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Background: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterized by abdominal pain, diarrhea or constipation, and changes in defecation patterns. No organic disease is found to explain these symptoms by routine clinical examination. This study aims to investigate the efficacy and safety of acupuncture therapy for IBS patients compared with those of conventional treatments. We also aim to identify the optimal acupoint combination recommended for IBS and to clarify the clinical advantage of the "multiacupoint co-effect and synergistic effect."Methods and Analysis: A total of 204 eligible patients who meet the Rome IV criteria for IBS will be randomly stratified into acupuncture group A, acupuncture group B, or the control group in a 1:1:1 ratio with a central web-based randomization system. The prespecified acupoints used in the control group will include bilateral Tianshu (ST25), Shangjuxu (ST37), Neiguan (PC6), and Zusanli (ST36). The prespecified acupoints used in experimental group A will include bilateral Tianshu (ST25), Shangjuxu (ST37), and Neiguan (PC6). The prespecified acupoints used in experimental group B will include bilateral Tianshu (ST25), Shangjuxu (ST37), and Zusanli (ST36). Each patient will receive 12 acupuncture treatments over 4 weeks and will be followed up for 4 weeks. The primary outcome is the IBS-Symptom Severity Scale (IBS-SSS) score. The secondary outcomes include the Bristol Stool Form Scale (BSFS), Work and Social Adjustment Score (WSAS), IBS-Quality of Life (IBS-QOL), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) scores. Both the primary outcome and the secondary outcome measures will be collected at baseline, at 2 and 4 weeks during the intervention, and at 6 weeks and 8 weeks after the intervention.Ethics and Dissemination: The entire project has been approved by the ethics committee of the Beijing University of Chinese Medicine (2020BZYLL0903).Discussion: This is a multicenter randomized controlled trial for IBS in China. The findings may shed light on the efficacy of acupuncture as an alternative to conventional IBS treatment. The results of the trial will be disseminated in peer-reviewed publications.Trial Registration: Chinese Clinical Trials Register ChiCTR2000041215 . First registered on 12 December 2020. http://www.chictr.org.cn/ . [ABSTRACT FROM AUTHOR]

Abstract: The 2008 Mw 7.9 Wenchuan earthquake is a consequence of ongoing India-Tibet collision and reflects the growth of the Longmen Shan fold-and-thrust belt. In this paper, we present new constraints on the deformation mechanism of the Longmen Shan fold-and-thrust belt, by comparing the physical models to the example of the Longmen Shan fold-and-thrust belt. The result indicates that the deformation mechanism of the belt is mainly dominated by the pre-Sinian layer, whereas locally is controlled by the Lower Triassic layer, such as the Longquan anticline. In addition, we discuss the deformation style of the Longquan anticline various along strike, based on the seismic reflection data, interpretations of structural cross-sections and field observations, as well as physical modeling. The sandbox modeling suggests that the deformation of the central segment of Longquan anticline is likely controlled by higher displacement rate, higher erosion and lower sedimentation, which is in contrast with the southern and northern segment. Moreover, the structural geometry of the central segment of Longquan anticline is more complex than the end-member models of fault-related folds, which is mainly controlled by pure-shear wedge fault-bend fold and bounded by west-verging thrust fault. Combining the studies of the structural geometry, deformation mechanism, and previous studies, we infer that the Longquan anticline is active and potentially seismogenic. Therefore, a quantitative re-evaluation of seismic hazard in Longquan anticline and adjacent area directly beneath the densely populated Sichuan basin is urgently needed. [Copyright &y& Elsevier]

ARS2 protein is important to early development and cell proliferation, in which ARS2–CASP8AP2 interaction is implicated. However, the predictive significance of ARS2 in childhood acute lymphoblastic leukemia (ALL) is unknown. Here we evaluate the predictive values of ARS2 expression and combined ARS2 and CASP8AP2 expression in relapse. We showed that ARS2 expression in ALL bone marrow samples at initial diagnosis was markedly lower than that in complete remission (CR). Likewise, the levels of ARS2 expression in the patients suffering from relapse were significantly lower than that of patients in continuous CR. Furthermore, low expression of ARS2 was closely correlated to poor treatment response including poor prednisone response and high minimal residual disease (MRD), and the patients with high MRD (≥10 −4 ) and low ARS2 were more subject to relapse. The multivariate analyses for relapse free survival and event free survival revealed that ARS2 expression remained an independent prognostic factor after adjusting other risk factors. In addition, combined assessment of ARS2 and CASP8AP2 expression was more accurate to predict relapse, based on which an algorithm composed of ARS2 and CASP8AP2 expression, prednisone response and MRD (day 78) was proposed. Together, ARS2 and CASP8AP2 expressions can precisely predict high-risk of relapse and ALL prognosis. [ABSTRACT FROM AUTHOR]

[Display omitted] • The relative motion between India and South China is accommodated by regional right-lateral shearing. • The newly formed Shan Plateau Shear Zone at depth drives the sinistral slip of ENE-trending faults and the upper crust clockwise rotation. • The pattern of Indo-South China Region results from wide dextral shear, clockwise rotation around the Eastern Himalayan Syntaxis. Indo-South China lying between the Indian Plate and the rigid South China Block is characterized by intense crustal deformation with severe seismic hazards. How deformation is partitioned through slip on various structural features provides key insights into understanding the regional geodynamic processes. Based on the up-to-date GPS velocity data together with the existing active tectonic, seismological, and geophysical data, we find that the relative motion between India and South China is mainly accommodated by two parts: ∼47 mm/yr dextral slip and 15–18 mm/yr contraction to the west of the Shan Plateau, and ∼ 10 mm/yr sinistral slip and ∼ 10 mm/yr extension to the east of it. The Burmese Range takes up ∼ 22 mm/yr dextral slip and 10–13 mm/yr contraction, while the Sagaing Fault accommodates ∼ 18 mm/yr dextral slip and 5–6 mm/yr contraction. The Shan Plateau Shear Zone absorbs ∼ 8 mm/yr dextral slip and 5–6 mm/yr extension. The Chuandian Terrane from east of the Red River Fault to the Xiaojiang Fault manifests 8–10 mm/yr sinistral slip and 5–6 mm/yr extension. The block motion inversion reveals that the clockwise rotation and deformation are caused by the northeastward motion of the India Plate and the clockwise lithospheric flow around the Eastern Himalayan Syntaxis. The Shan Plateau Shear Zone may be a newly formed dextral shear zone at depth of the middle and lower crust, driving the sinistral slip and extension along the ENE-trending faults in upper crustal level. The Shan Plateau Shear Zone might have replaced the Red River Fault as the western boundary to cause the southeastward coherent movement of the Chuandian Terrane. The complex pattern of active tectonic deformation in the region results from interactions among hyper-oblique subduction beneath the Burmese Range, clockwise rotation of lithospheric material around the Eastern Himalayan Syntaxis, and the apparently rigid Sundaland Block separating the two systems in between. [ABSTRACT FROM AUTHOR]

Background: Though the survival of breast cancer (BC) patients with malignant pleural effusion (MPE) has been studied, this has not been specifically studied in the luminal B subtype. Therefore, this study investigated the characteristics and survival of luminal B-BC patients presenting with MPE., Methods: We retrospectively analyzed 141 patients diagnosed with postoperative advanced Luminal B breast cancer, including 54 cases with MPE and 87 cases without MPE at the Tianjin Cancer Hospital from January 2012 to January 2015. We assessed the clinical characteristics between the groups., Results: The mean age of all patients was 47 years, with no significant difference between the two groups. Altogether, 29 (33%), 24 (28%), 28 (32%), 45 (52%), and 10 (11%) patients had lung, liver, bone, lymph node, and chest wall metastases, respectively. In addition. The difference in overall survival between the two groups was not significant (P>0.05). However, cox regression analysis showed that only the tumor clinical stage at initial diagnosis was related to short overall survival. Further, we conducted a subgroup analysis and found that the higher the clinical stage at initial diagnosis in age < 50 years patients, the shorter the overall survival, while age > 50 years patients was not. (P < 0.05)., Conclusions: There was no difference in the overall survival between luminal B-BC patients with MPE and those without. Clinical stages at initial diagnosis were an independent prognostic factor for age < 50 years luminal B BC with MPE overall survival. Our results may help clinicians make positive decisions regarding personalized treatment of luminal B-BC with MPE., (© 2024. The Author(s).)

Objective: To investigate the incidence, clinical and genetic characteristics of pediatric lymphoma patients of China with inborn errors of immunity (IEI)-related gene mutations, which have not been fully studied., Method: From Jan. 2020 to Mar. 2023, IEI-related genetic mutations were retrospectively explored in 108 children with lymphomas admitted to Beijing Children's Hospital by NGS. Genetic rule and clinical characteristics as well as treatment outcomes were compared between patients with or without IEI-related gene mutations., Results: A total of 17 patients (15.7 %) harbored IEI-associated mutations, including 4 cases with X-linked lymphoproliferative syndrome (XLP), 3 cases had mutations in tumor necrosis factor receptor superfamily 13B (TNFRSF13B), 2 cases with Activated p110 syndrome (APDS). Patients with IEI all had alteration of immunocompetence with decreased levels of immunoglobulin and lymphocyte subsets. Recurrent infection existed in 41.2 % of patients. The 18-month event-free survival (EFS) and the overall response rate (ORR) of patients with IEI are significantly lower than those without IEI (33.86% vs. 73.26 %, p = 0.011; 52.94% vs. 87.91 %, p = 0.002, respectively). In addition, patients with IEI had a higher progression disease (PD) rate of 23.5 % than those without IEI of 4.4 % (p = 0.006)., Conclusion: The present study demonstrated that IEI-associated lymphomas were much more common than originally appreciated in pediatric lymphomas, and those were insensitive to treatment and more likely to progress or relapse. The genomic analysis and a thorough review of the medical history of IEI can be used to distinguish them from pediatric lymphomas without IEI, which are beneficial for the early diagnosis and direct intervention., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2024 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

Purpose: We sought to investigate the effectiveness and safety of dabrafenib in children with BRAFV600E-mutated Langerhans cell histiocytosis (LCH)., Materials and Methods: A retrospective analysis was performed on 20 children with BRAFV600E-mutated LCH who were treated with dabrafenib., Results: The median age at which the patients started taking dabrafenib was 2.3 years old (range, 0.6 to 6.5 years). The ratio of boys to girls was 2.3:1. The median follow-up time was 30.8 months (range, 18.9 to 43.6 months). There were 14 patients (70%) in the risk organ (RO)+ group and six patients (30%) in the RO- group. All patients were initially treated with traditional chemotherapy and then shifted to targeted therapy due to poor control of LCH or intolerance to chemotherapy. The overall objective response rate and the overall disease control rate were 65% and 75%, respectively. During treatment, circulating levels of cell-free BRAFV600E (cfBRAFV600E) became negative in 60% of the patients within a median period of 3.0 months (range, 1.0 to 9.0 months). Grade 2 or 3 adverse effects occurred in five patients., Conclusion: Some children with BRAFV600E-mutated LCH may benefit from monotherapy with dabrafenib, especially high-risk patients with concomitant hemophagocytic lymphohistiocytosis and intolerance to chemotherapy. The safety of dabrafenib is notable. A prospective study with a larger sample size is required to determine the optimal dosage and treatment duration.

Acute lymphoblastic leukemia (ALL) is the most common malignancy among children. The trial Chinese Children Leukemia Group (CCLG)-ALL 2008 was a prospective clinical trial designed to improve treatment outcome of childhood ALL through the first nation-wide collaborative study in China. Totally 2231 patients were recruited from ten tertiary hospitals in eight cities. The patients were stratified according to clinical-biological characteristics and early treatment response. Standard risk (SR) and intermediate risk (IR) groups were treated with a modified BFM based protocol, and there was 25%-50% dose reduction during intensification phases in the SR group. Patients in high risk (HR) group received a more intensive maintenance treatment. Minimal residual disease (MRD) monitoring with treatment adjustment was performed in two hospitals (the MRD group). Complete remission (CR) was achieved in 2100 patients (94.1%). At five years, the estimate for overall survival (OS) and event-free survival (EFS) of the whole group was 85.3% and 79.9%, respectively. The cumulative incidence of relapse (CIR) was 15.3% at five years. The OS, EFS and CIR for the SR group were 91.5%, 87.9%, and 9.7%, respectively. The outcome of the MRD group is better than the non-MRD group (5y-EFS: 82.4% vs 78.3%, P = .038; 5y-CIR: 10.7% vs 18.0%, P < .001). Our results demonstrated that the large-scale multicenter trial for pediatric ALL was feasible in China. Dose reduction in the SR group could achieve high EFS. MRD-based risk stratification might improve the treatment outcome for childhood ALL., (© 2018 Wiley Periodicals, Inc.)

Freshwater resources are under stress around the world due to rapid urbanization and excessive water consumption. Cyanobacterial blooms have occurred frequently in surface waters, which produced toxic secondary metabolites causing a potential harm to aquatic ecosystems and humans. In this study, the relationship between different types of nitrogen source and the algal growth of Anabaena flos-aquae, which was isolated from Dianchi Lake in southern China, was investigated. Experiments were accomplished by using four types of isotope tracers including 15 N-ammonium chloride, 15 N-sodium nitrate, 15 N-urea, 15 N-l-alanine in culture medium to characterize the biosynthesis of 15 N-anatoxin-a (ATX-A), which is a major algal toxin from A. flos-aquae, through liquid chromatography-tandem mass spectrometry (LC-MS/MS). The results showed that all these four types of nitrogen can be incorporated into algal cells. The ATX-A production with urea as the nitrogen source was much higher than that with the other three types of nitrogen. The 15 N labeling experiments further demonstrated that the uptake of organic nitrogen nutrients was significantly greater than that of inorganic nitrogen. These results provide new evidence and deeper insight to explore the biosynthesis of ATX-A in the specific strain of A. flos-aquae., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Aim: To compare lymph node dissection results of minimally invasive esophagectomy (MIE) and open surgery for esophageal squamous cell carcinoma., Methods: We retrospectively reviewed data from patients who underwent MIE or open surgery for esophageal squamous cell carcinoma from January 2011 to September 2014. Number of lymph nodes resected, positive lymph node (pN+) rate, lymph node sampling (LNS) rate and lymph node metastatic (LNM) rate were evaluated., Results: Among 447 patients included, 123 underwent MIE and 324 underwent open surgery. The number of lymph nodes resected did not significantly differ between the MIE and open surgery groups (21.1 ± 4.3 vs 20.4 ± 3.8, respectively, P = 0.0944). The pN+ rate of stage T3 esophageal squamous cell carcinoma in the open surgery group was higher than that in the MIE group (16.3% vs 11.4%, P = 0.031), but no differences was observed for stages T1 and T2 esophageal squamous cell carcinoma. The LNS rate at left para-recurrent laryngeal nerve (RLN) site was significantly higher for open surgery than for MIE (80.2% vs 43.9%, P < 0.001), but no differences were noted at other sites. The LNM rate at left para-RLN site in the open surgery group was significantly higher than that in the MIE group, regardless of pathologic T stage., Conclusion: For stages T1 and T2 esophageal squamous cell carcinoma, the lymph node dissection result after MIE was comparable to that achieved by open surgery. However, the efficacy of MIE in lymphadenectomy for stage T3 esophageal squamous cell carcinoma, particularly at left para-RLN site, remains to be improved.

Background: Infections remain a major cause of therapy-associated morbidity and mortality in children with acute lymphoblastic leukemia (ALL)., Methods: We retrospectively analyzed the medical charts of 256 children treated for ALL under the CCLG-2008 protocol in Beijing Children's Hospital., Results: There were 65 infectious complications in 50 patients during vincristine, daunorubicin, L-asparaginase and dexamethasone induction therapy, including microbiologically documented infections (n = 12; 18.5%), clinically documented infections (n = 23; 35.3%) and fever of unknown origin (n = 30; 46.2%). Neutropenia was present in 83.1% of the infectious episodes. In all, most infections occurred around the 15 th day of induction treatment (n = 28), and no patients died of infection-associated complications., Conclusions: The infections in this study was independent of treatment response, minimal residual diseases at the end of induction therapy, gender, immunophenotype, infection at first visit, risk stratification at diagnosis, unfavorable karyotypes at diagnosis and morphologic type. The infection rate of CCLG-2008 induction therapy is low, and the outcome of patients is favorable.

Acute lymphoblastic leukemia (ALL) with distinct fusion transcripts has unique clinical features. In this study, the incidence, clinical characteristics, early treatment response, and outcomes of 1,004 Chinese pediatric ALLs were analyzed. Patients with TEL-AML1 and E2A-PBX1 fusion genes or other B cell precursor ALLs (BCP-ALL) had favorable clinical features, were sensitive to prednisone, had low minimal residual disease (MRD), and an excellent prognosis, with a 5-year event-free survival (EFS) of 84-92%. T-ALL was associated with a high WBC, increased age, more central nervous system involvement, a poor prednisone response, and high MRD, with a 5-year EFS of 68.4 ± 5.2%. Patients with BCR-ABL and MLL rearrangements usually had adverse clinical presentations and treatment responses, and a dismal prognosis, with 5-year EFS of 27.3 and 57.4%, respectively. We also showed that BCR-ABL and MLL rearrangements, the prednisone response, and MRD were independent prognostic factors. Interestingly, the BCH-2003 protocol resulted in a better outcome for E2A-PBX1(+) patients than the CCLG-2008 protocol. Intermediate and late relapses were more common in TEL-AML1(+) patients and other BCP-ALLs compared with other subgroups (P = 0.018). Therefore, this study suggests that a fusion gene-specific chemotherapy regimen and/or targeted therapy should be developed to improve further the cure rate of pediatric ALL., (Copyright © 2012 Wiley Periodicals, Inc.)

This study aimed to investigate whether there was a correlation between the genotype or haplotype of the methylenetetrahydrofolate reductase gene (MTHFR) and toxicities during consolidation therapy or plasma methotrexate (MTX) levels at 48 h after the first dose of MTX infusion. We retrospectively genotyped 181 children with newly diagnosed acute lymphoblastic leukemia (ALL) who were treated with the Chinese Children's Leukemia Group protocol. In standard- and medium-risk treatment branches, the 677T carriers (CT + TT) had a higher risk of developing thrombocytopenia when compared with carriers of the CC genotype (odds ratio [OR] 5.21, 95% confidence interval [CI] 1.18-23.01, p = 0.017). The 1298AC/CC genotypes were associated with a decrease in skin toxicity, as compared with the common AA genotype (p = 0.037). An estimation of haplotype frequencies showed that there was no 677T-1298C haplotype in the population. A lower frequency of anemia (OR 0.44, 95% CI 0.21-0.90, p = 0.025) and lower MTX level (p = 0.044) were observed in patients with the 677C-1298C haplotype than in those without. High plasma MTX level was correlated with anemia (p = 0.011) and neutropenia (p = 0.044). In the high-risk group, the polymorphisms or plasma MTX levels were not correlated with any toxicity. Taken together, our data demonstrate that genotyping of MTHFR and measurement of plasma MTX levels might be useful to optimize MTX therapy.

By using Landsat and high resolution ALOS images, and based on the comparison of the precision of sea area extracted from various water indices, a modified index MNDWI was adopted to study the shoal reclamation in Jinzhou Bay sea area in 1988, 1995, and 2006. In the period 1988-2006, the reclaimed area in Jinzhou Bay sea area reached 23.63 km2, among which, 12.38 km2, 5.48 km2, 3.47 km2, 1.37 km2, and 0.93 km2 were used for development zone, industry, port construction, seawater aquaculture, and beach bathing, respectively. The large acreage shoal reclamation reflected the urgent demand of land for coastal urban construction and economic development along the Jinzhou Bay, while at the meantime, brought about greater impacts on the local eco-environment, which needed to be further monitored and assessed.

Objective: To explore the status on visual disability and the leading causes in residents in Henan Province., Methods: It was a cross-sectional study and a part of the National Epidemiological Study on the disability in 2006. Sample size 120 000 was assigned to Henan study by the protocol of the National epidemiological study on the disability. Stratified, equal interval, proportional probability; four-stage sampling was adopted. Survey teams were organized, and survey personnel was trained in the sampled counties and cities. Visual disabled persons were screened by home to home visit and confirmed by ophthalmologists., Results: 130 415 persons in 36 923 households were studied. 1973 persons were confirmed to have the visual disability, the prevalence was 1.51%. Among them, 1376 persons just suffer from the visual disability (simple visual disability), 579 persons had multiple disability including the visual disability (multiple disability). Among them, 643 persons (0.49%) were blindness, 1330 persons (1.02%) were low vision. The age of the most of the persons with visual disability was more than 50 years old. The prevalence of the simple visual disability in male and female was 0.77% and 1.36% respectively and had significant statistical difference (chi(2) = 105.687, P < 0.01). The prevalence of the simple visual disability in urban and rural area was 0.58% and 1.15% respectively and also had significant statistical difference (chi(2) = 56.047, P < 0.01). The first five leading causes of the visual disability were cataract (54.69%), retinal and choroidal diseases (8.21%), corneal diseases (5.83%), genetic and congenital eye diseases (5.07%) and glaucoma (4.56%)., Conclusion: Government and health organizations should pay more attention to the prevention and treatment the visual disability in Henan province, especially the prevention and treatment of cataract, retinal and choroidal diseases, corneal diseases, genetic and congenital eye diseases and glaucoma.

Objective: To study the relationship between different strains of Salmonella enteritidis, a molecular epidemiologic analysis method-pulsed-field gel electrophoresis was established and Salmonella enteritidis isolated from food samples were tested., Methods: Food samples were collected from Henan province, Heilongjiang province and other provinces in 1991 - 2001. Strains were isolated and single colony of each Salmonella enteritidis strain from an agar plate was picked and enriched, then the total DNA was extracted in turn with lysozyme solution, proteinase K solution and TE buffer. The agarose pulgs were digested with restriction enzyme XbaI overnight at 37 degrees C, followed by pulsed-field gel electrophoresis (PFGE) with a CHEF Mapper system in 0.5 x TBE buffer with recirculation at 14 degrees C . DNA macrorestriction fragments were resolved on 1% agarose gels, pulse time were ramped from 5s to 45s during a 26h run at 6V/cm. A lambda ladder pulsed-field gel maker was used as a size standard., Results: 30 Salmonella enteritidis strains were identified in chicken, beef, cooked meat and vegetables. 18 strains were isolated from henna province. More of the stains (22 strains) were isolated in 2001. Two distinct DNA fragment profiles, PFGE types A and B, were observed, representing 63.3% and 36.7% of the isolates respectively. Type A could be subdivided further into two subtypes. Subtype A1 represented the majority (78.9%) of type A strains and differed from subtype A2 in that the latter lacked a band in the 50kb region. There was no correlation between the strains profiles and their isolation time or region. However, all the strains isolated from the chicken were totally type A1, and showed certain epidemiological trend which can be studied in the future., Conclusion: The pulsed-field gel electrophoresis is a good method to study the molecular epidemiological relationship between the different Salmonella enteritidis srtains.

Objective: To carry out national active surveillance on Listeria monocytogenes in foods in China., Methods: Four thousand and thirty-four random samples from raw meat, meat product, raw milk, vegetable, yoghurt, icecream and aquatic product were collected in 11 provinces (cities), and examined for Listeria monocytogenes according to the national standard method and confirmed by BAX system (DuPont Qualicon, Wilmington, DE)., Results: Seventy isolates four kinds of foods in seven provinces were found to have LM according to the national standard method with a total isolate rate of 1.74%. In Fujian, the rate was higher than in the other provinces. Raw meat was found to be most heavily contaminated in seven kinds of foods. Comparing to national standard method, BAX system showed good sensitivity (> 98%) and specificity (> 97%)., Conclusion: In each province seven kinds of food were all contaminated by Listeria monocytogenes to some degrees, suggesting that local sanitary surveillance should be strengthened. BAX system can be used to correctly and quickly screen Listeria monocytogenes.