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Topographic variables derived from digital elevation models (DEM) are the most commonly used predictor in soil organic carbon (SOC) prediction. The predictability of these variates for the spatial heterogenity of SOC is influenced by the size of DEM resolution. This paper aimed to investigate the resolution effect of the topography at multiple DEM resolutions and select the most important predictors and the optimal resolution for SOC prediction in a large-scale and morphologically complex area. The study area, covering 15 600 km2, was located in a mountainous province in China. A total of 3901 soil samples and three machine learning algorithms including random forest, gradient boosted regression tree, and artificial neural network were used to construct the SOC predictive models at resolutions of 30, 90, 150, 210, 270, 330, and 390 m. Topographic factors were derived from the DEM with an original resolution of 30 m and were subsequently resampled to varying resolutions by using the bilinear interpolation algorithm. The importance of each variate in each predictive model was computed for the most important predictor selection, and the determination coefficient (R2) and Root Mean Square Error (RMSE) of each predictive model were computed for the accuracy evaluation. Comparative analysis on point-based topographic representation, the accuracy of predictive models, and the variable importance was conducted among different resolutions to investigate the resolution effect on the SOC prediction and to select the optimal resolution for this study area. The results showed that topography was the key factor influencing the SOC distribution in this large-scale area due to the region's mountainous nature, and the relative contribution of the topography to predict SOC distribution varied with DEM resolutions. Elevation was the most important topographic factor at all DEM resolutions. Accuracies of predictive models built on the three machine learning algorithms were all dependent on DEM resolution, indicating that DEM resolution had an important effect on SOC prediction. Overall, the random forest predictive models outperformed the other two algorithms, and its most accurate result was obtained at the 210-m resolution with an R2 of 0.25 and an RMSE of 4.77 g kg–1. In conclusion, we found that finer resolutions did not necessarily produce more accurate SOC predictions even in a large-scale and morphologically complex area. Therefore, investigating the resolution effect is suggested to select an optimal resolution for the SOC prediction in other regions characterized by similar geomorphological conditions as this study area. [ABSTRACT FROM AUTHOR]

The origin of dolostones from the Lei 4 Member (T2l4) of the Middle Triassic Leikoupo Formation in the Western Sichuan Depression is unclear. The occurrence and genetic evolution of dolostones in T2l4 were analysed by polarised thin-sections and cathodoluminescence, major- and trace-element, scanning electron microscope, and carbon, oxygen and strontium isotope analyses. The study results are summarised as follows. (1) The dolostones were mainly precipitated in three stages of <40 °C, 40–60 °C and 60–80 °C, corresponding with three paleodepth ranges of 167–300 m, 433–1000 m and 1067–1433 m. The micritic dolostones and the fabric-retentive dolostones (algal dolostone, granular dolostone) mainly formed in a near-surface–shallow-burial environment, and the crystalline dolostones were mainly formed under intermediate burial conditions. (2) 87Sr/86Sr ratios are equivalent to that of the Middle Triassic seawater, Sr/Ba and V/Ni ratios >1, Na notably higher than that in coexisting limestones of T2l4, and the dolostones always coexist with evaporative minerals such as gypsum, indicating that dolomitisation fluids mainly originated from evaporative concentrated seawater. (3) The dolostones mainly inherit materials from precursor limestones based on trace-element distribution patterns, and carbon and oxygen isotope values that are consistent with coexisting limestones of T2l4. (4) Mediated by micro-organisms during the syngenetic period, micritic dolostones and some algal dolostones were formed by replacing aragonites and calcites. During shallow burial, concentrated seawater rich in Mg2+ from the supratidal–intertidal zone flowed downward owing to gravity along the platform and replaced the underlying carbonate rocks, promoting continuous growth of the early dolomites. In the intermediate burial period, the Mg2+-depleted dolomitisation fluid caused the early micritic and silt-crystalline dolostones to recrystallise into silt- or fine-crystalline dolostones with larger crystals and altered the fabric-retentive dolostones into crystalline dolostones. (5) The evaporative dolostones deposited in the near-surface environment are characterised by maximal enrichment of Fe, Sr and Na, the highest δ18O values, the lowest order degree and the highest Ca/Mg ratios. The reflux dolostones formed in a shallow-burial environment characterised by the lowest Fe, medium δ18O values and the lowest order degree. The burial dolostones that developed in the intermediate burial environment are characterised by relative enrichment of Fe and Mn, minimal Na, the lowest δ18O values, the highest order degree and medium Ca/Mg ratios. The fabric-retentive dolostones mainly formed in a near-surface–shallow-burial environment, and the crystalline dolostones mainly formed under intermediate burial conditions. Dolomitisation fluids mainly originated from the evaporative concentrated seawater, and the dolostones inherit materials from the precursor limestones. Micritic dolostones were formed by evaporative dolomitisation; algal dolostone and granular dolostone were formed by evaporative dolomitisation and reflux dolomitisation; and silt-crystalline dolostone were formed by reflux dolomitisation and burial dolomitisation. [ABSTRACT FROM AUTHOR]

Arsenic (As), Cadmium (Cd), Chromium (Cr), Copper (Cu), Lead (Pb), and Zinc (Zn) concentrations in Manila clam from Liaodong Bay (China) were determined by inductively coupled plasma mass spectrometry. Tissue-specific bioaccumulation, geographical variability (using metal pollution indices) and health risks (using target hazard quotients and maximum daily consumption values) were assessed. Cd concentrations were high at all sampling sites, particularly S6 and S7, where it reached Category III. Other metal concentrations were high at S7 (As), S1 (Cr), S5 (Pb), and S5 and S7 (Zn). As, Cr and Cu accumulated to a higher degree in the viscera than muscles, but Cd accumulated more in muscles than viscera. Heavy metal (HM) contamination was worse in the west than that in the east. The Cd target hazard quotients were greater than 1, but the other HM target hazard quotients were less than 1 at all sites, indicating Cd posed the greatest health risks to humans. The maximum daily consumption values also indicated Cd poses health risks. [ABSTRACT FROM AUTHOR]

Sensitivity to azoxystrobin and kresoxim-methyl of 80 single-spore isolates of Magnaporthe oryzae was determined. The EC50 values for azoxystrobin and kresoxim-methyl in inhibiting mycelial growth of the 80 M. oryzae isolates were 0.006-0.056 and 0.024-0.287 µg mL−1, respectively. The EC50 values for azoxystrobin and kresoxim-methyl in inhibiting conidial germination of the M. oryzae populations were 0.004-0.051 and 0.012-0.105 µg mL−1, respectively. There was significant difference in sensitivity to azoxystrobin or kresoxim-methyl between the tested isolates representing differential sensitivity to carbendazim ( MBC) and kitazin P ( IBP); however, there was no correlation between this difference in sensitivity to azoxystrobin or kresoxim-methyl and sensitivity to MBC or IBP, indicating that there was no cross-resistance between azoxystrobin or kresoxim-methyl and MBC or IBP. In the protective and curative experiments, kresoxim-methyl exhibited higher protective and curative activity than azoxystrobin when applied at 150 and 250 µg mL−1 accordingly, while azoxystrobin exhibited stronger inhibitory activity against M. oryzae isolates than that of kresoxim-methyl in the in vitro test. The results of field experiments also suggested that both azoxystrobin and kresoxim-methyl at 187.5 g.a.i. ha−1 gave over 73% control efficacy in both sites, exhibiting excellent activity against rice blast. Taken together, azoxystrobin and kresoxim-methyl could be a good substitute for MBC or IBP for controlling rice blast in China, but should be carefully used as they were both at-risk. [ABSTRACT FROM AUTHOR]

Summary: Systemic treatment with strontium ranelate (SR) was performed on ovariectomized (OVX) rats with fractured tibiae. Callus quality was assessed by radiographic, histological, micro-computerized tomography, and biomechanical examinations at 4 and 8 weeks after fracture. Results revealed that systemic applied SR promoted osteoporotic fracture healing. Introduction: Several studies have demonstrated the dual effect of SR on osteoporotic and undisturbed bone. However, reports of their effect on osteoporotic fracture healing are limited. This study was designed to investigate the effects of SR on bone regeneration in OVX rats with fractured tibiae. Methods: Three months after being OVX, female Sprague-Dawley rats accepted bilateral osteotomy on proximal tibiae fixed with intramedullary wires and were divided into two groups: OVX and OVX + SR (625 mg/kg/day). Callus quality was evaluated at 4 and 8 weeks postfracture. Results: Compared with OVX group, SR treatment significantly increased bone formation, BMD, biomechanical strength, and improved microstructural properties of the callus. The ultimate load was increased by 211.0% and 61.4% ( p < 0.01), and the total bone volume of callus by 74.8% and 79.3% ( p < 0.01) at 4 and 8 weeks postfracture, respectively. SR treatment also promoted healing progress with increased osteogenesis at 4 weeks; more mature and tightly arranged woven or lamellar bone at 8 weeks across the fracture gap in histological analysis. Conclusion: This study suggests that systemic treatment with strontium ranelate could promote tibial fracture healing in OVX rats. [ABSTRACT FROM AUTHOR]

The dominant part of PBDEs residue in pig tissues was BDE-47 accounted for 48.2% ~ 66.9%, followed by BDE-99 from 15.9% to 24.2%. When the data were on lipid weight basis, the ∑PBDEs concentrations in tissues of individual pig showed the same order of liver > muscle, intestine > fat. Principal component analysis and PBDE congener mean concentration ratios of muscle versus liver (M/L), fat versus liver (F/L) and intestine versus liver (I/L) showed the higher accumulation ability of PBDEs in liver than in other tissues. And the PBDE mean concentration ratios of M/L, F/L and I/L had the trend of decrease with increasing bromination degree of PBDE congeners. [ABSTRACT FROM AUTHOR]

37 PBDE congeners were analyzed at six different depths in two soil cores taken from a typical electronic waste polluted area in South China. The PBDEs were congregated in the surface layer (0–5 cm) of soil cores and were 29 times in MK and 18 times in NW higher than the second lower layers (5–10 cm). As a whole, the concentrations of PBDEs were decreased with the soil depth increased in two cores. Lower brominated PBDE had higher penetrability than the deca-BDE in soil. The deca-BDE could be detected in deeper soil layers (15–20 cm in MK and 20–30 cm in NW) and the percentage of deca-BDE decreased with the increase of depth. [ABSTRACT FROM AUTHOR]

The Eastern Qinling region, located in the southern margin of the North China Craton, is characterised by widespread granitoid intrusions. Precise geochronological constraints on the age and timing of these intrusions are lacking. In this paper, we report SHRIMP zircon U-Pb ages of 12 representative granitoid plutons, together with one syenite stock, dolerite, diorite and granitic dykes in Eastern Qinling. The results revealed two main magmatic events, which occurred in the Late Jurassic-Early Cretaceous (158 ± 3 to 136 ± 2 Ma) and the Early Cretaceous (134 ± 1 to 108 ± 2 Ma), respectively. The granitoids formed in the early magmatic event are similar in composition and are characterised by a mantle source mixed with variable amounts of crustal components, whereas those resulting from the late-stage magmatism show characters of I-, S- and A-types granite and coexist with coeval dolerite dykes and syenite stocks. A similar magmatic age distribution is also recognised in other belts or regions in East China, and even in other parts of the East Eurasian continental margin. This suggests that the Jurassic-Early Cretaceous magmatism was associated with the subduction of the Izanagi plate at a shallow angle or flat-slab subduction beneath the eastern China continent, whereas the Early Cretaceous magmatism was related to lithospheric thinning, asthenospheric upwelling and partial melting of the lower crust, induced by a change in Izanagi plate motion parallel to the continent margin. [ABSTRACT FROM AUTHOR]

Telluride-bearing gold deposits of the Pingyi area, western Shandong, China, are located on the southeastern margin of the North China Craton. There are two main types of deposits: (i) mineralized cryptoexplosive breccia, e.g., Guilaizhuang; and (ii) stratified, finely-disseminated mineralization hosted in carbonate rocks, e.g., Lifanggou and Mofanggou deposits. In Guilaizhuang, the cryptoexplosive breccia is formed within rocks of the Tongshi complex and Ordovician dolomite. The mineralization is controlled by an E–W-trending listric fault. Stratified orebodies of the Lifanggou and Mofanggou deposits are placed along a NE-trending, secondary detachment zone. They are hosted within dolomitic limestone, micrite and dolomite of the Early-Middle Cambrian Changqing Group. The mineralization in the ore districts is considered to be related to the Early Jurassic Tongshi magmatic complex that formed in a continental arc setting on the margin of the North China Craton. The host rocks are porphyritic and consist predominantly of medium- to fine-grained diorite and pyroxene (hornblende)-bearing monzonite. SHRIMP U–Pb zircon dating of diorites give a 206Pb/238U weighted mean age of 175.7 ± 3.8 Ma. This is interpreted as representing the crystallization age of the Tongshi magmatic complex. Considering the contact relationships between the magmatic and host sedimentary rocks, as well as the genetic link with the deposits, we conclude that this age is relevant also for the formation of mineralization in the Pingyi area. We hence consider that the deposits formed in the Jurassic. The principal gold minerals are native gold, electrum and calaverite. Wall-rock alteration comprises pyritization, fluoritization, silicification, carbonatization and chloritization. Fluid inclusion studies indicate that all the analyzed inclusions are of two-phase vapor–liquid NaCl–H2O type. Homogenization temperatures of the fluid inclusions vary from 103 °C to 250 °C, and the ice melting temperatures range from −2.5 °C to −13.5 °C, corresponding to a salinity range of 4.65 to 17.26 wt.% NaCl equiv. The δ34S values of pyrite associated with gold mineralization exhibit a narrow range of −0.71 to + 2.99‰, implying that the sulfur was probably derived from the mantle and/or dioritic magma. The δ13CPDB values of the fluid inclusions in calcite range from −7.3 to 0.0‰. The δ18OSMOW values of vein quartz and calcite range from 11.5 to 21.5‰, corresponding to δ18Ofluid values of −1.1 to 10.9‰; δD values of the fluid inclusions vary between −70 and −48‰. The isotope data for all three deposits suggest mixing of ore-forming fluids derived from the mantle and/or magma with different types of fluids at shallow levels. Pressure release and boiling of the fluids, as well as fluid-rock interaction (Lifanggou and Mofanggou) and mixing of magmatically-derived fluids with meteoritic waters (Guilaizhuang) played an important role in the ore-forming processes. [ABSTRACT FROM AUTHOR]

China banned the use of technical HCH (BHC: 1,2,3,4,5,6-hexachlorocyclohexane) in 1983; lindane has been used in this country since 1991. The total production was around 4 million t for technical HCH from 1952 to 1984, and 11,400 t for lindane between 1991 and 2000. Though the total produced technical HCH was considered to be used in China, only 3,200 t of lindane were used between 1991 and 2000 with the rest for export or on unused stack. Annual usage of these two compounds was located into each province first and then broken for different crops. Inventories of gridded usage of both technical HCH and lindane with 1/6° by 1/4° latitude/longitude resolution have been created by different gridded cropland data sets as surrogate data. The intensive use of technical HCH on croplands was concentrated in the southeastern part of China, but the use of lindane was concentrated in the northern part of China. [ABSTRACT FROM AUTHOR]

In this article, lead (Pb) content in snow of the early 1990s' from the Arctic, Antarctica and the Tibetan Plateau will be discussed, based on measurements along 1990 International Trans-Antarctic Expedition route, three glaciers on Tibetan Plateau as well as snowpack over the Canadian and central Arctic. Author C.D. Xiao and colleagues seek to highlight the human influence on atmosphere over the most remote regions and the upper troposphere. The distribution of Pb over northern Canada indicates that the Northwest Territory (NWT) of Canada is not an efficient channel for Pb transport to central Arctic. Pb concentrations display a decreasing trend from Ely to NWT Canada.

Length-weight relationships ( LWRs) were determined for seven fish species collected during 2014 and 2015 between January and July each year from Nandujiang River. The study used drift gillnet with 4 cm mesh (100 m long × 1.2 m high) as well as electrofishing. The parameter ' b' of the LWR equations varied between 2.963 to 3.171 for the species studied. [ABSTRACT FROM AUTHOR]

Background: In this study, we assessed the prognostic value of the lymph node ratio (LNR), established a hypothetical tumor–ratio–metastasis (TRM) staging system and compared it with the 7th edition International Union Against Cancer pathological N (pN) and tumor–node–metastasis (TNM) system.Patients and methods: A total of 1343 gastric cancer patients undergoing D2 resection were staged using the TRM staging system and the 7th edition TNM system. Optimal cut points of LNR were calculated using X-tile software and validated by bootstrapping. Homogeneity, discriminatory ability, and monotonicity of gradients of the TRM and TNM systems were compared using linear trend χ2, likelihood ratio χ2 statistics, and Akaike information criterion (AIC) calculations.Results: Optimal cut points classified patients into LNR0 (0%), LNR1 (1%–30%), LNR2 (31%–60%), and LNR3 (61%–100%) groups. In univariate, multivariate and stratified analyses, the LNR staging showed superiority to the 7th edition pN staging. The TRM staging system had higher linear trend and likelihood ratio χ2 scores and smaller AIC values compared with those for the TNM system, which represented the optimum prognostic stratification.Conclusions: The novel TRM staging system predicts survival of gastric cancer more accurately than the 7th edition TNM system. It may be considered as an alternative to TNM system. [ABSTRACT FROM AUTHOR]

Medical and preventive integration effectively bridges the gap between "treating diseases" and "preventing diseases". Over the years, medical and preventive integration research has focused on chronic and chronic infectious diseases, with insufficient attention to acute ones. Confronting newly emerging infectious diseases establishing continuous monitoring, early warning, emergency response, and appropriate treatment will be a key focus for developing and reforming the healthcare system. Interoperability and sharing of medical and health data are essential prerequisites for bridging the gap between medical treatment and disease prevention and are also important for promoting intelligent surveillance and early warning of infectious diseases. Informatization is necessary to achieve efficient collaboration between medical treatment and disease prevention. Reviewing the development of medical and health informatization in the United States and Europe, this paper compares and discusses the problems and challenges in developing medical and health informatization in China. The aim is to provide references for the development of medical and health informatization and the innovation of medical and preventive integration mechanisms in the country.

Objective: To report the long-term outcomes of Chinese rectal cancer patients after adopting a Watch and Wait (W&W) strategy following neoadjuvant therapy (NAT). Methods: This multicenter, cross-sectional study was based on real-world data. The study cohort comprised rectal cancer patients who had achieved complete or near complete clinical responses (cCRs, near-cCRs) after NAT and were thereafter managed by a W&W approach, as well as a few patients who had achieved good responses after NAT and had then undergone local excision for confirmation of pathological complete response. All participants had been followed up for ≥2 years. Patients with distant metastases at baseline or who opted for observation while living with the tumor were excluded. Data of eligible patients were retrospectively collected from the Chinese Wait-and-Watch Data Collaboration Group database. These included baseline characteristics, type of NAT, pre-treatment imaging results, evaluation of post-NAT efficacy, salvage measures, and treatment outcomes. We herein report the long-term outcomes of Chinese rectal cancer patients after NAT and W&W and the differences between the cCR and near-cCR groups. Results: Clinical data of 318 rectal cancer patients who had undergone W&W for over 2 years and been followed up were collected from eight medical centers (Peking University Cancer Hospital, Fudan University Shanghai Cancer Center, Sun Yat-sen University Cancer Center, Shanghai Changhai Hospital, Peking Union Medical College Hospital, Liaoning Cancer Hospital, the First Hospital of Jilin University, and Yunnan Cancer Hospital.) The participants comprised 221 men (69.4%) and 107 women (30.6%) of median age 60 (26-86) years. The median distance between tumor and anal verge was 3.4 (0-10.4) cm. Of these patients, 291 and 27 had achieved cCR or near-cCR, respectively, after NAT. The median duration of follow-up was 48.4 (10.2-110.3) months. The 5-year cumulative overall survival rate was 92.4% (95%CI: 86.8%-95.7%), 5-year cumulative disease-specific survival (CSS) rate 96.6% (95%CI: 92.2%-98.5%), 5-year cumulative organ-preserving disease-free survival rate 86.6% (95%CI: 81.0%-90.7%), and 5-year organ preservation rate 85.3% (95%CI: 80.3%-89.1%). The overall 5-year local recurrence and distant metastasis rates were 18.5% (95%CI: 14.9%-20.8%) and 8.2% (95%CI: 5.4%-12.5%), respectively. Most local recurrences (82.1%, 46/56) occurred within 2 years, and 91.0% (51/56) occurred within 3 years, the median time to recurrence being 11.7 (2.5-66.6) months. Most (91.1%, 51/56) local recurrences occurred within the intestinal lumen. Distant metastases developed in 23 patients; 60.9% (14/23) occurred within 2 years and 73.9% (17/23) within 3 years, the median time to distant metastasis being 21.9 (2.6-90.3) months. Common sites included lung (15/23, 65.2%), liver (6/23, 26.1%), and bone (7/23, 30.4%) The metastases involved single organs in 17 patients and multiple organs in six. There were no significant differences in overall, cumulative disease-specific, or organ-preserving disease-free survival or rate of metastases between the two groups (all P >0.05). The 5-year local recurrence rate was higher in the near-cCR than in the cCR group (41.6% vs. 16.4%, P <0.01), with a lower organ preservation rate (69.2% vs. 88.0%, P <0.001). The success rates of salvage after local recurrence and distant metastasis were 82.1% (46/56) and 13.0% (3/23), respectively. Conclusion: Rectal cancer patients who achieve cCR or near-cCR after NAT and undergo W&W have favorable oncological outcomes and a high rate of organ preservation. Local recurrence and distant metastasis during W&W follow certain patterns, with a relatively high salvage rate for local recurrence. Our findings highlight the importance of close follow-up and timely intervention during the W&W process.

Objective: To analyze the burden and changing trends of periodontal disease in adults of the mainland of China from 1990 to 2019, and to predict the incidence trends of periodontal disease in the next 25 years, with a goal to provide a basis for reducing the burden of periodontal disease and formulating relevant prevention and treatment measures. Methods: Data on the incidence, prevalence, and disability adjusted life years (DALY) rate of periodontal disease among adults in the mainland of China from 1990 to 2019 were extracted from the global burden of disease study 2019 (GBD 2019) database. The estimated annual percent change (EAPC) was used to estimate the temporal trend of periodontal disease, and the age-period-cohort model (APC) was used to predict the age-standardized incidence of periodontal disease in Chinese adults from 2020 to 2044. Results: From 1990 to 2019, the incidence, prevalence, and DALY rate of adult periodontal disease in the mainland of China showed an increasing trend, with EAPCs of 0.3 (95% CI : 0.1-0.6), 0.5 (95% CI : 0.1-0.8), and 0.5 (95% CI : 0.1-0.8), respectively. The incidence and prevalence of periodontitis among the population aged 35-39 years old and 40-44 years old increased the most significantly, with EAPCs of 0.8 and 0.7, respectively, whereas the change in periodontal disease prevalence tended to be stable and the increase trend in prevalence was lower in the elderly group (EAPC=0.4). The incidence (EAPC=2.1), prevalence (EAPC=2.6) and DALY rate (EAPC=2.6) of periodontal disease in females increased more than those in males (EAPC=1.9, 2.4, and 2.4, respectively), of which the prevalence had exceeded that of males in 2019. The APC model predicted that the prevalence of periodontal disease in the period of 2020-2044 in China would still be on an upward trend, and the increase rate would be higher in females than in males. Conclusions: The burden of periodontal disease among adults in China had been increasing over the past 30 years, especially among young and middle-aged adults as well as females, and the incidence of periodontal disease will continue to increase over the next 25 years.

To investigate two clusters of severe fever with thrombocytopenia syndrome virus (SFTSV) in Xinyang City, Henan Province, in 2022, and analyze their causes, transmission route, risk factors, and the characteristics of virus genetic variation. Case search and case investigation were carried out according to the case definition. Blood samples from cases, family members and neighbors and samples of biological vectors were collected for RT-PCR to detect SFTSV. The whole genome sequencing and bioinformatics analysis were performed on the collected positive samples. A total of two clustered outbreaks occurred, involving two initial cases and ten secondary cases, all of which were family recurrent cases. Among them, nine secondary cases had close contact with the blood of the initial case, and it was determined that close contact with blood was the main risk factor for the two clustered outbreaks. After genome sequencing analysis, we found that the SFTSV genotype in two cases was type A, which was closely related to previous endemic strains in Xinyang. The nucleotide sequence of the SFTSV in the case was highly homologous, with a total of nine amino acid mutation sites in the coding region. It was not ruled out that its mutation sites might have an impact on the outbreak of the epidemic.

Objective: To explore the related factors of negative conversion time (NCT) of nucleic acid in children with COVID-19. Methods: A retrospective cohort study was conducted. A total of 225 children who were diagnosed with COVID-19 and admitted to Changxing Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 3 rd to May 31 st 2022 were enrolled in the study. The infection age, gender, viral load, basic disease, clinical symptoms and information of accompanying caregivers were retrospectively analyzed. According to age, the children were divided into<3 years of age group and 3-<18 years of age group. According to the viral nucleic acid test results, the children were divided into positive accompanying caregiver group and negative accompanying caregiver group. Comparisons between groups were performed using Mann-Whitney U test or Chi-square test. Multivariate Logistic regression analysis was used to analyze the related factors of NCT of nucleic acid in children with COVID-19. Results: Among the 225 patients (120 boys and 105 girls) of age 2.8 (1.3, 6.2) years, 119 children <3 years and 106 children 3-<18 years of age, 19 cases were diagnosed with moderate COVID-19, and the other 206 cases were diagnosed with mild COVID-19. There were 141 patients in the positive accompanying caregiver group and 84 patients in the negative accompanying caregiver group.Patients 3-<18 years of age had a shorter NCT (5 (3, 7) vs. 7 (4, 9) d, Z =-4.17, P <0.001) compared with patients <3 years of age. Patients in the negative accompanying caregiver group had a shorter NCT (5 (3, 7) vs. 6 (4, 9) d, Z =-2.89, P =0.004) compared with patients in the positive accompanying caregiver group. Multivariate Logistic regression analysis showed that anorexia was associated with NCT of nucleic acid ( OR =3.74, 95%CI 1.69-8.31, P =0.001). Conclusion: Accompanying caregiver with positive nucleic acid test may prolong NCT of nucleic acid, and decreased appetite may be associated with prolonged NCT of nucleic acid in children with COVID-19.

Objective: This study aimed to determine the morbidity and comorbidity of glucolipid metabolic multiple noncommunicable diseases in a Chinese natural population and associated risk factors., Subjects and Methods: A cross-sectional survey with randomized sampling was conducted on a typical sample of 4,002 residents (aged 26-76 years) in the Pinggu District of Beijing. They were subjected to a questionnaire survey, physical examination, and laboratory examination to collect data. Multivariable analysis was used to establish the association between various risk factors and multiple noncommunicable diseases., Results: The overall prevalence rate of chronic glucolipid metabolic noncommunicable diseases was 84.28%. The most common type of noncommunicable diseases was dyslipidemia, abdominal obesity, hypertension, obesity, and type 2 diabetes. The prevalence rate of multiple noncommunicable diseases was 79.60%. Participants with dyslipidemia were at higher risk for underlying chronic diseases. Younger men and women after menopause were more likely to have multiple noncommunicable diseases compared to their older and younger counterparts, respectively. The results of multivariate logistic regression indicated that age above 50, male sex, high household income, low education level, and harmful alcohol consumption were independent risk factors for multiple noncommunicable diseases., Conclusions: The prevalence of chronic glucolipid metabolic noncommunicable diseases in Pinggu was higher than at the national level. Men with multiple noncommunicable diseases were younger, while women after menopause were more likely to suffer from multiple noncommunicable diseases and the prevalence rate was higher than in men. Intervention programs that aim to target risk factors by sex and region-specific are urgently needed.

The S3 level clinical practice guideline for the treatment of stage Ⅳperiodontitis, developed by the European Federation of Periodontology, was published in April 22, 2022 (DOI: 10.1111/jcpe.13639). According to the severity and complexity, stage Ⅳ periodontitis was grouped into four case types, and comprehensive treatment plans were formulated correspondingly in the guideline, including tooth splinting, occlusal adjustment, orthodontic therapy, restorative therapy, and personalized supportive periodontal care as well. The aim of present work is to intensively interpret the key points of the guideline and help the clinicians to understand this guideline better, in order to improve the treatment level of stage Ⅳ periodontitis in China.

Objective: To evaluate the efficacy and safety of bendamustine monotherapy in Chinese patients with relapsed/refractory (R/R) B cell non-Hodgkin lymphoma (B-NHL) . Methods: This prospective, multicenter, open label, single-arm, phase Ⅱ study investigated bendamustine's efficacy and safety in Chinese patients with R/R B-NHL. A total of 78 patients with B-NHL in 11 hospitals in China from March 2012 to December 2016 were included, and their clinical characteristics, efficacy, and survival were analyzed. Results: The median age of all patients was 58 (range, 24-76) years old, and 69 (88.4% ) patients had stage Ⅲ/Ⅳ disease. 61 (78.2% ) patients were refractory to previous treatments. Patients received a median of 4 (range, 1-10) cycles of bendamustine treatment. The overall response rate was 61.5 (95% CI 49.8-72.3) % , the median response duration was 8.3 (95% CI 5.5-14.0) months, and the complete remission (CR) rate was 5.1 (95% CI 1.4-12.6) % . In the full analysis set, median progression-free survival (PFS) and median OS were 8.7 (95% CI 6.7-13.2) months and 25.5 months (95% CI 14.2 months to not reached) , respectively, after a median follow-up of 33.6 (95% CI 17.4-38.8) months. Lymphopenia (74.4% ) , neutropenia (52.6% ) , and leukopenia (39.7% ) , thrombocytopenia (29.5% ) and anemia (15.4% ) were the most common grade 3-4 hematologic adverse events (AE) . The most frequent non-hematologic AEs included nausea (43.6% ) , vomiting (33.3% ) , and anorexia (29.5% ) . Univariate and multivariate analysis showed that <4 cycles of bendamustine treatment was a poor prognostic factor for PFS ( P =0.003) , and failure to accept fludarabine containing regimen was a poor prognostic factor for OS ( P =0.009) . Conclusion: Bendamustine monotherapy has good efficacy and safety in the treatment of patient with R/R B-NHL.

Preventive chemotherapy is one of the pivotal interventions for the control and elimination of schistosomiasis, which is effective to reduce the morbidity and prevalence of schistosomiasis. In order to promote the United Nations' sustainable development goals and the targets set for schistosomiasis control in the Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030 , WHO released the guideline on control and elimination of human schistosomiasis in 2022, with major evidence-based updates of the current preventive chemotherapy strategy for schistosomiasis. In China where great success has been achieved in schistosomiasis control, the preventive chemotherapy strategy for schistosomiasis has been updated several times during the past seven decades. This article reviews the evolution of the WHO guidelines on preventive chemotherapy and Chinese national preventive chemotherapy schemes, compares the current Chinese national preventive chemotherapy scheme and the recommendations for preventive chemotherapy proposed in the 2022 WHO guideline on control and elimination of human schistosomiasis, and proposes recommendations for preventive chemotherapy during the future implementation of the 2022 WHO guideline, so as to provide insights into schistosomiasis control among public health professionals engaging in healthcare foreign aid.

Objective: This study investigated the professional identity of administrators in 3rd class hospitals in Shanghai, analyzing the professional identity of administrators and associated factors in public hospitals. Methods: In May 2019, Huashan Hospital conducted a questionnaire survey. Through the analysis of the survey data, this study discussed the correlation between the professional identity degree and the external factors. Three main dimensions of occupational identity were extracted by principal component analysis, namely the professional self-identity, organizational identity and social identity. External influencing factors were analyzed by factor analysis, and five main factors were extracted. Results: It was found that the professional self-identity was much higher than the organizational and social identity. The degree of organizational identity was significantly related to external factors ( r =0.212,0.426,0.146,0.580,0.610, P <0.01). Respect factors ( r =0.553,0.580,0.570) and self-realization factors ( r =0.563,0.610,0.433) had the highest correlation with professional identity. Conclusion: Initiating with improving organizational identity, the authorities and hospitals should establish a scientific and reasonable promotion and incentive mechanism to enhance the degree of professional identity.

Objective: To understand the characteristics of HIV-1 genotypes and drug resistance among men who have sex with men in Kunming in 2018. Methods: A total of 193 plasma samples were collected from the newly reported HIV-1 infected MSM in Kunming from January to December 2018. Viral RNA was extracted, and the gag , pol , env gene segments were amplified by nested PCR. HIV-1 genotypes and drug resistance were also analyzed. Subsequently, the evolutionary characteristics of CRF55&#95;01B and CRF68&#95;01B among MSM in Kunming were analyzed by Bayesian Markov Chain Monte Carlo method. Results: Multiple HIV-1 genotypes were identified among these 193 samples, including CRF07&#95;BC (39.4%, 76/193), CRF01&#95;AE (34.2%, 66/193), unique recombinant forms (URFs) (20.2%, 39/193), CRF08&#95;BC (3.1%, 6/193), CRF55&#95;01B (1.6%, 3/193), subtype B (1.0%, 2/193) and CRF68&#95;01B (0.5%, 1/193). Results from the Bayesian evolutionary analysis showed that CRF55&#95;01B started to spread locally after being imported from other provinces, while CRF68&#95;01B was likely to have been brought in from the eastern provinces of China. Prevalence of HIV-1 drug resistant strains was 2.6%(5/190) before antiviral treatment, with mutation rates resistant to non-nucleoside reverse transcriptase inhibitors being the highest (2.1%, 4/190) among MSM in Kunming, 2018. Conclusion: The diversity of HIV-1 was increasing among MSM in Kunming. Although the resistance rate on pretreatment drug was relatively low, the emergence of multiple resistant strains to first-line antiviral drugs posed a challenge to antiretroviral therapy, in Kunming.

Objective: To investigate the prevalence of Schistosoma japonicum infections in Elaphurus davidianus released to Poyang Lake areas and evaluate the impact of the project of " E. davidianus released to wild environments for natural reproduction and growth" "( E. davidianus return home project") on the transmission of schistosomiasis in Poyang Lake areas., Methods: During the period from April 2018 to December 2019, the population distribution, inhabiting activity and natural reproduction of E. davidianus released to Poyang Lake areas were investigated by means of GPS and artificial observations. The S. japonicum infection was identified in animal feces in E. davidianus inhabitats using a hatching test, and snail distribution was surveyed in E. davidianus inhabiting grass islands using a systematic sampling method., Results: A total of 51 E. davidianus were released to the Poyang Lake areas in 2018, which subsequently produced 5 E. davidianus habitats in Yinlong Lake, Longkou, Nanchi Lake, Lianzi Lake and Zhu Lake. E. davidianus was found to predominantly inhibit in grass islands, farmlands and forest lands in hilly regions around the Poyang Lake areas. The natural reproduction rate of E. davidianus was 25% in the habitats in 2019, and the mean density of snails was 0.009 to 0.039 snails/0.1 m 2 in E. davidianus inhabitats; however, no S. japonicum infection was identified in snails. In addition, the mean densities of wild E. davidianus and bovine feces were 4.6 samples/hm 2 and 2.1 samples/hm 2 , Conclusions The E. davidianus released to Poyang Lake areas may get infections with S. japonicum , and cause schistosomiasis transmission through fecal contamination in grass islands. The impact on and the prevalence of S. japonicum infection was 4.35% and 13.16% ( P = 0.236), respectively; however, the intensities of S. japonicum infections were "+++" and "+", respectively., Conclusions: The E. davidianus released to Poyang Lake areas may get infections with S. japonicum , and cause schistosomiasis transmission through fecal contamination in grass islands. The impact on local schistosomiasis transmission and the response strategy requires to be investigated following the release of E. davidianus to lake regions, to ensure the achievement of the goal of schistosomiasis elimination and the successful implementation of the " E. davidianus return home project" in Poyang Lake areas.

Objective: To analyze the characteristics of HIV-1 molecular network in men who have sex with men (MSM) from 2016 to 2018 in Kunming, Yunnan province, explore the risk factors associated with HIV-1 transmission network and provide evidence for the effective implementation of intervention. Methods: A total of 540 samples of newly reported HIV-1 positive MSM were consecutively collected in Kunming from 2016 to 2018, the pol gene fragments were amplified by nested polymerase chain reaction (PCR). HIV-1 molecular networks were constructed according to the bootstrap value of the maximum likelihood evolutionary tree over 95% and the genetic distance less than 3%. The factors associated with the subjects entering network and network growth were further analyzed. Results: Among 459 successfully sequenced samples, seven genotypes were found, in which CRF07&#95;BC (49.2%, 226/459) and CRF01&#95;AE (40.3%, 185/459 ) were predominant. Other genotypes included URFs (4.8%, 22/459), CRF08&#95;BC (3.1%, 14/459), CRF55&#95;01B (1.7%, 8/459), B (0.7%, 3/459) and CRF68&#95;01B (0.2%, 1/459). A total of 163 sequences entered the network, with an entry rate of 35.5%(163/459), forming 56 clusters with the number of individuals in the cluster was between 2 and 13. The analysis of the factors associated with entering network showed that the MSM who married and had multiple homosexual partners were more likely to be found in HIV-1 molecular networks. Multivariate logistic regression analysis showed that the number of sexual partners was the factor for the growth of HIV-1 molecular network. According to the criteria for the emergence of three or more newly reported cases in every year, six transmission clusters were judged as active transmission clusters, in which MSM who were not Kunming natives, had sexually transmitted diseases (STD), were divorced and students were the key targets of intervention. Conclusions: HIV-1 genotypes in MSM in Kunming were becoming complex, the risk factors associated with transmission networks in MSM in Kunming included being married and having multiple partners, the intervention targets in active transmission clusters included MSM who were not Kunming natives, had STD, were divorced and students. This study provided the basis for applying HIV-1 molecular networks to real-time intervention in this population.

Objective: To investigate the prevalence and changing patterns of Schistosoma japonicum infections in goats in Dantu District of Zhenjiang City, so as to provide the scientific data for the management of in livestock., Methods: The S. japonicum infections were detected using a miracidial hatching test (one test for one stool specimen) in goats grazed in settings with snail habitats in Dantu District of Zhenjiang City at spring and autumn of each year from 2004 to 2019, and the prevalence and intensity of S. japonicum infections were estimated., Results: A total of 21 836 goat stool samples were detected from 2004 to 2019, and 86 were positive for S. japonicum (0.39% prevalence). The highest prevalence of S. japonicum infections in goats was seen in 2004 (1.25%) and no infections were detected in goats since 2013. S. japonicum -infected goats were identified in marshland-type endemic areas and plain regions with waterway networks, and there was a significant difference in the prevalence of S. japonicum infections in goats between these two types of endemic areas (0.50% vs. 0.15%; χ 2 = 11.566, P < 0.05). The prevalence of S. japonicum infections was significantly greater in goats at ages of more than 10 months (0.51%) and over 10 months (0.44%) than in other goats ( χ 2 = 13.088, P < 0.05), and higher prevalence was found in autumn than in spring (0.54% vs. 0.27%; χ 2 = 9.597, P < 0.05). In addition, there were 76.74% of S. japonicum -infected goats with intensity of"+++"and"++++"., Conclusions: Although the high prevalence of S. japonicum infections has been effectively controlled in goats in Dantu District, goat remains to be an important source of S. japonicum infections that should be given a high priority for control to consolidate the schistosomiasis control achievements.

Objective: To analyze the current status of duplicated reporting of brucellosis in China during 2005-2017, to understand the impact of duplicated reporting on the incidence of brucellosis, analyze the possible causes of duplicated reporting, and put forward propose solutions to further improve the brucellosis surveillance data quality. Methods: Data were from brucellosis case reporting cards in National Notifiable Disease Report System (NNDRS), Excel 2010 software was used to establish the database, the duplicated reporting was identified by using Spark DataFrame aggregation analysis in Python 3.2. Results: During 2005-2017, a total of 499 577 cases of brucellosis were reported, but the duplicated reporting rate was 75.76/10 000 (3 785/499 577). The duplicated reporting rate in same year was 37.21/10 000 (1 859/499 577), the duplicated reporting rate in other year was 39.87/10 000 (1 992/499 577) and the overall duplicated reporting rate increased year by year. The duplicated reporting rate in same institution was 33.59 % (1 271/3 785) and the duplicated reporting rate by other institutions was 66.41 % (2 514/3 785). Hospitals had the highest number of duplicated reporting (2 757), and community healthcare centers had the highest of duplicated reporting rate (281.27/10 000) (123/4 373). The reported incidence of brucellosis was 2.926 4/100 000 in 2017, the corrected incidence was 2.844 8/100 000 after removing the duplicated reporting, which was the maximum decrease from 2005 to 2017, the corrected incidence decreased by 2.79 % . From 2005 to 2017, the average reported incidence of brucellosis in Xinjiang Uygur autonomous region was 14.712 0/100 000, and the corrected incidence was 14.060 0/100 000 after removing the duplicate reporting, with a decrease by 4.43 % , the biggest decline in China. The average reported incidence of brucellosis in Ningxia Hui autonomous region was 13.987 1/100 000, and the corrected incidence of brucellosis was 13.662 2/100 000, with a decrease of 2.32 % , ranking second in China. The reasons for duplicated reporting of brucellosis included repeated medical care seeking in same or different medical institutions in same year or other year, including the repeated medical care seeking in other areas. Conclusions: During 2005-2017, the number of duplicated reporting of brucellosis cases was on the rise in China. Hospital and community health service centers had highest case number and rate of duplicate reporting respectively, the duplicated reporting was mainly caused by re-reporting by other institutions or in other years. The duplicated reporting of brucellosis had greatly affected the accuracy of surveillance data of brucellosis in some provinces, such as Xinjiang and Ningxia. It is recommended to further strengthen brucellosis reporting management, improve data quality of NNDRS.

Objective: To explore related factors affecting evolution of recent small subcortical infarct (RSSI) with small-artery occlusion. Methods: A total of 96 RSSI patients with RSSI were admitted from Shanghai Tongji Hospital between January 2015 and December 2018. The age of patients containing 60 men was 64.5 (58-73) years, and MRI follow-up time was 11.6 (6.3-11.8) months. Clinical information of patients, images data at baseline head MRI and evolution outcomes at follow-up MRI were collected. All patients were divided into cavitation group (lacunes) and no cavitation group (white matter hyperintensities (WMH) and disappearance) to analyze related factors. Results: Fifty-nine cases (61.5%) developed to cavities, 32 cases (33.3%) were focal WMH, and 5 cases (5.2%) disappeared.In the univariate analysis, RSSI maximum diameter on the DWI or T(2)WI sequence of cavitation group was significantly higher than non-cavitation group, but male proportion was lower (11.6 (9.9-16.6) vs 8.6 (6.9-13.0) mm, 11.8 (9.7-16.2) vs 8.8 (6.7-13.1) mm, 54.2% vs 75.7%, all P< 0.05). In Logistic regression analysis,the maximum diameter on DWI sequence was an independent predictor of cavity formation ( P= 0.022, OR= 1.138).When conducting quantitative analysis of infarct diameter and taking infarct maximum diameter ≤10 mm group as reference, the cavitation risk of maximum diameter > 15 mm group was about 7.5 times higher ( P= 0.010, OR= 7.464). The maximum diameter of 10-15 mm lost predictive value for cavity formation ( P= 0.129, OR= 2.444). Conclusions: About 61.5% of RSSI develop to cavitation and 38.5% to WMH or disappear. The RSSI showing larger diameter on DWI has a greater possibility of cavitation.

Acute schistosomiasis is a clinical type of schistosomiasis with severe symptoms. The number of acute schistosomiasis cases is not only a sensitive indicator to assess the endemic situation and control effects, but also an important indicator to define schistosomiasis outbreaks and evaluate the achievements of infection control or transmission control. Acute schistosomiasis control is therefore of great significance to achieve the goal of schistosomiasis elimination in China. This paper analyzes the features and causes of acute schistosomiasis, and proposes some suggestions for future acute schistosomiasis control in China.

Objective: To evaluate the efficacy and safety of apatinib combined with chemotherapy in the first-line treatment of advanced non-small cell lung cancer (NSCLC) with negative driving genes. Methods: From January 2016 to March 2018, 62 advanced NSCLC patients with negative driving genes diagnosed at Xuzhou Cancer Hospital were randomly divided into study group (30 cases) and control group (32 cases), respectively. The patients in the study group were treated with standard first-line chemotherapy combined with apatinib, while those in control group were treated with chemotherapy alone. Results: The disease control rate (DCR) and objective remission rate (ORR) in the study group were 60.0% and 16.7%, respectively, higher than 46.9% and 9.3% in the control group, but without statistical difference ( P >0.05). The median progression-free survival (PFS) of study group and control group were 6.4 months and 4.9 months, respectively ( P =0.004), and the median overall survival (OS) were 11.3 months and 9.2 months, respectively ( P =0.006). Multivariate survival analysis indicated that treatment regimen ( P =0.001) was the independent prognostic factor of PFS, and PS score ( P =0.002), clinical stage ( P =0.02) and treatment regimen ( P <0.001) were the independent prognostic factors of OS. After treatment, the incidence of hypertension and hand-foot syndrome in the study group were 46.7% and 53.3%, respectively, significantly higher than 3.3% and 0 in the control group, respectively ( P <0.05). The incidence of grade 3-4 adverse drug reactions (ADRs) in the study group was 26.7% (8/30), mainly including hypertension, hand-foot syndrome and bone marrow suppression. The incidence of grade 3-4 ADRs in the control group was 15.6% (5/32), all of which were bone marrow suppression, without significant difference ( P =0.286). There was no difference in serum levels of VEGF and CEA between the two groups before treatment. After treatment, the serum level of VEGF in the study group was (169.3±10.1) pg/ml, lower than (211.8±16.7) pg/ml of the control group ( P <0.05). Conclusion: Apatinib combined with first-line chemotherapy for advanced NSCLC patients with negative driving genes is safe and beneficial for survival. This therapeutic strategy can significantly prolong the PFS and OS, and further improvement and application can be considered as a choice in the clinical treatment.

Objective: To understand the situation of Schistosoma japonicum infections in wild animals in transmission-controlled schistosomiasis-endemic areas in Jiangxi Province, so as to provide scientific evidence for implementing precision control interventions and achieving the goal of transmission interruption and elimination of schistosomiasis., Methods: Five endemic villages from Ruichang City and Pengze County that were heavily endemic for schistosomiasis in Jiangxi Province, were selected as the study villages. Wild animals like wild mice were captured, and the livers of wild animals were purchased from the snail habitats in the study villages for detection of S. japonicum infections. In the study villages, S. japonicum human infections were screened using indirect hemagglutination assay (IHA) followed by parasitological examinations with miracidial hatching test and Kato-Katz method, and the S. japonicum infection in livestock was tested using a miracidial hatching test with a plastic tube. In addition, snail survey was conducted in the study villages by means of systematic sampling combined with environmental sampling, and the S. japonicum infection in snails was detected using a loop-mediated isothermal amplification (LAMP) assay., Results: A total of 240 liver specimens were sampled or purchased from 5 species of wild animals in the study villages, including wild mice, weasels, pigs, deer and rabbits. A total of 172 wild mice were captured, with a 2.91% rate of S. japonicum infection, and there was no S. japonicum infection detected in other wild animals. The prevalence of Capillaria hepatica infection was 12.21%, 1.96% and 12.50% in wild mice, deer and pigs, respectively. In addition, there was no S. japonicum infection found in either humans or livestock in the study villages, and the mean snail density varied from 0.13 to 0.80 snails/0.1 m 2 in the study villages. LAMP assay detected S. japonicum infection in 2 tubes in a study village., Conclusions: The role of wild animals in schistosomiasis transmission and their potential risks can not be neglected in hilly schistosomiasis-endemic areas of Jiangsu Province after transmission control. Intensified surveillance and targeted control measures should be implemented to consolidate schistosomiasis control achievements.

Cervical cancer has become an important disease that jeopardizes women's health, causing hundreds of thousands of new cases annually. Human papillomavirus (HPV) is the leading cause for cervical cancer. Since the world's first HPV vaccine was licensed in 2006, 92 countries around the world have introduced them in national immunization programs. The WHO recommends that scientific economic evaluation should be achieved before the introduction, but this is more difficult for low-and middle-income countries. Therefore, this article introduces a mathematical model recommended by WHO in 2014 to quickly and easily accomplish economic evaluation of HPV vaccine -the PRIME, and take the China's 2018 data published by International Agency for Research on Cancer (IARC) as an example. The evaluation result shows that the introduction of HPV vaccine in Chinese 12-year-old women is cost-effective.

Objective: To analyze the association between clinicopathological factors and clinical diagnosis, treatment and surgery of local regional recurrence (LRR) in breast cancer. Methods: A retrospective study was done to evaluate consecutive 7 823 breast cancer LRR cases between January 2009 and August 2018 at Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine. A total of 108 LRR patients were enrolled: 35 cases (32.4%) with ipsilateral breast tumor recurrence (IBTR) after breast conserving surgery, 40 cases (37.0%) of chest wall recurrence (CR), and 33 cases (30.6%) with regional lymph node recurrence (LNR). All patients were female, aged from 26 to 83 years with a mean of 49 years. Clinicopathological factor and its relationship with different sites of LRR and following surgical choice were analyzed by χ(2) test, rank-sum test and Logistic regression. Survival analysis were performed between different LRR patterns and whether undergoing second surgery. Kaplan-Meier survival curves and Log-rank tests demonstrated the distribution of overall survival. Results: Both univariate analysis and multivariate analysis found that axillary lymph nodes (ALN) status ( OR= 7.27, 95% CI: 1.30 to 40.53, P= 0.042) and disease-free interval ( OR= 0.18, 95% CI: 0.06 to 0.60, P= 0.013) were related to different site of LRR. Compared with patients with IBTR, LNR and CR patients had a higher rate of ALN metastasis and a shorter disease-free interval. A total of 36 LRR patients underwent following surgery. In univariate analysis, initial ALN surgery (χ(2)=16.705, P= 0.001), pathological type (χ(2)=7.047, P= 0.03), ALN status (χ(2)=10.812, P= 0.002), disease-free interval (χ(2)=6.118, P= 0.023) and LRR site(χ(2)=19.328, P= 0.000) were associated with surgical treatment for LRR patients. Multivariate analysis demonstrated that only site of LRR was independently associated with surgery ( OR= 0.17, 95% CI: 0.05 to 0.65, P= 0.024). The 5-year overall survival was 100% and 60.1% ( P= 0.018) for LRR patients treated with surgery or not. Furthermore, CR patients had significantly worse overall survival than LNR and IBTR patients, with 5-year overall survival 53.1%, 73.5%, and 100% respectively ( P= 0.021). Conclusions: Initial lymph nodes metastasis and disease-free interval are associated with different site of LRR. LRR site significantly influenced following surgery choice after LRR, which are both related with overall survival after LRR.

Objective: To investigate the changes of proportion on both consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above (LFSW), in order to provide evidence for targeted intervention strategies. Methods: A total of six cities-Liuzhou city and Pingnan couty of Guigang city of Guangxi Zhuang Autonomous Region, Jinghong city of Xishuangbanna Dai autonomous prefecture and Dali city of Dali Bai autonomous prefecture of Yunnan province, Zhangjiajie city and Jianghua Yao autonomous county of Yongzhou city Hunan province were involved in this study, with 60 eligible participants needed in each city, estimated through a pre-study. The first cross-sectional survey was completed from October 2012 to January 2013. Face-to-face questionnaire interview was carried out to collect information on socio-demography, work-related information and condom use situation. Blood was collected for syphilis testing. The second cross-sectional survey was carried out from June to September, 2015 under the same procedure. Results: A total of 371 and 403 eligible participants were included in the first and second survey, respectively. When comparing the two surveys, we noticed that the average age showed a slight change, from 42.4 years to 43.8 years old ( t =3.537, P <0.001) and the average price for every commercial sex exchange increased from 36.8 RMB to 49.5 RMB ( t =11.961, P <0.001). In the first survey, 46.9 % (174/371) of the participants had more than two years of experience working as LFSW, compared to 61.3 % (247/403) in the second survey ( χ (2)=16.125, P <0.001). Also, 46.9 % (174/371) of the participants consistently used condoms with clients in the past month in the first survey versus 64.3 % (259/403) ( χ (2)=23.641, P <0.001) in the second one. Rates of syphilis infection were found from 15.9 % (59/371) in the first survey reduced to 7.2 % (29/403) in the second survey ( χ (2)=14.533, P <0.001). Conclusion: Compared with the first survey, the proportion of consistent condoms use showed an increase. Although the proportion of syphilis infection decreased in the second survey, the scope did not meet the criteria on syphilis, set by the government. Targeted intervention strategies on condom promotion and syphilis control should be implemented consistently in this population.

Injury to the mandibular condyle in children usually leads to malocclusion and disharmony of facial growth. Our aim was to study the facial growth after reconstruction of the mandibular condyle using autogenous coronoid process grafts in children with unilateral ankylosis of the temporomandibular joint (TMJ). We followed up 10 growing patients with unilateral bony ankylosis of the TMJ who had been admitted to the West China Hospital of Stomatology, Sichuan University (Chengdu, China) between 1 January 2008 and 31 December 2012. There were three boys and seven girls, age range 5-12 years at the time of operation. In each case, patients were treated by gap arthroplasty, reconstruction of the condyle with an ipsilateral coronoid process, and interposition of the pedicled temporalis fascial flap during one operation. The mean (range) postoperative follow up was 4.73 (3-6) years. Postoperative panoramic radiographs were taken, and the growth of the mandibular height and length on the affected side was measured and compared with the healthy side. All patients had an uneventful, normal recovery. The mean (range) maximal mouth opening at the end of follow up was 35.6 (32-41) mm. Both the height of the ramus and the length of the mandible continued to grow after successful treatment of the ankylosis (using autogenous coronoid process grafts for reconstruction of the condyle) but the deficit in growth was not completely made up. The final height of the ramus on the affected side (at the end of follow up) had increased by 25% (p=0.012) and the final length of the mandible on the affected side by 26% (p=0.010) compared with immediately after operation. For comparison of the rate of growth, the increased height of the ramus of the affected side was 47% lower (p=0.003), while the increased length of the mandible on the affected side was 27% shorter (p=0.008) compared with the healthy side. The mandible on the affected side continued to grow after successful treatment of the ankylosis, but the growth deficit was not made up completely. The rate of growth of the affected mandible seemed to be less than on the undisturbed side even after treatment of the ankylosis., (Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

We know of no universally accepted classification for intracapsular condylar fractures. We propose here a new classification based on the concept of a "disc-condyle" unit, and validate the classification based on outcomes of treatment. From 1 January 2010 - 31 December 2014, 55 patients with unilateral intracapsular condylar fractures were classified into three types: type A has no reduction in mandibular height or displacement of the disc (n=7); type B has displacement of the disc with no reduction in mandibular height (n=17); and type C has reduced mandibular height with or without displacement of the disc (n=31). We treated types B and C by open reduction and fixation, while type A fractures were managed non-surgically. At six month follow-up, we found no significant differences in the vertical height of the ramus, mandibular deviation, protrusion, or lateral protrusion between the fractured and healthy sides. All patients had normal occlusion postoperatively and only one patient (type C) reported pain. Magnetic resonance imaging and computed tomography showed good osseous healing and disc-condylar relations in all cases. Our results show that this new classification of intracapsular condylar fractures is a safe and easy way to obtain satisfactory outcomes of treatment. However, it needs further independent validation., (Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Objective: To investigate the distribution patterns of 21-gene assay and its influencing factors in Chinese patients with early breast cancer. Methods: Nine hundred and twenty-seven early breast cancer patients were retrospectively recruited from January 2009 to December 2015 at Ruijin Hospital, Shanghai Jiaotong University School of Medicine. The 21-gene reverse transcriptase-polymerase chain reaction(RT-PCR) assay were conducted in paraffin-embedded tumor tissues to calculate the Recurrence Score(RS). Immunohistochemistry(IHC) assay was used to measure the expression levels of estrogen receptor(ER), progesterone receptor(PR) and Ki-67. Concordances of RT-PCR and IHC results were assessed. Correlations of RS and classical clinicopathological factors were evaluated, and logistic regression were applied to determine independent predictive factors for RS. Results: The median RS of 927 patients was 23(range: 0~90), and the proportions of patients categorized as having a low, intermediate, or high risk were 26.5%, 47.7% and 25.8%, respectively. The distribution of RS varied significantly according to different tumor grade, T stage, PR status, Ki-67 index and molecular subtypes( P <0.05 for all). Grade, PR status and Ki-67 index were independent predictive factors for RS. ER, PR status and Ki-67 index showed significantly correlation between RT-PCR and IHC assays, and the concordance rates for ER and PR status were 98.7% and 87.8%, respectively. Conclusions: RS significantly correlated with tumor grade, T stage, PR status, Ki-67 index and subtypes. Grade, PR status and Ki-67 index can independently predict RS. Remarkable concordances of ER, PR status and Ki-67 index are found between RT-PCR and IHC assays.

In the near future, the inactivated enterovirus 71 (EV71) vaccine is expected to become available on the market in China. Since EV71 is a major cause of hand, foot and mouth disease (HFMD), the vaccine is expected to significantly reduce the number of cases, as well as the detrimental economic effect of the disease. However, for a national vaccination strategy to be developed, policy-makers need more information on the socioeconomic burden of EV71 HFMD infection. Based on the 2011 population data, we estimated the clinical and economic effect of EV71 HFMD infection in children aged 0-9 years in Shanghai, China. The annual cost related to HFMD is >US$7.66 million for a population of 1·42 million children aged 0-9 years with an average cost of US$208.2/case. The extrapolated cost for EV71 HFMD infection was US$3.53 million, comprising 46·1% of the overall cost associated with HFMD. Around 97% of all of the HFMD-related expenses were paid for by the families creating a considerable economic burden. Our findings could provide the necessary recommendations on the most effective national EV71 vaccine implementation, as well as a baseline data for assessing the cost-effectiveness of the vaccine in China.

In this study, an inexact two-stage water resources management model was developed for multi-regional water resources planning in the Nansihu lake Basin, China. Four planning districts, four water users, and five water sources were considered in the optimization model, with net system benefit, recourse cost, water supply cost, and wastewater treatment cost being analyzed. Methods of interval-parameter programming (IPP) and two-stage stochastic programming (TSP) were incorporated into the model to tackle uncertainties described by both interval values and probability distributions. A number of scenarios corresponding to different river inflow levels were examined, and the results indicated that different inflow levels could lead to different water allocation schemes with varied system benefit and system-failure risk. In general, the developed model can provide an effective linkage between economic benefits and the associated penalties attributed to the violation of predefined policies. The modeling results were valuable for supporting the adjustment or justification of the existing water allocation schemes within a complicated water resources system under uncertainty., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

We retrospectively analysed the epidemiological data of all hand, foot, and mouth disease (HFMD) cases from the largest paediatric infectious diseases centre in Shanghai between 2007 and 2010. A total of 28 058 outpatients were diagnosed with HFMD, of which 3948 (14.07%) were hospitalized, 730 (2.60%) had complications with neurological disorders and pulmonary oedema/haemorrhage, and 11 (0.04%) died. The peak season was the summer months. Boys were more affected than girls. Since 2008, the major population group affected has shifted from native Shanghainese children attending preschool to migrant children and younger children cared for at home. Children aged 1-4 years constituted 82.27% of cases. EV-A71 was tested in clinical samples taken from severe cases in 2009 and 2010, and from most inpatients in 2010. EV-A71 was positive in 99.17% and 86.31% of severe cases, respectively in 2009 and 2010. All 12 cases with pulmonary oedema or haemorrhage were infected with EV-A71. Ten (90.90%) of 11 fatal cases were attributable to EV-A71 infection. In 2010, EV-A71-positive cases accounted for 54.12% of inpatients. The dominant circulation of EV-A71 led to the outbreak of HFMD and occurrence of severe and fatal cases.

The special flavor and health effects of chicken essence are being widely accepted by people. Scientific researches are revealing its truth as a tonic food in traditional health preservation. Chicken essence has been found to possess many bioactivities including relief of stress and fatigue, amelioration of anxiety, promotion of metabolisms and post-partum lactation, improvement on hyperglycemia and hypertension, enhancement of immune, and so on. These activities of chicken essence are suggested to be related with its active components, including proteins, dipeptides (such as carnosine and anserine), polypeptides, minerals, trace elements, and multiple amino acids, and so on. Underlying mechanisms responsible for the bioactivities of chicken essence are mainly related with anti-stress, anti-oxidant, and neural regulation effects. However, the mechanisms are complicated and may be mediated via the combined actions of many active components, more than the action of 1 or 2 components alone., (© 2012 Institute of Food Technologists®)

In this study, an inexact-chance-constrained water quality management (ICC-WQM) model is developed for planning regional environmental management under uncertainty. This method is based on an integration of interval linear programming (ILP) and chance-constrained programming (CCP) techniques. ICC-WQM allows uncertainties presented as both probability distributions and interval values to be incorporated within a general optimization framework. Complexities in environmental management systems can be systematically reflected, thus applicability of the modeling process can be highly enhanced. The developed method is applied to planning chemical-industry development in Binhai New Area of Tianjin, China. Interval solutions associated with different risk levels of constraint violation have been obtained. They can be used for generating decision alternatives and thus help decision makers identify desired policies under various system-reliability constraints of water environmental capacity of pollutant. Tradeoffs between system benefits and constraint-violation risks can also be tackled. They are helpful for supporting (a) decision of wastewater discharge and government investment, (b) formulation of local policies regarding water consumption, economic development and industry structure, and (c) analysis of interactions among economic benefits, system reliability and pollutant discharges., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Rotavirus gastroenteritis is an important pediatric disease in China. In a survey of rotavirus infection at two sentinel hospitals in China (Beijing Friendship Hospital and Changchun Children's Hospital), 296 cases were detected. A total of 283 (95.6%) cases of rotavirus infection occurred in children under 5 years of age. Serotype G1 (62%) was most prevalent followed by G2 (28.5%), G3 (5%) and G4 (2%). Mixed infections (n = 8, 3%) were rate, and 16 isolates (5.5%) remained non-typeable. A consistent epidemic occurred during the winter. Rotavirus was responsible for about 61.8% of diarrhea-related hospitalizations in children under 5 years of age, with a mean hospital stay of 5.6 days (1.0-21 days). The estimated rate of rotavirus-attributed hospitalizations was 16/1000 children under 5 years of age per year. Rotavirus-related death is rare in Changchun and Beijing. The present findings suggest that a rotavirus vaccine for the prevention of severe disease and a reduction of treatment costs would be of significant benefit to China.

In 1995, 234 adults from Qidong, People's Republic of China, were enrolled and followed in a Phase IIa 4-methyl-5-(N-2-pyrazinyl)-1,2-dithiole-3-thione (oltipraz) chemoprevention trial. Residents of this area are at high risk for development of hepatocellular carcinoma, in part due to consumption of aflatoxin-contaminated foods. The intervention was a randomized, placebo-controlled, double-blind study. Elements of the study design and clinical outcomes have been recently published (Jacobson et al, Cancer Epidemiol. Biomark. Prev., 6: 257-265, 1997). The primary objective was to conduct a preliminary assessment of the ability of oltipraz to modulate levels of a validated biomarker of aflatoxin exposure and of the risk of hepatocellular carcinoma by determining levels of aflatoxin-albumin adducts in sera. Healthy eligible individuals were randomized into three arms to receive p.o. 125 mg of oltipraz daily, 500 mg of oltipraz weekly, or placebo for 8 weeks. There were no consistent changes in biomarker levels in the placebo arm over the 16-week observation period, nor was any apparent effect observed in the arm receiving 125 mg of oltipraz each day. However, individuals receiving 500 mg of oltipraz once a week for 8 weeks showed a triphasic response to oltipraz. No effect was observed during the 1st month of the intervention, whereas a significant (P = 0.001) diminution in adduct levels was observed during the 2nd month of active intervention and during the lst month of follow-up. A partial rebound in adduct levels toward baseline values was observed during the 2nd month postintervention. Linear regression models up to week 13 confirmed a significant (P = 0.008) weekly decline of biomarker levels in the group receiving 500 mg of oltipraz once a week. However, despite these effects relative to baseline values within the 500-mg weekly arm, there were no statistically significant differences in biomarker trajectories between treatment arms. The genotype for glutathione S-transferase M1, an oltipraz-inducible isoform involved in the detoxification of aflatoxin B1, did not appear to affect either baseline levels or rates of decline in the biomarker. A follow-up Phase IIb trial with a longer intervention period will be necessary to determine the full extent to which aflatoxin biomarker burden can be reduced and whether diminution of biomarkers can be sustained over the long term.

In 1995, 234 adults from Qidong, Jiangsu Province, People's Republic of China, where hepatocellular carcinoma is the leading cause of cancer deaths and exposure to dietary aflatoxins is widespread, were enrolled and followed in a Phase II chemoprevention trial. The goals of the study were to define a dose and schedule of oltipraz for reducing levels of validated aflatoxin biomarkers and to characterize dose-limiting toxicities. Healthy eligible individuals, including those infected with hepatitis B virus, were randomized to receive either 125 mg of oltipraz daily, 500 mg of oltipraz weekly, or placebo. Blood and urine specimens were collected to monitor toxicities and evaluate biomarkers over the 8-week intervention period and subsequent 8-week follow-up period. Unique trial aspects included a synchronous follow-up schedule, daily observed administration of all medications, timely international data transference, and use of biomarkers as outcomes. One hundred thirty-two participants took their medications without interruptions, approximately 77% contributed all nine urine samples, and 78% contributed all seven blood samples. Fifty-one participants (21.8%) reported clinical adverse events. An extremity syndrome, developing soon after the start of treatment, was the only event that occurred more frequently (P = 0.002) among the active groups (18.4 and 14.1% of the daily 125 and weekly 500 mg arms, respectively) compared with placebo (2.5%). The oltipraz arms did not differ in symptom type or severity, and there were no indications of exacerbated drug intolerance among the few participants infected with hepatitis B virus. The good compliance with an intense follow-up schedule shows that chemoprevention trials with biomarker end points may be conducted in such populations.

Oltipraz has been used clinically in many regions of the world as an antischistosomal agent and is an effective inhibitor of aflatoxin hepatocarcinogenesis in rats. This chemopreventive action of oltipraz results primarily from an altered balance in aflatoxin metabolic activation and detoxication. In 1995, a randomized, placebo-controlled, double-blind intervention was conducted in residents of Qidong, People's Republic of China, who are at high risk for exposure to aflatoxin and development of hepatocellular carcinoma. The major study objectives were to define a dose and schedule for oltipraz that would reduce levels of aflatoxin biomarkers in biofluids of the participants, and to further characterize dose-limiting side effects. Two hundred thirty-four healthy eligible individuals, including those infected with HBV, were randomized to receive either 125 mg oltipraz daily, 500 mg oltipraz weekly, or placebo. Blood and urine specimens were collected to monitor potential toxicities and evaluate biomarkers over the 8-week intervention and subsequent 8-week follow-up periods. Overall, compliance in the intervention was excellent; approximately 85% of the participants completed the study. Objective evaluation of adverse events was greatly facilitated by inclusion of a placebo arm in the study design. A syndrome involving numbness, tingling, and pain in the fingertips was the only event that occurred more frequently among the active groups (18 and 14% of the daily 125 mg and weekly 500 mg arms, respectively) compared to placebo (3%). These symptoms were reversible and could be relieved with non-steroidal antiinflammatory agents. A more complete understanding of the chemopreventive utility of oltipraz awaits completion of an assessment of the efficacy of oltipraz in modulating levels of aflatoxin biomarkers.