceous. Uranium deposits of this type are spatially related to the Cretaceous red-bed basins and synchronous mafic magmatism. However, the contribution of basinal brines or mantle-derived fluids to the U mineralization is not well understood. This study examines the role of different hydrothermal fluids involved in the U mineralization process and traces their sources by using LA-ICP-MS analysis of fluid inclusions from the Shazhou deposit in the Xiangshan district, which is one of the largest volcanic-related type U ore-fields in the world. Two types of fluids were involved in the U mineralization process. One fluid was of higher salinity, enriched in U, Mo, and Cl, such that having low Br/Cl (0.3–1.0 × 10-3) similar to the basinal brines sourced from meteoric water. The other fluid was of lower salinity, enriched in Th and Sr, yet depleted in U and Mo, with Br/Cl ratios of 1.5–2.5 × 10-3, overlapping the range of mantle-derived fluids associated with the mafic dikes intruded into the felsic wall rocks at the U mineralization age. The high-U fluid and the low-U fluid also show distinct Rb/Na, K/Na, and Rb/Cs, indicating their respective origins of basinal brines and mantle-related fluids. The chemical variation of ore-forming fluids at the Shazhou deposit was comparable to the scenario at the Zoujiashan deposit, as reported in previous studies, suggesting similar fluid evolution history related to U mineralization in the west and the north of the Xiangshan U orefield. Our study suggests in situ analysis of Br/Cl of fluid inclusions can be a useful proxy to discriminate multiple hydrothermal fluids associated with volcanic-related type U mineralization in South China and to individually trace their origins. [ABSTRACT FROM AUTHOR]

[Display omitted] • In situ Sr-Nd isotopes of apatite are effective in tracing origins of ore forming fluids in the Shazhou U deposit. • The reducing U-poor fluid was derived from mantle-derived magma which formed the mafic dikes in wall rocks. • The oxidizing U-rich fluid originated from percolation of meteoric water in the adjacent red-bed basins. • The Late Cretaceous mafic magmatism and red-bed basins are two key factors controlling U mineralization in South China. The origin of ore-forming fluids of volcanic related U deposits remains controversial. This study reports in situ elemental and Sr-Nd isotopic compositions of apatite associated with U mineralization from the Shazhou volcanic related U deposit in South China, which provides a new perspective to constrain the origin and evolution of its ore-forming fluids. Hydrothermal apatites from the hematized rocks and U-mineralized rocks show distinct textures and chemical features, indicating two types of fluids involved in the U mineralization process. The hematitization fluid was oxidizing and enriched in U and Cl. A reducing fluid with lower Cl/F and U was introduced and mixed with the oxidizing hematitization fluid to cause U precipitation. Apatite from the hematized rocks has a lower 87Sr/86Sr (0.709246–0.714383) than that of apatite in U ore veins (0.710383–0.719318). The εNd(t) of apatite in the hematized rocks is from −7.6 to −9.4, whereas apatite in U ore veins has higher εNd(t) ranging from −1.2 to −8.4, close to that of mafic dikes intruded into the volcanic rocks. In situ Sr-Nd isotopes of apatite indicate the oxidizing fluid originated from the red-bed basins, whilst the origin of the reducing fluid was related to the mantle-derived mafic dikes. The reducing fluid has experienced assimilation by the metamorphic basement rocks to gain higher radiogenic strontium. This study demonstrates that in situ elemental and Sr-Nd isotopic compositions of apatite are effective in identifying different ore-forming hydrothermal fluids and constraining their origins and chemical evolution. [ABSTRACT FROM AUTHOR]

• Thirty-two chlorhexidine-tolerant isolates were detected from a total of 294 P. aeruginosa isolates collected from one of the largest comprehensive hospitals in China, accounting for a high rate of 10.9%. • Clinical data showed that reduced susceptibility to chlorhexidine was related to following factors: hospital length of stay, intensive care unit (ICU) admission, length of stay in ICU, invasive procedure, duration of mechanical ventilation, chlorhexidine usage, and occurrence of nosocomial pneumonia. • The hyperexpression of Mex-Opr efflux pump system was the main mechanism that lead to chlorhexidine tolerance. • Chlorhexidine usage or long-term exposure of P. aeruginosa to chlorhexidine could lead to the MDR or cross-resistance phenotypes of antimicrobial drugs. • Our study comprehensively investigates the development and molecular mechanisms of chlorhexidine-tolerant P. aeruginosa , which revealing that we should be aware of surveilling the chlorhexidine tolerance among P. aeruginosa and avoiding the continuous or unreasonable application of chlorhexidine in the hospital settings. Chlorhexidine is used widely to prevent the spread of bacteria in the hospital environment. However, bacteria are increasingly becoming tolerant to chlorhexidine. Here we investigated clinical characteristics, tolerance mechanisms, and molecular epidemiology of chlorhexidine-tolerant Pseudomonas aeruginosa. According to the proposed epidemiological cut-off value to determine chlorhexidine tolerance (50 µg/mL) in P. aeruginosa , 32 chlorhexidine-tolerant isolates were detected from 294 P. aeruginosa isolates, which accounted for 10.9%. Our results indicated MICs of chlorhexidine-tolerant strains were 64 µg/mL. Patient's data showed chlorhexidine tolerance was associated with following factors: hospital length of stay, ICU admission, length of stay in ICU, invasive procedure, duration of mechanical ventilation, chlorhexidine usage, and occurrence of nosocomial pneumonia. Tolerance mechanisms were analyzed by efflux pump inhibition test, qRT-PCR, and serial passage experiment. Increased expression of efflux pump genes mexA, mexC, mexE and mexX , and decreased expression of oprD were observed in chlorhexidine-tolerant and chlorhexidine-induced strains, which suggested that hyperexpression of Mex-Opr efflux pump was the main mechanism. Moreover, serial passage experiment found chlorhexidine-induced strains showed decreased susceptibility to tested antibiotics, which illustrated that long-term exposure of P. aeruginosa to chlorhexidine could result in multidrug-resistant (MDR) or cross-resistance phenotypes. MLST and PFGE analysis demonstrated the homology of 32 chlorhexidine-tolerant strains was low and no obvious clonal transmission was observed. We comprehensively investigated the development and molecular mechanisms of chlorhexidine-tolerant P. aeruginosa , which revealed that the control and surveillance of chlorhexidine tolerance should be more strict. Moreover, it seems to make sense to avoid the continuous or unreasonable application of chlorhexidine in hospital settings. [ABSTRACT FROM AUTHOR]

Despite the clear association between remnant cholesterol (RC)and diabetes risk, no study to date has examined the relationship between RC and reversal of prediabetes to normoglycemia. This retrospective cohort study included a total of 15,023 patients with prediabetes who underwent a physical examination between 2010 and 2016. The link between initial RC levels and the reversion from prediabetes to normoglycemia was analyzed using the Cox proportional-hazards regression model. Additionally, the study explored the possible relationship between RC and the probability of returning normoglycemia by applying Cox proportional hazards regression models with cubic spline functions. To address competing risks, a multivariate Cox regression analysis was undertaken, treating the onset of diabetes as a competing risk event for reversing prediabetes to normoglycemia. Additionally, the study incorporated extensive subgroup analyses alongside multiple sensitivity analyses, enhancing the reliability and robustness of the results. After adjusting for covariates, the findings indicated that RC was inversely associated with the likelihood of reverting to normoglycemia (per 5 mg/dL increase, HR = 0.918, 95% CI 0.909-0.927). The analysis also revealed a nonlinear relationship between RC and normoglycemia reversion, with an inflection point at 51.08 mg/dL. For RC values below this inflection point (RC < 50.08 mg/dL), the HR for the probability of returning to normoglycemia was 0.907 (95% CI 0.897-0.917 per 5 mg/dL). Additionally, the competing risks model demonstrated a negative relationship between RC and the reversal of prediabetes to normoglycemia (SHR = 0.92, 95% CI 0.91-0.93). Sensitivity analyses confirmed the robustness and stability of these results. This study demonstrated a negative and non-linear association between RC and the probability of reversion to normoglycemia in Chinese adults with prediabetes. By actively intervening to reduce RC levels, at least to below 51.08 mg/dL, further reduction of RC may significantly increase the probability of returning to normoglycemia from prediabetes., (© 2024. The Author(s).)

During bottom trawl surveys carried out between 20132021, 52 specimens (33.854.0 mm SL) of Egglestones bumblebee goby Egglestonichthys bombylios were collected at a depth of 1.515 m from Dongshan Bay, Sanmen Bay, and Niushan Island, China. They represent the first records of this species from China. A full description, including fresh colouration of the species is provided as it is poorly known. The individuals collected in China agree with most morphological features of the holotype, except for the pelvic fin fraenum that was not observed or appears to be absent in most specimens. A strong relationship between E. bombylios, Larsonella pumilus, and the genus Priolepis is herein demonstrated by the mitochondrial genome sequences of E. bombylios and twenty closely related species. This study enriches the existing genetic data of the so-called Priolepis lineage and provides useful insights into the phylogenetic relationships across species of the genera Egglestonichthys, Priolepis, and Larsonella.

Background: HL is the second most common congenital disability in China, and its high incidence brings a serious burden of medical and educational sequelae. HL genetic screening enables the identification of individuals with inherited HL and carriers in a large scale., Objective: This study aimed to measure the detection rates of hearing loss (HL)-associated gene mutations in the Gannan population. The molecular etiology and risk factors of hereditary HL were also analyzed., Methods: In total, 119,606 newborns from 18 districts of Gannan were enrolled in this multi-center study conducted between April 2019 and April 2021. Otoacoustic Emission (OAE) was used for primary hearing screening 3 days after birth in quiet conditions, and OAE combined with automated auditory brainstem response (AABR) was applied 29-42 days after birth for those who failed or missed the initial screening. Meanwhile, high-throughput sequencing of hotspot HL-associated mutations in GJB2, GJB3, MTRNR1, and SLC26A4 were performed., Results: Among the 119,606 newborns, 7796 (6.52%) failed the hearing screening. Genetic screening revealed that 5092 neonates (4.26%) carried HL-associated mutations. The detection rate of GJB2, SLC26A4, MTRNR1 and GJB3 mutations were 2.09%, 1.51%, 0.42% and 0.24%, respectively. The most prevalent variant was GJB2 c.235delC (1.74%). The second most prevalent variant was SLC26A4 c.919-2A > G (0.93%). The population who failed the hearing screening had a lower proportion (24.64%) of SLC26A4 gene variants compared to the population who passed (37.46%). Genetic screening identified 4612 (3.86%) carriers who were normal in hearing screenings. The concurrent hearing and genetic screening identified 480 (0.40%) neonates at high risk for hereditary HL., Conclusions: The results of this study suggest that the concurrent hearing screening and high-throughput genetic screening would greatly improve the effectiveness of newborn HL programs. This integration also facilitates the management of congenital HL, and aids in the prevention of aminoglycoside antibiotics-induced HL., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Phenylalanine hydroxylase deficiency (PAHD) is the most prevalent inherited disorder of amino acid metabolism in China. Its complex phenotype includes many variants and genotypes among different populations., Methods and Results: In this study, we analyzed the phenylalanine hydroxylase gene (PAH) variants in a cohort of 93 PAHD patients from Fujian Province. We also assessed genotype and phenotype correlation in patients with PAHD. A total of 44 different pathogenic variants were identified, including five novel variants. The three most prevalent variants among all patents were c.158G > A, p.(Arg53His) (18.03%), c.721C > T, p.(Arg241Cys) (14.75%), and c.728G > A, p.(Arg243Gln) (7.65%). The frequency of the c.158G > A, p.(Arg53His) variant was highest in patients with mild hyperphenylalaninemia, whereas the frequency of the c.1197A > T, p.(Val399 =) and c.331C > T, p.(Arg111Ter) variants was highest in patients with classic phenylketonuria. The most abundant genotypes observed in PAHD patients were c.[158G > A];[728G > A], c.[158G > A];[442-1G > A], and c.[158G > A];[721C > T]. Comparing allelic phenotype to genotypic phenotype values yielded fairly accurate predictions of phenotype, with an overall consistency rate was 85.71% for PAHD patients., Conclusions: Our study identified a PAH variant spectrum in PAHD patients from Fujian Province, Southeastern China. Quantitative correlation analysis between genotype and phenotype severity is helpful for genetic counseling and management., (© 2022. The Author(s).)

BACKGROUND The Gab1 gene has an important role in cell proliferation in meningioma via various signaling pathways. However, the relationship between polymorphisms of the Gab1 gene and meningioma remains unknown. In this study, we aimed to investigate the plausible association of single-nucleotide polymorphisms (SNPs) of the Gab1 gene and meningioma risk in a northern Chinese Han population. MATERIAL AND METHODS This case-control study included 205 patients with meningioma and 297 healthy controls. Four loci of the Gab1 gene were genotyped using the multiplex snapshot technique. The odds ratio (OR) and 95% confidence interval (CI) were calculated by chi-squared and logistic regression analysis. The distributions of Gab1 SNP genotypes and allele frequencies were compared between patients with meningioma and healthy controls and among patients stratified by clinical phenotypes. RESULTS The allelic frequency distributions of G at rs3805236 and C at rs1397529 were significantly higher in patients with meningioma than in healthy controls. The frequency of the rs3805236-GG and rs1397529-AC genotypes were significantly higher in patients with meningioma than in controls. Furthermore, there was a statistically significant difference between the genotypes of patients versus healthy individuals at rs1397529, according to stratification by dural invasion. The allelic frequency distributions of alleles or genotypes at rs3805246 and rs3828512 were not different in patients with meningioma and healthy controls. CONCLUSIONS The Gab1 gene rs3805236A>G and rs1397529A>C SNPs increased the risk of meningioma in the northern Chinese Han population. Furthermore, rs1397529A>C may be related to enhanced dural invasion in patients with meningioma.

Objective: The topical antispasmodic agent l-menthol is commonly used for gastric peristalsis suppression during diagnostic upper gastrointestinal (GI) endoscopy. We evaluated the efficacy and safety of a single dose l-menthol solution in suppressing gastric peristalsis during upper GI endoscopy in Chinese patients., Methods: In this phase III, multicenter, randomized, double-blind, placebo-controlled study (ClinicalTrials.gov: NCT03263910), 220 patients scheduled to undergo upper GI endoscopy at five Chinese referral centers received a single dose of either 160 mg of l-menthol (n = 109) or placebo (n = 111). Both treatments were sprayed endoscopically on the gastric mucosa. An independent committee evaluated the degree of gastric peristalsis (peristaltic score: grade 1-5)., Results: At baseline, the proportion of patients with grade 1 peristalsis (no peristalsis) did not differ between the groups. The proportion of patients with grade 1 peristalsis post-treatment was significantly higher in the l-menthol group (40.37%, 44/109) versus the placebo group (16.22%, 18/111; P < 0.001); the difference between the groups was 24.15% (95% confidence interval: 12.67%-35.63%; P < 0.001). In the l-menthol group, 61.47% of patients had grade 1 peristalsis after endoscopy versus 24.55% in the placebo group (P < 0.001). The ease of intragastric examination correlated significantly with the grade of peristalsis. The incidence of adverse events was comparable between the groups (P = 0.340)., Conclusions: During upper GI endoscopy, a single dose of l-menthol solution (160 mg) sprayed on the gastric mucosa significantly attenuated gastric peristalsis versus placebo, thereby improving the visual stability without any safety concerns., (© 2021 The Authors. Digestive Endoscopy published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)

Background & Aims: Peroral endoscopic myotomy (POEM) is a minimally invasive endoscopic surgical procedure that is effective in treatment for spastic esophageal motility disorders. However, little is known about the learning curve for endoscopists. We aimed to evaluate the effects of various factors on the POEM learning curve., Methods: We performed a retrospective study of 1346 patients who underwent POEM for achalasia at Shanghai Zhongshan Hospital in China from August 2010 through July 2015. We used risk-adjusted cumulative sum and moving average methods to evaluate outcomes. The primary outcome was a composite of technical failure and adverse events. Secondary outcomes included procedure time and the composite outcome of technical failure, adverse events, and clinical failure of the first 192 cases performed by only the original, training surgeon., Results: The primary composite outcome occurred in 54 (4%) of the 1346 patients: 10 technical failures and 44 adverse events. This composite outcome was independently associated with the case number (P = .010), full-thickness myotomy (P = .002), and procedure time (P = .001). After we adjusted for these risk factors, cumulative sum analysis showed that the primary composite outcome decreased gradually after 100 cases. The procedure time was high during the first few cases and decreased after endoscopists performed 70 cases. The secondary composite outcome of technical failure, adverse events, and clinical failure for the 192 cases performed by only the original surgeon gradually decreased after 90-100 cases., Conclusions: In a retrospective analysis of POEM procedures, we found that 100 cases were required to decrease the risk of technical failure, adverse events, and clinical failure (the learning curve). Seventy cases can be considered the threshold for decreasing procedure time., (Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.)