Search

Introduction: Baricitinib, a JAK1/JAK2 inhibitor, is approved for treatment of moderate-to-severe rheumatoid arthritis (RA) in China. This single-arm, prospective, multi-center, post-marketing safety study (PMSS) evaluated the safety and effectiveness of baricitinib in Chinese patients. Methods: This study included adult patients with moderate-to-severe active RA who received baricitinib over periods of approximately 12 and 24 weeks. The primary endpoint was safety, defined as week 12 adverse event (AE)/serious AE incidence. Secondary endpoints were week 24 safety and effectiveness (disease activity score with 28 joints/C-reactive protein [DAS28-CRP] and simplified/Clinical Disease Activity Index [SDAI/CDAI]). Results: Safety analyses included 667 patients (female, 82.3%; mean age, 53.3 years; mean RA duration, 86.9 months); 106/667 (15.9%) were 65–74 years old and 19/667 (2.8%) were ≥ 75 years old; 87.0% received baricitinib 2 mg QD. Total exposure was 262.1 patient-years (PY). At week 12, AEs had occurred in 214 (32.1%; exposure-adjusted incidence rate [EAIR], 172.5 per 100 PY) patients (serious AEs: 22 [3.3%; EAIR, 15.0]). At week 24, AEs had occurred in 250 (37.5%; EAIR, 125.9) patients (serious AEs: 28 [4.2%; EAIR, 10.9]). Two patients (0.3%) died (of pneumonia and unknown cause); EAIR for death, 0.77. Serious infection occurred in 1.2% of patients (EAIR, 3.1). Hepatotoxicity occurred in 3.4% of patients (EAIR, 9.0). No patients met potential Hy's law laboratory criteria (alanine/aspartate aminotransferases ≥ 3 × upper limit of normal (ULN) and total bilirubin ≥ 2 × ULN). Malignancy occurred in one patient. No patients experienced venous thromboembolism (VTE) or major adverse cardiovascular events (MACE). At week 24, 52.4%, 27.5%, and 27.6% of patients achieved remission per DAS28-CRP, SDAI, and CDAI, respectively. Conclusions: This PMSS investigated the safety and effectiveness of baricitinib in clinical practice in China. No VTE/MACE or new safety signals were reported and there was promising effectiveness, supporting the use of baricitinib in Chinese patients with moderate-to-severe active RA. Trial Registration: EU PAS Register: EUPAS34213. [ABSTRACT FROM AUTHOR]

The fracture characteristics of bedded sandstone determine the stability and safety of in situ coal gasification technology. Four semicircular stratified sandstone specimens with different strengths (0.3, 0.6, 1.0, and 1.5 times that of rock matrix) and seven different bedding angles (θ = 0°, 15°, 30°, 45°, 60°, 75°, and 90°) were numerically simulated using RFPA2D-Basic V2.0 software. The SCB specimen had no prefabricated crack, and its radius was 25 mm. The loading rate was 0.000001 m/step. The results show that the fracture characteristics of the sandstone are affected by both the strength of the laminae and the angle; the fracture toughness and peak strength of the ultra-weak sandstone, as well as the weak sandstone, are reduced and more easily affected by the bedding angle; the strength rate of the strong sandstone is higher than that of the homogeneous sandstone, and the difference between the fracture characteristics of the two is not significant. This paper suggests that the key mechanism of this phenomenon is the anisotropy between the bedding and the sandstone, along with the competition/synergy between the main crack and the bedding plane bias crack during fracture propagation. These research results can provide a theoretical reference for the safety and stability of underground engineering in China. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the genetic factors promoting widespread Q6 dissemination of tet(X4) between Escherichia coli and to characterize the genetic contexts of tet(X4). Methods: We isolated E. coli from feces, water, soil and flies collected across a largescale chicken farm in China in 2020. Antimicrobial susceptibility testing and PFGE typing were used to identify tigecycline resistance and assess clonal relationships among isolates. Plasmids present and genome sequences were analyzed by conjugation, S1 pulsed-field gel electrophoresis (PFGE), plasmid stability testing and whole-genome sequencing. Results: A total of 204 tigecycline-resistant E. coli were isolated from 662 samples. Of these, we identified 165 tet(X4)-carrying E. coli and these strains exhibited a high degree of multidrug resistance. Based on the geographical location distribution of the sampled areas, number of samples in each area and isolation rate of tigecyclineresistant strains and tet(X4)-carrying isolates, 72 tet(X4)-positive isolates were selected for further investigation. Tigecycline resistance was shown to be mobile in 72 isolates and three types of tet(X4)-carrying plasmids were identified, they were IncHI1 (n= 67), IncX1 (n= 3) and pO111-like/IncFIA(HI1) (n= 2). The pO111-like/IncFIA(HI1) is a novel plasmid capable of transferring tet(X4). The transfer efficiency of IncHI1 plasmids was extremely high in most cases and IncHI1 plasmids were stable when transferred into common recipient strains. The genetic structures flanked by IS1, IS26 and ISCR2 containing tet(X4) were complex and varied in different plasmids. Discussion: The widespread dissemination of tigecycline-resistant E. coli is a major threat to public health. This data suggests careful use of tetracycline on farms is important to limit spread of resistance to tigecycline. Multiple mobile elements carrying tet(X4) are in circulation with IncHI1 plasmids the dominant vector in this setting. [ABSTRACT FROM AUTHOR]

Purpose: To test the hypothesis that daily supplementation with low-dose B vitamins plus betaine could significantly reduce plasma homocysteine concentrations in Chinese adults with hyperhomocysteinemia and free from background mandatory folic acid fortification. Methods: One hundred apparently healthy adults aged 18–65 years with hyperhomocysteinemia were recruited in South China from July 2019 to June 2021. They were randomly assigned to either the supplement group (daily supplementation: 400 μg folic acid, 8 mg vitamin B6, 6.4 μg vitamin B12 and 1 g betaine) or the placebo group for 12 weeks. Fasting venous blood was collected at baseline, week 4 and week 12 to determine the concentrations of homocysteine, folate, vitamin B12 and betaine. Generalized estimation equations were used for statistical analysis. Results: Statistically significant increments in blood concentrations of folate, vitamin B12 and betaine after the intervention in the supplement group indicated good participant compliance. At baseline, there were no significant differences in plasma homocysteine concentration between the two groups (P = 0.265). After 12-week supplementation, compared with the placebo group, there was a significant reduction in plasma homocysteine concentrations in the supplement group (mean group difference − 3.87; covariate-adjusted P = 0.012; reduction rate 10.1%; covariate-adjusted P < 0.001). In the supplement group, the decreased concentration of plasma homocysteine was associated with increments of blood concentrations of both folate (β = –1.680, P = 0.004) and betaine (β = –1.421, P = 0.020) after 12 weeks of supplementation. Conclusions: Daily supplementation with low-dose B vitamins plus betaine for 12 weeks effectively decreased plasma homocysteine concentrations in Chinese adults with hyperhomocysteinemia. Trial registration: This trial was registered at clinicaltrials.gov as NCT03720249 on October 25, 2018. Website:https://clinicaltrials.gov/ct2/show/NCT03720249. [ABSTRACT FROM AUTHOR]

Co‐infection in patients with severe fever with thrombocytopenia syndrome (SFTS) has been reported, posing a serious threat to survival and treatment. We aimed to systematically investigate the SFTS associated pulmonary infection, particularly invasive pulmonary fungal infection (IPFI). During April 2019 to October 2021, we conducted a multicentre observational study on adult hospitalized patients confirmed with SFTS from three tertiary hospital in central China. Demographic, clinical and laboratory data of patients were collected and re‐assessed. A total of 443 patients (51.7% were male sex) were included for analysis with median age of 65‐year‐old. Among them, 190 (42.9%) patients met the criteria for pulmonary infection. Pulmonary infection was associated with shorter survival time (p < 0.0001 by log‐rank test), and adjusted hazard ratio was 1.729 [95% confidence interval, 1.076–2.780] (p = 0.024). Age (odds ratio (OR) 1.040 [1.019–1.062], p < 0.001), time from onset to admission (OR 1.163 [1.070–1.264], p < 0.001), having severe status (OR 3.166 [2.020–4.962], p < 0.001) and symptoms of skin change (OR 2.361 [1.049–5.316], p < 0.001) at admission and receiving intravenous immunoglobin (OR 2.185 [1.337–3.569], p = 0.002) were independent risk factors for the occurrence of pulmonary infection. A total of 70 (15.8%) patients were defined as IPFI. Multivariate analysis showed that time from onset to admission (OR 1.117 [1.016–1.229], p = 0.022), severe status (OR 5.737 [3.054–10.779], p < 0.001), having smoking history (OR 3.178 [1.251–8.070], p = 0.015) and autoimmunity disease (OR 7.855 [1.632–37.796], p = 0.010), receiving intravenous immunoglobin (OR 3.270 [1.424–7.508], p = 0.005) were independent risk factors for the occurrence of IPFI. In SFTS patients with pulmonary infection, white blood count <2.09 × 109 per L (OR 11.064 [3.708–33.012], p < 0.001) and CD3+CD4+ T cell count <104.0 per μL (OR 10.429 [3.395–32.038], p < 0.001) could independently predict IPFI. This study showed the high prevalence and poor outcomes of pulmonary infection and IPFI in patients with SFTS. These findings highlighted the need for active surveillance of fungal pathogens and early antifungal treatment in patients with SFTS. [ABSTRACT FROM AUTHOR]

Diesel engine exhaust (DEE) is an established lung carcinogen, but the biological mechanisms of diesel‐induced lung carcinogenesis are not well understood. MicroRNAs (miRNAs) are small noncoding RNAs that play a potentially important role in regulating gene expression related to lung cancer. We conducted a cross‐sectional molecular epidemiology study to evaluate whether serum levels of miRNAs are altered in healthy workers occupationally exposed to DEE compared to unexposed controls. We conducted a two‐stage study, first measuring 405 miRNAs in a pilot study of six DEE‐exposed workers exposed and six controls. In the second stage, 44 selected miRNAs were measured using the Fireplex circulating miRNA assay that profiles miRNAs directly from biofluids of 45 workers exposed to a range of DEE (Elemental Carbon (EC), median, range: 47.7, 6.1–79.7 μg/m3) and 46 controls. The relationship between exposure to DEE and EC with miRNA levels was analyzed using linear regression adjusted for potential confounders. Serum levels of four miRNAs were significantly lower (miR‐191‐5p, miR‐93‐5p, miR‐423‐3p, miR‐122‐5p) and one miRNA was significantly higher (miR‐92a‐3p) in DEE exposed workers compared to controls. Of these miRNAs, miR‐191‐5p (ptrend =.001, FDR = 0.04) and miR‐93‐5p (ptrend =.009, FDR = 0.18) showed evidence of an inverse exposure–response with increasing EC levels. Our findings suggest that occupational exposure to DEE may affect circulating miRNAs implicated in biological processes related to carcinogenesis, including immune function. [ABSTRACT FROM AUTHOR]

Objectives Diesel exhaust is an established human carcinogen, however the mechanisms by which it leads to cancer development are not fully understood. Mitochondrial dysfunction is an established contributor to carcinogenesis. Recent studies have improved our understanding of the role played by epigenetic modifications in the mitochondrial genome on tumorigenesis. In this study, we aim to evaluate the association between diesel engine exhaust (DEE) exposure with mitochondrial DNA (mtDNA) methylation levels in workers exposed to DEE. Methods The study population consisted of 53 male workers employed at a diesel engine manufacturing facility in Northern China who were routinely exposed to diesel exhaust in their occupational setting, as well as 55 unexposed male control workers from other unrelated factories in the same geographic area. Exposure to DEE, elemental carbon, organic carbon, and particulate matter (PM2.5) were assessed. mtDNA methylation for CpG sites (CpGs) from seven mitochondrial genes (D-Loop , MT-RNR1 , MT-CO2 , MT-CO3 , MT-ATP6 , MT-ATP8 , MT-ND5) was measured in blood samples. Linear regression models were used to estimate the associations between DEE, elemental carbon, organic carbon and PM2.5 exposures with mtDNA methylation levels, adjusting for potential confounders. Results DEE exposure was associated with decreased MT-ATP6 (difference = −35.6%, P -value = 0.019) and MT-ATP8 methylation (difference = −30%, P -value = 0.029) compared to unexposed controls. Exposures to elemental carbon, organic carbon, and PM2.5 were also significantly and inversely associated with methylation in MT-ATP6 and MT-ATP8 genes (all P -values < 0.05). Conclusions Our findings suggest that DEE exposure perturbs mtDNA methylation, which may be of importance for tumorigenesis. [ABSTRACT FROM AUTHOR]

Objective To analyze the relationship between the preoperative relative blood glucose ratio and the safety of cerebrovascular bypass of ischemic moyamoya disease (MMD) patients. Methods A total of 178 patients with ischemic MMD who were hospitalized in Department of Neurosurgery of Qilu Hospital of Shandong University from December 2016 to December 2019. A total of 186 cases underwent superficial temporal artery-middle cerebral artery (STA-MCA) bypass. The fasting blood glucose and glycated albumin of all patients at admission were recorded to calculate the relative blood glucose ratio. After STA-MCA bypass, the incidence of postoperative complications was counted. Univariate and multivariate Logistic regression were used to analyze the risk factors of postoperative complications of ischemic MMD. Results 186 cases were divided into 4 groups based on relative blood glucose ratio, Q1 < 0.404, Q2 0.404-, Q3 0.456-, Q4 ≥ 0.534. The proportion of right surgery side in Q1 group was higher than that in Q3 group (χ² = 4.762, P = 0.029) and Q4 group (χ² = 22.087, P = 0.000), while the proportion of right surgery side in Q2 group (χ² = 16.331, P = 0.000) and Q3 group (χ² = 7.355, P = 0.007) was higher than that in Q4 group. The incidence of mild complications in Q1 group (χ² = 6.389, P = 0.011) and Q2 group (χ² = 4.040, P = 0.044) was higher than that in Q4 group. The incidence of postoperative complications was 28.49% (53/186), of which 8.60% (16/186) were severe type and 19.89% (37/186) were mild type, including transient neurological dysfunction 97.30% (36/37), subdural hemorrhage 2.70% (1/37). Logistic regression analysis showed that the relative blood glucose ratio increased (OR = 1.484, 95%CI: 1.071-2.058; P = 0.018), hypertension (OR = 3.696, 95%CI: 1.805-7.569; P = 0.000), operative interval < 2 months (OR = 2.186, 95%CI: 1.041-4.590; P = 0.039) was risk factors for postoperative complications. Conclusions In order to reduce the incidence of postoperative complications in patients with ischemic MMD, the operation interval after infarction can be extended to 2 months, and the preoperative relative blood glucose ratio should be closely monitored and the perioperative blood pressure should be controlled. [ABSTRACT FROM AUTHOR]

Background: Schistosoma japonicum was once one of the most severe parasitic diseases in China. After 70 years of national schistosomiasis control programmes, the prevalence and associated morbidity of the infection have been reduced to a much lower level. However, due to the low sensitivity of the current detection approaches, many minor infections in humans could not be identified and ultimately develop chronic injuries with liver abnormalities, a specific 'network' echogenic pattern under ultrasonography. Therefore, as more people take part in physical examinations, we performed this meta-analysis to estimate the overall prevalence of schistosomiasis-associated liver abnormalities in China.Methods: The publications were searched systematically across five electronic databases. All eligible studies were assessed with quality evaluation forms. Heterogeneity of studies was determined using the I2 and Q tests. A random effects or fixed effects model was employed based on heterogeneity results. The pooled prevalence and its 95% confidence intervals were calculated with the Freeman-Tukey double arcsine transformation. All analyses were conducted using R with the "meta" package. The protocol registration number was CRD42021232982.Results: A total of 19 relevant articles, including 21 studies, were included. The average score of study quality was 6.4 (total score 7), indicating high quality of all included studies. A total of 268, 247 persons were included, and 43, 917 persons were diagnosed with schistosomiasis liver abnormalities by ultrasonography. High degrees of heterogeneity existed among all studies or within subgroups. The overall pooled prevalence was 18.64% (95% CI: 11.88-26.50%). The estimate significantly increased over time and varied among provinces, with the highest in Shanghai and the lowest in Sichuan. The estimate in people aged 60 years or older was significantly higher than that in people of all ages. No significant difference was seen when based on study areas (urban or rural areas) or gender.Conclusion: The long-term burden of schistosomiasis in China remains large, as nearly one-fifth of the examined persons were diagnosed with schistosomiasis liver abnormalities. The pooled prevalence was associated with regions or age groups. Such may have a high reference value in the exact calculation of the disease burden and can be helpful for policy makers in prioritizing public health. [ABSTRACT FROM AUTHOR]

Background: As China is moving onto schistosomiasis elimination/eradication, diagnostic methods with both high sensitivity and specificity for Schistosoma japonicum infections in humans are urgently needed. Microscopic identification of eggs in stool is proven to have poor sensitivity in low endemic regions, and antibody tests are unable to distinguish between current and previous infections. Polymerase chain reaction (PCR) technologies for the detection of parasite DNA have been theoretically assumed to show high diagnostic sensitivity and specificity. However, the reported performance of PCR for detecting S. japonicum infection varied greatly among studies. Therefore, we performed a meta-analysis to evaluate the overall diagnostic performance of variable-temperature PCR technologies, based on stool or blood, for detecting S. japonicum infections in humans from endemic areas. Methods: We searched literatures in eight electronic databases, published up to 20 January 2021. The heterogeneity and publication bias of included studies were assessed statistically. The risk of bias and applicability of each eligible study were assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool (QUADAS-2). The bivariate mixed-effects model was applied to obtain the summary estimates of diagnostic performance. The hierarchical summary receiver operating characteristic (HSROC) curve was applied to visually display the results. Subgroup analyses and multivariate regression were performed to explore the source of heterogeneity. This research was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and was registered prospectively in PROSPERO (CRD42021233165). Results: A total of 2791 papers were retrieved. After assessing for duplications and eligilibity a total of thirteen publications were retained for inclusion. These included eligible data from 4268 participants across sixteen studies. High heterogeneity existed among studies, but no publication bias was found. The pooled analyses of PCR data from all included studies resulted in a sensitivity of 0.91 (95% CI: 0.83 to 0.96), specificity of 0.85 (95% CI: 0.65 to 0.94), positive likelihood ratio of 5.90 (95% CI: 2.40 to 14.60), negative likelihood ratio of 0.10 (95% CI: 0.05 to 0.20) and a diagnostics odds ratio of 58 (95% CI: 19 to 179). Case-control studies showed significantly better performances for PCR diagnostics than cross-sectional studies. This was further evidenced by multivariate analyses. The four types of PCR approaches identified (convention PCR, qPCR, Digital droplet PCR and nested PCR) differed significantly, with nested PCRs showing the best performance. Conclusions: Variable-temperature PCR has a satisfactory performance for diagnosing S. japonicum infections in humans in endemic areas. More high quality studies on S. japonicum diagnostic techniques, especially in low endemic areas and for the detection of dual-sex and single-sex infections are required. These will likely need to optimise a nested PCR alongside a highly sensitive gene target. They will contribute to successfully monitoring endemic areas as they move towards the WHO 2030 targets, as well as ultimately helping areas to achieve these goals. Author summary: Schistosoma japonicum is a parasite that can cause serious intestinal schistosomiasis. The infection is mainly diagnosed by parasitological and immunological methods, such as Kato-Katz test and indirect hemagglutination assay. However, both of these are not sensitive enough to accurately assess schistosomiasis elimination/eradication. PCR assays, detecting parasite DNA, are theoretically a highly suitable, sensitive and specific, alternative. However, reported performance varies greatly among studies. Therefore, we performed this meta-analysis (PROSPERO, registered No. CRD42021233165) to analyze and summarize the data from relevant studies of variable-temperature PCR for the diagnosis of S. japonicum infections, using stool or blood samples from humans in endemic areas. We retrieved a total of 13 articles including data from 4268 participants across 16 studies. There was high heterogeneity among studies, but no publication bias was found. Analyses revealed that PCR techniques had a satisfactory performance for diagnosing S. japonicum infections in humans in endemic areas, with both high sensitivity and specificity. Further research on S. japonicum diagnostic techniques, especially in low endemicity areas and for detection of dual-sex and single-sex infections are required. These may be best using highly sensitive gene targets in nested PCR reactions. [ABSTRACT FROM AUTHOR]

Urinary mutagenicity reflects systemic exposure to complex mixtures of genotoxic/carcinogenic agents and is linked to tumor development. Coal combustion emissions (CCE) and diesel engine exhaust (DEE) are associated with cancers of the lung and other sites, but their influence on urinary mutagenicity is unclear. We investigated associations between exposure to CCE or DEE and urinary mutagenicity. In two separate cross‐sectional studies of nonsmokers, organic extracts of urine were evaluated for mutagenicity levels using strain YG1041 in the Salmonella (Ames) mutagenicity assay. First, we compared levels among 10 female bituminous (smoky) coal users from Laibin, Xuanwei, China, and 10 female anthracite (smokeless) coal users. We estimated exposure–response relationships using indoor air concentrations of two carcinogens in CCE relevant to lung cancer, 5‐methylchrysene (5MC), and benzo[a]pyrene (B[a]P). Second, we compared levels among 20 highly exposed male diesel factory workers and 15 unexposed male controls; we evaluated exposure‐response relationships using elemental carbon (EC) as a DEE‐surrogate. Age‐adjusted linear regression was used to estimate associations. Laibin smoky coal users had significantly higher average urinary mutagenicity levels compared to smokeless coal users (28.4 ± 14.0 SD vs. 0.9 ± 2.8 SD rev/ml‐eq, p = 2 × 10−5) and a significant exposure‐response relationship with 5MC (p = 7 × 10−4). DEE‐exposed workers had significantly higher urinary mutagenicity levels compared to unexposed controls (13.0 ± 10.1 SD vs. 5.6 ± 4.4 SD rev/ml‐eq, p =.02) and a significant exposure‐response relationship with EC (p‐trend = 2 × 10−3). Exposure to CCE and DEE is associated with urinary mutagenicity, suggesting systemic exposure to mutagens, potentially contributing to cancer risk and development at various sites. [ABSTRACT FROM AUTHOR]

Copyright of Gynecological Endocrinology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The admission of full-term neonates in the Neonatal Intensive Care Unit (NICU) is not an uncommon occurrence. All newborns admitted to the NICU attain benefits, such as highly specialized care, but there are also associated risks and high cost. This study aimed at identifying the patterns of full-term neonatal admissions at the NICU.Methods: A hospital-based retrospective cross-sectional study was carried out among all full-term neonates (≥37-week gestation) admitted to the NICU at the First Hospital of China Medical University from 1 January, 2009 to 30 June, 2018. We excluded babies with congenital anomalies. The parameters about the demographic and clinical characteristics of mothers and infants were included.Results: The study included 1573 anonymous neonates. During the study period, the rate of admission of full-term infants to the NICU was 6.8%. Meanwhile, 55.0% of the babies were born after cesarean section. Of the cesarean section, 56.0% were performed selectively. The majority of the newborns (60.5%) were admitted during the first 24 h of life. Respiratory complications accounted for 33.5% of admissions, followed by hypoglycemia (17.5%), perinatal asphyxia (11.4%), and infection (6.5%). The mean duration of NICU stay was 10 ± 2.5 days. Consequently, the mean expenditure associated with the NICU treatment amounted to $2052 for every infant. A total of 1369 infants (87.04%) survived until discharge. One infant died due to birth asphyxia.Conclusion: Some admissions could have been preventable, such as parent education on jaundice and weight control, regular, and continuous training of resuscitation skills and immediate actions needed for asphyxiated newborns. [ABSTRACT FROM AUTHOR]

BACKGROUND: Whether nighttime surgery will affect the safety and prognosis of patients has been controversial. OBJECTIVE: To compare the safety and prognosis of daytime surgery versus nighttime surgery in patients receiving total knee arthroplasty. METHODS: Data of 712 patients who received unilateral total knee arthroplasty from January 2015 to January 2018 in the Binzhou Medical University Hospital were retrospectively analyzed. Ofthe patients, 615 cases were treated by total knee arthroplasty during daytime hours (8:00-18:00) and the other 97 patients ware treated by total knee arthroplasty during nighttime hours (18:0 1-7:59). The perioperative and postoperative conditions of the two groups of patients ware compared. This study was approved by the Medical Ethics Committee of Binzhou Medical University Hospital, China (approval No. LW2016013). RESULTS AND CONCLUSION: (1) Peri operative period: The operation time in the nighttime surgery group was shorter than that in the daytime surgery group (P < 0.05). The amount of intraoperative bleeding and 24 hours postoperative drainage were more in the nighttime surgery group than that in the daytime surgery group (P < 0.05) There was no statistically significant difference in blood transfusion rate, the incidence of deep vein thrombosis, postoperative infection rate, postoperative periprosthetic infection rate, postoperative fever rate, and length of hospital stay between the two groups (P > 0.05). (2) Prognosis: There was no significant difference in motion range and knee joint function KSS score between the two groups (P > 0.05}. {3} The results showed that nighttime surgery did not increase the incidence of adverse reactions after total knee arthroplasty, and did not affect the prognosis of patients. [ABSTRACT FROM AUTHOR]

Analyzing and understanding the structure and growth dynamics of forests at different stages is helpful to promote forest succession, restoration and management. Three spots representing three succession stages of spruce-fir mixed forest (SF: polar-birch secondary forest, MF: spruce-fir mixed forest and PF: spruce-fir near primary forest) were established. Structure, growth dynamics during two growth seasons for dominant tree species, regeneration were examined, and a univariate O-ring function statistic was used to analyze the spatial patterns of main regeneration tree species. Results showed that, (1) composition of tree species, periodic annual increment (PAI) of the diameter at breast height (DBH), basal area for overstory trees and of ground diameter (DGH) for saplings, were significantly different with the succession; (2) the current species composition and regeneration dynamics of SF suggested a development towards spruce-fir mixed forests. Pioneer species like Betula platyphyllaa will gradually disappear while climax species, such as Abies nephrolepis, Pinus koraiensis, Picea koraiensis and Tilia amurensis will dominate forest stands; (3) Despite the highest volume occurring in PF, and saplings in it grew better than in the others, this forest type is unstable because of its unsustainable structure of DBH class and insufficient regeneration; and (4) MF had the most reasonable distribution of DBH class for adult trees (DBH > 5.0 cm) and DGH class for saplings (H ≥30 cm and DBH ≤5 cm), as well as an optimal volume increment. Limiting canopy opening size can lessen the physiological stress and promote the growth and competitive status of regeneration. Management implications for increasing the gaps and thus creating better growth conditions for understory saplings and facilitating forest succession were discussed. [ABSTRACT FROM AUTHOR]

This research explores the impact of environmental, social, and governance (ESG) performance on capital market performance in terms of stock liquidity. We establish that strong ESG disclosure boosts stock liquidity in the Chinese stock market during 2011–2020. Empirical results extend signaling theory and reputation theory by providing evidence that ESG disclosure can be regarded as an extra positive signal and help build the firm reputation via institutional investor preference channel and risk alleviation channel. Cross-sectional analysis using industry classifications demonstrate that the stock liquidity of firms in most service section is not significantly affected by ESG disclosure. And further analysis has shown that the positive impact of ESG disclosure is more pronounced for non-SOEs and firms in Midwest. Our baseline results are robust to DID-analysis and other tests. These findings help investors and firms better understand the role of ESG disclosure and provide insights for them. • The positive impact of ESG disclosure on stock liquidity is analyzed using listed-firms in China. • The impact shows evident heterogeneity in terms of firm industry, ownership, and location. • ESG disclosure by firms attracts more institutional investors engagements, and thus improve stock liquidity. • The effect of ESG disclosure is related to lowering both systematic risks and idiosyncratic risk. [ABSTRACT FROM AUTHOR]

Petrocodon retroflexus Q. Zhang & J. Guo, a new species of Gesneriaceae from Guizhou, China, is described and illustrated. The new species is morphologically similar to Petrocodon viridescens W. H. Chen, Mich. Möller & Y. M. Shui, but differs by its leaf blade being ovate, broadly ovate to elliptic, 8-20 × 5-15 cm and densely pilose on both surfaces, narrowly triangular, 9 mm long, densely pilose bracts, white corolla that is decurved near the middle, with adaxial lip shallowly 4-partitioned and retroflexed, and pistil ca 1.3 cm long and densely pilose and glandular-pilose. [ABSTRACT FROM AUTHOR]

China's rock salt deposits, which are mostly located in the Yunying area, are typically characterized by their interlayers. In the construction and operation of salt caverns, gypsum interlayers are soaked in brine and oil. To investigate the fracture toughness and weakening mechanisms of gypsum interlayers in corrosive environments, a series of laboratory tests, including cracked chevron notched Brazilian disc (CCNBD) tests and micro computed tomography (MCT) scanning, was performed. Ninety CCNBD specimens and 15 small specimens, with dimensions of 5 mm × 5 mm × 5 mm, were prepared and then soaked in 4 types of liquid and at 3 different temperatures. The results indicate that the fracture toughness of gypsum decreases significantly with increasing temperature when soaked in a given liquid. By contrast, the fracture toughness of gypsum remains approximately identical after treatment with water, half-saturated brine, and saturated brine at the same temperature. With increasing time and temperature, the porosity of the gypsum increases. The rate of porosity change (slope) increases with increasing temperature, but it remains stable with increasing brine concentration. Water and brine have more severe corrosive effects on gypsum than does acidic oil. The weakening of gypsum soaked in water and brine is attributed to the combined effects of water, temperature, and chlorine ions. Notably, the water-temperature effect contributes to a severe weakening of gypsum interlayers, but the chlorine ions have little effect. The mechanism of the weakening of gypsum soaked in acidic oil is chemical reactions and dehydration. Petroleum acid (naphthenic acid) reacts with gypsum to produce calcium naphthenate, which can be dissolved in the oil phase. During this process, the dissolution of calcium naphthenate in the oil phase promotes the forward reaction. Consequently, the study has significance for the evaluation of the leakage risk of storage caverns in bedded salt deposits. [ABSTRACT FROM AUTHOR]

With this study, we provide insight into the clinical characteristics, laboratory characteristics, and organ damage associated with incomplete lupus syndromes (ILE) and search for predictors of organ damage in ILE. A retrospective chart review was performed on 77 hospitalized patients with ILE. The control patient group comprised 2104 systemic lupus erythematosus (SLE) patients who were entered into the Chinese SLE Treatment and Research group (CSTAR). The Systemic Lupus International Collaborating Clinics (SLICC)/ACR Damage Index (SDI) was used to classify damage features. Based on their SDI score, ILE patients were divided into SDI > 0 and SDI = 0 groups. The percentages of anti-SSA-seropositive (54.5 %) and anti-RNP-seropositive (24.7 %) patients with ILE were higher than those found among the SLE patients from CSTAR ( p < 0.001). The mean SDI score was 0.66 (range 0-2), and a damage score greater than 0 was present in 41 (53.3 %) patients. The most prevalent damage category was pulmonary damage, present in 17 (22.1 %) patients. Peripheral vascular damage occurred in individuals who were significantly older than those who had musculoskeletal damage ( p = 0.031). The subgroup with SDI > 0 had a higher mean age (36.8 ± 2.04 years) than those with SDI = 0 (30.8 ± 2.08 years; p = 0.044). The mean SLEDAI score in the SDI > 0 patient group (8.2 ± 0.74) was higher than that of the SDI = 0 group (4.8 ± 0.54; p = 0.001). ILE patients may include a subset that is likely to experience progressive organ damage. Organ damage was more common in patients of older age and with high SLEDAI scores. [ABSTRACT FROM AUTHOR]

In 2012 a plot was established with 1-ha area in a mixed coniferous-broadleaf forest in the Changbai Mountains, northeastern China for examining local forest processes, structure and succession. A method of O-ring statistics (pair-correlation function) was applied to analyze the spatial patterns and associations of the dominant species within different vertical layers. After the evaluation by their importance values, six tree species (or group) (i.e. Abies nephrolepis, Picea jezoensis, Pinus koraiensis, Tilia amurensis, and species group of Betula ssp. and species group of Acer ssp.) were determined as dominant trees species. It was found that some of these species exhibited closely clustered distributions at fine distances. As spatial distance increased, a random or even regular distribution gradually appeared with the exception of the upper layers of A. nephrolepis and P. koraiensis, and the lower layers of P. jezoensis, P. koraiensis and Betula ssp., which were substantially randomly distributed. Intra- and inter-species spatial associations varied in accordance with species, tree height and reciprocal distances. Positive associations were observed between the lower and upper height classes of trees of the same species (except for that of P. jezoensis) at fine distances. This may be owing to limited seed dispersal and geological heterogeneity. The aggregation intensity declines with increasing distances and this consistent with the predictions of self-thinning. Some coniferous trees (e.g. Pinus koraiensis) in the lower height class were positively associated with T. amurensis and group of Betula ssp. of the upper height class at some distances, suggesting that saplings of coniferous trees occupy a broader niche and can grow well under the canopy of the adult of broad-leaved trees. Negative associations were observed between upper coniferous trees and lower broad-leaved trees and between upper P. jezoensis and lower P. koraiensis, suggesting that a canopy of these trees might not provide suitable environment for the survival, establishment, and growth of lower individuals, corresponding well to Janzen-Connell hypothesis. [ABSTRACT FROM AUTHOR]

Ichthyophis bannanicus is the only caecilian species in China. In this study, the phylogeography and population demography of I. bannanicus were explored, based on the mitochondrial DNA genes (cyt b and ND2) and 15 polymorphic microsatellite loci. Altogether 158 individuals were collected from five populations in Yunnan province, Guangxi province, Guangdong province, and Northern Vietnam. Phylogeographical and population structure analysis identified either two groups (Xishuangbanna, Northern Vietnam-Yulin-Yangchun-Deqing) or three groups (Xishuangbanna, Northern Vietnam-Yulin-Yangchun, and Deqing), indicating that the Red River and Pearl River systems may have acted as gene-flow barriers for I. bannanicus. Historical population expansion that happened 15–17 Ka ago was detected for mtDNA data and was possibly triggered by warmer weather after the Last Glacial Maximum. However, the Bayesian simulations of population history based on microsatellite data pinpointed population decline in all populations since 19,123 to 1,029 years ago, demonstrating a significant influence of anthropogenic habitat alteration on I. bannanicus. [ABSTRACT FROM AUTHOR]

Salt rock is a potential medium for the underground storage of hydrocarbons and nuclear waste. In China, salt deposits are typically composed of layered rocks, usually sandwiched by insoluble interlayers. These salt rock–gypsum interlayers significantly affect the integrity of bedded salt caverns. Therefore, it is important to assess how the permeability and porosity of salt interlayers in an excavation damage zone (EDZ) evolve at high temperatures and triaxial stress/seepage pressures. To address this, in this study, we have developed a triaxial testing system that uses thermo-hydro-mechanical-chemical (THMC) coupling. Then, the permeability and porosity of salt rock–gypsum interlayers with 0.6–0.9 degrees of damage (i.e.after being subjected to a triaxial stress of 60–90% of the triaxial compressive strength; the confining pressure is 25 MPa and experimental temperature is 20 °C) under a coupled THMC environment were measured. The results show that the permeability and porosity of gypsum with the four different damage degrees do not increase monotonically with increasing temperature under the coupled THMC condition. Especially for the 0.6 and 0.8 damaged gypsum specimens, the permeability and porosity tend to decrease in the temperature range of 300–500 °C. For the 0.8 and 0.9 damaged gypsum specimens, a vertical and catastrophic increase in permeability and porosity is observed at 550 °C and 300 °C, respectively. The variation trends of the permeability and porosity of the damaged specimens are closely related to the combined effects of the triaxial stress, seepage pressure, thermal stress, and degree of damage. • The permeability evolutions in damaged gypsum interlayer under THM environment were studied. • The porosity evolutions in damaged gypsum interlayer under THM environment were studied. • The weakening mechanism of damaged gypsum interlayer under THM environment was clarified. [ABSTRACT FROM AUTHOR]

Abstract: The ZDPS-1A pico-satellite, developed by the Zhejiang University, is featured with a three-axis stabilizing capability. It is 15×15×15cm3 cube-shaped satellite with a total mass of 3.5kg. ZDPS-1A is the first pico-satellite that has been launched successfully in China. The mission of ZDPS-1A is on-orbit system verification of student-build pico-satellite and wide range earth observation with a micro panoramic camera. A miniature momentum wheel is employed to offer gyro stiffness stability in the pitch (orbit normal) axis. Magnetic coils are employed to generate control torques to achieve the three-axis stabilization of nadir-pointing. The attitude sensors employed in the design include two three-axis magnetometers (TAMs), a three-axis gyro, and two sun sensors. Both ground simulations and on-orbit testing are conducted to verify the feasibility of the given attitude determination and control system (ADCS). [Copyright &y& Elsevier]

Abstract: Flows in large conduits are always difficult to measure. Ultrasonic flow meters developed in recent years are good for large flow conduits, especially for turbine performance testing in hydroelectric plants, because they are convenient to install, but then accuracy is difficult to estimate and there is no acknowledged estimation method when the installation requirements are not satisfied. The accuracy of the ultrasonic flow meter installed in the Three Gorges power station was analyzed both experimentally and with CFD analyses to analyze the effect of the complex flow field on the metering performance. A reduced scale (1:24) experimental system was built to study a series of cases, with the results showing that the flow error related to the complex flow field is about 0.3%. The penstock flow field of the Three Gorges dam was simulated, with the calculated flow error close to the experimental result. Analysis of the uncertainties in the experimental results and the Three Gorges flow meter measurement shows that the Three Gorges flow meter accuracy is better than 1%; thus the flow meter is sufficiently accurate for the turbine performance testing in the Three Gorges Power Station. [Copyright &y& Elsevier]

l In vivo effect of praziquantel on Schistosoma japonicum in mice was meta-analyzed. l Anti-schistosome effect increased with drug dosage and varied with parasite origins. l The effect did not decrease over time. l At the dosage of 300–600 mg/kg nearly 30% worms in mice were not killed. l Long survival of unpaired worms and their less sensitivity raise further warnings. Praziquantel (PZQ), the only choice of chemotherapy for schistosomiasis recommended by World Health Organization (WHO), has been widely used over 40 years. The long-term, and rapid expansion of, PZQ use for disease control across a large populations continues to raise concern regarding the potential for emergence and establishment of drug resistance. Recent research has also proposed that the long survival and low sensitivity of unpaired worms, derived from either incomplete treatment cure rates or single-sex schistosome infections within final hosts, could exacerbate the risk of PZQ resistance (PZQ-R) emerging. With the aim of assessing whether PZQ efficacy amongst S. japonicum may have changed over time in China, we performed a unique systematic review and meta-analyses on datasets which evaluated the efficacy of PZQ via laboratory assays of field S. japonicum isolates on experimental mice over time. Relevant published literatures from four electronic bibliographic databases and lists of article references were searched. Two indexes, d , a measure used in meta-analyses for worm burden difference between two groups, and r , a traditional measure for worm reduction percentage after treatment but without considering sample size were calculated for each study. A total of 25 papers including 127 experimental studies with eligible data on 2230 mice were retrieved. The pooled d (D) was 3.91 (3.56–4.25) and pooled r (R) was 54.52% (52.55%–56.52%). D significantly increased over time, whereas R non-significantly decreased; both estimates were significantly associated with the total drug dose. Such findings suggested no evidence of PZQ-R emergence S. japonicum to date. However, we consider the potential role of parasite origins, PZQ dosage, and single versus mixed gender infections of the results published to date, and the avenues now needed for further research. [ABSTRACT FROM AUTHOR]

[Display omitted] • Li mineralization of spodumene-bearing pegmatites in the Altai is mainly controlled by melt fractional crystallization. • Li gradually accumulates during magmatic-hydrothermal progress from the outer zones to inner zones. • The late-stage hydrothermal fluids mainly composed of Na, K, Ca-rich fluids and Li, F-rich fluids. • The reactivation and migration of Li in the hydrothermal stage would destroy Li mineralization in the magmatic stage. Pegmatite lithium (Li) deposits are usually associated with high fractionation and complex evolution of the magmatic–hydrothermal system. However, the mechanism that accounts for the evolution of the magmatic–hydrothermal system and Li mineralization remains unclear. The Li-mineralized pegmatites in the Altai orogenic belt in northwest of China, including the Koktokay No.3 pegmatite, Xiaohusite No.91 pegmatite, and Talati No.1 pegmatite used in this study, show different rock-formation ages and ore deposit scales but similar magmatic–hydrothermal evolution and ore mineral assemblage. This study focuses on the relative contributions of magmatic and hydrothermal processes to the formation of Li deposits. Therefore, the texture and compositions of Li-rich minerals (micas, spodumene, montebrasite, and holmquistite) were systematically analyzed in these three pegmatites. From the outer to the inner zones of the studied pegmatites, micas varied from muscovite to Li-bearing muscovite and Li-bearing phengite to zinnwaldite to lepidolite, with decreasing K/Rb ratios (27.4–5.3, 27.0–4.1, and 15.5–5.0, respectively, in Koktokay No.3 pegmatite, Xiaohusite No.91 pegmatite and Talati No.1 pegmatite) and increasing Li (545–12540, 652–35519, and 627–2599 ppm), Rb (3388–16820, 3447–20970, and 5930–17096 ppm), Cs, Ta, and F concentrations, showing that fractional crystallization is the most important factor controlling Li mineralization in the magmatic stage. However, primary muscovite, spodumene, and montebrasite were altered by subsequent hydrothermal fluids, forming F, Li-rich mica rims, secondary montebrasite, secondary spodumene, and other secondary minerals. The occurrence of holmquistite indicated that Li-rich hydrothermal fluids entered into wall rock. These processes indicate that Li reactivation and migration during the hydrothermal stage would destroy Li mineralization in the pegmatite. [ABSTRACT FROM AUTHOR]

Accurately assessing the changes in soil organic carbon storage （SOCS） before and after the Grain for Green Project （GFG） in the Loess Plateau （LP） and exploring the relationship between its spatial and temporal distribution and the influencing factors were important references for the development of regional recycling as well as the formulation of ecological protection policies. Based on the data of climate, human activities, and SOCD in the surface （0-20 cm） and deep （0-100 cm） soil before and after GFG in the LP from 2001 to 2020, we investigated the changes in SOCD at different spatial and temporal scales by using the methods of trend analysis, the kriging method, and variance partitioning analysis. The results showed that： ① Before and after the GFG, the surface SOCS of the whole region increased by 8 338.7×10 4 t； the deep SOCS increased by 1 160.02×10 4 t. ② In each bioclimatic subregion, the whole-region average SOCD of Ⅰ （Semi-Humid Forest Region）, Ⅱ （Semi-Humid Semi-Arid Forest and Grassland Region）, and Ⅲ （Semi-Arid Typical Grassland Region） showed a significant increasing trend, with a decreasing trend in Ⅳ （arid semi-arid desert grassland area） and Ⅴ （arid desert area）. ③ The average surface SOCS increase in different ecosystems was ranked as follows： cropland &gt; grassland &gt; woodland &gt; shrubs &gt; bare land and sparse vegetation. The deep soil increase was ranked as follows： grassland &gt; cropland &gt; woodland &gt; shrubs &gt; bare land and sparse vegetation. ④ Climate factors were the most important driving factors for changes in SOCD； the annual average temperature and precipitation were significantly positively correlated with changes in SOCD. The results of the study could provide data support for regional ecological management and land use policy formulation to promote high quality development of the ecological environment in the LP.

Human milk represents the gold standard for infant nutrition, with approximately 50% of the energy in human milk derived from lipids. Odd-chain fatty acids (OCFAs) have been recognized as a category of bioactive milk fatty acids in recent research; however, limited data exist on OCFAs in human milk. This study collected human milk samples spanning the postpartum period from 0 to 400 days. Phospholipids containing OCFAs (PL-OCFAs) were determined in 486 human milk samples using hydrophilic liquid chromatography-electrospray ionization-triquadrupole-mass spectrometry. Triacylglycerols containing OCFAs (TAG-OCFAs) were analyzed in 296 human milk samples using ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. The average total concentration of PL-OCFA ranged from 30.89 ± 14.27 mg L -1 to 93.48 ± 36.55 mg L -1 during lactation, and the average total TAG-OCFA content ranged from 103.1 ± 147.15 mg L -1 to 965.41 ± 651.67 mg L -1 . Despite the lower absolute concentration of PL-OCFA, its relative concentration (8.75%-11.75%) was significantly higher than that of TAG-OCFA (0.37%-1.85%) throughout lactation. PC-OCFA, SM-OCFA and PE-OCFA are major sub-classes of PL-OCFA. Furthermore, C17:0 was the major chain length in both PL-OCFA and TAG-OCFA, followed by C15:0. C17:1 was characteristic of TAG-OCFA, while long-chain fatty acids C19:0, C21:0 and C23:0 were characteristic of PL-OCFA. Our findings highlighted the importance of bioactive lipids in human milk, suggesting that OCFAs could be targeted in future studies in relation to the health and development of infants.

Background: Gangliosides are crucial for early-life cognition and immunity development. However, limited data exist on gangliosides within the Chinese population, and maternal-to-fetal/infant ganglioside transport remains unclear., Objectives: This study aimed to investigate gangliosides concentrations and trajectories in Chinese human milk during the first 400 d of lactation, and seek to understand gangliosides transmission between mother and offspring., Methods: This study involved 921 cross-sectional participants providing human milk samples across 0-400 d of lactation and 136 longitudinal participants offering maternal plasma, cord plasma, and human milk samples within the first 45 d postpartum. Ultrahigh-performance liquid chromatography-tandem mass spectrometry was used for the quantification of gangliosides., Results: Human milk GM3 (Neu5Acα2-3Galβ1-4GlcβCer) concentration increased from 2.29 ± 1.87 to 13.93 ± 4.82 μg/mL, whereas GD3 (Neu5Acα2-8Neu5Acα2-3Galβ1-4GlcβCer) decreased from 17.94 ± 6.41 to 0.30 ± 0.50 μg/mL during the first 400 d postpartum (all P < 0.05). Consistent results were observed in cross-sectional and longitudinal participants. GD3 concentration gradually increased from maternal plasma (1.58 μg/mL) through cord plasma (2.05 μg/mL) to colostrum (21.35 μg/mL). Significant positive correlations were observed between maternal and cord plasma for both GM3 (r = 0.30, P < 0.001) and GD3 (r = 0.35, P < 0.001), and maternal plasma GD3 also correlated positively with colostrum concentrations (r = 0.21, P = 0.015). Additionally, in maternal and cord plasma, gangliosides were mainly linked with 16- and 18-carbon fatty acids. However, human milk GM3 showed a broad spectrum of fatty acid chain lengths, whereas GD3 was primarily tied to very long-chain fatty acids (≥20 carbon)., Conclusions: We identified an increase in GM3 and a decrease in GD3 concentration in human milk, with GD3 notably more concentrated in cord plasma and colostrum. Importantly, ganglioside concentrations in maternal plasma positively correlated with those in cord plasma and colostrum. Our findings contribute to the existing Chinese data on gangliosides and enhance understanding of their transmission patterns from mother to offspring. This trial was registered at chictr.org.cn as ChiCTR1800015387., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Triacylglycerol (TAG) is the primary constituent of human milk fat and plays a vital role in the healthy development of infants. But few studies reported the sophisticated profile of TAG molecular species in human breast milk and its temporal changes during a prolonged lactation period. An efficient ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) method was adopted to examine TAGs. A total of 128 TAGs in 296 human breast milk samples collected during postnatal 0 to 400 days were identified. The changes in the human milk TAG profile mainly took place in the early stages of lactation (postnatal 0-45 days), and the TAG profile became stable in mature milk after 200 days of lactation. Odd chain fatty acids (OC-FAs) may be important markers for identifying human breast milk of different lactation stages. This study could provide evidence for developing safe and efficacious human-milk substitutes for children without access to human breast milk.

Objective: We aimed to investigate the association between weight retention at 6 weeks postpartum after the first pregnancy and large-for-gestational age (LGA) risk in a subsequent pregnancy., Study Design: A retrospective cohort study., Setting: A tertiary hospital of China., Participants: 5950 Chinese singleton pregnancies that delivered their second singletons between 28 and 42 weeks of gestation., Outcomes Measures: We calculated the weight retention at 6 weeks postpartum after the first pregnancy (the body mass index (BMI) at 6 weeks after the first birth minus the prepregnant BMI of the first pregnancy) and the gestational weight gain in the second pregnancy. We used the logistic regression to obtain adjusted OR. We determined the relationship between maternal BMI change at 6 weeks after the first pregnancy and LGA risk in the second pregnancy., Results: Relative to other categories of BMI change at 6 weeks postpartum, women who gained ≥3 kg/m 2 compared with the prepregnancy BMI were at increased LGA risk. The stratified analysis showed that LGA risk was increased in the second pregnancy in underweight and normal weight women who gained ≥3 kg/m 2 when using remain stable women as the reference group (OR=3.35, 95% CI 1.11 to 10.12 for underweight women; OR=2.23, 95% CI 1.43 to 3.45 for normal weight women) at 6 weeks postpartum. For the women who gained ≥3 kg/m 2 at 6 weeks postpartum, LGA risk was increased in normal weight women with an adequate (OR=3.21, 95% CI 1.10 to 9.33) and excessive (OR=2.62, 95% CI 1.02 to 6.76) gestational weight in the second pregnancy when using obese women as the reference., Conclusion: Postpartum weight retention at 6 weeks after the first pregnancy provides us a new early window to identify LGA risk in a subsequent pregnancy and allows us to implement primary preventative strategies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Because acquired hemophilia (AH) is a rare entity in systemic lupus erythematosus (SLE), we aimed to investigate the clinical features of SLE-related AH in Chinese patients., Methods: This is a medical records review study carried out at a large tertiary care hospital in China from years 1986 to 2018. We searched the case database in Peking Union Medical College Hospital using the International Classification of Diseases. The clinical data on SLE-related AH patients were collected., Results: A total of 9282 SLE patients had been hospitalized. Six female SLE-related AH patients were identified. Four patients had acquired hemophilia A (AHA), and 2 patients had acquired von Willebrand syndrome. Their mean age was 33.67 ± 13.77 years. Five patients had active disease. The mean SLE disease activity index measured at the time of diagnosis of AH was 10.50 ± 5.28. The average level of activated partial thromboplastin time was 86.5 seconds. Coexistence of secondary antiphospholipid syndrome and AHA was found in one case, and pulmonary embolism was observed 3 years later. After immunosuppressive therapy and symptomatic treatment, an overall remission rate of 83.3% was achieved., Conclusions: The frequency of SLE-related AH was low. The development of AH in SLE patients frequently occurs with active disease. The AH could be the first clinical presentation of SLE. Secondary antiphospholipid syndrome and AHA could appear in the same SLE patient. Early and aggressive treatment contributes to a favorable prognosis., Competing Interests: The authors declare no conflict of interest. Dr Yong Hou is funded by grants from the National Natural Science Foundation of China (81671614, www.nsfc.gov.cn/), Chinese Academy of Medical Sciences Initiative for Innovative Medicine 2017-12M-3-001., (Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc.)

Phospholipids are critical for milk digestion and infant development. But the profile of phospholipid molecular species in human milk and its dynamic changes during the lactation period have never been reported. The present study elucidated precise qualitative and quantitative analysis of 258 phospholipid molecular species in 486 human milk samples. Phosphatidylcholine is the most abundant class, followed by phosphatidylserine, phosphatidylethanolamine and sphingomyelin as the second abundant class in different lactation period. The plasmalogens declined along the lactation period, and the polyunsaturated-phospholipids decreased after 10-15 days. The decrease of phosphatidylcholines and phosphatidylglycerols, and the increase of lysophosphatidylethanolamines and lysophosphatidylcholines are critical changes from 0 to 5 days to 10-15 days; increase of phosphatidylinositols, phosphatidylserines, lysophosphatidylethanolamines and lysophosphatidylcholines is the key changes from 10-15 days to 40-45 days; the decrease of most phospholipid molecular species is the characteristic change from 40-45 days to 200-240 days; and the phospholipid profile achieved stability after 200 days., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Disease activity indices (DAIs) including disease activity score 28 (DAS28), simplified disease activity index (SDAI), and clinical disease activity index (CDAI) have been widely used in clinical practice and research studies of rheumatoid arthritis (RA). The objective of our study was to evaluate the correlation and concordance among different DAIs in Chinese patients with RA., Methods: A cross-sectional study, including patients enrolled in the Chinese registry of rheumatoid arthritis from November 2016 to August 2018, was conducted. The correlations were evaluated using Spearman correlation coefficient and concordance with Bland-Altman plots, quadratic weighted kappa, and discordance rates in the crosstab. For other indices, the optimal cutoff points corresponding to SDAI remission were explored through receiver operating characteristic curve analysis., Results: A total of 30,501 patients were included, of whom 80.46% were women. Most individuals were with moderate disease activity or high disease activity. High correlations among DAS28-erythrocyte sedimentation rate (ESR) and DAS28-C-reactive protein (CRP), SDAI and CDAI were observed. Similarly, the weighted kappa value among the indices was high. In Bland-Altman plots, a positive difference between DAS28-ESR and DAS28-CRP was observed, with an absolute difference of >1.2 in 3079 (10.09%) patients. In crosstab, approximately 30% of the patients were classified into different groups. Concordance values between SDAI remission and the optimal cutoff points of DAS28-ESR, DAS28-CRP, and CDAI were 3.06, 2.37, and 3.20, respectively., Conclusions: Although DAIs had high correlations and weighted kappa values, the discordance between DAIs was significant in Chinese patients with RA. The four DAIs are not interchangeable., (Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

We explored the effects of disturbance densities on the spatial pattern and the association of tree species in the coniferous broadleaved mixed forest in Pangquangou Nature Reserve of Guandi Mountain. Using three factors including canopy density, stand density and number of stumps, we classified the disturbance intensities of different forest stands into three levels, non-disturbance, moderate disturbance, and severe disturbance. The spatial distribution pattern and the association of different tree species were analyzed by spatial point pattern K2 function. The results showed that the diameter distribution of trees in undisturbed plots was inverted 'J' type, while that of moderate disturbance and serious disturbance plots was under bimodal curve distribution. The stand distribution pattern showed a small-scale aggregated distribution under undisturbed and moderately distur-bance, and a random distribution under heavy disturbance. At the small scale, the coniferous and broadleaved species showed no correlation in undisturbed stands, were positively correlated in moderately disturbed stands, and negatively correlated in seriously disturbed stands. At large scale, they were no correlated in both moderately and seriously disturbed stands. The results suggested that abundance of trees with small diameter in the forests was negatively with disturbance intensity, which led to the lower degree of intraspecific aggregation at small scale. Meanwhile, appropriate levels of disturbance would benefit the collaborative use of environmental resources for trees. Our results revealed the impacts of disturbance density on forest community structure and could provide theoretical basis for forest management.

The European cohort study has indicated about CD74 IgG-autoantibodies as potential marker for axial spondyloarthritis (axSpA) diagnosis. However, multiple studies have questioned the diagnostic value of various disease-specific autoantibodies in different ethnic groups. Here, we have tried to assess the diagnostic value of anti-CD74 IgG and IgA autoantibodies in axSpA patients from Chinese Han population.The anti-CD74 IgG and IgA autoantibodies were analyzed using ELISA assay in a cohort of 97 axSpA patients, including 47 treatment-naïve axSpA patients never treated with steroids or immunosuppressants and 50 treated axSpA patients. The rheumatic disease control (RDC) group consisted of 40 rheumatoid arthritis, 25 systemic lupus erythematosus, 18 psoriatic arthritis patients, and 60 healthy controls (HC).Our data demonstrated the presence of anti-CD74 IgA auto-antibodies in 25.8% of the axSpA patients, 30.1% of the RDC group patients and none in HC. Similarly, anti-CD74 IgG autoantibodies were observed in 23.7% of the axSpA patients, 18.1% of the RDC patients and 18.3% of the HC. The sensitivity, specificity, and accuracy of IgA autoantibodies were 21.3%, 82.5%, & 67.4%, respectively, while for IgG, it was 27.7%, 81.8%, and 68.4%, in treatment-naïve axSpA patients. Furthermore, weak positive relationship between anti-CD74 IgA autoantibodies and bath ankylosing spondylitis disease activity index ( r = 0.253, P = .012) and functional index (bath ankylosing spondylitis functional index; r = 0.257, P = .011) was observed.Overall, our study demonstrated little clinical and predictive value of CD74 autoantibodies in the diagnosis of axSpA and its related manifestations, among Chinese Han population.

Background: It is well known that insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2) rs4402960 polymorphism is associated with Type 2 diabetes mellitus, which has a shared genetic background with gestational diabetes mellitus (GDM). Previous studies have yielded controversial results about the link between IGF2BP2 rs4402960 polymorphism and GDM risk. Thus, a meta-analysis was performed to obtain more conclusive results., Methods: Clinical and genotype data were determined for 305 GDM and 1216 healthy participants recruited. Eligible studies were retrieved in PubMed, Web of science, EMBASE, and Scopus. Odds ratios (ORs) with 95% confidence intervals (CIs) were utilized to evaluate the relationship between IGF2BP2 polymorphisms and GDM susceptibility in five genetic models. The subgroup stratified analysis and trial sequential analysis (TSA) were performed., Results: In this case-control study, no significant association was revealed between IGF2BP2 polymorphism and GDM (P>0.05). When combined with the previous studies in the meta-analysis, there was no statistical association between IGF2BP2 polymorphism and GDM (allele model: OR = 1.01, 95% CI = 0.86-1.18; dominant model: OR = 1.00, 95% CI = 0.81-1.24; recessive model: OR = 1.08, 95% CI = 0.91-1.29; heterozygous model: OR = 0.99, 95% CI = 0.80-1.24; homozygous model: OR = 1.06, 95% CI = 0.78-1.42). No association was observed in five genetic models in each subgroup. TSA indicated sufficient proof of such null association in the overall population., Conclusions: This meta-analysis provides sufficient statistical evidence indicating null association between IGF2BP2 rs4402960 polymorphism and GDM risk., (© 2020 The Author(s).)

Background: Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patient-assessed) and proportions of treatment cost to household income., Methods: This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (<10%, 10-30%, 31-50%, and >50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients' treatment satisfaction., Results: When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P < 0.001). Effectiveness, side effects, and convenience scores were higher in the <10% subgroup compared to those in the >50% subgroup (all P < 0.05). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup (F = 13.183, P = 0.004). For biological disease-modifying anti-rheumatic drugs, effectiveness and convenience scores were lower in the severe RA subgroup than those in the extremely mild RA subgroup (both P < 0.05). Convenience score was higher in the <10% subgroup compared to that in the 31% to 50% and >50% subgroups (F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup (F = 8.794, P = 0.032)., Conclusion: Higher disease severity and higher financial burden were associated with lower patient satisfaction.

Objective: We investigated renal injury characteristics in Chinese patients with systemic sclerosis (SSc) who had undergone renal biopsy., Methods: We searched the medical records of patients with SSc who were hospitalized at Peking Union Medical College Hospital between January 1990 and August 2019. We analyzed the clinical characteristics and pathological results of these patients., Results: We identified 25 patients who had undergone renal biopsy. Of these patients, 10 had scleroderma renal crisis (SRC); one underwent renal biopsy twice (for diffuse mesangial proliferative glomerulonephritis and for SRC); two had antineutrophil cytoplasmic antibody-associated glomerulonephritis; one had immunoglobulin M nephropathy; one had minimal change nephropathy; seven had lupus nephritis; one had scleroderma renal crisis with comorbid lupus nephritis; and two had drug-related kidney injury (caused by aristolochic acid in one and D-penicillamine in the other). Acute tubular necrosis was observed in the patient taking oral aristolochic acid, while minimal change nephropathy was observed in the patient with D-penicillamine-induced renal injury., Conclusions: SRC was the most commonly encountered renal damage in patients with SSc. We recommend biopsy for patients undergoing treatment for SRC who have persistent renal injury with proteinuria, regardless of hematuria. Rheumatologists in Eastern countries should be aware of aristolochic acid nephropathy.

Solid-phase speciation and porewater chemistry measured by the diffusive gradients in thin films (DGT) technique were used to understand the diagenesis of sulfur (S), iron (Fe), and phosphorus (P) in sediments of Jiaozhou Bay (China), which has been impacted by multiple anthropogenic perturbations. Despite water eutrophication, sediments of the bay are low in organic carbon and sulfide, but high in unsulfidized Fe(II). Dissimilatory iron reduction (DIR) prevails in sediments of the bay, and there is no evidence for responses of S and Fe diagenesis to the water eutrophication, which is largely attributable to unique depositional and diagenetic regimes in association with multiple anthropogenic perturbations. Good coupling of porewater Fe 2+ and P in the porewaters suggests that P mobilization is driven mainly by DIR. Low Fe 2+ /P ratios in porewaters imply that oxidative regeneration of Fe oxides within the upper sediments is incapable of efficiently scavenging upward diffusing P., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: To assess the effectiveness of infectious source control at various stages of transmission control of schistosomiasis in Eryuan County of Yunnan Province, so as to provide insights into the further monitoring and management of infectious sources of schistosomiasis., Methods: Wenbi Village, a plateau subtype region and Qiandian Village, a mountain subtype region in Eryuan County were selected as the study areas. The species, schistosome infection and transmission capability of infectious sources were investigated in Wenbi and Qiandian villages in 2011 and 2018 and were compared., Results: Schistosome infections were detected in human, bovine, horse, dog and mouse in Qiandian Village in 2011, with positive rates of 1.19%, 0.91%, 1.25%, 3.13% and 0.95%, respectively, and human, bovine and dog were found to have schistosome infections, with positive rates of 0.76%, 1.66% and 9.30%, respectively. However, no infections were identified in human, bovine, horse, pig, dog, sheep or mouse in these two villages in 2018. A total of 731 wild feces were collected in both villages in 2011. In Qiandian Village, horse, bovine and dog feces accounted for 34.40%, 29.80% and 20.20% of all fecal samples, and dog and horse feces were found to have schistosome infections (11.94% and 6.90% positive rates, respectively). In Wenbi Village, dog, bovine and human feces accounted for 44.59%, 39.83% and 14.29% of all fecal samples, and dog, human and bovine feces were found to have schistosome infections (16.95%, 9.52% and 2.33% positive rates, respectively). In 2018, a total of 204 wild feces were collected in both villages, and no schistosome infections were identified. Sheep, dog and bovine feces accounted for 36.27%, 33.33% and 27.45% of all fecal samples in Qiandian Village, and dog, bovine and human feces accounted for 72.55%, 11.76% and 10.78% of all fecal samples in Wenbi Village., Conclusions: A remarkable achievement has been obtained in the control of infectious sources of schistosomiasis in Eryuan County, and the role of human and bovine as the major infectious sources of schistosomiasis has been effectively controlled. In the future, the integrated strategy with emphasis on the control of infectious sources should be intensified, and the management of reservoir hosts including dog and mouse should be strengthened.

A three-level (provincial, municipal and county levels) schistosomiasis diagnosis network platform had been created in Yunnan Province, and assessment of laboratory quality-control samples and field evaluation of nucleic acid diagnostic techniques and immunodiagnostic reagents had been performed. This paper described the review process of the schistosomiasis diagnosis network laboratory and the operation of schistosomiasis diagnosis network laboratory and analyzed the problems of the schistosomiasis diagnosis network laboratory in Yunnan Province. The establishment of the schistosomiasis diagnosis reference (network) laboratory will provide a strong support for schistosomiasis control in Yunnan Province in the new era.

Objective: To evaluate the potential risk of schistosomiasis transmission so as to provide the evidence for formulating the control strategy., Methods: Two villages were selected as the investigated sites in Chuxiong City and the risk of schistosomiasis transmission was evaluated by reviewing the data of schistosomiasis epidemic situation and prevention and control work, and carrying out the field survey for Oncomelania hupensis snail status, wild faeces, and schistosome infection of the population from 2015 to 2017., Results: There was 1.49 hm 2 area of snail habitats, with an average density of 0.54 snails/0.1 m 2 . The occurrence rate of frames with snails was 5.41%. No schistosome-infected snails were found. The positive rate of schistosomiasis serological tests of the residents was 3.36%, but the stool examination positive cases were not found. A total of 58 wild faeces samples were collected but no schistosome infested cases were found. The risk levels of schistosomiasis transmission in both villages were Grade III., Conclusions: Although Chuxiong City has been in a low risk state of schistosomiasis transmission, the density of snails is still high, and there is a risk of infection source importation. In the future, the infection source control and snail control should be strengthened.

Dissolved sulfide, iron (Fe), and phosphorus (P) in a mudflat (Jiaozhou Bay, China) impacted by shellfish aquaculture were measured in situ by the diffusive gradients in thin films (DGT) technique. A combination of porewater and solid-phase chemistry was used to characterize the interplays of Fe and S, and their control on P mobilization. Below the subsurface layer, two times higher fluxes (F DGT ) of dissolved Fe 2+ from porewater to the DGT device than those of dissolved sulfide indicate that dissimilatory iron reduction (DIR) dominates over sulfate reduction (SR). Spatial coupling of dissolved Fe 2+ and P points to P release driven mainly by reductive dissolution of Fe. Much higher F DGT values of dissolved Fe 2+ relative to dissolved P imply that oxidative regeneration of Fe oxides at the sediment-water interfaces (SWIs) of the transitional mudflat serves as an effective "iron curtain" of upward diffusing P. In the mudflat sediments of DIR prevalence, the accumulation of total reduced inorganic sulfur (TRIS) is dampened, which can largely ascribed to enhanced oxidative loss of sulfide and/or limited availability of degradable organic carbon in the dynamic regimes. Low dissolved sulfide concentrations in the sediments leave the majority of reactive Fe unsulfidized and thus abundantly available to buffer newly produced sulfide.

Aim: A prospective and longitudinal study to investigate the correlations between Krebs von den Lungen-6 (KL-6) serum levels and systemic sclerosis associated with interstitial lung disease (SSc-ILD)., Method: Blood samples of baseline and the time point at 2 years follow-up intervals were collected for the measurement of serum KL-6 levels. The baseline clinical, laboratory characteristics, and incidence density of newly diagnosed ILD during the follow up were compared between SSc patients with elevated serum KL-6 levels (KL-6 > 500 U/mL) and those with normal KL-6 levels (KL-6 ≤ 500 U/mL) at baseline. Further, we explored the association between serum KL-6 and deterioration of ILD measured by lung function parameters during follow-up of 2 years., Results: Patients with elevated baseline serum KL-6 had a significant tendency to have disappearance of the finger pad. The incidence density of new-onset ILD in SSc patients with elevated baseline serum KL-6 and those with normal baseline serum KL-6 was 1.33% and 0.51%, respectively. Among the mild lung injury group, the incidence density of ILD deterioration in SSc patients with elevated baseline serum KL-6 and those with normal serum KL-6 was 1.2% and 0.74%, respectively., Conclusion: Serum KL-6 level correlates with the clinical manifestations of microvascular injury. Baseline elevated serum KL-6 may predict deterioration of lung function of SSc-ILD patients with mild lung injury., (© 2018 The Authors. International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Background: The aim of this study is to improve the preoperative diagnostic accuracy and treatment results by investigating the clinical features and prognosis of primary liver sarcoma (PLS)., Methods: Clinical data, surgical treatments, adjuvant chemotherapy, and prognosis of 17 PLS patients whose diseases were pathologically confirmed were retrospectively analyzed., Results: The main clinical symptoms included epigastric pain in 9 patients, epigastric distention in 7, and loss of appetite in 4; these symptoms were detected during the postoperative follow-up for gastric carcinoma in 1. The resection rate was 64.7% (12/17), including R0 resection in 10 patients and R1 resection in 2, and laparotomy with biopsy in 5. Five patients accepted an adjuvant selective hepatic artery infusion chemotherapy (mitomycin C 16-20 mg+ 5-fluorouracil 5.0 g+ epirubicin 40-50 mg), and 4 accepted adjuvant systemic chemotherapy (vincristin, cisplatin, cyclophosphamide, and adriamycin). All 5 patients with simple laparotomy died within 1 year, and the overall 1-, 3-, and 5-year survival rates for all patients were 58.8% (10/17), 29.4% (5/17) and 11.7% (2/17), respectively, whereas those were 100.0% (10/10), 50.0% (5/10), and 20.0% (2/10) for R0 resected patients respectively., Conclusions: The diagnosis of PLS is difficult before operation due to its nonspecific manifestations, and the high survival rate can be achieved by radical resection with adjuvant chemotherapy., (© 2018 S. Karger AG, Basel.)

Exposure to diesel engine exhaust (DEE) was associated with various adverse health effects including lung cancer. Particle size distribution and profiles of organic compounds in both particle and gas phases of DEE that could provide valuable insights into related health effects were measured in a diesel engine testing workshop. Concentrations of urinary 6 mono-hydroxylated polycyclic aromatic hydrocarbons (OH-PAHs) in 137 DEE-exposed workers and 127 non-DEE-exposed workers were determined. Benchmark dose method was applied to estimate lower limit of benchmark dose (BMDL) of urinary OH-PAHs most specific to DEE exposure for previously reported cancer biomarkers. We found that 84.3% of diesel exhaust particles were ultrafine particles. Indeno[123-cd]pyrene and phenanthrene were the most abundant carcinogenic and noncarcinogenic PAHs in the particle phase of DEE, respectively. Principal component analysis demonstrated that urinary hydroxyphenanthrene (OHPhe) had highest loading value on principal component (PC) representative of DEE exposure and lowest loading value on PC representative of smoking status. BMDLs of urinary OHPhe from best-fitting models for cancer biomarkers including micronucleus and 1,N 6 -ethenodeoxyadenosine were 1.08 μg/g creatinine and 2.82 μg/g creatinine, respectively. These results provided basis for understanding DEE exposure induced health effects and potential threshold for regulating DEE levels in an occupational setting.

Diesel exhaust (DE) as the major source of vehicle-emitted particle matter in ambient air impairs lung function. The objectives were to assess the contribution of local (eg, the fraction of exhaled nitric oxide [FeNO] and serum Club cell secretory protein [CC16]) and systemic (eg, serum C-reaction protein [CRP] and interleukin-6 [IL-6]) inflammation to DE-induced lung function impairment using a unique cohort of diesel engine testers (DETs, n = 137) and non-DETs (n = 127), made up of current and noncurrent smokers. Urinary metabolites, FeNO, serum markers, and spirometry were assessed. A 19% reduction in CC16 and a 94% increase in CRP were identified in DETs compared with non-DETs (all p values <10-4), which were further corroborated by showing a dose-response relationship with internal dose for DE exposure (all p values <.04) and a time-course relationship with DE exposure history (all p values <.005). Mediation analysis showed that 43% of the difference in FEV1 between DETs and non-DETs can be explained by circulating CC16 and CRP (permuted p < .001). An inverse dose-dependent relationship between FeNO and internal dose for cigarette smoke was identified (p = .0003). A range of 95% lower bounds of benchmark dose of 1.0261-1.4513 μg phenanthrols/g creatinine in urine as an internal dose was recommended for regulatory risk assessment. Local and systemic inflammation may be key processes that contribute to the subsequent development of obstructive lung disease in DE-exposed populations.