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Tannin extract desulfurization technology is widely applied in China, however, in which there are sulfur-containing byproducts that can cause negative effects, such as reducing desulfurization efficiency and increasing operating cost etc. Thus, inhibiting side reactions and controlling byproducts is an important problem to be resolved. In this article, the cause of byproducts formation by thermodynamic analysis is reported. First, the reaction mechanism between HS−and pentavalent vanadium V(V) in desulfurization solution is researched, and it is conclude that HS−can transforms instantly into polysulfide ionsSx2−, thenSx2−forms the element sulfur. Thus,Sx2−is the main source to generate byproducts. Second, by calculating and comparing the Gibbs free energy change of side reactions, the results show thatSx2−is more active than HS−in solution and can react more easily with oxygen to produce byproducts. Therefore, quickening the transformation fromSx2−to element sulfur is a key measure to resolve the problem on side reaction. [ABSTRACT FROM PUBLISHER]

Yaks are a major source of livelihood for the high landers where agriculture does not exist. This multipurpose animal has remained a subject of studies since the second half of 18th century. However, there is limited data available on the chemistry of yak milk in China. The objective of this study was to analyze the chemical composition and nutrient profiles of Chinese yak milk. Fresh milk samples from 7 mid-lactating yaks (Maiwa breed) in Hongyuan county of Sichuan Province in China were collected, pooled, lyophilized and stored at -20 °C before use. Gross composition (total solids, protein, fat, ash, and lactose), minerals, and profiles of fatty acids, amino acids and proteins of the milk samples were examined. The average values of gross composition were 14.35% total solids, 3.51% protein, 5.80% fat, 3.90% lactose, and 0.58% ash in the yak milk. The levels of Ca, Na, K, Mg, Zn, and Fe were 1149.4, 276.8, 1066.1, 105.3, 6.9, and 1.5 mg/L, respectively. Gas liquid chromatography analysis of milk fat showed that major fatty acids in yak milk were C16:0, C18:1, C18:0, and C14:0. There was a small amount (2.68 mg/g fat) of conjugated linoleic acid in yak milk. Results of amino acid analysis indicated that glutamic acid (183.79 mg/g protein) was the most abundant amino acid in yak milk. The mean values of lysine and methionine were 81.01 and 30.61 mg/g protein, respectively. The total essential amino acid percentage is 46.36% which suggests that the yak milk may be a good supply of essential amino acids. SDS-PAGE and densitometry results demonstrated that, similar to cow's milk, the major proteins in yak milk are caseins, which accounts for over 60% relative percentage of total proteins. The relative percentage of α-lactalbumin in yak milk was significantly lower (P < 0.05) compared to bovine milk. As information about yak milk chemistry is limited, especially in China, more systematic studies in this area are needed in order to utilize this valuable resource. [ABSTRACT FROM AUTHOR]

Purpose: To present the process from acute Posner-Schlossman syndrome (PSS) relapse to remission under 2% ganciclovir (GCV), corticosteroids and anti-glaucoma agents on 323 patients., Methods: A retrospective study enrolling 323 PSS patients. Demographics and ophthalmic examination results were generated. Patients were treated with GCV, corticosteroids and anti-glaucoma agents andfollowed up every 2-6 weeks., Results: Patients were divided into the GCV monotherapy ( N  = 65, 20.12%), GCV and corticosteroids (G+C, N  = 106) and GCV, corticosteroid and IOP-lowering drugs (G+C+L, N  = 152) group. The G+C+L group had the highest intraocular pressure (IOP, 26.33 ± 10.26 mmHg, P  < 0.001) and largest cup-to-disc ratio (0.58 ± 0.19, P  < 0.05). After treatment, IOP of three groups dropped to similar level. Ninety-nine (30.65%) patients were corticosteroid-dependent whose daily corticosteroid consumption decreased after using GCV (from 2.23 ± 1.02 to 0.97 ± 0.98 drops/day)., Conclusion: 2% GCV solutions worked effectively on PSS relapse with corticosteroids and anti-glaucoma agents. In patients suspected of CMV infection, proper GCV could reduce the chance of corticosteroid dependence.

Purpose: This study focused on the prevalence, unique features, and required treatment of steroid-dependent Posner-Schlossman syndrome (SD-PSS), and analyzed the outcome of 2% Ganciclovir and gradual decrement steroid combination therapy in SD-PSS patients., Methods: Retrospective comparative and interventional study. SD-PSS was defined as PSS patients with continuous steroid use for over 3 months and relapsed within 2 weeks after steroid withdrawal or tapered dosage. Totally 74 SD-PSS eyes were compared with 78 randomly chosen non-steroid dependent PSS eyes. SD-PSS patients who underwent 2% GCV and gradual decrement steroid therapy with at least two follow-ups ( n  = 50) were analyzed for the treatment outcome., Results: The prevalence of SD-PSS is 26.87% (97/361) in our PSS patients. SD-PSS patients demonstrated significantly younger onset age, longer disease course, higher intraocular pressure (IOP), and higher degree of iris depigmentation at the first visit. They required significantly more IOP-lowering medication and stronger steroid after the first visit. Our 2% GCV and gradual decrement steroid therapy helped 66% (33/50) SD-PSS patients with steroid withdrawal (median stable time: 13 weeks) and another 32% (16/50) SD-PSS managed to lower the dose or strength of topical steroid. Steroid-induced ocular hypertension happened in 5.26% (19/361) of the PSS patients., Conclusion: Young onset age, high IOP, and high iris depigmentation level during acute stage are indicators of steroid dependency in PSS patients. SD-PSS patients require more medical surveillance. Two percent ganciclovir and gradual decrement steroid combination therapy help with steroid withdrawal and minimize steroid use.

Objective: This prospective cohort study, conducted at the Fenglin Community Health Service Center (FCHC) in Xuhui District, Shanghai, aimed to investigate the impact of maternal psychological status on offspring neurodevelopment., Methods: A total of 430 mother-child pairs were included, with pregnant women enrolled between February 18, 2020, and April 19, 2021. Face-to-face interviews and electronic data collection on demographic characteristics, health conditions and medical history were employed at various stages of pregnancy and postpartum. Maternal depression and anxiety were assessed using the PHQ-9 and GAD-7 scales, while offspring neurodevelopment was measured at six months using the Ages and Stages Questionnaire 3rd Edition (ASQ-3). In statistical analyses, group-based trajectory modeling (GBTM) was employed to identify the latent groups for maternal psychological trajectories, including depression and anxiety, and logistic regression was used to explore associations between maternal psychological trajectories and offspring neurodevelopment, adjusting for potential confounders., Results: Five latent trajectory groups were identified for both depression and anxiety, exhibiting distinct patterns over time. Results indicated that maternal psychological trajectories were associated with various domains of offspring neurodevelopment, including communication, problem-solving, personal-social, and gross motor skills. Specifically, mothers in trajectory groups characterized by the highest level of depression or anxiety showed increased odds of offspring neurodevelopmental delays compared to reference groups., Conclusion: Our findings underscore the importance of maternal mental health during the perinatal period and highlight the potential implications for offspring neurodevelopment. Further research is warranted to elucidate underlying mechanisms and inform targeted interventions to support maternal mental well-being and optimize offspring outcomes., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Fire blight, caused by the bacterium Erwinia amylovora , is a major threat to pear production worldwide. Bacteriophages, viruses that infect bacteria, are a promising alternative to antibiotics for controlling fire blight. In this study, we isolated a novel bacteriophage, RH-42-1, from Xinjiang, China. We characterized its biological properties, including host range, plaque morphology, infection dynamics, stability, and sensitivity to various chemicals. RH-42-1 infected several E. amylovora strains but not all. It produced clear, uniform plaques and exhibited optimal infectivity at a multiplicity of infection (MOI) of 1, reaching a high titer of 9.6 × 10 9 plaque-forming units (PFU)/mL. The bacteriophage had a short latent period (10 min), a burst size of 207 PFU/cell, and followed a sigmoidal one-step growth curve. It was stable at temperatures up to 60 °C but declined rapidly at higher temperatures. RH-42-1 remained viable within a pH range of 5 to 9 and was sensitive to extreme pH values. The bacteriophage demonstrates sustained activity upon exposure to ultraviolet radiation for 60 min, albeit with a marginal reduction. In our assays, it exhibited a certain level of resistance to 5% chloroform (CHCl 3 ), 5% isopropanol (C 3 H 8 O), and 3% hydrogen peroxide (H 2 O 2 ), which had little effect on its activity, whereas it showed sensitivity to 75% ethanol (C 2 H 5 OH). Electron microscopy revealed that RH-42-1 has a tadpole-shaped morphology. Its genome size is 14,942 bp with a GC content of 48.19%. Based on these characteristics, RH-42-1 was identified as a member of the Tectiviridae family, Alphatectivirus genus. This is the first report of a bacteriophage in this genus with activity against E. amylovora .

Pregnant women and women of childbearing age were enrolled in our study and their knowledge about the Hepatitis B virus (HBV) and chronic hepatitis B (CHB) was evaluated. A questionnaire was distributed to every woman in the cross-sectional study. The questionnaire was answered by all participants before they received health education and advice about HBV and CHB from the doctors visited. Data collected from all answers were analyzed using the χ2 test and logistic regression models. A total of 206 pregnant women and women of childbearing age with CHB infection were enrolled in the study during their first visit to the Infectious Diseases Clinic of the Third Affiliated Hospital of Guangzhou Medical University. Some women of childbearing age (40.8%) and pregnant women with CHB infection (30.6%) still believed HBV could be transmitted through diet and/or mosquito bites. Some women of childbearing age and pregnant women with CHB infection had limited knowledge of the prevention of HBV transmission (111 of 206, 53.9%). Women with higher levels of education had more knowledge about HBV (senior middle school, P = 0.02; university, P <0.01). The majority of participants were willing to take antiviral medicine to decrease the mother-to-child transmission (MTCT) rate of HBV. Some women of childbearing age and/or pregnant women with CHB infection have relatively limited knowledge about HBV or CHB. This situation contributes to the timeliness, or lack thereof, of these women with CHB to see a doctor and receive antiviral therapy. As a result, the morbidity and mortality of HBV-related complications could increase along with the rate of MTCT of HBV.

Objective: The Omicron variant has a weaker pathogenicity compared to the Delta variant but is highly transmissible and elderly critically ill patients account for the majority. This study has significant implications for guiding clinical personalized treatment and effectively utilizing healthcare resources., Methods: The study focuses on 157 patients infected with the novel coronavirus Omicron variant, from December, 2022, to February, 2023. The objective is to analyze the baseline data, test results, imaging findings and identify risk factors associated with severe illness., Results: Among the 157 included patients, there were 55 cases in the non-severe group (all were moderate cases) and 102 cases in the severe group (including severe and critical cases). Infection with the Omicron variant exhibits significant differences between non-severe and severe cases (baseline data, blood routine, coagulation, inflammatory markers, cardiac, liver, kidney functions, Chest CT, VTE score, etc.). A multifactorial logistic regression analysis showed that neutrophil percentage >75%, eosinophil percentage <0.4%, D-dimer >0.55 mg/L, PCT >0.25 ng/mL, LDH >250 U/L, albumin <40 g/L, A/G ratio <1.2, cholinesterase<5100 U/L, uric acid >357 mole/L and blood calcium<2.11 mmol/L were the most likely independent risk factors for severe novel coronavirus infection., Conclusion: Advanced age, low oxygenation index, elevated neutrophil percentage, decreased eosinophil percentage, elevated PCT, elevated LDH, decreased albumin, decreased A/G ratio, elevated uric acid, decreased blood calcium, and elevated D-dimer are independent prognostic risk factors for non-severe patients progressing to severe illness. These factors should be closely monitored and actively treated to prevent or minimize the occurrence of severe illness., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Wang, Liu, Yue, Zhang, Sheng, Wu, Wang, Zhang, Wang, Wang and Yu.)

Objectives: Surgery is generally considered as the first-line therapy for membranous duodenal stenosis (MDS) in children. However, abdominal surgery leaves permanent scars and may even cause intestinal adhesion. Therefore, an effective, safe, and minimally invasive method is urgently needed. This study aimed to evaluate the safety, efficacy, and feasibility of endoscopic balloon dilatation-based membrane resection (EBD-MR) to treat MDS in children., Methods: We retrospectively reviewed patients with MDS treated with EBD-MR in Shanghai Children's Hospital from May 2016 to August 2021. Primary study outcome was clinical success, defined as weight gain and complete remission of vomiting, without the need for repeat endoscopic or surgical intervention during follow-up. Secondary outcomes included technical success, diameter changes of the membrane opening, and adverse events., Results: Nineteen children (9 females, mean age 14.5 ± 11.2 months) received endoscopic treatment for MDS, and clinical success was achieved in 18 of 19 patients (94.7%). No bleeding, perforation, and jaundice occurred. Diameters of the membrane opening increased from 2.97 ± 2.87 mm to 9.78 ± 1.27 mm after the treatment, symptoms of vomiting did not reappear during 10-73 months of follow-up, and body mass index of the children increased from 14.9 ± 2.2 kg/m 2 (pre-operation) to 16.2 ± 3.7 kg/m 2 (6 months after operation). One patient required surgical revision because of existence of a second web; three patients received 2-3 sessions of endoscopic treatment to obtain the final remission., Conclusions: The EBD-MR technique is safe, effective, and feasible for MDS, which provided an excellent alternative to surgical management for the disease in pediatric patients., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

Medical information extraction consists of a group of natural language processing (NLP) tasks, which collaboratively convert clinical text to pre-defined structured formats. This is a critical step to exploit electronic medical records (EMRs). Given the recent thriving NLP technologies, model implementation and performance seem no longer an obstacle, whereas the bottleneck locates on a high-quality annotated corpus and the whole engineering workflow. This study presents an engineering framework consisting of three tasks, i.e., medical entity recognition, relation extraction and attribute extraction. Within this framework, the whole workflow is demonstrated from EMR data collection through model performance evaluation. Our annotation scheme is designed to be comprehensive and compatible between the multiple tasks. With the EMRs from a general hospital in Ningbo, China, and the manual annotation by experienced physicians, our corpus is of large scale and high quality. Built upon this Chinese clinical corpus, the medical information extraction system show performance that approaches human annotation. The annotation scheme, (a subset of) the annotated corpus, and the code are all publicly released, to facilitate further research., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Health literacy (HL) is associated with health outcomes, but little is known about the occupational HL (OHL) for port employees and its link to the length of service and job category., Method: A cross-sectional survey was conducted on 3492 port employees from the Occupational Health Survey for Port Employees project, and a special questionnaire was utilized to measure the OHL status. Binary and ordinal logistic regressions were used to estimate the association., Result: Among the participants, 72.90% had sufficient OHL with a mean score (standard deviation) of 53.10 (7.26). Binary logistic regression results indicated that the association between length of service (33-40 years group Adjusted OR = 1.11; 41-49 years group Adjusted OR = 1.14; ≥50 years group Adjusted OR = 1.19) and job category (longshoremen Adjusted OR = 0.90; driver Adjusted OR = 0.91) with OHL were statistically significant. Ordinal logistic regression results indicated that, for OHL, Adjusted OR was increased in different lengths of service level (33-40 years group, Adjusted OR = 1.50; 41-49 years group, Adjusted OR = 1.75; ≥50 years group, Adjusted OR = 2.19), and the Adjusted OR of skilled workers was 1.60., Conclusion: Most port participants had sufficient OHL, and the length of service and job category could affect OHL. The effect of the length of service may be more obvious; the length of service can promote the improvement of OHL continuously., (© 2023. The Author(s).)

Background: Gonorrhea and chlamydia are the most common sexually transmitted diseases (STDs) among men who have sex with men (MSM) in China. Previous studies have shown pay-it-forward (PIF) interventions to be associated with a substantial increase in gonorrhea and chlamydia test uptake compared to standard-of-care. We propose a 'pay-it-forward' gonorrhea and chlamydia testing randomized controlled trial (PIONEER). The trial would evaluate the effectiveness of two pay-it-forward strategies in promoting testing uptake compared to the standard of care (in which men pay for their tests out-of-pocket) among MSM and male STD patients in China., Methods: PIONEER will be a three-armed, pragmatic cluster randomized controlled trial (RCT), conducted across 12 clinics (six MSM-led and six public STD clinics) to compare the effectiveness of three implementation strategies. Each facility will be randomized to a standard pay-it-forward intervention of gonorrhea/ chlamydia testing with minimal encouragement for testing, a community-engaged pay-it-forward arm, or a control arm where men pay for their tests out-of-pockets. The primary outcome will be dual gonorrhea/chlamydia test uptake. Secondary outcomes will include syphilis testing, amount donated in pay-it-forward, number of positive gonorrhea and chlamydia tests, and measures of antimicrobial resistance. A sequential transformative mixed methods design will be used to evaluate the implementation process in type 2 effectiveness-implementation hybrid design. Data sources will include survey on acceptability, and feelings and attitudes towards the interventions among participants; testing and treatment uptake data from clinic records, WeChat records, and qualitative data to gain insights into men's perceptions and attitudes towards the pay-it-forward, mechanisms driving uptake, and donating behaviors. Implementers and organizers will be interviewed about fidelity and adherence to protocol, sustainability of pay-it-forward intervention, and barriers and facilitators of implementing the intervention., Discussion: PIONEER will substantially increase gonorrhea/chlamydia testing among MSM in China, providing an innovative and new financial mechanism to sustain STD screening among sexual minorities in low- and middle-income countries. This study will answer compelling scientific questions about how best to implement pay-it-forward and the individual and organizational characteristics that moderate it., Trial Registration: The study with identification number NCT05723263 has been registered on clinicaltrials.gov/., (© 2023. The Author(s).)

Nymphaea nouchali is a native species of Chinese water lily with important ornamental, economical, and medicinal purposes. However, due to the serious disturbance by alien biological invasion and human factors, N. nouchali is in an endangered state in China and urgently needs to be protected. Here, we reported the complete chloroplast genome of N. nouchali for the first time, and we found that its plastome is 159 978 bp long, comprising large and small single copies and two inverted repeats (90 001, 19 603, and 50 374 bp, respectively), indicating a typical tetrad structure. In total, 130 genes were identified, including 85 protein-coding genes, 37 transfer RNAs, and 8 ribosomal RNAs. Additionally, 136 simple sequence repeat sites were identified, composed mainly of single nucleotide (46.32%) and trinucleotide (47.05%) sequences. Five highly variable sites (psaI, rps19, ndhF, rps15, and ycf1) with a high Pi value were identified as potential molecular markers. Phylogenetic analysis showed that N. nouchali and N. ampla are closely related, and further validated previous water lily classification results based on morphological characteristics, which divided water lilies into five subgenera: Nymphaea, Brachyceras, Anecphya, Hydrocallis, and Lotos. These results are valuable for the identification and the formulation of protection strategies of N. nouchali, as well as contributing to understanding the evolutionary relationships among Nymphaeaceae species., 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.)

As an important part of urban ecosystems, plants can reduce NO 2 concentrations in the air. However, there is little evidence of the effects of different plant communities on NO 2 concentrations in street-scale green spaces. We used a multifunctional lifting environmental detector to investigate the impact of environmental factors and small plant communities on NO 2 concentrations in street green spaces during the summer and winter in Nanjing, China. The results showed that temperature, atmospheric pressure, and noise were significantly (P < 0.05) correlated with seasonal changes, temperature and humidity significantly (P < 0.01) influenced NO 2 concentrations in winter and summer, and the average NO 2 concentration in summer was generally higher than in winter. By comparing NO 2 concentrations in different plant community structures and their internal spaces, we found that the plant community structure with tree-shrub-grass was more effective in reducing pollution. These findings will help predict the impact of plant communities on NO 2 concentrations in urban streets and help city managers and planners effectively reduce NO 2 pollution., (© 2023. The Author(s).)

Background: Evidence on the relationship between prenatal exposure to NO 2 and CO and spontaneous abortion (SAB) is insufficient. We investigated whether there is an association between maternal exposure to nitrogen dioxide (NO 2 ) and carbon monoxide (CO) before and during pregnancy and SAB., Methods: We conducted a case-control study using medical records of 2445 pregnant women who admitted for abortion prior to 20 weeks of gestational age from January 2014 to December 2019 at a tertiary-care hospital in Shanghai, China. Of the 2445 participants, 1075 were SAB cases and 1370 were healthy controls (underwent elective abortions). Maternal exposure to NO 2 and CO before and during pregnancy was estimated using daily air pollution concentration data. Multivariable logistic regression models were constructed to quantify the relationships between maternal exposure to NO 2 or CO and the risk of SAB while controlling for potential confounders., Results: NO 2 exposure levels during pregnancy were significantly higher in SAB cases than in healthy controls (42.26 vs. 40.67, p  < .01). NO 2 exposure during pregnancy was positively associated with the risk of SAB. An interquartile range (16 μg/m 3 ) increase in NO 2 exposure was associated with 68% increase in the odds of SAB (OR = 1.68, 95% CI, 1.28, 2.21). Analyses of associations by quartile of NO 2 exposure showed that elevated NO 2 exposure during pregnancy was associated with increased odds of SAB in linear dose-response manners. Compared with the lowest quartile of NO 2 exposure, the odds of SAB in the fourth quartile of NO 2 exposure increased 61% (OR = 1.61, 95% CI, 1.03-2.53). No associations of CO exposure with SAB risk were observed., Conclusions: Our study suggested that exposure to NO 2 during early pregnancy was associated with increased risk of SAB. Further studies are needed to confirm our results and explore the potential biological mechanism underlying these associations.

Background: Multivessel coronary disease (MVCD) is the common type of coronary artery disease in acute coronary syndrome (ACS). Coronary artery calcification (CAC) has been confirmed the strong predictor of major adverse cardiovascular events (MACEs). Several studies have validated that triglyceride glucose (TyG) index can reflect the degree of coronary calcification or predict MACEs. However, no evidence to date has elucidated and compared the predictive intensity of TyG index or/and coronary artery calcification score (CACS) on multi-vascular disease and MACEs in ACS patients., Methods: A total of 935 patients, diagnosed with ACS and experienced coronary computed tomography angiography (CCTA) from August 2015 to March 2022 in the Second Hospital of Shandong University, were selected for retrospective analysis. The subjects were divided into TyG index quartile 1-4 groups (Q1-Q4 groups), non-multivessel coronary disease (non-MVCD) and multivessel coronary disease (MVCD) groups, respectively. The general data, past medical or medication history, laboratory indicators, cardiac color Doppler ultrasound, CACS, and TyG indexes were respectively compared among these groups. The ROC curve preliminarily calculated and analyzed the diagnostic value of TyG index, CACS, and the combination of the two indicators for MVCD. Univariate and multivariate logistic regression analysis discriminated the independent hazard factors for forecasting MVCD., Results: Compared with the lower TyG index and non-MVCD groups, the higher TyG index and MVCD groups had higher values of age, smoking history, waist circumference, systolic blood pressure, low-density lipoprotein cholesterol(LDL-C), fasting blood glucose and glycosylated hemoglobin, and CACS, but lower values of high-density lipoprotein cholesterol(HDL-C) (all P < 0.01). Coronary artery calcification is more common in the left anterior descending artery. Compared with non-MVCD, each unit increase in TyG index was associated with a 1.213-fold increased risk of MVCD. Logistic regression analysis adjusted for potential confounders indicated that TyG index is an independent risk factor for MVCD. With the increase of TyG index, the incidence of MACEs, apart from all-cause death, cardiac death, unexpected re-hospitalization of heart failure, recurrent ACS or unplanned revascularization, and non-fatal stroke in coronary artery increased (P log-rank < 0.001)., Conclusion: TyG index could completely substitute for CACS as a reliable, practical, and independent indicator for predicting the severity and prognosis of MVCD in patients with ACS., (© 2022. The Author(s).)

Objectives: This study aimed to analyze the prevalence of rheumatic diseases and its correlation with temperature and humidity among middle-aged and elderly adults in China from a spatial perspective. Methods: Data on rheumatic diseases among middle-aged and elderly adults were sourced from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Moran's I was applied to explore the spatial autocorrelation of rheumatic diseases. Spatial lag model (SLM) was established to probe the correlation between rheumatic diseases and temperature and humidity. Results: The age-standardized prevalence of rheumatic diseases was 33.2% for middle-aged and elderly adults in China, varying from 12.0% to 51.4% depending on regions. The Global Moran's I was 0.506 ( p = 0.001). Average temperature had negative correlation while average relative humidity had positive correlation with age-standardized prevalence of rheumatic diseases in the SLM. Conclusion: The age-standardized prevalence of rheumatic diseases of middle-aged and elderly adults showed spatial autocorrelation in China. We recommend taking measures to prevent rheumatic diseases for the middle-aged and elderly adults, especially for those living in cold and humid regions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Han, Sheng and Fang.)

Background: Nursing students face a lot of complicated situations and problems when they participate in psychiatric clinical practice for the first time. However, the nursing students' internship experience and career intention in psychiatry have not been well described in China., Purpose: This study aims to explore the experience and career intention of Chinese nursing undergraduates during their first psychiatric internship., Method: This is a qualitative design using phenomenological approach. Data were collected through a case-study, semi-structured, two face-to-face in-depth interviews (N = 13) with third-year nursing students from a university in China on their first clinical internship in a psychiatric department. We followed the consolidated criteria for reporting qualitative research (COREQ) checklist., Results: Four themes were identified: negative stereotype perceptions about mental illness, professional maturation, personal development, attitude towards psychiatric patients and career choice., Conclusions: The experience of nursing students in psychiatric clinical practice was constantly changing. This study indicated that nursing students went through a continuous development process of psychiatric care professional maturation and personal development. However, psychiatric nursing was not an ideal career choice of nursing students. This study provides guidance for educators to optimize the internship experience and take comprehensive measures to improve the professional attractiveness and professional identity of psychiatric nursing., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Aims: The study was to explore the experience of frontline nurses four months after COVID-19 rescue task., Background: Frontline medical staff are prone to follow-up mental health problems and different feeling after COVID-19 rescue task. However, the experience of frontline nurses after COVID-19 rescue task has not been well described., Methods: The study used a qualitative study design with semi-structured interview guide. Individual semi-structured face-to-face interviews were conducted with 15 frontline nurses who were involved COVID-19 rescue task from two tertiary-A hospitals in Hefei, China from July 10, to August 28, 2020. We followed the consolidated criteria for reporting qualitative research (COREQ) checklist., Results: Four main themes emerged from the interviews: recurring involuntary memories about the experience, feeling guilty and depressed, cultivation of occupational ability, increased professional pride and happiness., Conclusion: The study demonstrated that frontline nurses had both positive and negative experiences four months after COVID-19 rescue task. It is necessary to long-term follow up and attention to the experience of the frontline nurses after COVID-19 rescue task. These insights provide a specific direction for the psychological reconstruction of frontline nurses and the construction of nursing team., Relevance to Clinical Practice: Nursing managers should formulate psychological reconstruction plan according to the experience of frontline nurses after COVID-19 rescue task, so as to relieve the psychological stress and promote the mental health of nurses. At the same time, we should strengthen the disaster rescue ability training of nurses should be strengthened to better respond to future rescue task., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Pyriform sinus fistula (PSF) is a rare congenital anomaly, and the preferred definitive treatment is yet to be verified. In this study, we investigated the treatment outcomes of PSF specifically comparing endoscopic-assisted surgery and endoscopic radiofrequency ablation (RA)., Methods: The medical records of patients treated for PSF at the Shanghai Children's Hospital between October 2016 and September 2019 were retrospectively evaluated., Results: There were 93 girls and 98 boys. The median age at onset and operation was 3 years and 5 years, respectively. Endoscopic-assisted surgery was performed in 143 patients. During the same period, RA was performed in 48 patients, and 10 of them concurrently underwent incision and drainage of neck abscesses. Longer hospital stay was found in the endoscopic-assisted surgery group than in the RA group (10.50 ± 3.93 vs. 5.02 ± 3.30 days, P < 0.001). Postoperative complications were not significantly different between the two groups, except for neck infection (0 vs. 8.3%, P = 0.004). After a median follow-up period of 21 months, no significant difference was found between the two groups in terms of recurrence (1.4% vs. 0, P = 0.560)., Conclusion: Patients treated with RA had a significantly shorter hospital stay than those treated with endoscopic-assisted surgery. Outcomes of endoscopic-assisted surgery and RA were not significantly different for the management of PSF and treatment method should be tailored to the patient., Level of Evidence: IV., (Copyright © 2020. Published by Elsevier Inc.)

The current study explored Chinese parents' experiences of caring for their only child with mental illness. Face-to-face interviews with semi-structured questions were conducted to learn about the care experiences of parents whose only child had mental illness. Purposeful sampling was used to recruit parents (n = 14) and thematic analysis was used. Five themes were identified: (1) Having Responsibility to Care for Children, (2) Feeling Guilt and Self-Blame, (3) Experiencing Loneliness and Helplessness, (4) Drained by Caregiving, and (5) Worrying About the Future. Parents who cared for their only child with mental illness experienced considerable emotional and physical challenges. Professionals and health care providers should recognize and understand the experiences of these parents to identity their needs and provide adequate support. Targeted support services and appropriate professional information should be developed and provided for parents to relieve them of negative caregiving experiences and improve their psychological and physical well-being. [Journal of Psychosocial Nursing and Mental Health Services, 59(1), 29-37.]., (Copyright 2020, SLACK Incorporated.)

Background: The aim of this study was to determine the disease spectrum and drug types causing drug-induced liver injury (DILI) in northeast China, so that the affected population can be reminded of the need to increase their post-medication monitoring., Methods: A total of 470 DILI patients hospitalized at Shengjing Hospital between 2013 and 2016 were involved in this retrospective study., Results: There were significant differences in the disease spectrum of the different age groups (P < 0.001) and genders (P = 0.009). Drugs used to treat osteopathies, dermatitis and infections, as well as health care supplements, each accounted for > 10% of all drugs that caused DILI. The percentage of DILIs related to Chinese herbal medicines (CHMs) gradually increased with patient age (P = 0.002). The percentage of males taking health supplements or CHMs was significantly lower compared with females. Total bilirubin (β = 0.01, OR = 1.01, P < 0.001) and INR (β = 0.74, OR = 2.11, P < 0.001) were found to be independent predictors of liver damage., Conclusions: The main type of drug that causes DILI in northeast China is a CHM. There are differences in the disease spectrum found in DILI patients of different ages and gender. Making appropriate changes in the drug-taking habits of high-risk groups and the drugs used to treat high-risk underlying diseases, as well as increasing patient monitoring, may help to reduce the incidence of DILIs.

Aims: To explore the influence of experiences of involvement in the COVID-19 rescue task on professional identity among Chinese nurses from a qualitative method perspective., Background: Professional identity of nurses is not static and easily affected by many factors. The COVID-19 epidemic brings the tremendous physical and psychological challenges for rescue nurses. At present, there are limited data on the influence of rescue experiences on the nurses' professional identity., Methods: This study used a face-to-face interview with semi-structured questions to learn about the influence of rescue experiences on the professional identity of nurses. Purposeful sampling was used to collect participants (n = 14), and interview data were analysed following the Colaizzi's phenomenological analysis., Results: The 'impression of exhaustion and fear', 'feeling the unfairness', 'perceiving incompetence in rescue task' and 'unexpected professional benefits' were the main factors affecting the professional identity of rescue nurses., Conclusion: The present study showed that special attention and targeted support measures should be provided to improve the professional identity of rescue nurses., Implications for Nursing Management: Nurse managers should make a post-epidemic recovery plan to help nurses to improve the professional identity. Designed education programmes and complete disaster response system should be developed to deal with infection disease in the future., (© 2020 John Wiley & Sons Ltd.)

Background: Data on tenofovir alafenamide fumarate (TAF) for preventing mother-to-child transmission of hepatitis B virus (HBV) are lacking., Aims: To investigate the efficacy and safety of TAF therapy for preventing hepatitis B mother-to-child transmission., Methods: Mothers with chronic HBV infection, positive for hepatitis B e-antigen and with HBV DNA >200 000 IU/mL received TAF for preventing mother-to-child transmission were enrolled retrospectively from multiple centres with data collection on mother-infant dyads up to postpartum week 24-28. Primary measurements were the mother-to-child transmission rate and infants' malformation rate. Secondary assessments included maternal HBV DNA reduction at delivery, and maternal or infant adverse events during follow up., Results: Among 71 mothers enrolled, the mean (±SD) age was 30.3 (±2.2) years. TAF was initiated during the second or third trimester and continued to delivery with a mean (±SD) duration of 12.8 (±4.0) weeks. At delivery, 85.9% (61/71) of the mothers achieved HBV DNA <200 000 IU/L. Seventy-three infants (two sets of twins) were born from mothers treated with TAF and none had congenital defects or malformations. All infants received HBV immunoglobulin and vaccine at birth with additional HBV vaccinations at one and six months. At age 24-28 weeks, all infants had negative hepatitis B surface antigen and undetectable levels of HBV DNA (<100 IU/mL). Body weight, height, and head circumferences were comparable to national standards for physical development. No severe adverse effects were reported in either mothers or infants., Conclusions: TAF for highly viraemic mothers effectively prevented mother-to-child transmission of hepatitis B. There were no safety concerns for either mothers or infants with 24-28 weeks of follow up., (© 2020 John Wiley & Sons Ltd.)

The prevalence of hepatitis B virus (HBV) infection was an imbalance in different provinces of China. This study aimed to investigate the prevalence of HBV infection and evaluate the prophylactic measures in a public hospital of northeast China over the preceding 13 years. A total of 13,948 patients in 2004 and 15,256 patients in 2017 of Shengjing Hospital of China Medical University were tested of serum HBsAg, HBeAg, HBsAb, HBeAb, and HBcAb levels with Abbott MEIA Kits. In people born before 1992, HBsAg-positive rate was 5.45% and 6.47%; isolated HBsAb positive rate was 14.62% and 21.24%; HBV marker negative rate was 54.27% and 42.77% in 2004 and 2017 survey, respectively. The males had a significant higher HBsAg-positive rate than the females. In people born during 1992-2004, HBsAg positive rate was 0.58% and 0.57%, isolated HBsAb positive rate was 41.47% and 46.57%; and HBV marker negative rate was 51.97% and 46.86% in 2004 and 2017 survey, respectively. Males and females had no difference of HBsAg-positive rate. In children born after 2005, HBsAg positive rate was 0.11%, isolated HBsAb positive rate was 76.68%, and HBV marker negative rate was 18.51% in 2017 survey. No difference of HBsAg-positive rate was found between the genders. A dramatic decrease of HBsAg positive rate and a progressive increase of HBsAb-positive rate were found among people born after 1992 and progressed further in those born after 2005. Immunization of infants and timely birth dose was the key method for prevention of HBV infection. Expanded HB vaccination would be needed for people born before 2005, especially those born between 1992 and 2004.

Life expectancy (LE) is a comprehensive and important index for measuring population health. Research on LE and its influencing factors is helpful for health improvement. Previous studies have neither considered the spatial stratified heterogeneity of LE nor explored the interactions between its influencing factors. Our study was based on the latest available LE and social and environmental factors data of 31 provinces in 2010 in China. Descriptive and spatial autocorrelation analyses were performed to explore the spatial characteristics of LE. Furthermore, the Geographical Detector (GeoDetector) technique was used to reveal the impact of social and environmental factors and their interactions on LE as well as their optimal range for the maximum LE level. The results show that there existed obvious spatial stratified heterogeneity of LE, and LE mainly presented two clustering types (high-high and low-low) with positive autocorrelation. The results of GeoDetector showed that the number of college students per 100,000 persons (NOCS) could mainly explained the spatial stratified heterogeneity of LE (Power of Determinant (PD) = 0.89, p < 0.001). With the discretization of social and environmental factors, we found that LE reached the highest level with birth rate, total dependency ratio, number of residents per household and water resource per capita at their minimum range; conversely, LE reached the highest level with consumption level, GDP per capita, number of college students per 100,000 persons, medical care expenditure and urbanization rate at their maximum range. In addition, the interaction of any two factors on LE was stronger than the effect of a single factor. Our study suggests that there existed obvious spatial stratified heterogeneity of LE in China, which could mainly be explained by NOCS., Competing Interests: The authors declare no conflict of interest.

Background: This study aimed to evaluate the clinical efficacy and safety of endoscopic thoracic sympathicotomy and to explore strategies to decrease the incidence of transfer hyperhidrosis (TH)., Methods: From January 2003 to July 2016, 10,275 patients with primary palmar hyperhidrosis underwent endoscopic thoracic sympathicotomy in 15 different institutions. We carried out a retrospective analysis of these patients who were grouped into group A, those with nonretained R2 (R2, R2-3, or R2-4 ablation), and group B, those with retained R2 (single R3 or R4 ablation)., Results: All procedures were performed successfully. Both hands of all patients became warm and dry immediately after endoscopic thoracic sympathicotomy. Pneumothorax occurred in 146 patients, and 39 patients had intraoperative bleeding. Follow-up was carried out from 6 months to 13 years. A total of 531 patients (5.2%) were lost to follow-up. The effective rate for primary palmar hyperhidrosis was 100%. Palmar hyperhidrosis recurred in 73 patients (0.7%). Transfer hyperhidrosis appeared in 7,678 patients (78.8%). For groups A and B, the incidence of TH was 80.4% and 78.5%, respectively (P > .05), but the incidence of grade III+IV TH in group B (1.6%) was less than that in group A (4.8%; P < .001)., Conclusion: Endoscopic thoracic sympathicotomy is a minimally invasive, safe, and effective therapeutic method for primary palmar hyperhidrosis. Although the overall incidence of TH is high, the incidence of grade III to IV TH can be decreased by reserving R2, lowering the level of thoracic sympathicotomy, and single severing of R3 or R4., (Copyright © 2019 Elsevier Inc. All rights reserved.)

In freshwater aquaculture ecosystems with high-frequency occurrences of cyanobacteria blooms, a chronic neurotoxic cyanobacteria toxin, β-N-methylamino-l-alanine (BMAA), is a new pollutant that affects the normal growth, development, and reproduction of aquaculture organisms. BMAA poses a great threat to the food quality and food safety of aquatic products. In this paper, high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS) was used to detect the contents of BMAA in the edible portions of six representative freshwater aquaculture products (Corbicula fluminea, Anodonta arcaeformis, Macrobrachium nipponense, Eriocheir sinensis, Ctenopharyngodon idella, and Mylopharyngodon piceus) from Taihu Lake Basin in China. Noncarcinogenic health risks were assessed with reference to the model recommended by the International Environmental Modelling and Software Society and based on the biomagnification characteristics of BMAA in the various aquaculture products investigated by the stable nitrogen isotope technique. The average BMAA concentrations in the edible portions of the six freshwater culture products were from 2.05 ± 1.40 to 4.21 ± 1.26 μg g -1 dry weight (DW), and the difference was significant (p < 0.05), such a difference increased with the increase in the trophic level in the aquaculture products. Although a biomagnification indication was observed, the trophic magnification factor (TMF) was only 1.20 which exhibited a relatively low biomagnification efficiency. The annual health risk values of BMAA in all the measured aquatic products were within the maximum tolerable range (<1 × 10 -6 a -1 ), and the health risk increased with the increase in the trophic level. The risk values of BMAA in the six freshwater aquaculture products for children was slightly higher than the negligible level (<1 × 10 -7 a -1 ), thus there might have potential health risks for children's long-term consumption. Considering China's national conditions, the guidance values of BMAA based on the quality and safety of freshwater aquaculture products were proposed to be 7.2 μg g -1 DW for adults and 1.8 μg g -1 DW for children., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The tetrigid genus Criotettix Bolívar, 1887 from China is taxonomically reviewed. The genus now includes 39 species from China, in which two new species are described and illustrated, namely: Criotettix longispinus Deng, sp. nov. and Criotettix undatifemurus Deng, sp. nov..Their distribution and an annotated identification key to Chinese species are provided.

Air pollution is an important environmental and health concern all over the world and PM 2.5 is one of the most important constituents of air pollution. In urban area with high population density, vehicles contribute a big portion of PM 2.5 . The effect of vegetations along road, i.e., road greenbelts, on PM 2.5 concentration is still a hot research topic. This study used three-dimensional green volume (3DGV, the three-dimensional volume of the crown and stems of all vegetations including trees, shrubs and grass) to evaluate the vegetation quantity of road greenbelts along four main roads in Nanjing, China. High spatial resolution images were collected with unmanned aerial vehicle (UAV) for othomosaic and feature extraction analysis. A Geographic Information System (GIS) database was developed to cover the location, crown diameter, crown height, and 3DGV information of vegetations in the road greenbelts. The environmental benefits of the road greenbelts were evaluated based on 3DGV information. The relationship between 3DGV of road greenbelts and PM 2.5 concentration was analyzed and it was found that large 3DGV does not mean lower PM 2.5 concentration. A road greenbelt with even vertical distribution of biomass and diversified vegetation species works better to reduce PM 2.5 concentration. The implication of this research is that road greenbelt development should systematically consider surface water control, noise reduction, recreation, aesthetic, and air pollution control, thus to maximize its ecoservices to human being., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Purpose: To evaluate the efficacy and safety of nucleos(t)ide analogues, especially telbivudine (LdT) for the prevention of mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in women with high viremia. Methods: We conducted a prospective, open-label, multicenter study of LdT for treating pregnant women having high viral loads of hepatitis B virus (HBV DNA>5 log 10 IU/mL) but normal levels of alanine aminotransferase (ALT). Maternal HBV DNA, HBV serologic status and ALT were measured at baseline, 4 weeks after therapy, before delivery, 4 weeks after delivery, and 12 weeks after delivery. Infant HBV serologic status and HBV DNA levels were measured at 7 months. We calculated the MTCT rate of LdT-treated and LdT-untreated groups and analyzed the efficacy and safety of LdT. Results: Ninety-one women (the treatment group) were treated with LdT, and twenty-one patients (the observation group) did not undergo antiviral therapy. The baseline HBV DNA levels were 8.15±0.82 log 10 IU/mL in the treatment group, and 8.09±1.04 log 10 IU/mL in the observation group. The MTCT rate was 0% in the treatment group, and 9.5% in the observation group (p=0.042). In the treatment group, HBV DNA levels were 5.02±0.74 log 10 IU/mL at one month after therapy, and 3.95±0.94 log 10 IU/mL before delivery. Both groups had significant differences from baseline levels in HBV DNA levels (p<0.001). In total, five patients had elevated ALT levels but without evidence of decompensate liver function. No severe adverse events or complications were observed in women or infants. Conclusions: For pregnant women with HBV DNA greater than 5 log 10 IU/mL, LdT therapy was effective in reducing HBV MTCT. If serum HBV DNA was detectable at delivery, discontinuation of LdT immediately was found to be safe and rarely induced off-treatment hepatitis flare., Competing Interests: Competing Interests: The authors have declared that no competing interest exists.

Objective: To explore the difference of liver inflammation and fibrosis in patients with chronic hepatitis B virus (HBV) infection and chronic hepatitis C virus (HCV) infection, and to investigate the relationship between hepatic pathology and alanine aminotransferase (ALT). Methods: 57 patients with chronic HCV infection and 346 patients with chronic HBV infection who were hospitalized at Shengjing Hospital of China Medical University from January 2012 to September 2016 were enrolled. In chronic HBV infection, including 88 cases whose ALT were more than two times of upper limited of normal (ALT≥2×ULN) and 258 cases whose ALT were less than two times of upper limited of normal (ALT < 2×ULN).All the patients were underwent liver biopsy. Chronic HBV infection (ALT≥2×ULN and ALT < 2×ULN) and chronic HCV infection were compared respectively. Statistical analyses were performed using a Univariate χ ²-test and Mann-Whitney U test for comparison. Correlations between variables were analyzed using Spearman's rank correlation. Results: In chronic HBV infection group, 169 cases (48.8%) had inflammation grade≥2 (G≥2), 98 cases (28.3%) had fibrosis stage≥2 (S≥2), 81 cases (23.4%) with G≥2 and S≥2.In the ALT < 2×ULN group, there were 109 cases (42.2%) with G≥2, 62 cases (24%) with S≥2, 49 cases (19%) with G≥2 and S≥2. In the ALT≥2×ULN group, 60 cases (68.2%) with G≥2, 35 cases (39.8%) with S≥2, 31 cases (35.2%) with G≥2 and S≥2. The grade of inflammation and fibrosis have significantly different between ALT≥2×ULN group and ALT < 2×ULN group ( χ ² = 17.66, χ ² = 8.06, P < 0.01). In chronic HCV infection group, 47 cases (82.5%) with G≥2, 20 cases (35.1%) with S≥2, 20 cases (35.1%) with G≥2 and S≥2. ALT had no correlation with inflammation and fibrosis ( P > 0.05). The grade of inflammation was significantly different between chronic HCV infection and chronic HBV infection whose ALT < 2×ULN ( χ ² = 30.19, P < 0.01) but the fibrosis have no difference ( χ ² = 2.96, P > 0.05). Compared with chronic HBV infection whose ALT≥2×ULN, both inflammation and fibrosis had no significantly different ( χ ² = 3.65, χ ² = 0.32, P > 0.05 respectively). Conclusion: In chronic HBV infection whose ALT < 2×ULN, about 30%-40% liver tissue with significant necroinflammation and /or fibrosis. About 80% chronic HCV infection with significant necroinflammation, and the grade of inflammation has no correlation with ALT. The grade of inflammation has significantly different between chronic HCV infection group and chronic HBV infection group whose ALT < 2×ULN.

Benthic bivalves are important links between primary production and consumers, and are essential intermediates in the flow of energy through estuarine systems. However, information on the diet of filter feeding bivalves in estuarine ecosystems is uncertain, as estuarine waters contain particulate matter from a range of sources and as bivalves are opportunistic feeders. We surveyed bivalves at different distances from the creek mouth at the Yangtze estuarine marsh in winter and summer, and analyzed trophic dynamics using stable isotope (SI) and fatty acid (FA) techniques. Different bivalve species had different spatial distributions in the estuary. Glauconome chinensis mainly occurred in marshes near the creek mouth, while Sinonovacula constricta preferred the creek. Differences were found in the diets of different species. S. constricta consumed more diatoms and bacteria than G. chinensis, while G. chinensis assimilated more macrophyte material. FA markers showed that plants contributed the most (38.86 ± 4.25%) to particular organic matter (POM) in summer, while diatoms contributed the most (12.68 ± 1.17%) during winter. Diatoms made the largest contribution to the diet of S. constricta in both summer (24.73 ± 0.44%) and winter (25.51 ± 0.59%), and plants contributed no more than 4%. This inconsistency indicates seasonal changes in food availability and the active feeding habits of the bivalve. Similar FA profiles for S. constricta indicated that the bivalve had a similar diet composition at different sites, while different δ13C results suggested the diet was derived from different carbon sources (C4 plant Spartina alterniflora and C3 plant Phragmites australis and Scirpus mariqueter) at different sites. Species-specific and temporal and/or spatial variability in bivalve feeding may affect their ecological functions in intertidal marshes, which should be considered in the study of food webs and material flows in estuarine ecosystems.

Spartina alterniflora, an aggressive invasive plant species at the estuarine wetlands of China's coasts, has become a major threat to the natural ecosystems. To understand its potential influence on nitrification processes, the community structures and abundance of ammonia-oxidizing archaea (AOA) and ammonia-oxidizing bacteria (AOB) were investigated using 454-pyrosequencing and quantitative real-time PCR (qPCR) in S. alterniflora invading salt marsh sediments at the Yangtze River estuary in Chongming island, Shanghai, China. Copy numbers of archaeal and bacterial ammonia monooxygenase subunit A (amoA) genes did not show accordant shifts with S. alterniflora invasion in the two sampling sites. However, the copy numbers of archaeal amoA gene were higher in summer than in spring. Phylogenetic analysis indicated that more than 90% of the archaeal and 92% of the bacterial amoA gene sequences were closely related to marine group I.1a and the clusters 13 and 15 in Nitrosospira lineage, respectively. The effect of different seasons (spring and summer) was important for the abundance variation of AOA, while different stages of S. alterniflora invasion did not show significant effect for both AOA and AOB. Variation of AOA community was significantly related to total carbon (TC) and sulfate concentration (P < 0.05), whereas the AOB community was significantly related to sulfate concentration, total nitrogen (TN), TC and pH (P < 0.05). In conclusion, the abundance and diversity of ammonia oxidizing microbial communities were not strongly affected by S. alterniflora invasion.

A novel HLA-B allele, B*15:179:02, has been identified during typing of donors in Anhui province, China., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Dendritic tidal creek networks are important habitats for sustaining biodiversity and ecosystem functioning in salt marsh wetlands. To evaluate the importance of creek heterogeneity in supporting benthic secondary production, we assess the spatial distribution and secondary production of a representative polychaete species (Dentinephtys glabra) in creek networks along a stream-order gradient in a Yangtze River estuarine marsh. Density, biomass, and secondary production of polychaetes were found to be highest in intermediate order creeks. In high order (3rd and 4th) creeks, the density and biomass of D. glabra were higher in creek edge sites than in creek bottom sites, whereas the reverse was true for low order (1st and 2nd) creeks. Secondary production was highest in 2nd order creeks (559.7 mg AFDM m-2 year-1) and was ca. 2 folds higher than in 1st and 4th order creeks. Top fitting AIC models indicated that the secondary production of D. glabra was mainly associated with geomorphological characters including cross-sectional area and bank slope. This suggests that hydrodynamic forces are essential factors influencing secondary production of macrobenthos in salt marshes. This study emphasizes the importance of microhabitat variability when evaluating secondary production and ecosystem functions.

Objective: To investigate the status of iron deficiency and the rate of anemia of 3 - 11 year-old children in Chinese cities and countryside and explore the possible related influencing factors., Methods: The multistage stratified cluster random sampling was used to select one kindergarten and one primary school in seven cities (Beijing, Shenyang, Suzhou, Zhengzhou, Chengdu, Lenzhou and Guangzhou) and two countryside randomly in Hebei Province one bottom class, middle class, top class in one kindergarten and one second grade and fifth grade in one primary school were selected randomly. All of the healthful students of these classes were investigated and the element iron and the parameters of red blood cell were detected., Results: 1863 students in 7 cities and 2 countryside were investigated in the research. The incidence of iron deficiency of different ages had statistical significance and with the age increasing, the incidence showed a decreasing trend. The incidences of iron deficiency were 47.1% and 38.2% in 3 -4 year-old children and 4 - 5 year-old children, respectively. The incidence of anemia of different ages had statistical significance. The incidences of anemia of 3 - 4 year-old children and 4 -5 year-old children were significantly higher than those of 5 - 6 year-old children. The incidences of anemia were 4.0% and 7.1% in 3 - 4 year-old children and 4 -5 year-old children, respectively. No statistical significance for different sex of the same age was found for iron deficiency and anemia incidence. The incidence (12%) of anemia of the children in countryside area was significantly higher than those in first-tier cities and second-tier cities., Conclusion: The status of iron deficiency and the rate of anemia of 3 - 11 year-old children in Chinese cities and countryside were improved recently, but still serious. It should be paid more attention to the children with lower serum iron content and the children in rural areas.

Background: The main transmission route of the hepatitis B virus (HBV) is mother to child transmission and contributes significantly to chronic HBV infection. Even though immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine is administrated to neonates whose mothers are hepatitis B surface antigen (HBsAg) positive, about 10% of the neonates suffer from HBV infection in their early life., Objectives: To survey chronic HBV infection among pregnant women and their infants and analyze the reason for immunoprophylaxis failure., Methods: Serum HBsAg was tested in all pregnant women. HBVDNA and other serum HBV markers including hepatitis B e antigen (HBeAg), hepatitis B core antibody (anti-HBc) and hepatitis B surface antibody (anti-HBs) were tested among HBsAg positive pregnant women. All infants whose mothers were HBsAg positive were vaccinated with a standard immunoprophylaxis. Serum HBV markers and HBVDNA were tested among these infants at 7 months of age. HBV genotypes were analyzed among the infants and pregnant women who were HBVDNA positive., Results: The prevalence of HBsAg, anti-HBc and anti-HBs among 4,536 pregnant women was 5.49%, 29.65% and 58.55%, respectively. The prevalence of HBsAg, anti-HBc and anti-HBs among pregnant women older than 20 years of age was significantly different compared to pregnant women younger than 20 years of age (4.54, 5.69 and 0.61 times, prevalence older vs. younger, respectively. P<0.05, 0.01, 0.05, respectively). Among 249 HBsAg positive pregnant women, 167 (67.07%) were HBeAg positive, 204 (81.93%) were HBVDNA positive and only 37 (14.86%) had HBVDNA >107 IU/ml. Among the infants whose mothers were HBsAg positive, 214 (85.94%) infants were anti-HBs positive. There were 12 (4.82%) infants who were HBsAg and HBVDNA positive, and all 12 of these infants mothers were HBeAg positive and had HBVDNA >107 IU/ml. Genotypes B and C were present among 165 pregnant women and genotype C was present in 85 pregnant women. There were 12 infants who were HBsAg positive and had the same HBV genotypes as their mothers. There was a significant difference in genotypes between the pregnant women whose infants were infected with HBV compared to those without HBV infection (P < 0.05)., Conclusions: There was a significant decline in HBsAg prevalence among pregnant women and their infants in Shenyang. Genotype C might be a risk factor for mother to child transmission of HBV.

Objective: To investigate the epidemic characteristics of etiological agents and analyze the clinic differences in children with hand, foot and mouth diseases in Shanghai., Methods: Collection 551 specimens including vesicle fluid, stool and throat swabs to detect the pathogens. The positive rates were tested by RT-PCR assay with Enterovirus consensus primer and specific primer for Enterovirus 71 (EV71) and Coxsackie A16 (CoxA16), respectively., Results: Out of 357 patients, the overall positive rate was 79.7%. CoxA16 infection was mainly popular in 2009, EV71 was mainly popular in 2011. The epidemic characteristics of enterovirus infection within 2009-2011 had significant differences (P = 0.005). The positive rate of vesicle fluid was highest. The concurrent rate of fever and tendency to be frightened had significant differences in three patients' groups. The count of the peripheral white blood cells and the ratio of the neutrophil in the patients with EV71 infection was higher than that in the patients with CoxA16 or PE infection., Conclusion: HFMD showed alternant epidemic characteristics at different times of enterovirus infection in Shanghai. Analyzing the differences of clinic characteristic of EV71 and CoxA16 infection is helpful to prevent and control EV71 infection.

Purpose: The aim of this study is to review the authors' 12-year experience with re-operative surgery for Hirschsprung's disease (HD) including indications of re-operation and surgical technique., Methods: We retrospectively reviewed the data of 24 patients who underwent re-operation from 1998 to 2010. The type of initial procedure, clinical presentations, indications and details of redo surgery, and the functional results were analyzed., Results: The primary operations performed on these patients included Duhamel (nine cases), Soave (12 cases), Swenson (one case) and Rehbein (two cases). The indications for re-operation were recurrent constipation due to severe anastomotic stricture (five cases), residual aganglionic segments (five cases) and gate syndrome after Duhamel procedure (five cases); fistula formation including rectocutaneous fistula (six cases), rectovaginal fistula (one case), complex fistula (two cases). The redo procedure ranged from posterior sagittal approach combined with laparotomy (seven cases), Soave procedure (seven cases, six conventional Soave + one transanal Soave), Duhamel procedure (one case), Rehbein procedure (three cases), re-using the stapling device (five cases), repairing the rectovaginal fistula via laparotomy (one case). We have followed up the patients for 7 months to 6 years (mean 2.5 years). After re-operation, in 22 patients older than 3 years, 19 (86.4%) have normal or near normal bowel habits with a stool frequency of 1-5 times per day, two have voluntary bowel movements but occasional soiling (once or twice per week) and without significant incontinence, one presented rectosacral fistula due to careless dilatation. There were no deaths., Conclusion: Re-operation can work out the anatomical or pathological problems resulted from failed initial procedure and improve the patient's quality of life. Posterior sagittal approach, Soave and Duhamel are all safe and effective, but we still need to try our best to diminish the necessity of re-operation.

Objective: To evaluate the effect of control on soil-transmitted nematode infections in the demonstration plot of integrated control on parasitic diseases, Hainan Province., Methods: The plot (county) was divided into east, west, north, south and central areas and the villages in these areas were selected with the random sampling method, and then the residents in these villages were investigated with Kato-Katz technique for soil-transmitted nematode infections and with questionnaires for knowledge, attitude and practice (KAP) and so on before and after the implementation of the control measures. All the results were analyzed and compared statistically., Results: Compared with the results of the baseline survey, the overall infection rate of soil-transmitted nematode decreased by 68.66%. The infection rates of soil-transmitted nematode in the male and female decreased by 69.56% and 67.73%, respectively, and the rates in the children and adults decreased by 70.51% and 68.09%, respectively. The infection rates of Ascaris lumbricoides, Trichuris trichiura and hookworm decreased by 95.87%, 90.00% and 65.22%, respectively. The awareness rate of health knowledge increased by 115.23% and the qualified rate of health behavior increased by 51.61%., Conclusion: The remarkable results of soil-transmitted nematodiasis control have been achieved in the demonstration plot of integrated control on parasitic diseases, Hainan Province.

Objective: This study investigated factors associated with hot flashes in Chinese perimenopausal and postmenopausal women., Methods: This cross-sectional study recruited Chinese women aged 40-60 years who were perimenopausal or postmenopausal and examined factors associated with hot flashes. Participants completed a questionnaire detailing demographic information, characteristics of menstruation, reproductive history, use of hormone replacement therapy or oral contraceptives, personal lifestyle factors (exercise, multivitamin use, soy products use, diet), and symptoms of hot flashes. Height, weight, blood pressure, and waist and hip circumference were also measured., Results: A total of 1399 participants (817 perimenopausal women and 582 postmenopausal women) completed the study. In perimenopausal women, college or higher education decreased the prevalence of hot flashes (odds ratio (OR) 0.63; 95% confidence interval (CI) 0.46-0.86). In postmenopausal women, an omnivorous diet decreased the prevalence of hot flashes (OR 0.38; 95% CI 0.17-0.85). Strenuous exercise (> or =3 times a week) increased the prevalence of hot flashes (OR 1.41; 95% CI 1.08-1.83) in perimenopausal women., Conclusions: It is possible that modifiable risk factors for hot flashes exist in Chinese perimenopausal and postmenopausal women. Future studies with larger populations are needed to confirm these findings.

Objective: Qinba Mountain area of Shanxi Province, China, is one of the poorest, culturally backward regions in China with a high incidence of mental retardation. To investigate whether cytomegalovirus (CMV) plays a role in the high incidence of mental retardation in this region, we studied the incidence of CMV infection during pregnancy and possible risk factors associated with CMV infection., Methods: 386 consecutive pregnant women in Qinba Mountain area were monitored for the level of a CMV-specific IgM antibody. Polymerase chain reaction was used to detect CMV in breast milk obtained within 2 weeks postpartum and urine samples of newborn infants born to actively CMV-infected mothers. Serum levels of TNF-alpha, IL-6, zinc, copper, iron and selenium were analyzed in CMV-infected pregnant women., Results: The incidence of CMV-active infection during pregnancy, intrauterine transmission and excretion in breast milk were 15.03, 33.33, and 39.58%, respectively. Active CMV infection during pregnancy was correlated with maternal age, education and economic status, parity, and history of obstetric complications. Those women who had active CMV infection, intrauterine transmission, or CMV excretion in milk showed higher values of TNF-alpha and IL-6, lower values of zinc as compared with health age-matched controls (p < 0.05). No differences were identified between studied cases and controls in the level of copper, iron, and selenium (p > 0.05)., Conclusion: The incidence of CMV-active infection during pregnancy was high in Qinba Mountain area of Shanxi Province. Zinc deficiency may be a risk factor for the development of CMV infection. TNF-alpha and IL-6 may be involved in the pathophysiologic process., ((c) 2007 S. Karger AG, Basel.)