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BACKGROUND: This study aimed to establish an effective nomogram to predict the survival of heat stroke (HS) based on risk factors. METHODS: This was a retrospective, observational multicenter cohort study. We analyzed patients diagnosed with HS, who were treated between May 1 and September 30, 2018 at 15 tertiary hospitals from 11 cities in Northern China. RESULTS: Among the 175 patients, 32 patients (18.29%) died before hospital discharge. After the univariate analysis, mechanical ventilation, initial mean arterial pressure <70 mmHg, maximum heart rate, lab results on day 1 (white blood cell count, alanine aminotransferase, creatinine), and Glasgow admission prediction score were included in multivariate analysis. Multivariate Cox regression showed that invasive ventilation, initial mean arterial pressure <70 mmHg (1 mmHg=0.133 kPa), and Glasgow admission prediction score were independent risk factors for HS. The nomogram was established for predicting 7-d and 14-d survival in the training cohort. The nomogram exhibited a concordance index (C-index) of 0.880 (95% confidence interval [95% CI] 0.831-0.930) by bootstrapping validation (B=1,000). Furthermore, the nomogram performed better when predicting 14-d survival, compared to 7-d survival. The prognostic index cut-off value was set at 2.085, according to the operating characteristic curve for overall survival prediction. The model showed good calibration ability in the internal and external validation datasets. CONCLUSION: A novel nomogram, integrated with prognostic factors, was proposed; it was highly predictive of the survival in HS patients. [ABSTRACT FROM AUTHOR]

The establishment of Xiong'an New Area in Hebei Province has gained immense attention from the whole scientific community. The Daqing River Basin (DRB), where the New Area is located, has become a new focus of hydrological scientists. The vegetation cover plays a key role in hydrological and biogeochemical cycles, serving as a reference to understand the ecological environment and water circulation status of the watershed. To analyse the current situation of climate and vegetation changes in the DRB, kriging interpolation, moving average, trend analysis of Theil-Sen median, and Mann-Kendall statistical test were used based on groundbased observation data and Moderate-resolution Imaging Spectroradiometer (MODIS) normalized difference vegetation index (NDVI) data. The annual mean values of NDVI showed a significant upward trend from 2000 to 2015. The fluctuations in seasonal NDVI values followed this trend correspondingly to various extents. The variations in NDVI value positively correlated with those in temperature, both on the annual scale and during summer seasons (P = 0.05). A large improvement in the vegetation cover of DRB was observed (54.21% of the areas), mainly distributed in the northeast of Mountainous Areas of Daqing River Basin and West Plain of Baiyangdian Lake. The findings might be helpful to understand the water and energy flux cycling in the changing environment of this region, providing guiding information on river basin management and the planning and construction of New Area. [ABSTRACT FROM AUTHOR]

Poria cocos is an edible medicinal fungus known as "Fuling" in Chinese and has been used as a Chinese traditional medicine for more than two thousand years. Pharmacological studies reveal that polysaccharide is the most abundant substance in Poria cocos and has a wide range of biological activities including antitumour, immunomodulation, anti‐inflammation, antioxidation, anti‐ageing, antihepatitis, antidiabetics and anti‐haemorrhagic fever effects. As a result, "Poria cocos polysaccharide oral solution" was developed and sold as an over‐the‐counter health supplement since 1970s. In 2015, "Polysaccharidum of Poria cocos oral solution" was approved as a drug by Chinese Food and Drug Administration for treating multiple types of cancers, hepatitis and other diseases alone or during chemo‐ or radiation therapy for patients with cancer. In this article, biochemical, preclinical and clinical studies of Poria cocos polysaccharide from 72 independent studies during the past 46 years (1970‐2016) based on PubMed, VIP (Chongqing VIP Chinese Scientific Journals Database), CNKI (China National Knowledge Infrastructure) and Wanfang database searches are summarized. The structure, pharmacological effects, clinical efficacy, immunobalancing molecular mechanism and toxicity of Poria cocos polysaccharide are deliberated to provide a general picture of Poria cocos polysaccharide as a clinically used antitumour drug. [ABSTRACT FROM AUTHOR]

Drought over Southwest China occurs frequently and has an obvious seasonal characteristic. Proper management of regional droughts requires knowledge of the expected frequency or probability of specific climate information. This study utilized k-means classification and copulas to demonstrate the regional drought occurrence probability and return period based on trivariate drought properties, i.e., drought duration, severity, and peak. A drought event in this study was defined when 3-month Standardized Precipitation Evapotranspiration Index (SPEI) was less than −0.99 according to the regional climate characteristic. Then, the next step was to classify the region into six clusters by k-means method based on annual and seasonal precipitation and temperature and to establish marginal probabilistic distributions for each drought property in each sub-region. Several copula types were selected to test the best fit distribution, and Student t copula was recognized as the best one to integrate drought duration, severity, and peak. The results indicated that a proper classification was important for a regional drought frequency analysis, and copulas were useful tools in exploring the associations of the correlated drought variables and analyzing drought frequency. Student t copula was a robust and proper function for drought joint probability and return period analysis, which is important for analyzing and predicting the regional drought risks. [ABSTRACT FROM AUTHOR]

Background: Patient safety culture is an important measure in assessing the quality of health care. There is a growing recognition of the need to establish a culture of hospital focused on patient safety. This study explores the attitudes and perceptions of patient safety culture for health care workers in China by using a Hospital Survey on Patient Safety Culture (HSPSC) questionnaire and comparing it with the psychometric properties of an adapted translation of the HSPSC in Chinese hospitals with that of the US. Method: We used the modified HSPSC questionnaire to measure 10 dimensions of patient safety culture from 32 hospitals in 15 cities all across China. The questionnaire included 1160 Chinese health-care workers who consisted of predominately internal physicians and nurses. We used SPSS 17.0 and Microsoft Excel 2007 to conduct the statistical analysis on survey data including descriptive statistics and validity and reliability of survey. All data was input and checked by two investigators independently.Result: A total of 1500 questionnaires were distributed of which 1160 were responded validly (response rate 77%). The positive response rate for each item ranged from 36% to 89%. The positive response rate on 5 dimensions (Teamwork Within Units, Organization Learning-Continuous Improvement, Communication Openness, Non-punitive Response and Teamwork Across Units) was higher than that of AHRQ data (P < 0.05). There was a statistical difference on the perception of patient safety culture in groups of different work units, positions and qualification levels. The internal consistency of the total survey was comparatively satisfied (Cronbach's α = 0.84). Conclusion: The results show that amongst the health care workers surveyed in China there was a positive attitude towards the patient safety culture within their organizations. The differences between China and the US in patient safety culture suggests that cultural uniqueness should be taken into consideration whenever safety culture measurement tools are applied in different culture settings. [ABSTRACT FROM AUTHOR]

[Display omitted] • This study examines the neuroprotective effects of Polyphyllin VI (PPVI) in Parkinson's disease (PD). • PPVI demonstrates improved cell viability and morphology in an in vitro PD model. • PPVI effectively attenuates oxidative stress and maintains mitochondrial function. • The neuroprotective potential of PPVI may involve FOXO3α, CREB1, and DJ-1 signaling pathways. A substantial body of evidence is drawing connections between Parkinson's disease (PD) and the phenomena of oxidative stress and mitochondrial dysfunction. Polyphyllin VI (PPVI), an active compound found in Rhizoma Paridis-commonly known as Chonglou (CL) in China, has been identified for its various pharmacological properties, including anti-tumor and anti-inflammatory effects. In the present study, an in vitro model of PD was established by treating SH-SY5Y cells with rotenone (ROT), to evaluate the potential neuroprotective effects of polyphyllin VI and its underlying mechanism. SH-SY5Y cells were treated with ROT to establish an in vitro model of PD. The effects of polyphyllin VI on cell viability were assessed using the resazurin assay. Cell morphology was examined using a microscope. The YO-PRO-1/PI was used to detect apoptosis. Mito-Tracker Red CMXRos, Mito-Tracker Green, and JC-1 were used to detect the effects of polyphyllin Ⅵ on mitochondrial viability, morphology, and function. Oxidative stress-related marker detection kits were used to identify the effects of polyphyllin VI on oxidative stress. Western blot analysis was employed to investigate the signaling pathways associated with neuroprotection. PPVI increased ROT-induced SH-SY5Y cell viability and improved ROT-induced cellular morphological changes. PPVI ameliorated ROT-induced oxidative stress status, and attenuated mitochondrial function and morphological changes. PPVI may exert neuroprotective effects through FOXO3α/CREB1/DJ-1-related signaling pathways. These preliminary findings suggested that PPVI possesses neuroprotective attributes in vitro , and it may be a potential candidate for PD treatment. However, extensive research is necessary to fully understand the mechanisms of PPVI and its effectiveness both in vitro and in vivo. [ABSTRACT FROM AUTHOR]

The impact of climate change on rice yield in China remains highly uncertain. We examined the impact of the change of maximum temperature ( T max ) and minimum temperature ( T min ) on rice yields in southern China from 1967 to 2007. The rice yields were simulated by using the DSSAT3.5 (Decision Support System for Agro-technology Transfer)-Rice model. The change of T max and T min in rice growing seasons and simulated rice yields as well as their correlations were analyzed. The simulated yields of middle rice and early rice had a decreasing trend, but late rice yields showed a weak rise trend. There was significant negative correlation between T max and the early rice yields, as well as the late rice yields in most stations, but non-significant negative correlation for the middle rice yields. An obviously negative relationship was found between T min and the early and middle rice yields, and a significant positive relationship was found between T min and the late rice yields. It indicated that under the recent climate warming, the increased T max brought strong negative impacts on early rice yields and late rice yields, but a weak negative impact on the middle rice yields; the increased T min had a strong negative impact on the middle rice yields and the early rice yields, but a significant positive impact on the late rice yields. It suggested that it is necessary to adjust rice planting date and adapt to higher T min . [ABSTRACT FROM AUTHOR]

Purpose: Lentinan is a polysaccharide extracted from Shiitake mushrooms that have been used to improve general health for thousands of years in Asia. Lentinan injection is a clinically approved drug in several countries in Asia. The purpose of this study is to review the structure, preclinical and clinical studies, and molecular mechanisms of lentinan. Most importantly, the clinical effectiveness of lentinan as an adjuvant therapeutic drug in treating patients with lung cancer in China during the past 12 years is analyzed statistically., Methods: We carried out literature search of randomized controlled trials (RCTs) published from 2004 to 2016 based on CNKI (China National Knowledge Infrastructure), VIP (Chongqing VIP Chinese Scientific Journals Database) and Wanfang database, and 38 eligible RCTs of lentinan-associated lung cancer treatment were identified, containing 3,117 patients., Results: The structure and function relationship and underlying molecular mechanism of lentinan as an immunostimulant has been summarized. The mean value of overall response rate in treating lung cancer was increased from 43.3% of chemotherapy alone to 56.9% of lentinan plus chemotherapy [p < 0.001, 95% confidence interval (CI) 0.102-0.170]. Compared with chemotherapy alone, lentinan plus chemotherapy showed more efficacy in treating lung cancer (pooled RR 0.79, 95% CI 0.74-0.85) and no statistical heterogeneity was found among studies (I 2  = 11%)., Conclusion: Clinical data presented in the past 12 years shows that lentinan is effective not only in improving quality of life, but also in promoting the efficacy of chemotherapy during lung cancer treatment.

Grifola frondosa, a species of Basidiomycotina, is an edible medicinal mushroom with a large fruiting body characterized by overlapping caps. The β-glucan is the major biologically active component in G. frondosa polysaccharide (GFP) or D-fraction, which has been studied extensively for nearly 30 years. GFP was approved as an adjunctive therapeutic drug in China for treating cancers in 2010. In this article, based on the search results of Chinese VIP, CNKI, and Wanfang databases, 105 independent animal studies were summarized. The chemical structure, the antitumor, immunomodulatory, anti-diabetic, anti-hyperlipidemia, and antiviral activities and molecular mechanisms of GFP are reviewed and discussed.

Ganoderma sinense or "Chinese Lingzhi" is a well-known medicinal fungus in China for more than 2000 years. Polysaccharide is the main immunomodulatory and antitumor component in G. sinense. In 2010, G. sinense polysaccharide (GSP) tablet is approved as an adjunctive therapeutic drug in China for treating leukopenia and hematopoietic injury caused by concurrent chemo/radiation therapy during cancer treatment by the State Food and Drug Administration (SFDA). β-glucan, an established immunostimulant, is one of the components in GSP. Based on CNKI (China National Knowledge Infrastructure), VIP (Chongqing VIP Chinese Scientific Journals Database), Wanfang database, and PubMed searches, we have not only summarized but also translated all the basic and preclinical studies about GSP published in Chinese into English in this review article. Unfortunately, all the clinical studies about GSP tablet could not be found during the search or by contacting the drug manufacturers. However, both basic and preclinical studies showed that GSP has antitumor, antioxidant, anticytopenia, and unique mushroom-poison detoxification properties that are different from that of G. lucidum polysaccharide, another "Lingzhi" polysaccharide. The structure and molecular mechanisms of GSP are also discussed. This article urges availability of clinical study results of GSP tablet that would allow in-depth evaluation if the tablet is appropriate to serve as an immunomodulatory drug during cancer therapy at world stage., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

This study assessed the true accuracy of follicular output rate (FORT) as a prognostic indicator of response to FSH and reproductive competence after IVF/intracytoplasmic sperm injection. A total of 1643 cycles, including 140 polycystic ovary syndrome (PCOS) patients who underwent ovarian stimulation, were studied. FORT was calculated as the ratio of preovulatory follicle count on the day of stimulation×100/small antral follicle count (3-10mm in diameter) at baseline. Low, medium and high FORT groups were defined according to tertile values. Among 1503 non-PCOS cycles, numbers of retrieved oocytes and of all embryos that could be transferred, as well as rates of good-quality embryos, embryo implantations and clinical pregnancies, progressively increased with FORT. In PCOS patients, FORT were significantly lower in patients who achieved clinical pregnancy compared with those who did not (0.56±0.21 versus 0.66±0.29, P=0.031). Fertilization and good-quality embryo rates were significantly higher with medium FORT than low and high FORT (P=0.001 and P=0.047, respectively). Medium FORT in PCOS patients and high FORT in non-PCOS patients may predict better outcomes for IVF/ICSI., (Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)

Evidence indicates that CYP11alpha is a positional and functional candidate for genetic study in polycystic ovarian syndrome (PCOS). In the present study, we have evaluated the association between the CYP11alpha promoter pentannucleotide (tttta)n polymorphism and PCOS among Han Chinese women. Subjects include 125 patients with PCOS and 121 healthy controls, and all were Han Chinese women. Clinical characteristics of patients with PCOS and control subjects were examined according to the Rotterdam consensus criteria. The CYP11alpha promoter pentannucleotide (tttta)n polymorphism was genotyped with PCR and fluorescent capillary electrophoresis protocol. Results indicate that common alleles of the CYP11alpha promoter pentannucleotide (tttta)n polymorphism in this population of Han Chinese women were P4, P6 and P8, and allele P6 was the most common one. Frequencies of those three common alleles between PCOS cases and controls (24.8, 65.6, 6.8% and 23.6, 65.7, 9.9%, respectively) were similar. No significant allelic association of this polymorphism with PCOS was found. However, the carriers with allele P6 among patients with PCOS had increased WHR (0.85+/-0.05 vs 0.82+/-0.08, P=0.039) and decreased AUCG (9.5+/-2.1 vs 11.4+/-2.8, P=0.021) compared to the patients carrying other alleles. Therefore, the most common allele of the CYP11alpha promoter pentannucleotide (tttta)n polymorphism in the population of Han Chinese women is P6, while the most common allele in European Caucasians, as previously reported, is P4. This polymorphism is an ethnic and racial variant, and may have the risk susceptibility in abnormal metabolism of patients with PCOS in Han Chinese women.

Objective: To investigate whether the single nucleotide polymorphisms (SNPs) in the gene of megsin, a novel serine protease inhibitor, account for the pathogenicity of IgA nephropathy (IgAN)., Methods: A comprehensive megsin gene survey, including the entire coding region, part of the regulatory region, and exon-intron connection region, was performed by PCR-direct sequencing on the DNA samples of peripheral blood from 12 randomly selected IgAN patients and 12 randomly selected healthy persons. Eight SNPs with moderate or high frequencies (with the frequency > 5%) selected from the 11 SNPs found were used as candidate SNPs. Then 210 IgAN patients proven by renal-biopsy, all of Chinese Han nationality, and 103 normal volunteers were recruited. The 8 candidate SNPs were genotyped by direct sequencing or PCR-RFLP and a case-control association study was carried out., Results: The SNP of 267G/A in 5'untranslated region within exon1 was significantly associated with IgAN. The frequency of AG/AA genotype of the IgA patients was 29.0%, significantly higher than that of the controls (16.5%, P < 0.05). The frequency of A allele of the IgA patients was 14.8%, significantly higher than that of the controls (8.7%, P < 0.05). The odds ratio of AG/AA genotype versus GG genotype was 2.07 with the 95% confidence interval of 1.15 - 3.74. The linkage disequilibrium between two SNPs existed commonly within one gene., Conclusion: 267G/A in megsin gene is associated with IgAN susceptibility. AG and AA genotypes are the risk factors of pathogenesis of IgAN.