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This study reports the development and validation of a culturally sensitive, domain-specific measure of life satisfaction for Chinese Elders--The Life Satisfaction Scale-Chinese ("LSS-C"). The "LSS-C" was administered to 1,502 randomly-selected older Chinese persons in three newly developed towns in Mainland China. Confirmatory factor analysis supported a conceptually meaningful two-factor model--one of instrumental needs of daily life and one of social and relational needs. Criterion-related validity was satisfactory when positively correlated with a single-item global life satisfaction measure and the Life Satisfaction Index A, and negatively correlated with the Center for Epidemiological Studies Depression Scale. The reliability of the eight-item scale was satisfactory, with the internal consistency coefficient equal to 0.78 and the split half coefficient equal to 0.81. "LSS-C" was direct and easy to administer, and it is recommended for use on Chinese elders. (Contains 5 tables.)

Background: Dementia is a global public health priority due to rapid growth of the aging population. As China has the world's largest population with dementia, this debilitating disease has created tremendous challenges for older adults, family caregivers, and health care systems on the mainland nationwide. However, public awareness and knowledge of the disease remain limited in Chinese society.Objective: This study examines online public discourse and sentiment toward dementia among the Chinese public on a leading Chinese social media platform Weibo. Specifically, this study aims to (1) assess and examine public discourse and sentiment toward dementia among the Chinese public, (2) determine the extent to which dementia-related discourse and sentiment vary among different user groups (ie, government, journalists/news media, scientists/experts, and the general public), and (3) characterize temporal trends in public discourse and sentiment toward dementia among different user groups in China over the past decade.Methods: In total, 983,039 original dementia-related posts published by 347,599 unique users between 2010 and 2021, together with their user information, were analyzed. Machine learning analytical techniques, including topic modeling, sentiment analysis, and semantic network analyses, were used to identify salient themes/topics and their variations across different user groups (ie, government, journalists/news media, scientists/experts, and the general public).Results: Topic modeling results revealed that symptoms, prevention, and social support are the most prevalent dementia-related themes on Weibo. Posts about dementia policy/advocacy have been increasing in volume since 2018. Raising awareness is the least discussed topic over time. Sentiment analysis indicated that Weibo users generally attach negative attitudes/emotions to dementia, with the general public holding a more negative attitude than other user groups.Conclusions: Overall, dementia has received greater public attention on social media since 2018. In particular, discussions related to dementia advocacy and policy are gaining momentum in China. However, disparaging language is still used to describe dementia in China; therefore, a nationwide initiative is needed to alter the public discourse on dementia. The results contribute to previous research by providing a macrolevel understanding of the Chinese public's discourse and attitudes toward dementia, which is essential for building national education and policy initiatives to create a dementia-friendly society. Our findings indicate that dementia is associated with negative sentiments, and symptoms and prevention dominate public discourse. The development of strategies to address unfavorable perceptions of dementia requires policy and public health attention. The results further reveal that an urgent need exists to increase public knowledge about dementia. Social media platforms potentially could be leveraged for future dementia education interventions to increase dementia awareness and promote positive attitudes. [ABSTRACT FROM AUTHOR]

Background There are ethnic differences in the prevalence and types of androgenetic alopecia (AGA). Although there have been several reports on the prevalence and types of AGA in caucasian and Asian populations, there are very few data on a Chinese population that have been derived from a sufficient number of samples. Objectives To estimate the prevalence and types of AGA in a Chinese population, and to compare the results with those in caucasians and Koreans reported previously in the literature. Methods A population-based cross-sectional study was carried out in 7056 subjects (3519 men and 3537 women) from May 2006 to December 2006 in a community of Shanghai. Questionnaires were completed during face-to-face interviews at the subjects’ homes. The degree of AGA was classified according to the Norwood and Ludwig classifications. Results The prevalence of AGA in Chinese men was 19·9%, and the prevalence of female pattern AGA in men was 0·1%. The most common type in men was type III vertex (3·5%). The prevalence of AGA in women was 3·1%, while male pattern AGA was found in those aged over 50 years (0·4%), and the most common type was type I (Ludwig classification) (1·4%). A family history of AGA was present in 55·8% of men and 32·4% of women with AGA. Conclusions The prevalence of AGA in Chinese men was lower than in caucasian men but was similar to that in Korean men; however, over the age of 60 years it was approaching that in caucasian men but was higher than that in Korean men. The most common type in Chinese men with AGA was type III vertex. Interestingly, the prevalence of AGA in Chinese women was lower than that in Korean women and caucasian women, and type I was the most common type (Ludwig classification). [ABSTRACT FROM AUTHOR]

The widespread use of milk mid-infrared (MIR) spectroscopy for phenotype prediction has urged the application of prediction models across regions and countries. Spectra standardization is the most effective way to reduce the variability in the spectral signal provided by different instruments and labs. This study aimed to develop different standardization models for MIR spectra collected by multiple instruments, across 2 provinces of China, and investigate whether the standardization method (piecewise direct standardization, PDS, and direct standardization, DS), testing scenario (standardization of spectra collected on the same day or after 7 mo), infrared prediction model accuracy (high or low), and instrument (6 instruments from 2 brands) affect the performance of the standardization model. The results showed that the determination coefficient (R 2 ) between absorbance values at each wavenumber provided by the primary and the secondary instruments increased from less than 0.90 to nearly 1.00 after standardization. Both PDS and DS successfully reduced spectra variation among instruments, and performed significantly better than nonstandardization. However, DS was more prone to overfitting than PDS. Standardization accuracy was higher when tested using spectra collected on the same day compared with those collected 7 mo after, but great improvement in model transferability was obtained for both scenarios compared with the nonstandardized spectra. The less accurate infrared prediction model (for C8:0 and C10:0 content) benefited the most from spectra standardization compared with the more accurate model (for total fat and protein content). For spectra collected 7 mo after standardization, after PDS the root mean square error between predictions obtained by different machines decreased on average by 86% and 94% compared with the values before standardization for C8:0 and C10:0, respectively. The secondary instrument had no significant effect on the R 2 between predictions. The variation in the spectral signal provided by different instruments was successfully reduced by standardization across 2 provinces in China. This study lays the foundations for developing a national MIR spectra database to provide consistent predictions across provinces to be used in dairy farm management and breeding programs in China. Additionally, this provides opportunities for data exchange and cooperation at international levels., (The Authors. Published by Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Urinary incontinence (UI) is a disease that quietly yet seriously impacts women's health and represents a global health burden that is often neglected. This study aims to systematically assess the prevalence and dynamics of female UI in China, and can inform further policies and have international implications. This study used three nationwide investigations: A national cross-sectional survey in 2021; another nationwide cross-sectional survey in 2006; and data regarding the institutions and physicians providing pelvic floor rehabilitation services from 2005 to 2019. The weighted prevalence of female UI and its subtypes, including stress UI (SUI), urgency UI (UUI), and mixed UI (MUI), were estimated as primary outcomes. Knowledge, attitude and care-seeking behaviors of UI were evaluated. It was found that the weighted prevalence of female UI was 16.0 % (95% CI, 13.3 %-19.1%) with SUI remaining the predominant subtype (7.0%) in 2021, followed by MUI (6.5%) and UUI (1.9%). The estimated absolute number of Chinese adult women with UI was 85.8 million in 2021. 52.7% (95% CI, 45.9%-59.4 %) of women were aware that UI was a medical condition, and only 10.1% of women with UI sought health care. After 15 years of development, there were 8400 pelvic floor rehabilitation institutions and nearly 10,000 relevant physicians in China-they were found to be associated with UI prevalence. The UI prevalence in China was significantly lower in 2021 compared to that in 2006. Despite the achievement, UI remains a public health problem, especially given China's fast aging and three-child policy. More innovations, especially those that can facilitate care seeking, are needed to address this prevalent yet treatable condition., (Copyright © 2024 Science China Press. Published by Elsevier B.V. All rights reserved.)

Purpose: To develop and evaluate a new intraocular lens (IOL) formula based on Chinese eyes., Methods: A training dataset of 709 eyes undergoing uneventful cataract surgery was used to train the algorithm for effective lens position estimation. The algorithm was then integrated with Gaussian optics to develop the new IOL formula (Jin-AI). From the same center, 177 eyes served as an internal test dataset. An independent dataset of 557 eyes served as an external test dataset. The standard deviation (SD) of prediction errors was compared among the Jin-AI formula, traditional third-generation formulas (SRK/T, Holladay 1, Hoffer Q), and newer generation formulas (Kane, Barrett Universal II [BUII], Hill-radial basis function [RBF] 3.0, and PEARL-DGS)., Results: In the internal test dataset, the Jin-AI formula showed the lowest SD (0.25 D), followed by the BUII (0.31 D), Kane (0.33 D), and PEARL-DGS (0.33 D) formulas. In the external test dataset, the Jin-AI, Kane, and PEARL-DGS formulas had the lowest SD (0.38 D), followed by the BUII (0.39 D), Hill-RBF 3.0 (0.39 D), SRK/T (0.45 D), Holladay 1 (0.48 D), and Hoffer Q (0.48 D) formulas. The SD of the Jin-AI formula was significantly lower than the third-generation formulas and comparable to the four newer generation formulas. Predictive accuracy of the Jin-AI formula was similar to the newer generation formulas across all axial length, keratometry, and anterior chamber depth ranges., Conclusions: The new formula has exhibited good performance in predicting postoperative refractions. Its overall predictive accuracy was better than the third-generation formulas and comparable to the newer generation ones., Translational Relevance: The Jin-AI formula could be a reliable alternative for IOL power calculation in Chinese.

Equal rights to rent and purchase affects the supply of compulsory education resources. How to promote the balanced compulsory education resources supply in the context of equal rights to rent and purchase is currently a hot issue amongst government and society. To achieve such balance, conducting research in the context of equal rights to rent and purchase becomes crucial. However, existing research has yet to provide sufficient explanations for the differentiated paths for realizing the balanced compulsory education resources supply in practice. This study uses 31 cities in China as case samples and jointly applies fuzzy-set qualitative comparative analysis and the 'technology-organization-environment' (TOE) framework. The findings are summarized as follows. Firstly, the balanced compulsory education resources supply in the context of equal rights to rent and purchase is affected by six key technological, organizational, and environmental factors. Namely, data co-construction and sharing, technological infrastructure, attention allocation, government information disclosure, policy support for equal rights to rent and purchase, and level of urban economic development. Secondly, the linkage matching of technological, organizational and environmental conditions forms diversified configurations that drive the balanced compulsory education resources supply in the context of equal rights to rent and purchase. These configurations include the 'organization' driving model, 'technology-environment' driving model, 'technology-organization-environment' driving model, and 'technology-organization' driving model. Finally, eastern, central and western China are driven by different configuration paths. Amongst them, eastern China has relatively good basic conditions at the technological, organizational and environmental levels. The combination of different conditions can drive the balanced compulsory education resources supply in a 'different paths lead to the same destination' manner. Although the development in central China is somewhat restricted, the radiation and impetus from eastern China, in combination with the different conditions in central China, can drive the balanced compulsory education resources supply. Western China shows no advantages at the technological, organizational and environmental levels. Faced with restrictions in organizational and environmental conditions, the government in western China should develop the necessary technological conditions to drive the balanced compulsory education resources supply., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lou, Li. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: Insufficient sleep and skipping breakfast are increasingly prevalent among children and adolescents. Both behaviors are associated with the onset of depression. This study aims to examine the independent and joint associations of these two behaviors with depressive symptoms, and investigate whether these associations varied by age or sex., Methods: The Center for Epidemiological Studies Depression Scale (CES-D) was used to evaluate the depressive symptoms. This cross-sectional study including 11,887 students aged 11-19 years using a stratified cluster, multistage sampling method in Ningbo, China. Multiple logistic regressions were conducted to evaluate the independent and joint association between insufficient sleep, skipping breakfast and depressive symptoms. Sensitivity analyses and stratified analyses by age and sex were performed using the same modelling strategies., Results: The overall prevalence of depressive symptoms was 15.27%. Skipping breakfast (Odds Ratio (OR) = 2.557, 95% Confidence Interval (CI) = 2.236-2.925) and insufficient sleep (OR = 1.547, 95%CI = 1.390-1.723) was independently associated with depressive symptoms. Compared to students with "sufficient sleep and breakfast every day", the OR was 4.385 (95%CI = 3.649-5.271) for those with "insufficient sleep and skipping breakfast". Meanwhile, the joint association was moderated by age group, with a more apparent association observed in the 11-15-year-old group compared to the 16-19-year-old group., Conclusions: These findings indicated that insufficient sleep and skipping breakfast were independently and jointly associated with depressive symptoms. Insufficient sleep and skipping breakfast could be considered as two of the predictors of depression., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: To analyze the perioperative bleeding and hidden blood loss (HBL) of sacroiliac screw minimally invasive treatment of pelvic posterior ring injury and explore the influential factors of HBL after operation for providing reference for clinical treatment., Method: A retrospective analysis was conducted on data from 369 patients with posterior pelvic ring injuries treated with sacroiliac screws internal fixation at our hospital from January 2015 to January 2022. The research was registered in the Chinese Clinical Trial Registry in July 2022 (ChiCTR2200061866). The total blood loss (TBL) and HBL of patients were counted, and the factors such as gender, age, and surgical duration were statistically analyzed. The influential factors of HBL were analyzed by multiple linear regression., Results: The TBL was 417.96 ± 98.05 ml, of which the visible blood loss (VBL) was 37.00 ± 9.0 ml and the HBL was 380.96 ± 68.8 ml. The HBL accounted for 91.14 ± 7.36% of the TBL. Gender, surgical duration, fixed position, and fixed depth had significant effects on the HBL (P < 0.05)., Conclusions: The HBL was the main cause of anemia after minimally invasive treatment of posterior pelvic ring injury with a sacroiliac screw. Gender, surgical duration, fixed position, and fixed depth were closely related to the occurrence of HBL. In clinical treatment, we should consider these influential factors and take effective measures to reduce the impact of HBL on patients., (© 2024. The Author(s).)

The scale of tourism has continued to expand in recent years, and many associated activities cause damage to the natural environment. The tourism, economy and natural environment constitute a system: destruction of the natural environment reduces the value of tourism and a lack of tourism affects the development of the economy. To explore the relationship between the tourism, economy and natural environment, and to explore possibilities for sustainable development, this paper takes Hangzhou, a tourist city in China, as a research object. An analysis of time series data is carried out. First, the tourism, economy and natural environment subsystems are constructed by extracting time series data acquired between 2010 and 2020. Second, a tourism evaluation model with coupled economic and natural environment data is constructed and the coupling degree and coupling coordination level in Hangzhou are evaluated. Third, the time series of each subsystem and the coupling coordination level of the whole system are analyzed. Finally, an optimization strategy is proposed for the coupled coordinated development of the tourism, economy and natural environment in Hangzhou. A key result is that the tertiary industry represented by tourism has become the main source of local income. Hangzhou's tourism coupling coordination level has changed from slight disorder in 2010 to good in 2020. It is also found that the COVID-19 pandemic has become a major factor restricting the development of tourism. Before the outbreak of COVID-19, Hangzhou's tourism industry and economy were synchronized. After the outbreak of COVID-19, both the number of tourists and tourism revenue in Hangzhou fell by nearly 15%.

Soil and groundwater Cr(VI) pollution resulting from improper disposal and accidental spills is a critical problem worldwide. In this study, a comprehensive study was conducted to assess the hydrogeological conditions of a contaminated site, obtain spatiotemporal distribution and trend forecasts of pollutant Cr(VI), and determine the feasibility of applying clayey engineered barriers for pollution control. The results showed that the hydraulic conductivity (K) of the clayey barrier (1.56E-5 m/d) is several orders of magnitude lower than that of the stratum beneath the contaminated site, with K values ranging from 0.0014 to 4.76 m/d. Cr(VI) exhibits high mobility and a much higher concentration in the vadose zone, with maximum values of 6100 mg/kg in topsoil and 2090 mg/L in the perched aquifer. The simulation results indicated that the groundwater in the vicinity of the contaminated site, as well as downstream of the Lianshui River, is seriously threatened by Cr(VI). Notably, the pollution plume could occur downstream of the Lianshui River after 8 years. The retention efficiency of clayey engineered barriers will decrease over time, at 61.6% after 8 years and 33% after 20 years. This work contributes to an in-depth understanding of Cr(VI) migration at contaminated sites., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Houses mean a lot to Chinese people, and in the context of the urban-rural dualist system, town housing has a special significance for rural-urban migrants. Based on the 2017 China Household Finance Survey(CHFS) data, this study uses the Ordered Logit (OLogit) model to empirically test the effect of owning commercial housing on the subjective well-being(SWB) of rural-urban migrants, and through the mediating effect and moderating effect to conduct an in-depth investigation into the intrinsic effect mechanism and further explains the relationship between the two and the current residential location of their family. The results of the study show that: (1) Owning commercial housing can significantly enhances the subjective well-being(SWB) of rural-urban migrants, and the findings remain robust after using alternative model, adjusting the sample size, correcting for sample selectivity bias using propensity score matching(PSM), and controlling for potential endogeneity bias combining instrumental variables and conditional mixed process(CMP); (2) The effect of owning commercial housing on the subjective well-being(SWB) of the first generation rural-urban migrants, rural-urban migrants in the eastern and central regions, and those who obtained housing before the rapid rise in house prices is more pronounced; (3) Commercial housing acts on the subjective well-being(SWB) of rural-urban migrants through the mediating effect of housing assets, and there is some regional variation in the mediating effect of housing assets. At the same time, the household debt acts as a positive moderator between commercial housing and the subjective well-being(SWB) of rural-urban migrants; (4) Even with commercial housing, rural-urban migrants whose families are currently living in rural areas still have a stronger sense of subjective well-being (SWB)., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Lou et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The rapid development of the smelting industry increases the release of antimony (Sb) into the soil environment, which threatens human health and ecosystems. A total of 87 samples were collected from an abandoned Sb smelting site to evaluate pollution characteristics and environmental risks of the potentially toxic elements (PTEs). The contents of As, Cu, Ni, Pb, Sb, and Zn in the fresh soils determined by P-XRF were 131, 120, 60, 145, 240, and 154 mg/kg, respectively, whilst following drying, grinding, and sieving pretreatments, the corresponding contents increased to 367, 179, 145, 295, 479, and 276 mg/kg, respectively. There was a significant correlation between the data obtained by P-XRF and ICP-OES in the treated samples, which showed the application feasibility of P-XRF. The average contents of Sb and As were 440.6 and 411.6 mg/kg, respectively, which exceeded the control values of the development land in GB 36600-2018. The ecological risk levels of the six PTEs decreased in the following order: As > Sb > Pb > Zn > Ni > Cu. Non-carcinogenic risk revealed that As, Pb, and Sb posed health risks for children, whilst for carcinogenic risk, the risk values for As and Ni were higher than the limit values for both children and adults. Anthropogenic sources accounted for more than 70.0% of As, Pb, and Sb concentrations in soils, indicating a significant influence on PTEs accumulation. The findings provide a basis for quick determination of the contamination characteristics and risk control of PTEs at Sb smelting sites., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier B.V.)

The authentication of geographical origin of food is important using stable isotope analysis. However, the isotopic databank is still short of comprehensive. The isoscapes model based on environmental similarity is used for the first time to predict the geospatial distribution of δ 13 C, δ 2 H and δ 18 O in Chinese rice in 2017 and 2018. 794 rice samples in 2017 were used to build isoscapes model. Independent verification shows that the predicted isotope distribution from this new approach is of high accuracy, with a root mean square error (RMSE) of 0.51 ‰, 7.09 ‰ and 2.06 ‰ for δ 13 C, δ 2 H and δ 18 O values for 2017, respectively. Our results indicate that it is possible to predict the spatial distribution of stable isotopes in rice using an isoscapes model based on environmental similarity. This novel strategy can enrich and complement a stable isotope reference database for rice origin identification at regional scale., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Despite a variety of studies on the tropical cyclone (TC) response to climate change, few of them have examined the projected damages of future TCs. Here we quantify the impact of anthropogenic warming on TC-induced damages in the late twenty-first century along the coasts of Southeast China based on convection-permitting TC simulations and machine-learning-based damage models. We found that if the area's 10 super typhoons between 2013 and 2019 were to occur at the end of the century under the high emissions RCP8.5 scenario, they would have on average a 12% ± 4% increase in landfall intensity, 25% ± 23% increase in precipitation, and 128% ± 70% increase in economic losses, compared to historical simulations. We also found a significant increase in the full risk profile. The estimated typhoon loss with a 50-year return period for Zhejiang, Fujian, Guangdong, and Hainan (four most typhoon-prone provinces among the seven provinces in the region) would increase by 71%, 170%, 20%, and 85%, respectively, towards the end of the century even under the lower emissions RCP4.5 pathway. Our findings imply the need to design effective local hazard mitigation measures to reduce future typhoon risks., (© 2022. The Author(s).)

Rivers in urban environments are significant components of their ecosystems but remain under threat of pollution from unchecked discharges of industrial sewage and domestic wastewater. Such river pollution, particularly over the longer term involving heavy metals, is an issue of worldwide concern regarding risks to the ecological environment and human health. In this study, we investigate the long-term pollution characteristics of the Huafei River, an important urban river in Kaifeng, China. River sedimentary samples were analyzed, assessing the degree and ecological risk of heavy metal pollution using the geo-accumulation index and potential ecological risk index methods, whilst Pearson's correlation, principal component and cluster analyses were used to identify the sources of pollution. The results show that heavy metal concentrations are significantly higher than their corresponding fluvo-aquic soil background values in China, and the geo-accumulation indexes indicate that of the eight heavy metals identified, Hg is most prevalent, followed in sequence by Cd > Zn > Cu > Pb > Ni > As > Cr. The potential ecological risk index of the Huafei River is very high, with the potential ecological risk intensity highest in the midstream and downstream sections, where it is recommended that pollution control is carried out, especially concerning Hg and Cd. Long-term sequence analysis indicates that Cu and Pb dropped sharply from 1998 to 2017, but rebounded in 2019, and that Zn shows a continuous decreasing trend. Four main sources for the heavy metal contaminants were identified: Cr, Cu, Ni, Pb, Zn and Hg derived mainly from industrial activities, traffic sources and natural sources; Cd originated mainly from industrial and agricultural activities; whilst As was mainly associated with industrial activities. Thus, special attention should be paid to Hg and Cd, and measures must be taken to prevent further anthropogenic influence on heavy metal pollution.

As cancer is increasingly considered a metabolic disorder, it is postulated that serum metabolite profiling can be a viable approach for detecting the presence of cancer. By multiplexing mass spectrometry fingerprints from two independent nanostructured matrixes through machine learning for highly sensitive detection and high throughput analysis, we report a laser desorption/ionization (LDI) mass spectrometry-based liquid biopsy for pan-cancer screening and classification. The Multiplexed Nanomaterial-Assisted LDI for Cancer Identification (MNALCI) is applied in 1,183 individuals that include 233 healthy controls and 950 patients with liver, lung, pancreatic, colorectal, gastric, thyroid cancers from two independent cohorts. MNALCI demonstrates 93% sensitivity at 91% specificity for distinguishing cancers from healthy controls in the internal validation cohort, and 84% sensitivity at 84% specificity in the external validation cohort, with up to eight metabolite biomarkers identified. In addition, across those six different cancers, the overall accuracy for identifying the tumor tissue of origin is 92% in the internal validation cohort and 85% in the external validation cohort. The excellent accuracy and minimum sample consumption make the high throughput assay a promising solution for non-invasive cancer diagnosis., (© 2022. The Author(s).)

Background: Prophylactic somatostatin to reduce the incidence of clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy remains controversial. We assessed the preventive efficacy of somatostatin on clinically relevant postoperative pancreatic fistula in intermediate-risk patients who underwent pancreaticoduodenectomy at pancreatic centres in China., Methods: In this multicentre, prospective, randomised controlled trial, we used the updated postoperative pancreatic fistula classification criteria and cases were confirmed by an independent data monitoring committee to improve comparability between centres. The primary endpoint was the rate of clinically relevant postoperative pancreatic fistula within 30 days after pancreaticoduodenectomy., Results: Eligible patients (randomised, n = 205; final analysis, n = 199) were randomised to receive postoperative intravenous somatostatin (250 μg/h over 120 h; n = 99) or conventional therapy (n = 100). The primary endpoint was significantly lower in the somatostatin vs control group (n = 13 vs n = 25; 13% vs 25%, P = 0.032). There were no significant differences for biochemical leak (P = 0.289), biliary fistula (P = 0.986), abdominal infection (P = 0.829), chylous fistula (P = 0.748), late postoperative haemorrhage (P = 0.237), mean length of hospital stay (P = 0.512), medical costs (P = 0.917), reoperation rate (P > 0.99), or 30 days' readmission rate (P = 0.361). The somatostatin group had a higher rate of delayed gastric emptying vs control (n = 33 vs n = 21; 33% vs 21%, P = 0.050)., Conclusions: Prophylactic somatostatin treatment reduced clinically relevant postoperative pancreatic fistula in intermediate-risk patients after pancreaticoduodenectomy., Trial Registration: NCT03349424., (© 2021. Japanese Society of Gastroenterology.)

Abstract: Subacromial impingement syndrome (SIS) after hook plate fixation for acromioclavicular joint (AC) dislocation was the most common complication. However, the researches on its' influential factors were rare. The purpose of this study was to identify the risk factors by analyzing the influencing factors of postoperative SIS and minimize the incidence of SIS in clinical surgery.We retrospectively analyzed the prospectively collected data from 330 consecutive patients with AC joint dislocation between August 2014 and August 2017 at our institute. The SIS was presented as the dependent variable at the last follow-up when the internal fixation was removed. The independent variables included age, gender, body-mass index (BMI), smoking status, alcohol consumption, type of injury, Rockwood Classification, site of injury, operation time, injury-to-surgery, the distance between the hook body and the acromion (DBA), the depth of hook tip (DHT), the distance between the hook plate and the humeral head (DHH), the distance between the acromion and the humeral head (DAH), the hook plate angle (AHP) and acromial shape. Logistic regression analysis was performed to identify independent influential factors of SIS.A total of 312 cases were included and 18 cases were lost. The follow-up rate was 94.5%. In without SIS group, there were 225 cases (123 males and 102 females). In with SIS group, a total of 87 cases were included (56 males and 31 females). The incidence of SIS was 27.8%. DHT (OR = 9.385, 95% CI = 4.883 to 18.040, P < .001) and DBA (OR = 2.444, 95% CI = 1.591 to 3.755, P < .001) were the significant independent risk factor for SIS of AC dislocation treat with hook plate. DAH (OR = 0.597, 95% CI = 0.396 to 0.900, P = .014) and acromial shape with flat and straight (OR = 0.325, 95% CI = 0.135 to 0.785, P = .012) were also independent factors of SIS, but they were all protective.The SIS had a high incidence in fixation of clavicular hook plate for AC dislocation. DHT and DBA were two independent risk factors, DAH and acromial shape with flat and straight were two independent protective factors for SIS. In clinical surgery, we should avoid risk factors to reduce the incidence of SIS., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

The emerging field of hydrogen biology has to date mainly been applied in medicine. However, hydrogen biology can also enable positive outcomes in agriculture. Agriculture faces significant challenges resulting from a growing population, climate change, natural disasters, environmental pollution, and food safety issues. In fact, hydrogen agriculture is a practical application of hydrogen biology, which may assist in addressing many of these challenges. It has been demonstrated that hydrogen gas (H 2 ) may enhance plant tolerance towards abiotic and biotic stresses, regulate plant growth and development, increase nutritional values, prolong the shelf life, and decrease the nitrite accumulation during the storage of vegetables, as well as increase the resilience of livestock to pathogens. Our field trials show that H 2 may have a promising potential to increase yield and improve the quality of agricultural products. This review aims to elucidate mechanisms for a novel agricultural application of H 2 in China. Future development of hydrogen agriculture is proposed as well. Obviously, hydrogen agriculture belongs to a low carbon economy, and has great potential to provide "safe, tasty, healthy, and high-yield" agricultural products so that it may improve the sustainability of agriculture., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Surufatinib showed superior efficacy in extrapancreatic neuroendocrine tumours (NETs) in the phase 3 SANET-ep study. In SANET-p, we aimed to assess the efficacy and safety of surufatinib in patients with advanced pancreatic NETs., Methods: SANET-p was a multicentre, randomised, double-blind, placebo-controlled, phase 3 study, done in 21 hospitals across China. Eligible patients were adults (aged 18 years or older) with progressive, advanced, well differentiated pancreatic NETs, Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, and progression on up to two kinds of previous systemic regimens for advanced disease. Patients were randomly assigned (2:1) via an interactive web response system to receive 300 mg of surufatinib or placebo, taken orally once per day in consecutive 4-week treatment cycles until disease progression, intolerable toxicity, withdrawal of consent, poor compliance, use of other antitumour medication, pregnancy, loss to follow-up, or if the investigator deemed discontinuation in the patient's best interest. Randomisation was done centrally using stratified block randomisation (block size three), stratified by pathological grade, previous systemic antitumour treatment, and ECOG performance status score. Patients, investigators, research staff, and the sponsor study team were masked to treatment allocation. Crossover to surufatinib was permitted for patients in the placebo group with disease progression. The primary endpoint was investigator-assessed progression-free survival in the intention-to-treat population, which included all patients in randomisation. A pre-planned interim analysis was done at 70% of the predicted progression-free survival events. This study is registered at ClinicalTrials.gov, NCT02589821., Findings: Between Feb 18, 2016, and Nov 11, 2019, of 264 patients who were screened, 172 (65%) patients were randomly assigned to receive surufatinib (n=113) or placebo (n=59). The median follow-up was 19·3 months (95% CI 9·3-19·4) in the surufatinib group and 11·1 months (5·7-35·9) in the placebo group. The median investigator-assessed progression-free survival was 10·9 months (7·5-13·8) for surufatinib versus 3·7 months (2·8-5·6) for placebo (hazard ratio 0·49, 95% CI 0·32-0·76; p=0·0011). The trial met the early stopping criteria at the interim analysis and was terminated on recommendation from the independent data monitoring committee. The most common grade 3 or worse treatment-related adverse events were hypertension (43 [38%] of 113 with surufatinib vs four [7%] of 59 with placebo), proteinuria (11 [10%] vs one [2%]), and hypertriglyceridaemia (eight [7%] vs none). Treatment-related serious adverse events were reported in 25 (22%) patients in the surufatinib group and four (7%) patients in the placebo group. There were three on-treatment deaths in the surufatinib group, including two deaths due to adverse events (gastrointestinal haemorrhage [possibly treatment-related] and cerebral haemorrhage [unlikely to be treatment-related]), and one death attributed to disease progression. One on-treatment death in the placebo group was attributed to disease progression., Interpretation: Surufatinib significantly improves progression-free survival and has an acceptable safety profile in patients with progressive, advanced pancreatic NETs, and could be a potential treatment option in this patient population., Funding: Hutchison MediPharma., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

To investigate (1) the effects of indoor incense burning upon cognition over 3 years; (2) the associations between indoor incense burning with the brain's structure and functional connectivity of the default mode network (DMN); and (3) the interactions between indoor incense burning and vascular disease markers upon cognitive functions. Community older adults without stroke or dementia were recruited (n = 515). Indoor incense use was self-reported as having burnt incense at home ≥ weekly basis over the past 5 years. Detailed neuropsychological battery was administered at baseline (n = 227) and the Montreal Cognitive Assessment at baseline and year 3 (n = 515). MRI structural measures and functional connectivity of the DMN were recorded at baseline. Demographic and vascular risk factors and levels of outdoor pollutants were treated as covariates. Indoor incense burning was associated with reduced performance across multiple cognitive domains at baseline and year 3 as well as decreased connectivity in the DMN. It interacted with diabetes mellitus, hyperlipidemia and white matter hyperintensities to predict poorer cognitive performance. Indoor incense burning is (1) associated with poorer cognitive performance over 3 years; (2) related to decreased brain connectivity; and (3) it interacts with vascular disease to predispose poor cognitive performance.

Objective: The genetic aberrations that underlie chromatin remodeling in sporadic nonfunctional pancreatic neuroendocrine tumors (NF-pNETs) remain largely unknown. Here, we investigated the dysregulation of the switch/sucrose nonfermentable (SWI/SNF) component ARID1A and its correlation with clinicopathological features and prognosis., Methods: We sequenced the exomes of sporadic NF-pNETs. Quantitative real-time polymerase chain reaction and immunohistochemistry were used to determine messenger RNA level and protein expression., Results: The sporadic NF-pNETs harbored 264 somatic mutations in 228 different genes, most commonly affecting the SWI/SNF components ARID1B (57.1%) and ARID1A (42.9%). The expression of ARID1A was remarkably downregulated in NF-pNETs and corresponding liver metastases compared with that in normal pancreatic islet tissue. Reduced expression of ARID1A was associated with malignant clinicopathological features (P < 0.05). The loss of ARID1A was related to a high Ki-67 index (P < 0.05). Patients with ARID1A-negative expression had a significantly worse overall survival rate than those with ARID1A-positive expression (P < 0.05). The ARID1A status was an independent predictor of overall survival, and a nomogram integrating ARID1A with clinicopathological features was proposed., Conclusions: The loss of SWI/SNF components ARID1A may be associated with malignant behaviors and an unfavorable prognosis. Aberrations of ARID1A may contribute to tumorigenesis and metastasis in sporadic NF-pNETs.

Objective: To evaluate the role of multidisciplinary team (MDT) clinic in the diagnosis of pancreatic diseases and patient compliance with MDT advice in the current medical system. Methods: The study included 512 patients that had visited the pancreas-oriented MDT clinic of Zhongshan Hospital between May 2015 and May 2019.The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. Compliance was determined according to whether a patient received corresponding therapies or undergoing further checks or follow-ups. Results: Among the 512 patients that had visited the MDT clinic, 121 patients were referred due to undetermined diagnosis. Classified according to the final diagnosis, the rate of undetermined diagnosis in different disease categories from high to low in order was inflammatory diseases of the pancreas (75.0%, 24/32), other lesions of the pancreas (56.1%,23/41), pancreatic cystic lesions (19.1%,17/89), pancreatic carcinomas (18.3%,48/262) and pancreatic neuroendocrine neoplasms (pNEN)(10.2%,9/88). The MDT clinic made diagnosis to 68 patients directly with an accuracy of 89.7%. The rate of compliance in the entire cohort was 63.4%. The rate of compliance of patients from June 2017 to May 2019 (68.4%) was higher than that of patients from May 2015 to May 2017(59.6%). The compliance rate of patients in different disease categories from high to low in order was inflammatory diseases of the pancreas(84.4%, 27/32), pancreatic carcinomas (67.9%, 178/262), pNEN(60.2%,53/88), other lesions of the pancreas (56.1%,23/41), and pancreatic cystic lesions(49.4%, 44/89). The compliance rate of patients with different MDT advice from high to low in order was best supportive care(78.6%,22/28), antitumor approaches beyond surgery(71.6%,159/222), further tests(62.6%, 77/123), surgery(53.7%, 65/121) and follow-up(49.2%, 31/63). In patients suggested for surgery, the compliance rate of patients with carcinomas(67.4%, 33/49) was higher than patients with other kinds of neoplasms. Conclusions: MDT clinic could facilitate the diagnosis of pancreatic diseases conveniently and inexpensively. The overall compliance rate of MDT clinic patients is rather low, and patients with carcinomas have a relative high rate of compliance with the suggestion of surgery.

Intertidal macroalgae suffer different environmental conditions and mat densities during growing period. In the present study, Ulva lactuca Linnaeus were collected from high, intermediate, and low tidal zones at Nan'ao Island, China. These algal photosynthetic pigments and photosynthesis behaviors with different mat densities were measured. The aim is to examine how the physiological responses and acclimation match the representative tidal distribution and algal mat density. The photosynthetic pigment (chlorophyll a and carotenoid) contents and irradiance-saturated maximum photosynthetic rates (P max ) were greater in low zone-grown U. lactuca compared with the algae grown at high and intermediate zones. Under low algal mat density, the P max , apparent photosynthetic efficiency (α), and dark respiration rate (R d ) of U. lactuca grown at low zone were increased, whereas the irradiance saturation points (I k ) were decreased, compared with the algae grown at higher zone. However, the P max of high and intermediate zone-grown U. lactuca at high algal mat density were greater than at low density. Moreover, the pH compensation point of low zone-grown thalli (9.98) was lower than the higher zone-grown thalli (more than 10.15); however, the chlorophyll fluorescence parameters (reflect photosynthetic system activity) of the thalli collected from the three different zones were similar. Therefore, we proposed that the effects of varied densities on the photosynthetic rates of these three tidal zone-grown U. lactuca thalli were different, which might be related with different capacity of HCO 3 - utilization of macroalgae at their zonations.

Objectives: The aims of this study were to introduce our experience with treating patients with pancreatic solid pseudopapillary tumors (SPTs) and to investigate the clinical risk factors for recurrence of SPTs because no consensus has been established to date., Methods: One hundred twenty-one patients underwent surgical resection from January 2008 to December 2015 in our institution. Clinical data were collected from the standardized reports., Results: Of the 121 patients, 93 (76.9%) were women, 28 (23.1%) were men, and the mean age at diagnosis was 33.7 years (range, 11-68 years). Sixty patients were subjected to short-term complications, and 8 patients experienced long-term complications, some of whom may require surgery. The tumor located in the distal pancreas (P = 0.02), and a Ki-67 index value > 1.5 (P = 0.01) indicated malignancy according to the World Health Organization 2000 classification. One hundred three patients responded to follow-up, and 3 cases (2.9%) were subject to liver metastases. Recurrence was more frequently observed in tumors classified as high-grade malignancies according to the World Health Organization 2010 classification (P = 0.013), synchronous metastases (P < 0.001), peripancreatic fat infiltration (P = 0.018), and lymphovascular invasion (P < 0.001)., Conclusions: Evaluating the risk of the recurrence of SPTs still requires systematic and multicenter trials in the future, even some pathological features showed statistical differences.

Biomarkers for the early diagnosis of pancreatic cancer (PC) are urgent needed. Plasma microRNAs (miRNAs) might be used as biomarkers for the diagnosis of cancer. We analyzed 361 plasma samples from 6 surgical centers in China and performed machine learning approach. We gain insight of the association between the aberrant plasma miRNA expression and pancreatic disease. 671 microRNAs were screened in the discovery phase and 33 microRNAs in the training phase and 13 microRNAs in the validation phase. After the discovery phase and training phase, 2 diagnostic panels were constructed comprising 3 microRNAs in panel I (miR-486-5p, miR-126-3p, miR-106b-3p) and 6 microRNAs in panel II (miR-486-5p, miR-126-3p, miR-106b-3p, miR-938, miR-26b-3p, miR-1285). Panel I and panel II had high accuracy for distinguishing pancreatic cancer from chronic pancreatitis (CP) with area under the curve (AUC) values of 0.891 (Standard Error (SE): 0.097) and 0.889 (SE: 0.097) respectively, in the validation phase. Additionally, we demonstrated that the diagnostic value of the panels in discriminating PC from CP were comparable to that of carbohydrate antigen 19-9 (CA 19-9) 0.775 (SE: 0.053) (P = 0.1 for both). This study identified 2 diagnostic panels based on microRNA expression in plasma with the potential to distinguish PC from CP. These patterns might be developed as biomarkers for pancreatic cancer., Competing Interests: None of the authors received honoraria or sponsorship. No authors declared any potential conflicts of interest.

Based on phenological and economic output models established and meteorological data from 1972 to 2013, changes in the phenology, frost risk, and economic output of the Longjing-43 tea tree in the Yuezhou Longjing tea production area of China were evaluated. As the local climate has changed, the beginning dates of tea bud and leaf plucking of this cultivar in all five counties studied has advanced significantly by -1.28 to -0.88 days/decade, with no significant change in the risk of frost. The main tea-producing stages in the tea production cycle include the plucking periods for superfine, grade 1, and grade 2 buds and leaves. Among the five bud and leaf grades, the economic output of the plucking periods for superfine and grade 1 decreased significantly, that for grade 2 showed no significant change, and those for grades 3 and 4 increased significantly. The economic output of large-area tea plantations employing an average of 45 workers per hectare and producing superfine to grade 2 buds and leaves were significantly reduced by 6,745-8,829 yuan/decade/ha, depending on the county. Those tea farmers who planted tea trees on their own small land holdings and produced superfine to grade 4 tea buds and leaves themselves experienced no significant decline in economic output.

Desalination has been considered as an essential way to solve water stress all over the world. Most of previous studies focused on its environmental impacts, energy consumption and desalination technologies rather than human health. However, the safety of desalinated water remains unclear. This study was undertaken to investigate the knowledge, attitude and practice (KAP) of the residents in an island county in eastern China to desalinated water. Seventeen people working in medical and water industries were recruited, and focus group discussion and in-depth interview were conducted among them. Our results showed that the majority of people interviewed knew the definition and local supply pattern of desalinated water, while some of them showed some concern about the safety and nutrition of desalinated water. Current drinking water standard has no specific item for desalination, so we strongly suggest issuing a standard for desalinated water.

Objective: The purpose was to describe the clinicopathological characteristics of pancreatic neuroendocrine tumors (pNETs) and evaluate prognosis-related factors in potentially resectable pNETs., Methods: The clinical data of 104 patients with pNETs who underwent surgery were retrospectively analyzed., Results: The mean (SD) age was 49.8 (14.6) years. The percentages of TNM stages I, II, III, and IV tumors were 25.0%, 44.2%, 22.1%, and 8.7%, respectively. Twenty-seven cases were functional. Nonfunctional pNETs were more common in patients with large tumors, advanced age, higher mitotic count, neural invasion, extrapancreatic organ invasion, liver metastases, and advanced staging (P < 0.05). The 5-year overall survival rate was 93%. The relapse rate was 28.6% (28/98), and the mean (SD) relapse time was 38.7 (31.7) months. Reduced survival rate was associated with older patients (>60 years) (P = 0.026), patients with a higher Ki-67 index (>2%) (P = 0.024), regional lymph node metastases (P = 0.033), liver metastases (P = 0.015), neural invasion (P = 0.017), necrosis (P = 0.042), and major vascular invasion (P = 0.023). Age of more than 60 years (P = 0.047; hazard ratio [HR], 5.2), major vascular invasion (P = 0.030; HR, 5.8), and a Ki-67 index greater than 2% (P = 0.008; HR, 10.3) were independent predictors., Conclusions: Nonfunctional pNETs were more common with aggressive clinical presentation. Age of more than 60 years, major vascular invasion, and a Ki-67 index greater than 2% were independent predictive factors. Patients who underwent a potentially curative resection seemed to achieve long-term survival.

Background: The reported prevalence of unruptured cerebral aneurysms (UCAs) varies widely., Objective: To measure the prevalence of UCAs by using 3-dimensional time-of-flight magnetic resonance angiography in adults aged 35 to 75 years., Design: Cross-sectional study done between June 2007 and June 2011., Setting: Two communities chosen at random from 2 districts (1 urban and 1 suburban) in Shanghai, China., Participants: 4813 adults aged 35 to 75 years., Measurements: Three-dimensional time-of-flight magnetic resonance angiography, interpreted by 3 observers blinded to the participants' information, was used to identify the location and size of UCAs and to estimate the overall, age-specific, and sex-specific prevalence., Results: 369 UCAs were found in 336 participants (130 men and 206 women); 4477 participants had no evidence of UCAs. The prevalence was 7.0% overall (95% CI, 6.3% to 7.7%), with 5.5% for men (CI, 4.6% to 6.4%) and 8.4% for women (CI, 7.3% to 9.5%). The overall prevalence of UCAs was higher in women than in men (P < 0.001) and peaked at ages 55 to 64 years in men and women. The UCAs were mostly located in the internal carotid artery (81%), and 90.2% had a maximum diameter less than 5 mm. Mean diameter was larger in women than in men (3.7 mm vs. 3.2 mm; P < 0.009)., Limitation: Participants were from 2 communities selected from 2 districts in Shanghai, and adults older than 75 years were not studied., Conclusion: The overall prevalence of UCAs was 7.0% in Chinese adults aged 35 to 75 years, and most lesions had a diameter less than 5 mm., Primary Funding Source: National Natural Science Foundation of China.

In 1982 and 1990, two epidemiological surveys of dental caries of primary and middle school in Shanghai were carried out, using similar standards and methods. A comparison of the results revealed that: the incidence of caries of milk teeth continued to stay at a high level; the incidence of caries of permanent teeth showed a marked reduction. There was no difference between the two sexes. The incidence of caries of permanent teeth of the urban pupils is higher than that of the rural ones. Conversely, the incidence of caries of milk teeth of the rural pupils is still higher than that of the urban ones.