Search

The western flower thrips, Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae), is an invasive species and currently occurs in only a few areas in China. An easy, accurate and developmental-stage independent method to identify F. occidentalis would be a valuable tool to facilitate pest management decision making and, more importantly, to provide an early warning so actions can be taken to prevent its introduction into non-infested areas. Morphological identification of thrips adults and, to a lesser extent, of second-stage larvae is the main method currently available to identify F. occidentalis. Molecular identification, however, can be easily carried out by a non-thrips-specialist with a little training. In this study, DNA sequence data [within the mitochondrial cytochrome oxidase I gene ( COI)] and polymerase chain reaction (PCR) were utilized to develop a molecular diagnostic marker for F. occidentalis. A primer set and PCR cycling parameters were designed for the amplification of a single marker fragment (340 bp) of F. occidentalis COI mtDNA. Specificity tests performed on 28 thrips species, efficacy tests performed on five immature developmental stages as well as on male and female adults and tests on primer sensitivity all demonstrated the diagnostic utility of this marker. Furthermore, the primer set was tested on seventeen F. occidentalis populations from different countries and invaded areas in China and proved to be applicable for all geographic populations. It was used successfully to clarify the distribution of F. occidentalis in the Beijing metro area. These results suggested that this diagnostic PCR assay provides a quick, simple and reliable molecular technique for the identification of F. occidentalis. [ABSTRACT FROM AUTHOR]

Abstract: Aims: Soft tissue sarcomas are uncommon, but relatively aggressive tumours. Although surgical resection remains the primary therapeutic modality for all localised tumours, brachytherapy combined with function-preserving excision is a popular treatment for extremity soft tissue sarcomas. The objective of this study was to evaluate the effect of interstitial permanent brachytherapy using I125 seeds in patients undergoing the combined modality in the management of soft tissue sarcomas at our institution. Materials and methods: Between January 2007 and January 2012, 110 adult patients aged 18–86 years (median = 44 years) with extremity soft tissue sarcomas and who underwent interstitial permanent brachytherapy as part of the local treatment were included in this study. Treatment included wide local excision of the tumour and brachytherapy using a permanent I125 implantation. Complications were assessed in terms of wound complication and peripheral nerve damage. Results: After a median follow-up of 43.7 months, the local control, disease-free survival and overall survival for the entire cohort studied were 74, 54 and 77%, respectively. The actual rates of wound complications requiring reoperation and nerve damage were 4.5 and 1.8%, respectively. Conclusions: We conclude that interstitial permanent brachytherapy with I125 after function-preserving surgery results in a satisfactory outcome in patients with extremity soft tissue sarcomas and the complication rate is low. [Copyright &y& Elsevier]

A substantial reservoir of nitrogen (N) in soil poses a threat to the quality and safety of shallow groundwater, especially under extreme precipitation that hastens nitrogen leaching into groundwater. However, the specific impact of varying precipitation intensities on the concentration and sources of nitrate (NO 3 - concentration, sources, and controlling factors in shallow groundwater under different intensities of precipitation (extreme heavy precipitation and continuous heavy precipitation) in a typical alluvial-pluvial fan of the North China Plain by using stable isotopes (δ 3 - concentration, sources, and controlling factors in shallow groundwater under different intensities of precipitation (extreme heavy precipitation and continuous heavy precipitation) in a typical alluvial-pluvial fan of the North China Plain by using stable isotopes (δ 2 H-H 2 O, δ 18 O-H 2 O, δ 15 N-NO 3 - , δ 18 O-NO 3 - ), hydrochemical analyses and the SIAR model. Affected by extreme heavy precipitation the depleted isotopes of δ 2 H-H 2 O and δ 18 O-H 2 O in groundwater of the entire area suggested the rapid recharge of fast flow by precipitation. The enriched isotopes of δ 2 concentrations increased to 78.9 mg/L after extreme heavy precipitation and increased to 105.3 mg/L after continuous heavy precipitation when compared to those in normal year (56.8 mg/L) of north part of the alluvial fan. However, NO 2 O and δ 18 O-H 2 O of north part in alluvial fan after continuous heavy precipitation showed the recharge of translatory flow of soil water. NO 3 - concentrations increased to 78.9 mg/L after extreme heavy precipitation and increased to 105.3 mg/L after continuous heavy precipitation when compared to those in normal year (56.8 mg/L) of north part of the alluvial fan. However, NO 3 - concentrations had slight variation after continuous heavy precipitation of south part of the fan due to the deep vadose zone. The contribution ratio of sources of NO 3 - in groundwater by using SIAR analysis revealed manure & sewage (MS) as the primary NO 3 - source (accounting for 59.7-78.1%) before extreme heavy precipitation, chemical fertilizer (CF) making a minor contribution (6.9-17.3%). Different precipitation events and land use types lead to changes in NO 3 - sources. Affected by extreme heavy precipitation, the contribution of MS decreased while CF increased, particularly in vegetables (26.2-28.1%) and farmland (29.2-34.7%). After continuous heavy precipitation, MS increased again, particularly in vegetables (50.0%) and farmlands (20.4-66.4%), with CF either increasing or remaining steady. This indicated that continuous heavy precipitation accelerated the leaching of nitrogen (organic manure application) stored in deep soil to groundwater and it has a larger influence on the increasing of NO 3 - concentrations of groundwater than extreme heavy precipitation which carried nitrogen (chemical fertilizer application) in shallow soil to groundwater by fast flow. These findings underscore the importance of considering soil chemical N stores and their implications for groundwater contamination mitigation under future extreme climate scenarios, particularly in agricultural management practices., 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. Published by Elsevier Ltd.)

Antibody-drug conjugates (ADCs) have demonstrated effectiveness in treating various cancers, particularly exhibiting specificity in targeting human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Recent advancements in phase 3 clinical trials have broadened current understanding of ADCs, especially trastuzumab deruxtecan, in treating other HER2-expressing malignancies. This expansion of knowledge has led to the US Food and Drug Administration's approval of trastuzumab deruxtecan for HER2-positive and HER2-low breast cancer, HER2-positive gastric cancer, and HER2-mutant nonsmall cell lung cancer. Concurrent with the increasing use of ADCs in oncology, there is growing concern among health care professionals regarding the rise in the incidence of interstitial lung disease or pneumonitis (ILD/p), which is associated with anti-HER2 ADC therapy. Studies on anti-HER2 ADCs have reported varying ILD/p mortality rates. Consequently, it is crucial to establish guidelines for the diagnosis and management of ILD/p in patients receiving anti-HER2 ADC therapy. To this end, a panel of Chinese experts was convened to formulate a strategic approach for the identification and management of ILD/p in patients treated with anti-HER2 ADC therapy. This report presents the expert panel's opinions and recommendations, which are intended to guide the management of ILD/p induced by anti-HER2 ADC therapy in clinical practice., (© 2024 American Cancer Society.)

Background: Tea is one of the most widely consumed beverages in the world, with significant economic and cultural value. However, tea production faces many challenges due to various biotic and abiotic stresses, among which fungal diseases are particularly devastating., Results: To understand the identity and pathogenicity of isolates recovered from tea plants with symptoms of wilt, phylogenetic analyses and pathogenicity assays were conducted. Isolates were characterized to the species level by sequencing the ITS, tef-1α, tub2 and rpb2 sequences and morphology. Four Fusarium species were identified: Fusarium fujikuroi, Fusarium solani, Fusarium oxysporum, and Fusarium concentricum. The pathogenicity of the Fusarium isolates was evaluated on 1-year-old tea plants, whereby F. fujikuroi OS3 and OS4 strains were found to be the most virulent on tea., Conclusions: To the best of our knowledge, this is the first report of tea rot caused by F. fujikuroi in the world. This provides the foundation for the identification and control of wilt disease in tea plants., (© 2024. The Author(s).)

Malignant pleural mesothelioma (MPM) is a malignant tumor originating from the pleura, and its incidence has been increasing in recent years. Due to the insidious onset and strong local invasiveness of MPM, most patients are diagnosed in the late stage and early screening and treatment for high-risk populations are crucial. The treatment of MPM mainly includes surgery, chemotherapy, and radiotherapy. Immunotherapy and electric field therapy have also been applied, leading to further improvements in patient survival. The Mesothelioma Group of the Yangtze River Delta Lung Cancer Cooperation Group (East China LUng caNcer Group, ECLUNG; Youth Committee) developed a national consensus on the clinical diagnosis and treatment of MPM based on existing clinical research evidence and the opinions of national experts. This consensus aims to promote the homogenization and standardization of MPM diagnosis and treatment in China, covering epidemiology, diagnosis, treatment, and follow-up., (© 2023 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.)

The aim of this article is to explore the impact of housing investment on household entrepreneurship. Using survey data from China and employing a Probit model, we examine three aspects of housing status and innovatively subdivide household entrepreneurship into agricultural entrepreneurship and business entrepreneurship. The results show that households with higher housing investment are less likely to become agricultural entrepreneurs, but more likely to start a new business. Households with full-owned housing enjoy a higher likelihood to become business entrepreneurs. However, other ownerships have no relation with the choice of entrepreneurship. More housing loans discourage entrepreneurial activities. One exception is that bank loan raises the chance of being agricultural entrepreneurs. Households who build their own houses have a higher agricultural entrepreneurship. Buying market price houses encourages households to be business entrepreneurs. Low-price house and inherited house prevent households from being business entrepreneurs., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Huang 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.)

Thymic epithelial tumors (TETs) are a relatively rare type of thoracic tumor, accounting for less than 1% of all tumors. The incidence of TETs is about 3.93/10000 in China, slightly higher than that of European and American countries. For resectable TETs, complete surgical resection is recommended. Radiotherapy or chemotherapy may be used as postoperative adjuvant treatment. Treatment for advanced, unresectable TETs consist mainly of radiotherapy and chemotherapy, but there is a lack of standard first- and second-line treatment regimens. Recently, targeted therapies and immune checkpoint inhibitors have shown promising outcomes in TETs. Based on the currently available clinical evidences and the opinions of the national experts, the Thymic Oncology Group of Yangtze River Delta Lung Cancer Cooperation Group (East China LUng caNcer Group, ECLUNG; Youth Committee) established this Chinese expert consensus on the clinical diagnosis and treatment of TETs, covering the epidemiology, diagnosis, treatment, prognosis and follow-up of TETs., (© 2023 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.)

In this present study, 195 cow milk, 100 goat milk, 50 buffalo milk, 50 camel milk, and 50 yak milk samples were collected in China in May and October 2016. The presence of aflatoxin M1 (AFM1) was determined using enzyme-linked immunosorbent assay method. For all cow milk samples, 128 samples (65.7%) contained AFM1 in concentrations ranging from 0.005 to 0.191 µg/L, and 6 samples (3.1%) from Sichuan province in October were contaminated with AFM1 above 0.05 µg/L (EU limit). For all goat milk samples, 76.0% of samples contained AFM1 in concentrations ranging from 0.005 to 0.135 µg/L, and 9 samples (9.0%) from Shanxi province in October were contaminated with AFM1 above 0.05 µg/L. For all buffalo milk samples, 24 samples (48.0%) contained AFM1 in concentrations ranging from 0.005 to 0.089 µg/L, and 2 samples collected in October were contaminated with AFM1 above 0.05 µg/L. Furthermore, 28.0% of samples contained AFM1 in concentrations ranging from 0.005 to 0.007 µg/L in camel milk samples, and 18.0% of samples contained AFM1 in concentrations ranging from 0.005 to 0.007 µg/L in yak milk samples. Our survey study has expanded the current knowledge of the occurrence of AFM1 in milk from five dairy species in China, in particular the minor dairy species.

Immune checkpoint inhibitors (ICIs) have successfully treated a number of different types of cancer, which is of great significance for cancer treatment. With the widespread use of ICIs in clinical practice, the increasing checkpoint inhibitor pneumonia (CIP) will be a challenge to clinicians. To guide the diagnosis and treatment of CIP, we conducted in-depth discussions based on the latest evidence, forming a consensus among Chinese experts on the multidisciplinary management of CIP., (© 2022 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.)

The excessive emission of carbon dioxide will bring unpredictable ecological crisis, so it is particularly urgent to study the related factors of carbon emissions. Based on the grey correlation model, 31 factors in 5 aspects are selected as the reference frame for low-carbon governance, and the grey correlation degree of urban carbon emissions is calculated by using the IPCC method to calculate the annual carbon emissions of 9 major cities in the Yangtze River Delta from 2010 to 2019. Through the calculation and analysis of panel data, the following conclusions are drawn: The allocation of urban environmental practitioners is an important factor in carbon governance, and the reasonable and scientific allocation of environmental practitioners can have a significant impact on low-carbon development; the relationship between the amount of industrial power consumption and carbon dioxide emissions is not significant. On the contrary, the power consumption of urban residents can well reflect the level of carbon emissions. High residential power consumption means that the living standard of the people in the region is high, and the corresponding resource and energy consumption is large, so the carbon emissions will increase; the size of population density is particularly important for carbon governance, which is more obvious in economically developed areas. Urban economic development will inevitably lead to the improvement of people's quality of life, a stronger demand for resources, and a significant increase in carbon emissions., Competing Interests: The author declares that there are no conflicts of interest., (Copyright © 2022 Li Min.)

Background: The endoprosthetic knee reconstruction using a current universal femoral stem might not be suitable for local population due to the anatomical difference between Chinese and Western populations. We measured the anatomical parameters of Chinese femurs as reference for stem design, and proposed a cementless, curved, short endoprosthesis stem for the reconstruction of distal femur. This study analyzed the biomechanical performance of the newly designed stem aimed at the identification of better operative strategy., Methods: The CT-scanning data of femurs derived from 96 healthy Chinese volunteers were imported into the Mimics software, and a segmental measurement strategy was applied to evaluate the radius of curvature (ROC) of the femoral medullary cavity. Then, 4 kinds of endoprosthetic replacement models were created based on the measurement results. Model A: the distal tumor resected femora + straight stem A; Model B: the distal tumor resected femora + curved stem B; Model C: the distal tumor resected femora + curved stem C; Model D: the distal tumor resected femora + curved stem D. Finally, the mechanical difference among these models were compared by finite element analysis., Results: The mean femoral ROC of Segment 1, 2, 3, 4, 5 measured in the present study was 724.5 mm, 747.5 mm, 1016.5 mm, 1286.5 mm, and 1128 mm, respectively. Based on the femoral ROC of Segment 2, the stem ROC of the curved stem B, C, and D was designed as 475 mm, 700 mm, and 1300 mm, respectively. Generally, all endoprosthetic replacement models showed a normal-like stress distribution on the femurs. However, compared to the straight stem, the biomimetic curved stem showed better biomechanical performance both in terms of reducing the extent of the stress shielding of the femur and in terms of minimizing the stress distribution of the implant., Conclusions: The uncemented, curved, short stem with suitable ROC can perfectly match the Chinese femoral canal morphology which has better mechanical properties than the conventional femoral stem. Thus, this newly designed femoral stem might be an optimized method for treatment of malignant femoral tumours in the Chinese populations in the case that the numerical results are supported by future experimental studies., (© 2022. The Author(s).)

Evaluation of the nitrate transport process in the deep vadose zone (DVZ) is important for groundwater quality management, especially in intensive agricultural regions, such as the North China Plain (NCP). The NCP produces ~20% of the total food grain in China, owing to timely groundwater irrigation and excessive chemical N fertilizer applications, and faces severe groundwater environmental degradation. This study evaluated the potential impacts of intensive agriculture on groundwater quality by investigating nitrate accumulation and transport in the DVZ of wheat-maize double-cropping field based on sediment sampling (maximum depth of 45.2 m) over three sub-regions of the NCP. The results showed that legacy nitrate‑nitrogen (NO 3 - -N) accumulated in the DVZ ranged from 118.5 to 6302.8 kg N ha -1 across the NCP; it increased with depth at an average rate of ~157 kg ha -1 m -1 . Nitrate transport and accumulation in the DVZ were spatially varied and mainly controlled by the DVZ sediment textures, in addition to water and nitrogen inputs from the ground surface. Coarse sediments retained lower soil water content, resulting in less nitrogen storage; however, they provided greater nitrate transport velocity. Higher transport velocities observed in the alluvial-proluvial fan allowed chemical N fertilizer to reach the water table. However, in other regions, nitrate transport velocities were lower than the water table decline rates, implying that groundwater quality may not have been impaired by chemical N fertilizer. Furthermore, a reductive environment was identified in some areas with fine sediments, indicating a favorable environment for denitrification in the DVZ. The findings of the current study could provide an important foundation for groundwater quality management in agricultural areas, such as the NCP and similar regions., 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 Elsevier B.V. All rights reserved.)

Background. Carbapenem-resistant Klebsiella pneumoniae (CRKP) is increasingly isolated in paediatric wards, posing a severe threat to these vulnerable populations. This study investigated the clinical features, determinants of carbapenem resistance and clonal relatedness among CRKP in our hospital. Hypothesis. The prevalence of carbapenem-resistant K. pneumoniae in paediatric patients differs from the strains isolated from adult patients in carbapenemase and predominant clones. Aim. To investigate the pattern of carbapenemase and the clonal relationships between carbapenem-resistant Klebsiella pneumoniae in a paediatric hospital in Jiangxi Province. Methodology. Forty-five CRKP isolates were consecutively collected from October 2016 to October 2020. Medical records were reviewed to analyse clinical features. Detection of carbapenemase genes was used to determine CRKP resistance mechanisms and clonal relatedness among CRKP was identified through multi-locus sequence typing (MLST). Results. Forty-three (95.6 %) patients developed CRKP infection, and two (4.4 %) were colonized by CRKP in the urinary tract. The overall mortality rate was 13.3 %. In total, 42 (93.3 %) strains were positive for carbapenemase genes, and bla NDM (62.2 %) was the predominant gene. The MLST identified 24 different sequence types (STs) of CRKP, in which ST11 ( n =8, 17.8 %) and ST2735 ( n =8, 17.8 %) were the most common STs. Conclusion. The pattern of CRKP in paediatric patients reflects evolving changes. The ST2735 K. pneumoniae may present as a dangerous CRKP clone circulating in paediatric patients.

Objectives: To use a quantitative approach to examine the effects of high-intensity interval training (HIIT) interventions on sleep for adults., Methods: PubMed, Ebsco, Web of Science, Cochrane Central Register of Controlled Trials, the China National Knowledge Infrastructure, and Wanfang Data were searched from their inception to December 2020. Intervention studies with a control group that examined the effects of HIIT interventions on sleep were included in this meta-analysis. The risk of bias was assessed using the tool provided by the Cochrane Handbook for Systematic Reviews of Interventions. Effect sizes (ESs), calculated as weighted mean difference (WMD) and standardized mean difference (SMD), were used to examine the effects of objective outcomes and subjective outcomes separately., Results: A large increase in sleep quality (SQ) reflected by the Pittsburgh Sleep Quality Index global scores [WMD = -0.90, 95%CI (-1.72, -0.07), p = 0.03, n = 8] and a small-to-medium favorable effect on sleep efficiency (SE) [SMD = 0.43, 95%CI (0.20, 0.65), p = 0.0002, n = 10] were found after HIIT intervention. In addition, sub-analyses results suggest that ESs were moderated by the type, duration and frequency, as well as the length of the HIIT intervention., Conclusions: HIIT may be a promising way to improve overall subjective SQ and objective SE. PROSPERO, protocol registration number: CRD42021241734.

While studies on the health benefits of Tai Chi have sprung up over the past four decades, few have engaged in collecting global data, estimating the developing trends, and conducting reviews from the perspective of visualization and bibliometric analysis. This study aimed to provide a summary of the global scientific outputs on Tai Chi research from 1980 to 2020, explore the frontiers, identify cooperation networks, track research trends and highlight emerging hotspots. Relevant publications were downloaded from the Web of Science Core Collection (WoSCC) database between 1980 and 2020. Bibliometric visualization and comparative analysis of authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords were systematically conducted using CiteSpace software. A total of 1078 publications satisfied the search criteria, and the trend of annual related publications was generally in an upward trend, although with some fluctuations. China (503) and Harvard University (74) were the most prolific country and institution, respectively. Most of the related researches were published in the journals with a focus on sport sciences, alternative medicine, geriatrics gerontology, and rehabilitation. Our results indicated that the current concerns and difficulties of Tai Chi research are "Intervention method", "Targeted therapy", "Applicable population", "Risk factors", and "Research quality". The frontiers and promising domains of Tai Chi exercise in the health science field are preventions and rehabilitations of "Fall risk", "Cardiorespiratory related disease", "Stroke", "Parkinson's disease", and "Depression", which should receive more attention in the future.

Objective: To determine whether diabetes mellitus (DM) contributes to the drug resistance of carbamazepine (CBZ), we investigated the correlation between the blood glucose status and the CBZ resistance condition in patients with trigeminal neuralgia (TN)., Patients and Methods: A total of 155 TN patients treated with the CBZ monotherapy were selected at Shanghai General Hospital and Shanghai Xinhua Hospital from September 2018 to January 2020. Among them, 15 were diagnosed with DM. Patients' CBZ resistance levels were evaluated according to progression-free survival. We utilized ordered multiple classification logistic regression to determine the dominant factors leading to CBZ resistance. We analyzed the correlation between hemoglobin A1c (HbA1c) and progression-free survival using the Pearson correlation analysis., Results: The regression analysis showed that DM was the only factor affecting CBZ resistance (p = 0.035; OR = 0.327; 95% CI, 0.115-0.926). Progression-free survival was 28.5 ± 21.2 months in the DM group and 66.0 ± 33.2 months in the non-DM group. The concentration of HbA1c in the blood was negatively correlated with progression-free survival (r = - 0.197; p = 0.014)., Conclusions: This study shows that blood glucose status is a significant factor contributing to the CBZ resistance in the treatment of TN. The progression-free survival of patients is affected by the status of DM and blood HbAlc levels.

Phosphate-solubilizing bacteria (PSB) have beneficial effects on plant health and soil composition. To date, studies of PSB in soil have largely been performed under field or greenhouse conditions. However, less is known about the impact of introducing indigenous PSB in the field, including their effects on the local microbial community. In this study, we conducted greenhouse and field experiments to explore the effects of the addition of indigenous PSB on the growth of Chenmou elm (Ulmus chenmoui) and on the diversity and composition of the bacterial community in the soil. We obtained four bacterial isolates with the highest phosphate-solubilizing activity: UC_1 (Pseudomonas sp.), UC_M (Klebsiella sp.), UC_J (Burkholderia sp.), and UC_3 (Chryseobacterium sp.). Sequencing on the Illumina MiSeq platform showed that the inoculated PSB did not become the dominant strains in the U. chenmoui rhizosphere. However, the soil bacterial community structure was altered by the addition of these PSB. The relative abundance of Chloroflexi decreased significantly in response to PSB application in all treatment groups, whereas the populations of several bacteria, including Proteobacteria and Bacteroidetes, increased. Network analysis indicated that Chloroflexi was the most strongly negatively correlated with Proteobacteria, whereas Proteobacteria was strongly positively correlated with Bacteroidetes. Our findings indicate that inoculation with PSB (UC_1, UC_M, UC_J, and UC_3) can improve the growth of U. chenmoui and regulate its rhizosphere microbial community. Therefore, inoculation with these bacterial strains could promote the efficient cultivation and production of high-quality plant materials., Competing Interests: The authors declare that they have no conflicts of interest associated with this work.

Objective: To study the safety and feasibility of total hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and transumbilical laparoendoscopic single site surgery (TU-LESS). Methods: The study was a retrospective cohort analysis. In West China Second University Hospital, from October 1, 2018 to June 30, 2019, the patients with an indication for hysterectomy due to benign uterine diseases were enrolled, and were grouped by the surgical procedure. Various post-operative surgical outcomes, including the success rate of operation, uterine volume, operative time, blood loss, intraoperative complications, postoperative complications, the first time of flatus, the preserved time of catheter after operation, and the length of hospitalization were measured. The data were assessed by the software of SPSS. Results: Totally 30 patients were included in the vNOTES group, and 77 patients were included in the TU-LESS group, all of the procedures were completed successfully without conversion to traditional multiport laparoscopy or laparotomy. Non differences were observed between two groups, including uterine volume [(165±36) vs (235±38) cm 3 , P =0.243], operation time [(150±41) vs (169±48) minutes, P =0.063], blood loss [(54±15) vs (54±14) ml, P =0.985], the rate of intraoperative complications [3% (1/30) vs 4% (2/77), P =1.000], the rate of postoperative complications [13% (4/30) vs 4% (3/77), P =0.095] and the rate of bilateral salpingo-oophorectomy [50% (15/30) vs 31% (24/77), P =0.069]. Patients in the vNOTES group had significantly less recovery time of intestine function [(1.7±0.5) vs (2.3±0.6) days, P =0.001], shorter time of indwelling catheter [(1.9±0.4) vs (2.3±0.6) days, P =0.004], and duration of hospitalization [(3.2±0.8) vs (3.6±0.9) days, P =0.045]. Conclusions: vNOTES and TU-LESS are both safe and feasible for total hysterectomy. Compared with TU-LESS, vNOTES may be a promising approach with earlier recovery, less injury and better cosmetic.

As a representative foreign medicinal material, olibanum(Ruxiang) was imported to China since the Qin and Han Dynasties. Olibanum was first described as a medicinal by the name "Xunluxiang" in Miscellaneous Records of Famous Physicians(Ming Yi Bie Lu). This study investigated historical records on olibanum and conducted the herbalogical study. It was found that olibanum came from the resin mainly obtained from the bark of Pistacia lenticus before the Tang Dynasty. With the prosperity of the Maritime Silk Road, instead, the resin obtained from the bark of Boswellia carterii was mainly used as olibanum. In ancient time, the oleo-gum-resin secreted from the cut bark was collected in spring and summer, and the quality was judged based on transparency and shape. The processing methods of olibanum went through many evolutions, which changed from simple methods such as grinding and frying to complex methods such as levigating and grinding with wine, and now to frying and processing with vinegar. The usage of olibanum included alchemy, folk and religious incense, bathing, cosmetic and medicinal since ancient times. From the Song Dynasty, olibanum had been mainly used as medicinal because of its good effect to treat wounds. In traditional Chinese medicine, olibanum unblocks menstruation, relieves pain and reduces swelling and generated muscles. The medicinal efficacy of olibanum is not much different from ancient to modern. Only the efficacy of replenishing energy and promoting the movement of Qi was rarely mentioned in modern reference. In this article, the historical evolutions of olibanum about original plants, processing and medicinal efficacy were sorted out. The results could provide historical basis for the further development and clinical utilization of olibanum.

To introduce current literature reporting situations of the off-label drug use(OLDU) by analyzing relevant literatures published in China, this study comprehensively focused on literatures about OLDU in China in seven Chinese and English databases, then extracted and analyzed the data by different literature types. A total of 667 papers were analyzed. The number of literatures about OLDU data analyzed in hospitals was 325, and the number of clinical studies relating to OLDU was 329, in which case series and case reports were the majority(69.91%). In addition, there were 13 expert consensuses of OLDU and another 56 studies about drug use based on the real-world data characteristics and influencing factors. The number of OLDU data studies has increased year by year. Based on the existing studies, there were more western medicine reports than traditional Chinese medicines, and OLDU types were mainly for over-dosage use. The literatures from OLDU data in hospital were mostly limited to one or several tertiary hospitals in a certain area, and the OLDU types were not uniform. Clinical studies were mainly clinical control trials and case series/reports, but with contradictory reporting results. There were fewer OLDU consensus, and the recommended classification was not uniform. The characteristics and analysis of influencing factors of drug using data in real-world focused on traditional Chinese medicine injections, and the results were not the same. In the future, we shall pay more attention to and strengthen reporting and analysis of OLDU, define study objectives, and unify the content and reporting standards, so as to promote the integrated utilization of OLDU data and reflect real situations in our country.

In this paper, the name, origin and producing area of Sojae Semen Nigrum were studied to provide the basis for the selection of medicinal varieties of Sojae Semen Nigrum. The textual research of this herbal was carried out through the textual research of ancient and modern literature and the comparative study of botany, combined with agricultural archaeology and the investigation of adulterant products. Before Qin Dynasty, the Sojae Semen Nigrums had not been selected, and the edible beans should only be Glycine soja. From Qin to the Northern and Southern dynasties, the Sojae Semen Nigrums G. max were selected,but the medicinal Sojae Semen Nigrum was G. soja. After Tang Dynasty, Sojae Semen Nigrums were recorded more, the medicinal Sojae Semen Nigrums referred to G. soja,G. max and G. gracilis. In modern times, G. soja was hardly to use as the medicine. The harvest time is August or September, and there are many processing methods, such as frying, making tofu, making Semen Sojae Praeparatum, boiling, boiling with auxiliary materials, germination, etc. The quality evaluation of Sojae Semen Nigrum was consistent in past dynasties, and it was considered that "it is better for those who are tight and small". Before Tang Dynasty, the better should only be G. soja. After the Qing Dynasty, the better should be green cotyledon varieties of G. max,which are recommended. In addition, there are many varieties of Sojae Semen Nigrum. It is hoped that that the scientific researchers of traditional Chinese medicine can use modern technology to distinguish the efficacy of Sojae Semen Nigrum with green and yellow cotyledon, and make a comparison between large and small Sojae Semen Nigrum. The results provide scientific basis for the selection of medicinal varieties of Sojae Semen Nigrum.

Sesami Semen Nigrum has a long history of dual use(medicine and food). The research of its processing technology is related to the development and utilization of its own "medicine-food balance" feature, which is the basis for Sesami Semen Nigrum to realize the modernization of technology and standardization of quality. Due to its various processing methods and the long history span, the traditional medical classics(from the end of Han Dynasty to the Republic of China), modern standard specification and researches on processing were sorted out with the help of database and document mining technology, and the visual thinking was adopted to analyze the evolution trend of Sesami Semen Nigrum processing methods. In addition, the processing characteristics of Sesami Semen Nigrum in various periods and effect of processing on its chemical compositions and pharmacological effect were briefly described to explore the differences and their reasons in the processing of Sesami Semen Nigrum from ancient times to the present time, aiming to provide an idea and documentary basis for the study of traditional processing technology.

Objective: To evaluate the long-term effectiveness of patients received surgical treatment under the guidance of "West China Classification" of desmoid-type fibromatosis (DTF) in the shoulder girdle., Methods: The clinical data of 32 patients with DTF in the shoulder girdle admitted between June 2003 and December 2016 were retrospectively analyzed, including 14 males and 18 females, aged 14-56 years with an average age of 36.8 years. The maximum diameter of the tumor was 7-19 cm, with an average of 11.1 cm. According to the "West China Classification" of DTF in the shoulder girdle, there were 4 cases of region Ⅰ, 3 cases of region Ⅱ, 6 cases of region Ⅲ, 3 cases of region Ⅳ, 5 cases of regions Ⅰ+Ⅱ, 5 cases of regions Ⅱ+Ⅲ, and 6 cases of regions Ⅰ+Ⅱ+Ⅲ. In addition, the involvement of blood vessels and nerves was also taken into consideration for choosing a surgical approach. Finally, 12 cases were operated via anteroposterior approach (group A), 14 via posterior approach (group B), and 6 via combined anterior-posterior approach (group C). The 1993 Musculoskeletal Tumor Society (MSTS93) score (including pain, limb function, satisfaction, hand position, hand flexibility, and lifting ability), Japanese Orthopedic Association (JOA) score, range of motion (ROM) of shoulder joint (including flexion, extension, abduction, and adduction), and complications of patients in the 3 groups were recorded and compared., Results: All the 32 patients were followed up 30-190 months, with an average of 94.6 months. At last follow-up, complications occurred in 5 cases (15.6%), including 2 cases (16.6%) in group A, 2 (14.3%) in group B, and 1 (16.6%) in group C. There was no significant difference in the incidence of complications among the 3 groups ( P =1.000). Tumor recurrence occurred in 5 (15.6%) cases, including 1 (8.3%) case in group A, 2 (14.3%) in group B, and 1 (16.6%) in group C. No significant difference was found in the recurrence rate among the 3 groups ( P =1.000). At last follow-up, MSTS93 score of pain, limb function, satisfaction, hand flexibility, and hand position in groups A and B were significantly better than those in group C ( P <0.05), even though no significant difference existed between group A and group B ( P >0.05). The lifting ability score in group C was significantly lower than in group A ( P <0.05), and no significant difference was found between other groups ( P >0.05). The JOA score and flexion, extension, abduction, and adduction activities of shoulder in groups A and B were significantly better than those in group C ( P <0.05). The extension activity in group A was significantly better than that in group B ( P <0.05), the flexion activity in group B was significantly better than that in group A ( P <0.05). There was no significant difference in other indexes between groups A and B ( P >0.05)., Conclusion: Taking a rational approach to fully expose and completely remove the tumor is the key point of surgical treatment for patients with DTF in the shoulder girdle. At the same time, preservation of vital structures and reconstruction of soft tissues should also be taken into consideration. Overall, surgical treatment under the guidance of "West China Classification" of DTF in the shoulder girdle has achieved satisfactory long-term effectiveness.

Background: Encephalitis is caused by infection, immune mediated diseases, or primary inflammatory diseases. Of all the causative infectious pathogens, 90% are viruses or bacteria. Granulomatous amoebic encephalitis (GAE), caused by Balamuthia mandrillaris, is a rare but life-threatening disease. Diagnosis and therapy are frequently delayed due to the lack of specific clinical manifestations., Method: A healthy 2 year old Chinese male patient initially presented with a nearly 2 month history of irregular fever. We present this case of granulomatous amoebic encephalitis caused by B. mandrillaris. Next generation sequencing of the patient's cerebrospinal fluid (CSF) was performed to identify an infectious agent., Result: The results of next generation sequencing of the CSF showed that most of the mapped reads belonged to Balamuthia mandrillaris., Conclusion: Next generation sequencing (NGS) is an unbiased and rapid diagnostic tool. The NGS method can be used for the rapid identification of causative pathogens. The NGS method should be widely applied in clinical practice and help clinicians provide direction for the diagnosis of diseases, especially for rare and difficult cases., (© American Society for Clinical Pathology 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Based on theoretical and methodological research and the results of a literature review, we evaluated and comparatively analyzed the quality of long-term care for older populations in China and in Western countries., Methods: We performed a literature review, using the search terms long-term care and care services for older adults, in the databases ProQuest, CNKI, and Wanfang Data., Results: Our comparative analysis demonstrated that the overall quantity of articles related to long-term care for older populations was relatively large. The literature comprises advanced accumulated experiences in terms of theoretical and methodological perspectives in developed countries. The field of long-term care is relatively young in China and we could retrieve only a few related studies., Conclusions: The system of long-term care for older populations in China has much room for improvement. In addition, the evaluation criteria for long-term care quality remain controversial. Relevant research focusing on the quality of long-term care services in the country lacks comprehensive, systematic, and scientific validation, comparison, and evaluation. This topic warrants further evidence-based investigation in China.

Background: In order to treat proximal femur fibrous dysplasia (FD) patients combined with hip joint osteoarthritis (OA), the three-dimensional (3D) designing osteotomy and implantation of femoral component was firstly used for deformity correction and total hip arthroplasty (THA). The purpose is to present the detailed design, perioperative management and evaluate short-term clinical outcomes of this novel therapeutic method., Method: A retrospective study was performed in twelve FD patients combined with hip joint OA who were treated in our hospital between July 2013 and April 2015. Seven patients received 3D designing combined osteotomy and THA, and the other five patients underwent 3D designing THA only., Results: All patients were followed-up with an average duration of 47 months (range, 35-56 months). There was no infection, dislocation, postoperative wound problems or mechanical failures. For the seven patients receiving 3D designing corrective osteotomy, the mean extremity lengthening was 2.8 (range, 1.5-4) cm. The average duration of bone union was 4.2 months. The average Harris Hip Score was improved from 46.08 (range, 13-67) points preoperatively to 93.72 (range, 83-100) points at the last follow-up. The average modified criteria of Guille was improved from 3.2 (range, 1-7) points preoperatively to 8.6 (range, 6-10) points at the last follow-up., Conclusions: The 3D designing THA with long uncemented stem, including 3D designing corrective osteotomy and implantation of long prosthesis stem, seems to be a reliable method for FD patients combined with hip joint OA. Through preoperative 3D design, corrective osteotomy and implantation of long prosthesis stem can be precise to re-store alignment, uttermost preserve host bone, obtain primary stem stability and provide necessary condition for long-term stem survival, finally leading to better limb function. Besides, perioperative management should be abided strictly for late stability. Nevertheless, the outcomes of long-term follow-up and larger cases are still required.

Objective: To understand the endemic situation and control effect of schistosomiasis through the surveillance in a national surveillance site of Jurong City, so as to provide the evidence for formulating the prevention and control measures., Methods: According to the National Schistosomiasis Monitoring Scheme (2014 Edition) , the surveillance of schistosome infection in Oncomelania hupensis snails, residents and livestock was performed in the Kongqing Village, a national surveillance site of Jurong City, from 2015 to 2017., Results: The areas with snails were 0, 0, and 0.63 hm 2 in 2015, 2016, and 2017 respectively; the average densities of living snails were 0, 0, and 0.19 snails/0.1 m 2 in 2015, 2016, and 2017 respectively. No schistosome-infected snails were found. The positive rates of blood tests for schistosomiasis in the local residents were 7.72%, 7.45% and 3.45%, and the positive rates of blood tests in the floating population were 4.90%, 3.47% and 0.97% in 2015, 2016 and 2017, respectively. No positives were found in the schistosome etiology detection in the crowd and livestock., Conclusions: The effect of schistosomiasis prevention and control is obvious in Jurong City, but O. hupensis snails are still of recurrence. Therefore, the monitoring and control efforts should be strengthened to consolidate the achievements of schistosomiasis prevention and control.

Aim: To investigate nursing work patterns in a neurology department in a Chinese hospital., Background: Knowledge of nursing work patterns is important for nursing management and work design, and for the evaluation of organizational process change associated with the introduction of an innovation., Methods: A time-and-motion method was used to observe 14 registered nurses' (RNs') work patterns in a neurology department in a Chinese hospital., Results: There were 147 hr of observation. Overall, the most time-consuming activities were verbal communication (28.5%) and documentation (28.3%), followed by indirect care (14.6%) and direct care (14%). Compared to support RNs, charge RNs spent 20% more time on documentation and 11% more time on verbal communication. Two-thirds of the observed activities had a duration of less than 40 s., Conclusions: Communication, in verbal and written forms, consumed more than half of the nursing time. Conversely, nurses only spent about a quarter of their worktime on preparation for care provision and direct care provision. This reflects the significant role and resource-consuming nature of communication to provide safe and quality care., Implications for Nursing Management: Communication methods need to be enhanced to improve nursing productivity. This may be achieved through the introduction of more effective nursing documentation methods., (© 2018 John Wiley & Sons Ltd.)

Background: Hsp90-beta has been investigated to be correlated with the occurrence and development of tumor. The intention of this research was to test the level of Hsp90-beta in malignant pleural effusion (MPE) of patients with lung cancer and disclose the clinical significance of Hsp90-beta as a potential tumor marker for differential diagnosis of pleural effusion caused by lung cancer., Methods: The level of Hsp90-beta was determined using enzyme-linked immunosorbent assay. Calculations of the Hsp90-beta threshold, the sensitivity and specificity for distinguishing MPE from benign pleural effusion were performed using receiver operator characteristic curve., Results: The level of Hsp90-beta in MPE of lung cancer patients was higher than that in control individuals (P < 0.05) and increased MPE Hsp90-beta was correlated with the pathological differentiation, tumor size and lymphatic metastasis (P < 0.05). The cutoff value of Hsp90-beta produced by receiver operator characteristic curve for distinguishing lung cancer from control individuals were 1.659 ng/mL and the sensitivity and specificity were 93.46 and 79%., Conclusions: Increased Hsp90-beta in MPE was correlated with malignant biological behavior of lung cancer patients, indicating that the level of Hsp90-beta could be a tool of referential value for differential diagnosis of pleural effusion caused by lung cancer.

Neuronal ceroid lipofuscinosis is a hereditary disease, and ceroid-lipofuscinosis neuronal protein 5 (CLN5) has been proved to be associated with neuronal ceroid lipofuscinosis. Here we report 3 patients from 2 families diagnosed with CLN5 neuronal ceroid lipofuscinosis. Whole genome sequencing of DNAs from 3 patients and their families revealed 3 novel homozygous mutations, including 1 deletion CLN5.c718 719delAT and 2 missense mutations c.1082T>C and c.623G>A. We reviewed 278 papers about neuronal ceroid lipofuscinosis resulting from CLN5 mutations and compared Chinese cases with 27 European and American cases. The overall age of onset of European and American patients occur mainly at 3 to 6 years (66%, 18/27), 100% (27/27) of patients had psychomotor regression, 99% (26/27) patients presented vision decline, and 70% (19/27) of patients suffered seizures. In China, the age of onset in 3 patients was 5 years, but for 1 patient it was at 17 months. Four Chinese patients presented psychomotor deterioration and seizures; only 1 had visual problems.

Background: The openEHR approach can improve the interoperability of electronic health record (EHR) through two-level modeling. Developing archetypes for the complete EHR dataset is essential for implementing a large-scale interoperable EHR system with the openEHR approach. Although the openEHR approach has been applied in different domains, the feasibility of archetyping a complete EHR dataset in a hospital has not been reported in academic literature, especially in a country where using openEHR is still in its infancy stage, like China. This paper presents a case study of modeling an EHR in China aiming to investigate the feasibility and challenges of archetyping a complete EHR dataset with the openEHR approach., Methods: We proposed an archetype modeling method including an iterative process of collecting requirements, normalizing data elements, organizing concepts, searching corresponding archetypes, editing archetypes and reviewing archetypes. Two representative EHR systems from Chinese vendors and the existing Chinese EHR standards have been used as resources to identify the requirements of EHR in China, and a case study of modeling EHR in China has been conducted. Based on the models developed in this case study, we have implemented a clinical data repository (CDR) to verify the feasibility of modeling EHR with archetypes., Results: Sixty four archetypes were developed to represent all requirements of a complete EHR dataset. 59 (91%) archetypes could be found in Clinical Knowledge Manager (CKM), of which 35 could be reused directly without change, and 23 required further development including two revisions, two new versions, 18 extensions and one specialization. Meanwhile, 6 (9%) archetypes were newly developed. The legacy data of the EHR system in hospitals could be integrated into the CDR developed with these archetypes successfully., Conclusions: The existing archetypes in CKM can faithfully represent most of the EHR requirements in China except customizations for local hospital management. This case study verified the feasibility of modeling EHR with the openEHR approach and identified the fact that the challenges such as localization, tool support, and an agile publishing process still exist for a broader application of the openEHR approach.

This survey was performed to investigate the occurrence of aflatoxin M1 (AFM1) contamination of raw milk from manufacturers of infant milk powder in China. A total of 1207 raw milk samples were collected overall from four seasons of 2016 in Northeast China, Northwest China, Northern China, and Central China (11 provinces and one municipality). Results showed that 56 of the 1207 raw milk samples (4.64%) were positive for AFM1, which were obtained from Heilongjiang (two samples), Gansu (one sample), Shaanxi (46 samples), Beijing (one sample), and Hunan (six samples) provinces. None of the raw milk samples from manufacturers of infant milk powder exceeded the Chinese limit (62.5 ng/L) in 2016. Only a few raw milk samples were not suitable for use in infant milk according to EU (European Union) or U.S. infant milk limits. Furthermore, based on this survey and previous studies, it is particularly important to avoid AFM1 contamination in raw milk during the winter.

Objective: The objective of this study is to investigate the significance of functional GRP78 polymorphisms in predicting the risk of type 2 diabetic peripheral neuropathy in Chinese population., Methods: Between the years of 2006 and 2010, a total of 295 definitely diagnosed type 2 diabetes mellitus (T2DM) patients were included into our study cohort and followed for 3 years. At baseline and annual re-examinations, the patients underwent physical examinations, laboratory tests and evaluation of Michigan diabetic neuropathy score (MDNS). Age, gender, disease course, waist-hip circumference ratio (WHR), body mass index (BMI), triglycerine (TG), total cholesterol (Tch), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), glycosylated haemoglobin (HbA1c), uric acid elimination rate (UAER) and uric acid (UA) were recorded and GRP78 polymorphisms were tested by direct sequencing. The prognostic significance of GRP78 polymorphisms were analysed using monovariate and multivariate logistic regression., Results: Three years after baseline, 32.9% (97/295) of the T2DM patients had suffered the development of diabetic peripheral neuropathy and GRP78 rs391957 promoter polymorphism is a significant risk factor for the onset of type 2 diabetic peripheral neuropathy. In monovariate regression model, the OR values of GRP78 rs391957 promoter polymorphism were 2.233 (C/T) and 2.734 (T/T). As for the model calibrated with demographic and laboratory indexes, the OR values were, respectively, 2.124 (C/T) and 2.423 (T/T)., Conclusion: Our study suggested that the GRP78 rs391957 promoter polymorphism is a potential risk factor for type 2 diabetic peripheral neuropathy.

We retrospectively analysed routinely collected baseline data of 2252 patients with HIV infection registered in the National Free Antiretroviral Treatment Program in Xinjiang province, China, from 2006 to 2011 to estimate the prevalence and predictors of anaemia at the initiation of combined antiretroviral therapy. Anaemia was diagnosed using the criteria set forth by the World Health Organisation, and univariate and multivariate logistic regression analyses were performed to determine its predictors. The prevalences of mild, moderate, and severe anaemia at the initiation of combined antiretroviral therapy were 19.2%, 17.1%, and 2.6%, respectively. Overall, 38.9% of the patients were anaemic at the initiation of combined antiretroviral therapy. The multivariate logistic regression analysis indicated that Uyghur ethnicity, female gender, lower CD4 count, lower body mass index value, self-reported tuberculosis infection, and oral candidiasis were associated with a higher prevalence of anaemia, whereas higher serum alanine aminotransferase level was associated with a lower prevalence of anaemia. The results suggest that the overall prevalence of anaemia at the initiation of combined antiretroviral therapy in patients with HIV infection is high in Xinjiang, China, but severe anaemia is uncommon. Patients in China should be routinely checked for anaemia prior to combined antiretroviral therapy initiation, and healthcare providers should carefully select the appropriate first-line combined antiretroviral therapy regimens for anaemic patients., (© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

Diabetes mellitus (DM) is currently known to be one of the risk factors for pulmonary tuberculosis (PTB) and the proportion of DM in PTB is rising along with the increased prevalence of DM in countries with high PTB burden. This study was designed to explore the impact of DM on clinical presentation and treatment outcome of PTB in China. In an urban setting in Beijing, 1126 PTB patients, 30·6% with positive sputum smear, registered in two PTB dispensaries from January 2010 to December 2011 were screened for DM and were followed up prospectively during PTB treatment. DM was observed in 16·2% of patients with PTB. PTB with DM appeared to be associated with older age and a higher proportion of re-treatment. On presentation, DM was associated with more severe PTB signs with higher proportions of smear positivity [odds ratio (OR) 2·533, 95% confidence interval (CI) 1·779-3·606], cavity (OR 2·253, 95% CI 1·549-3·276) and more symptoms (OR 1·779, 95% CI 1·176-2·690). DM was also associated with non-TB deaths (OR 5·580, 95% CI 2·182-14·270, P < 0·001) and treatment failure (OR 6·696, 95% CI 2·019-22·200, P = 0·002). In Beijing, the findings of this study underlined the need to perform early bi-directional screening programmes and explore the underlying mechanism for different treatment outcomes for PTB with DM.

Inconsistent results have been reported for the impact of sex on stroke outcomes. We investigated the differences in health-related quality of life between adult male and female stroke survivors in Northeastern China. Information on background variables was collected during hospital stay. Follow-up data were obtained through a phone interview 6 months after discharge, which included the Barthel Index and a 36-Item Short-Form Health Survey (SF-36) reflecting overall health status. The independent effects of sex on activities of daily living independence (Barthel Index ⩾ 95) were analyzed. Our results showed that female stroke patients were older than male stroke patients and were more likely to have transient ischemic attack and hypertension. Male stroke patients were more likely to have a history of smoking, heart disease and dyslipidemia, while female patients were less likely to achieve daily living independence. The mean scores of physical functioning, bodily pain, vitality, social functioning, emotional role, and mental health in the SF-36 survey were significantly higher in men than woman. Regression analyses confirmed that female sex was adversely associated with overall health status at discharge. In conclusion, our data demonstrated that there were sex differences in stroke recovery and quality of life among Chinese stroke survivors at 6 months post-discharge, with an overall worse stroke outcome for female stroke survivors., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objective: To evaluate the myocardial protective effect of exogenous creatine phosphate added to a cardioplegic solution for elderly patients undergoing a coronary artery bypass graft (CABG) in China., Methods: Twenty-four patients (age>65 years) who underwent CABG were randomly divided into a control group (n=12) and an experimental group (n=12). The concentrations of malonyldehyde and superoxide dismutase in the blood were measured before aortic clamping and at 0, 30, 60, and 120 min after the release of aortic clamping. Creatine phosphokinase (CK), creatine phosphokinase-MB (CK-MB), lactate dehydrogenase, and cardiac troponin T were measured before aortic clamping and at 2, 24, and 48 h after the release of aortic clamping. Myocardial ultrastructures were examined under an electron microscope., Results: The concentrations of malonyldehyde in both groups increased after the release of aortic clamping (at 0, 30, 60, and 120 min), but were higher in the control group compared with the experimental group (P<0.01). The concentrations of superoxide dismutase in both groups were decreased after the release of aortic clamping and were higher in the experimental group compared with the control group (P<0.01) at 0, 30, 60, and 120 min after the release of aortic clamping. The values of CK, CK-MB, lactate dehydrogenase, and cardiac troponin T at 2, 24, and 48 h after the release of the aortic clamping were lower in the experimental group than in the control group (P<0.01). Electron microscopy showed that the mitochondria in the experimental group were histologically better than those in the control group., Conclusion: Exogenous creatine phosphate added to the cardioplegia solution can provide energy to myocardial cells and can relieve ischemia/reperfusion-related injury in elderly patients during CABG in China.

Objective: To comparatively analyze the medical records of patients with limb fractures as well as rescue strategy in Wenchuan and Yushu earthquakes so as to provide references for post-earthquake rescue., Methods: We retrospectively investigated 944 patients sustaining limb fractures, including 891 in Wenchuan earthquake and 53 in Yushu earthquake, who were admitted to West China Hospital (WCH) of Sichuan University., Results: In Wenchuan earthquake, WCH met its three peaks of limb fracture patients influx, on post-earthquake day (PED) 2, 8 and 14 respectively. Between PED 3-14, 585 patients were transferred from WCH to other hospitals outside the Sichuan Province. In Yushu earthquake, the maximum influx of limb fracture patients happened on PED 3, and no one was shifted to other hospitals. Both in Wenchuan and Yushu earthquakes, most limb fractures were caused by blunt strike and crush/burying. In Wenchuan earthquake, there were 396 (396/942, 42.0%) open limb fractures, including 28 Gustilo I, 201 Gustilo II and 167 Gustilo III injuries. But in Yushu earthquake, the incidence of open limb fracture was much lower (6/61, 9.8%). The percent of patients with acute complications in Wenchuan earthquake (167/891, 18.7%) was much higher than that in Yushu earthquake (5/53, 3.8%). In Wenchuan earthquake rescue, 1 018 surgeries were done, composed of debridement in 376, internal fixation in 283, external fixation in 119, and vacuum sealing drainage in 117, etc. While among the 64 surgeries in Yushu earthquake rescue, the internal fixation for limb fracture was mostly adopted. All patients received proper treatment and survived except one who died due to multiple organs failure in Wenchuan earthquake., Conclusion: Provision of suitable and sufficient medical care in a catastrophe can only be achieved by construction of sophisticated national disaster medical system, prediction of the injury types and number of injuries, and confirmation of participating hospitals?exact role. Based on the valuable rescue experiences after Wenchuan earthquake, the rescue was faster, more orderly and effective in Yushu earthquake. Nevertheless, there is still a long way to go in the development of a stronger emergent response to the disasters.

The aim of the study was to detect differences in serum levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), cartilage oligomeric matrix protein (COMP), type II collagen (CTX-II) between patients with Kashin-Beck disease (KBD) or osteoarthritis (OA) and to assess the correlation between these differences with the clinical grade of KBD. A total of one hundred fifty adult serum samples were collected; these samples belonged to the KBD group (n = 64), the OA group in KBD-prevalent areas (n = 47) and a healthy control group in non-KBD area (n = 39). Serum levels of TNF-α, IL-1β, COMP, and CTX-II were determined by a sandwich enzyme-linked immunosorbent assay, and the results were compared among the 3 groups (KBD/OA/normal) and between the different grades of KBD as well. The serum levels of IL-1β, TNF-α, COMP, and CTX-II were significantly higher in the KBD and OA group than the healthy adult group (P < 0.001), and TNF-α and IL-1β levels in the KBD group were similar to the OA group (for TNF-α, 14.38 ± 7.42 pg/ml vs. 12.61 ± 4.00 pg/ml, respectively, [P = 0.29]; for IL-1β, 141.53 ± 71.35 pg/ml vs. 135.61 ± 68.60 pg/ml, respectively, [P = 0.63]). However, the COMP level was significantly lower and the CTX-II level was higher in the KBD group than in the OA group (for COMP, 7.03 ± 3.11 ng/ml vs. 9.20 ± 3.51 ng/ml, respectively, [P = 0.003]; for CTX-II, 2.23 ± 0.79 ng/ml vs. 1.80 ± 0.87 ng/ml, respectively, [P = 0.026]). Moreover, no significant correlations were found between clinical grade and serum levels of TNF-α, IL-1β, COMP, and CTX-II for the 3 grades of KBD patients (P = 0.645, 0.481, 0.832, and 0.270, respectively). This study showed that serum levels of COMP in KBD patients decreased and CTX-II levels increased compared with the levels in OA patients, but TNF-α and IL-1β levels in KBD and OA group were similar. In addition, increased serum levels of TNF-α, IL-1β, COMP, and CTX-II were not associated with the KBD grade.

Purpose: The aim of this study was to evaluate the early clinical outcome of reconstruction with modular hemipelvic prostheses after pelvic sarcoma resection., Methods: We retrospectively reviewed eight patients between 2004 and 2007 who had periacetabular resections and reconstruction with a modular hemipelvic prosthetic system for pelvic sarcoma with a mean follow-up of 27 (range,10~54) months. Oncology outcome was assessed with survival rate, local recurrence rate, International Society of Limb Salvage (ISOLS) score and complications. Two patients had types I and II (periacetabular and ilium) pelvic resections, three had types II and III (periacetabular and pubis) pelvic resections and three had type I , II and III (ilium, periacetabular and pubis) pelvic resections. Nobody received chemotherapy or radiotherapy., Results: Five patients were free of disease; three patients died of disease. The overall survival rate was 62.5%. None had local recurrence, and 37.5% had metastasis. The mean ISOLS score was 19.5. No one had deep infection or dislocation., Conclusions: Reconstruction with a modular hemipelvic prosthetic system after periacetabular resection is a promising method because of the acceptable complication rate and satisfactory functional outcome.

Objective: In this study, we performed anatomic and computed tomography (CT) measurements of C2 lamina in Chinese people in order to provide the anatomic and radiographic data, and to verify the clinical applicability of trans-lamina screws to this population., Methods: The anatomic and radiographic measurement was conducted on two separate groups, group A and group B. In group A, a total of 96 human adult (male 51, female 45) cadaver spines were included. The minimal height (H1), thickness (T), length (L1) of C2 lamina, height of the root of lamina (H2), distance from the entry point to the lateral rim of lamina (L2) and to the lateral rim of lateral mass (L3) were bilaterally measured using high precision calipers. The spino-laminar angles (angle A) were also included. In group B, a total of 112 volunteers (male 58, female 54) without upper cervical abnormality were enrolled. Angle A, H1, T, L1, H2, L2 and L3 were bilaterally measured using plain X-rays and reconstruction CT. All measurements were taken at the thinnest part of the lamina in the axial and coronal plane., Results: All the measurements (except angle A) in males were significantly higher than those in females (P < 0.05). There was no significant difference in the values of bilateral laminae between group A and group B (P > 0.05). The thickness of 45% specimens was less than 6 mm. The length of lamina in all specimens was less than 2.5 cm, while only 5% of the specimens had a length of >3 cm from the entry point to the rim of lamina. The length from the entry point to the lateral rim of lateral mass was between 2.5 and 4.6 cm. In contrast, the length of only 5% specimens was longer than 4 cm., Conclusions: The preoperative radiographic evaluation is very important to determine the suitable size of screws. The diameter of screws is mainly restricted by the thickness of C2 lamina. It is safe to use screws with a length of 2.5-3.0 cm for Chinese people. The radiographic measurement method we used is simple, accurate and reliable for preoperative measurement.

To investigate the possible association of polymorphisms, cyclooxygenase-2 (COX-2) promoter region -899G>C, COX-2 codon 587G>A, with risk of gastric cancer in the high incidence Hexi area of Gansu province in China. Blood samples from 140 patients with gastric carcinoma and 125 normal persons were collected in Hexi area of Gansu province in China. Polymorphisms of COX-2 -899G>A and COX-2 587G>A were genotyped by PCR-TaqMan. For detection Helicobacter pylori infection, Warhin-Starry staining was used. Three kinds of polymorphisms of COX-2 -899G>C were GG, GC and CC. The frequencies in gastric cancer patients were 72.9, 21.4 and 5.7%, and the frequencies in controls were 84.0, 12.8 and 3.2%, respectively. COX-2 -899C carrier (GC + CC) increased risk of gastric carcinoma with an odds ratio 1.950 (95% CI: 1.067-3.586, P=0.029). The genotype of COX-2 587G>A polymorphism were GG, GA and AA. The frequencies in patients group were 86.4, 11.4 and 2.2%, and the frequencies in controls were 89.6, 9.6 and 0.8%, respectively. There was no significant difference between cases and controls in each genotype. Helicobacter pylori infection rate was 68.6% in patients group and 50.4% in healthy controls. Helicobacter pylori infection rate in gastric cancer patients was remarkably higher than that in normal people (OR: 2.147, 95% CI: 1.302-3.541, P=0.003). Stratification analysis was showed that COX-2 -899C carrier genotype with Helicobacter pylori infection was significantly higher in cases than that in healthy controls (OR: 4.000, 95% CI: 1.638-9.770). The polymorphism of COX-2 -899G>C could be a risk factor for gastric cancer in high incidence Hexi area of Gansu Province in China. COX-2 -899C carrier genotype and Helicobacter pylori positive infection may have a synergistic effect on gastric cancer in high incidence Hexi area of Gansu Province in China. However, the polymorphisms of COX-2 587G>A is no association with gastric cancer in the high incidence Hexi area of Gansu Province in China.

Background and Objective: Oesophageal cancer is one of the most common and deadliest cancers worldwide. Our previous population-based study reported a high prevalence of oesophageal cancer in Chaoshan, Guangdong Province, China. Ancestors of the Chaoshan population migrated from the Taihang Mountain region of north-central China, which is another high-incidence area for oesophageal cancer. The purpose of the present study was to obtain evidence of inherited susceptibility to oesophageal cancer in the Chaoshan population, with reference to the Taihang Mountain population, with the eventual goal of molecular identification of the disease genes., Methods: We conducted familial correlation, commingling, and complex segregation analyses of 224 families from the Chaoshan population and 403 families from the Taihang population using the FPMM program of S.A.G.E. version 5.3.0. A second analysis focused on specific families having large numbers of affected individuals or early onset of the disease., Results: For the general population, moderate sib-sib correlation was noticed for esophageal cancer. Additionally, brother-brother correlation was even higher. Commingling analyses indicated that a three-component distribution model best accounts for the variation in age of onset of oesophageal cancer, and that a multifactorial model provides the best fit to the general population data. An autosomal dominant mode and a dominant or recessive major gene with polygenic inheritance were found to be the best models of inherited susceptibility to oesophageal cancer in some large families., Conclusions: The current results provide evidence for inherited susceptibility to oesophageal cancer in certain high-risk groups in China, and support efforts to identify the susceptibility genes.

Objective: To analyse the temporal and spatial characteristics of traumatic brain injury and the distribution of combined injuries in the Wenchuan earthquake, and describe the treatment opportunities and preferences for therapy., Methods: The diagnosis and treatment of 92 patients with traumatic brain injury who survived the massive earthquake (magnitude 8) in Wenchuan, Sichuan Province, on 12 May 2008 were systematically analysed., Results: The patients all came from the plains northwest of Chengdu city. Seventy-six patients were admitted during the early stage (within 12 h) after the earthquake. Ten patients underwent surgery and three patients died., Conclusion: Patients with traumatic brain injury during the early period accounted for a large proportion of the patients wounded in the Wenchuan earthquake, and their conditions changed quickly. The patients all came from the plain area which has convenient transportation. After admission, providing first-aid early had a significant effect on increasing the success of treatment for these patients.

Objective: To examine the relations of sociodemographic factors and infant neurobehaviors to maternal confidence in China., Methods: The Brazelton Neonatal Behavioral Assessment Scale, Family APGAR, and Maternal Confidence in Caring for the Newborn scales were administered to 40 healthy, full-term neonates., Results: Range and regulation of state, autonomic stability, and reflex cluster scores were positively correlated; the autonomic stability cluster score was negatively correlated with maternal confidence in meeting the infant's social and instrumental needs. Educational level, age, income, satisfaction with family conditions, and infant sex were not associated with maternal confidence. Range of state and autonomic stability cluster scores predicted maternal confidence., Conclusions: The infant's abilities to tolerate stimuli, and to be consoled, were associated with maternal confidence. Also, maternal confidence was related to the recognition of infant autonomic cues. Family and sociodemographic variables were not associated with maternal confidence. The sex of the newborn did not affect maternal confidence.

Two groups of elderly chinese were selected from a large epidemiological sample on the basis of a low ("best" group) or a high ("worst" group) number of sites with attachment loss levels > or = 6 mm and/or pocket depth > or = 4 mm and at least 16 teeth present. Six years later the patients were clinically reexamined and the subgingival microflora was assessed. This paper presents the clinical characteristics of destructive periodontal disease progression among the two subgroups. The "best" group lost an average of 1.8 teeth, contrasting the average loss of 5.3 teeth among the "worst" group. Virtually all teeth lost among the "worst" group had a baseline attachment loss level > or = 4 mm, in contrast to 48% among the "best" group. While dental caries could be identified as a cause of tooth loss in both groups, the excess tooth loss among the "worst" group seems attributable to periodontal destruction. The average of 1.21 mm attachment/site lost among the "best" group was not statistically significantly different from the 1.36 mm/site lost among the "worst" group during the 6 years. Individual mean losses of attachment ranged from a gain of 0.03 mm to a loss of 3.19 mm. An attachment loss > or = 2 mm at a site was highly positively associated with a high initial attachment loss level (> or = 4 mm) at that site among the "best" group, whereas a highly negative association was seen among the "worst" group.(ABSTRACT TRUNCATED AT 250 WORDS)

The use of untreated night soil as a fertilizer in agriculture or as a source of nutrients in fish farming presents a considerable health hazard in the form of pathogens and parasites. A pilot study is reported in which night soil was placed in an anaerobic digester, producing biogas and residual organic matter. The latter was introduced into biostabilization ponds, and nutrients were thus obtained for the rearing of fish. Fish ponds receiving nutrients derived from treated night soil were less contaminated than ones to which untreated night soil was applied, and the fish reared in them were of superior quality.

The study comprised 544 persons aged 60 yr or more from two urban Residential Areas and one rural village (including a nursing home) of Beijing area. Overall, the sample accounted for 81% of the total population of elderly aged 60 yr or more in the village/areas so defined. Each person was examined for dental status, plaque, calculus, gingivitis, loss of attachment, pocket depth and tooth mobility. Edentulousness was seen in 0-29% of the persons examined, depending on age and sex. The mean number of teeth present ranged from 6.9 to 23.9, depending on age and sex, and area. The oral hygiene was poor; approximately 50% of all surfaces had immediately visible plaque deposits and calculus. About 50% of the surfaces had a loss of attachment greater than or equal to 4 mm, while less than 15% presented pockets greater than or equal to 4 mm. More than 50% of the individuals had loss of attachment greater than or equal to 4 mm on more than 40% of their surfaces. The proportion of surfaces per person with loss of attachment greater than or equal to 7 mm; and pockets greater than or equal to 4 mm, respectively, showed a pronounced skewed distribution. These findings indicate that a subfraction of individuals is responsible for a substantial proportion of the severe periodontal breakdown leading to loss of teeth. This, in turn, raises important questions as to the most appropriate strategies for the prevention and control of periodontal diseases for the Chinese population.