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Background: The canine influenza virus (CIV) outbreak has garnered considerable attention as it poses a significant threat to dog health. During the H3N2 CIV evolution in beagles, the virus formed a new clade after 2019 and gradually became more adaptable to other mammals. Therefore, successfully elucidating the biological characteristics and constructing a canine influenza infection model is required for CIV characterization., Methods: We performed genetic analyses to examine the biological characteristics and infection dynamics of CIV., Results: The genotype of our H3N2 CIV strain (from 2019 in Shanghai) belonged to the 5.1 clade, which is now prevalent in China. Using MDCK cells, we investigated viral cytopathic effects. Virus size and morphology were observed using transmission electron microscopy. Beagles were also infected with 10 4 , 10 5 , and 10 6 50% egg-infectious doses (EID 50 ). When compared with the other groups, the 10 6 EID 50 group showed the most obvious clinical symptoms, the highest virus titers, and typical lung pathological changes. Our results suggested that the other two treatments caused mild clinical manifestations and pathological changes. Subsequently, CIV distribution in the 10 6 EID 50 group was detected by hematoxylin and eosin (H&E) and immunofluorescence (IF) staining, which indicated that CIV primarily infected the lungs., Conclusions: The framework established in this study will guide further CIV prevention strategies., (© 2024. The Author(s).)

Quality improvement is an international priority, and quality education and training are important parts of hospital quality management. The aim of this study was to understand the knowledge, attitudes and practices (KAP) and its influencing factors related to quality training in medical staff. A questionnaire survey was conducted by convenience sampling to assess the KAP of quality training in Taizhou Enze Medical Center. Principal component analysis was used to extract factors from the questionnaire. Descriptive statistics (frequency, median, mean), Kendall grade correlation analysis, and Mann-Whitney U tests were used to analyze the data. A total of 205 staff members participated in the questionnaire survey. For the 5 factors of the KAP scale, the highest score was factor F4, recognition and support for quality training (mean = 90.55, median = 100), followed by factor F3, perceived benefits (mean = 84.46, median = 85.65). Relatively lower scores were found for factor F2, quality knowledge learning and mastery (mean = 63.09, median = 63.89), and F5, quality management practices and sharing (mean = 82.07, median = 75.00). There was a correlation between the 5 factors. The scores of F2 (quality knowledge learning and mastery) for staff with senior professional titles were higher than those for staff with intermediate professional titles or below. The score of F3 (perceived benefits of quality training) in medical technicians and nurses was higher than in doctors and administrative personnel. Our findings showed that the respondents' attitude toward quality training was positive, but their knowledge mastery and practice behaviors should be further improved. Occupational category and professional title were the influencing factors of the quality training KAP. Therefore, hospital should conduct quality management training at a wider scope according to the competency requirements of different groups, and further optimize the improvement and innovation system., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Little is known about trends in or projections of the disease burden of dietary gastric and esophageal cancer (GEC) in China., Objective: We aim to report GEC deaths and disability-adjusted life years (DALYs) from 1990 to 2019, predict them through 2044, and decompose changes in terms of population growth, population aging, and epidemiological changes., Methods: We retrieved dietary GEC data from the Global Burden of Disease (GBD) online database and used joinpoint regression and age-period-cohort models to analyze trends in dietary GEC deaths and DALYs from 1990 to 2019 in China. We used a Bayesian age period cohort model of integrated nested Laplace approximations to predict the disease burden of GEC through 2044 and obtained the estimated population of China from 2020 to 2050 from the Global Health Data Exchange website. Finally, we applied a recently developed decomposition method to attribute changes between 2019 and 2044 to population growth, population aging, and epidemiological changes., Results: The summary exposure values and age-standardized rates decreased significantly from 1990 to 1999, with percentage changes of -0.06% (95% CI -0.11% to -0.02%) and -0.05% (95% CI -0.1% to -0.02%), respectively. From 1990 to 2019, for dietary esophageal cancer, the percentage change in age-standardized mortality rate (ASMR) was -0.79% (95% CI -0.93% to -0.58%) and the percentage change in age-standardized DALY rate (ASDR) was -0.81% (95% CI -0.94% to -0.61%); these were significant decreases. For dietary stomach cancer, significant decreases were also observed for the percentage change in ASMR (-0.43%, 95% CI -0.55% to -0.31%) and the percentage change in ASDR (-0.47%, 95% CI -0.58% to -0.35%). In addition, data from both the joinpoint regression and annual percentage change analyses demonstrated significantly decreasing trends for the annual percentage change in ASMR and ASDR for GEC attributable to dietary carcinogens. The overall annual percentage change (net drift) was -5.95% (95% CI -6.25% to -5.65%) for dietary esophageal cancer mortality and -1.97% (95% CI -2.11% to -1.83%) for dietary stomach cancer mortality. Lastly, in 2044, dietary esophageal cancer deaths and DALYs were predicted to increase by 192.62% and 170.28%, respectively, due to age structure (121.58% and 83.29%), mortality change (76.81% and 92.43%), and population size (-5.77% and -5.44%). In addition, dietary stomach cancer deaths and DALYs were predicted to increase by 118.1% and 54.08%, with age structure, mortality rate change, and population size accounting for 96.71% and 53.99%, 26.17% and 3.97%, and -4.78% and -3.88% of the change, respectively., Conclusions: Although the predicted age-standardized rates of mortality and DALYs due to dietary GEC show downward trends, the absolute numbers are still predicted to increase in the next 25 years due to rapid population aging in China., (©Hui-Xiao Guo, Qi Wang, Can Wang, Qing Chen Yin, Hua Zhi Huo, Bing Hua Yin. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 21.09.2023.)

Objectives: To evaluate COVID-19 burnout syndrome among healthcare workers in Taizhou, China. Methods: A total of 1,103 qualified healthcare workers in Taizhou were included in the study. The Maslach Burnout Inventory-General Survey (MBI-GS) was used to assess burnout syndrome. Results: Among the healthcare workers surveyed, 25.9% experienced COVID-19 burnout syndrome, including 22.3% and 3.6% with mild and moderate burnout, respectively. Multivariate linear regression models revealed associations with emotional exhaustion among healthcare workers, as follows: occupation, education level and professional qualifications. Professional efficacy was impacted by the pandemic, as follows: sex and occupation. The following factors were associated with cynicism among healthcare workers: occupation and underlying disease. Occupation (medical technician vs. physician, β = -7.40, 95% confidence interval: -12.09 to -2.71, p = 0.002) was significantly related to MBI-GS scores after adjusting for confounding factors. Conclusion: COVID-19 burnout syndrome was common among healthcare workers in Taizhou, China, and its impact was more burdensome to physicians., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2023 Tung, Yang, Zhang, Chen and Pan.)

Objectives: Concerns about the safety of the SARS-CoV-2 vaccine have been a stumbling block in the promotion of vaccination uptake. Although many studies have focused on the investigation of people's intention to receive the COVID-19 vaccine, little attention has been paid to the underlying mechanism. This study explored whether concerns about the adverse reactions to the vaccine mediated the relationship between attitudes toward the effectiveness of the vaccine and proactively taking the vaccine for family., Methods: Questionnaires were completed by 1,673 (39.9%, 1673/4191) healthcare workers at Taizhou Hospital, Taizhou, Zhejiang, China. Among these, 1,397 (83.5%) have received two doses of the SARS-Cov-2 vaccine. Mediation analysis approach was applied in this research., Results: Attitudes toward the effectiveness of vaccines were positively correlated with proactively taking the COVID-19 vaccine for family. Additionally, concerns about the side effects to the SARS-Cov-2 vaccine mediated the relationship between attitudes toward the effectiveness of vaccines and proactively taking vaccines for family., Conclusion: The findings imply inextricable relationships among attitudes toward the effectiveness of the SARS-Cov-2 vaccine, fears about side effects to vaccines, and taking vaccines for family. It further suggested that the importance of highlighting the safety of vaccine in promotion of vaccination uptake.

Objective: Improving the satisfaction and medical experience of patients is a basic goal of the comprehensive reform of public hospitals in China. This study aimed to investigate the patient experience and its influencing factors, and to compare medical experiences between patients with and without chronic disease, with a view to providing suggestions for improving the quality of public hospitals in China., Methods: A cross-sectional comparative study involving 102 patients discharged from Taizhou Hospital of Zhejiang Province, a tertiary public hospital in China, was conducted. The patients were invited to participate in a survey comprising the Picker Patient Experience Questionnaire (PPE-15), and an overall satisfaction evaluation (on a scale of 1-10). The patients were divided into two groups according to whether or not they had a chronic disease, and the medical experience and overall satisfaction of the groups were compared. Descriptive statistics (frequency, median, mean), chi-square analysis, and Mann-Whitney U tests were used to analyze the data., Results: No statistical significance was found in overall satisfaction between patients with and without chronic diseases, but there were differences in the patient experience score. Chronic illness had negative impacts on the experience of care coordination for patients and respect for patient preferences. Of the seven dimensions of the PPE-15, the scores for emotional support and respect for patient preferences were the lowest in both groups, and the item "want to be more involved in decisions made about care and treatment" scored the lowest among all items., Conclusions: Hospital managers and staff members should pay more attention to the emotional support and preferences of patients. For patients with chronic diseases, the standardization of medical care and patient participation in the medical process should be strengthened. Hospitals should also subdivide patient groups, ascertain the demands and expectations of patients, and carry out targeted evaluation and intervention measures.

Ammonia-oxidizing archaea (AOA) and bacteria (AOB) are the crucial players in nitrogen cycle. Both AOA and AOB were examined along a gradient of human activity in a coastal ecosystem from intertidal zone, grassland, and Casuarina equisetifolia forest to farmland. Results showed that the farmland soils had noticeably higher nitrate-N, available P than soils in the other three sites. Generally, AOA and AOB community structures varied across sites. The farmland mainly had Nitrosotalea-like AOA, intertidal zone was dominated by Nitrosopumilus AOA, while grassland and C. equisetifolia forest primarily harbored Nitrososphaera-like AOA. The farmland and C. equisetifolia forest owned Nitrosospira-like AOB, intertidal zone possessed Nitrosomonas-like AOB, and no AOB was detected in the grassland. AOA abundance was significantly greater than AOB in this coastal ecosystem (p < 0.05, n = 8). AOB diversity and abundance in the farmland were significantly higher than those in the other three sites (p < 0.05, n = 2). The biodiversity and abundance of AOA were not significantly correlated with any soil property (p < 0.05, n = 8). However, the diversity of AOB was significantly correlated with pH, available P and total P (p < 0.05, n = 6). The abundance of AOB was significantly correlated with pH, nitrite, available N, available P and total P (p < 0.05, n = 6). This study suggested that the community structures of AOA and AOB vary in the different parts in the bio-engineered coastal ecosystem and agricultural activity appears to influence these nitrifiers., (© 2021. Springer Science+Business Media, LLC, part of Springer Nature.)

Background : Although the inactivated SARS-CoV-2 vaccine (CoronaVac) has undergone preclinical tests and clinical trials evaluating its efficacy and safety, few data have been reported in the post-licensure real-world setting. We aimed to assess the safety of the vaccine among healthcare workers. Methods : A self-administered online survey on monitoring adverse reactions post vaccination was conducted among the staff who worked at and were vaccinated in a tertiary hospital in Taizhou, China, from February 24 to 7 March 2021. A total of 1526 subjects responded to the questionnaire when they received an e-mail or an e-poster on WeChat. Results : The incidences of overall adverse reactions after the first and second injections were 15.6% (238/1526) and 14.6% (204/1397), respectively. The most common adverse reaction was localized pain at the injection site, with an incidence of 9.6% and 10.7% after each dose, accounting for 61.8% and 73.0% of adverse reactions, respectively. Fatigue, muscle pain, and headache were the most common systemic adverse reactions. Conclusions : These findings implied that the inactivated CoronaVac vaccine has an acceptable safety profile among healthcare workers due to the low incidence of self-reported adverse reactions. This may boost public confidence in nationwide mass vaccination campaigns.

Background & Aims: Nucleotides with add-on interferon treatment (NUC-IFN) provide significantly higher rates of hepatitis B surface antigen (HBsAg) loss in patients with chronic hepatitis B (CHB). This study aimed to investigate the sustainability of HBsAg loss and the prevention of clinical relapse., Methods: Patients with CHB who achieved HBsAg loss and HBV DNA levels <20 IU/ml after IFN or NUC-IFN therapy were enrolled and followed up for 96 weeks. The primary outcome was HBsAg negativity without viremia at week 96. Secondary outcomes included virological or clinical relapse and predictors of relapse., Results: 420 patients were included in intention-to-treat analysis with 290 and 130 in the IFN and NUC-IFN groups respectively. At week 96, the intention-to-treat analysis revealed similar outcomes between groups, including HBsAg seroreversion (24.83% vs. 23.08%, P = .70), viremia (16.90% vs 13.08%, P = .32) and clinical relapse (11.38% vs 10.00%, P = .68); the per-protocol analyses also showed HBsAg seroreversion, viremia and clinical relapse in IFN group (15.50%, 6.59% and 0.39%) did not differ from those in NUC-IFN group (15.25%, 4.24% and 0.85%, P > .05). These outcomes were similar between patients who received entecavir and those who received telbivudine/lamivudine/adefovir before the combination therapy. In NUC-IFN-treated patients, fibrosis regression was observed at week 96. Baseline HBsAb negativity was independent predictors of HBsAg sero-reversion and recurrence of viremia in IFN treated group., Conclusion: NUC-IFN and IFN therapies are equally effective in achieving sustained functional cure and fibrosis regression. (ClinicalTrials.gov, Number NCT02336399)., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

We performed this study to investigate the diagnostic performance of prostate-specific antigen density (PSAD) in a multicenter cohort of the Chinese Prostate Cancer Consortium. Outpatients with prostate-specific antigen (PSA) levels ≥4.0 ng ml -1 regardless of digital rectal examination (DRE) results or PSA levels <4.0 ng ml -1 and abnormal DRE results were included from 18 large referral hospitals in China. The diagnostic performance of PSAD and the sensitivity and specificity for the diagnosis of prostate cancer (PCa) and high-grade prostate cancer (HGPCa) at different cutoff values were evaluated. A total of 5220 patients were included in the study, and 2014 (38.6%) of them were diagnosed with PCa. In patients with PSA levels ranging from 4.0 to 10.0 ng ml -1 , PSAD was associated with PCa and HGPCa in both univariate (odds ratio [OR] = 45.15, P < 0.0001 and OR = 25.38, P < 0.0001, respectively) and multivariate analyses (OR = 52.55, P < 0.0001 and OR = 26.05, P < 0.0001, respectively). The areas under the receiver operating characteristic curves (AUCs) of PSAD in predicting PCa and HGPCa were 0.627 and 0.630, respectively. With the PSAD cutoff of 0.10 ng ml -2 , we obtained a sensitivity of 88.7% for PCa, and nearly all (89.9%) HGPCa cases could be detected and biopsies could be avoided in 20.2% of the patients (359/1776 cases). Among these patients who avoided biopsies, only 30 cases had HGPCa. We recommend 0.10 ng ml -2 as the proper cutoff value of PSAD, which will obtain a sensitivity of nearly 90% for both PCa and HGPCa. The results of this study should be validated in prospective, population-based multicenter studies., Competing Interests: None

Background: Pemphigus is a rare but life-threatening autoimmune skin disease characterized by blistering on skin and/or mucous membranes. The physiological process of blister formation involves IgG antibodies against the desmogleins (Dsgs) and desmocollins (Dscs). Additional autoAbs have also been suggested to mediate the disease heterogeneity, such as anti-thyroid peroxidase (anti-TPO) and antithyroglobulin (anti-Tg) antibodies, the essential culprits of the immune system in autoimmune thyroid diseases., Purpose: To investigate the levels and antibody positivity of anti-TPO and anti-Tg antibodies in pemphigus patients., Methods: Antibody positivity and levels of anti-TPO and anti-Tg antibodies in pemphigus patients as compared to healthy controls were examined. A meta-analysis was conducted by reviewing six similar studies., Results: 98 Chinese pemphigus patients and 65 healthy controls were enrolled in the study. Our meta-analysis revealed a significant correlation between increased presence of positive anti-TPO and anti-Tg antibodies and pemphigus, particularly for pemphigus vulgaris (PV). Such correlation was also observed in our own hospitalized PV patients, but not in pemphigus foliaceus (PF) patients. In addition, the status of anti-TPO and anti-Tg antibodies were also compared between females and males within PV patients, PF patients or controls, as well as compared for females or males between pemphigus patients and controls. In the analysis of T cell counts, we found abnormal low CD3 + T cell counts (< 690 n/µl) were only detected in patients whose thyroid antibody levels were less than 20 IU/ml., Conclusion: Pemphigus patients showed higher levels and antibody positivity of anti-TPO and anti-Tg antibodies than healthy controls. Further investigations are needed to identify the pathogenic functions of these antibodies in pemphigus, as well as to identify the potential shared susceptibility genes., 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 © 2021 Wang, Yang, Hu, Zhang, Cai, Guo, Xiao, Chen, Gao and Qiao.)

In February and December of 2019, two large-scale outbreaks of diarrhea were observed in the same swine farm with 3,000 sows in Shanghai, China. We successfully isolated two porcine epidemic diarrhea virus (PEDV) isolates (strains shxx1902 and shxx1912 in February and December, respectively) from clinical samples in this farm using suspension Vero cells. A third PEDV strain (SH1302) tested positive in another farm of Shanghai, China, in 2013 and was also isolated using suspension Vero cells. The three isolates were better adapted to growth in adherent Vero cells through serial passages in the suspension Vero cells. The three isolated strains were detected positive by an immunofluorescence assay (IFA) and observed through electron microscopy. Phylogenetic analysis of the complete genomic sequence demonstrated that shxx1902 (the 5th passage) and shxx1912 (the 5th passage) clustered with a new GII subgroup (GII-c), which consisted of SINDEL strains from America (e.g., OH851), and their S gene belonged to GII-a. Both strains(the 35th passage) have incurred dramatic changes in their genomes compared with the 5th passage. The 5th and 35th passages of SH1302 belonged to the GI-b genotype. The anti-N protein antibody titer of the strain shxx1902 was elevated to the same level as the vaccine strain (CV777) in mice. The use of the suspension Vero cells to isolate and propagate PEDV provides an effective approach for studies of the epidemiological characteristics and vaccine development of this virus., (Copyright © 2021 American Society for Microbiology.)

Liriomyza spp. (Diptera: Agromyzidae) represent a group of economically-significant highly polyphagous pests of plants grown in field and greenhouse conditions. Liriomyza spp. share similar biological and morphological characteristics, and complex interspecific interactions have been documented among these species in various geographical regions. Where the displacement of one of these species by the other has been studied, no unique mechanisms have been identified as causing it. The impact of competitive factors (such as, insecticide tolerance, thermotolerance, and adaptability to cropping systems) may be unique to specific geographic regions of Liriomyza spp., but more research is needed to confirm these hypotheses. In this study, RNA-seq was used to determine the transcriptomes of three closely-related leafminers, e.g. L. sativae, L. trifolii, and L. huidobrensis. Over 20 Gb of clean reads were generated and assembled into unique transcriptomes, and 38,747 unigenes were annotated in different databases. In pairwise comparisons, L. trifolii and L. sativae had more up-regulated genes than L. huidobrensis. With respect to common differentially-expressed genes (Co-DEGs), the three leafminers exhibited distinct groups of highly-expressed gene clusters. When genes related to competitive factors were compared, expression patterns in L. trifolii and L. sativae were more closely related to each other than to L. huidobrensis. The data suggest that DEGs involved in competitive factors may play a key role in competition and displacement of leafminers. The divergent genes identified in this study will be valuable in revealing possible mechanisms of invasion, displacement and interspecific competition in Liriomyza spp., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Acute urinary retention (AUR) is one of the progressive manifestations of benign prostatic hyperplasia (BPH). This cross-sectional study was conducted to analyse the possible association between serum interleukin 8 (sIL-8) and AUR in BPH patients to provide evidence of sIL-8 as a potential biomarker for the prediction of AUR. The relationship between sIL-8 levels and AUR was evaluated by logistic regressions in 245 ageing Chinese men with BPH. The discriminant validity of sIL-8 and the optimal cut-off value were determined by a receiver operating characteristic curve. The levels of sIL-8 increased significantly in BPH patients with AUR (p < 0.001). The sIL-8 concentration was positively correlated with AUR in BPH patients (OR = 1.024, 95% CI: 1.009-1.040, p = 0.002). The correlation with AUR in the group with a high sIL-8 level (≥43.05 pg/ml) was significantly enhanced (OR = 8.853, 95% CI: 2.433-32.205, p = 0.001). The sIL-8 level correlated with AUR in Chinese BPH patients independently. As a possible predictor, sIL-8 may contribute to the screening of high-risk populations for AUR to create opportunities for the early effective interventions to improve prognosis and enhance the quality of life. Prospective studies are needed to support all these results., (© 2020 Wiley-VCH GmbH.)

To explore the clinical characteristics and outcomes in Chinese patients with type I cryoglobulinemia (CG), we retrospectively analyzed the clinical data, management, and outcomes of 45 patients diagnosed with type I CG in our hospital from January 2015 to March 2019. In our study, all type I CGs were secondary to hematologic diseases, and monoclonal gammopathy of unknown significance was the most common primary disease, accounting for 48.9% (n = 22). Additionally, B cell non-Hodgkin lymphoma, Waldenström's macroglobulinemia, and multiple myeloma accounted for 24.4% (n = 11), 20.0% (n = 9), and 6.7% (n = 3), respectively. In patients with type I CG, skin damage was the most common symptom, presenting in 57.8% of the patients, followed by peripheral neuropathy (22.2%) and renal involvement (15.6%). Treatment was initiated in 29 patients (64.4%), and the most common choice was a rituximab-based regimen in 13 patients (44.8%), followed by bortezomib-based regimen in 11 patients (37.9%). Clinical symptoms were significantly improved after treatment, and the clinical remission rate was 86.2%, including 34.5% of complete clinical remission, while the laboratory response rate was 88.9%, including 33.3% of complete response and 55.6% of partial response. The expected 1-year overall survival was 97.8%. In conclusion, for patients with multisystemic involvement, such as skin damage, kidney damage, or peripheral neuropathy, the diagnosis of type I CG should be considered, and the underlying disease needs to be explored. Symptoms and primary diseases should be taken into consideration before choosing initial management.

Objectives: Pandemic COVID-19 has become a seriously public health priority worldwide. Comprehensive strategies including travel restrictions and mask-wearing have been implemented to mitigate the virus circulation. However, detail information on community transmission is unavailable yet., Methods: From January 23 to March 1, 2020, 127 patients (median age: 46 years; range: 11-80) with 71 male and 56 female, were confirmed to be infected with the SARS-CoV-2 in Taizhou, Zhejiang, China. Epidemiological trajectory and clinical features of these COVID-19 cases were retrospectively retrieved from electronic medical records and valid individual questionnaire., Results: The disease onset was between January 9 to February 14, 2020. Among them, 64 patients are local residents, and 63 patients were back home from Wuhan from January 10 to 24, 2020 before travel restriction. 197 local residents had definite close-contact with 41 pre-symptomatic patients back from Wuhan. 123 and 74 of them contact with mask-wearing or with no mask-wearing pre-symptomatic patients back from Wuhan, respectively. Data showed that incidence of COVID-19 was significantly higher for local residents close-contact with no mask-wearing Wuhan returned pre-symptomatic patients (19.0% vs. 8.1%, p < 0.001). Among 57 close-contact individuals, 21 sequential local COVID-19 patients originated from a pre-symptomatic Wuhan returned couple, indicated dense gathering in congested spaces is a high risk for SARS-CoV-2 transmission., Conclusions: Our findings provided valuable details of pre-symptomatic patient mask-wearing and restriction of mass gathering in congested spaces particularly, are important interventions to mitigate the SARS-CoV-2 transmission., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

An avian-origin canine influenza virus (CIV) has recently emerged in dogs and is spreading in China. Given that humans have frequent contact with dogs, this has prompted an increased emphasis on biosafety. In this study, we collected 693 nasal swab samples and 800 blood samples from stray dogs in animal shelters to survey canine influenza epidemiology and characterize the evolution of CIV H3N2 in Shanghai. We tested samples for canine influenza antibodies and canine influenza RNA in January-May, 2019, and the results showed that the positive rate was 17.62% by ELISA, 15.75% by microneutralization (MN) assay, and 18.51% by real time RT-PCR, respectively. We also performed phylogenetic and genomic analysis on six H3N2 CIV isolates. The H3N2 viruses which prevailed in Shanghai originated from Beijing and Jiangsu isolates. Phylogenetic analysis showed that the sequences of CIV isolates have multiple amino acid antigenic drifts, deletions, and substitutions. The time of the most recent common ancestor (TMRCA) of HA and NA was 2004 and 2005, respectively. Notably, the substitution, 146S, in hemagglutinin and the deletion in the neuraminidase (NA) stalk region we found in this study warrant attention because they have frequently been identified in human influenza viruses. The potential adaptation of this CIV H3N2 clade to mammals and its public health threat should be further evaluated.

Unplanned surgery cancellation (USC) was an important quality management issue in the course of medical care for surgical patients, which caused inappropriate use of hospital resources and had negative impacts on quality and safety. This study used Lean Six Sigma to reduce the incidence of USC. Following the Lean Six Sigma DMAIC (Define, Measure, Analyze, Improve, and Control) process, the main factors influencing the USC were identified, such as the time of informing patient admission, the time of submitting operation notice, and the management of test report follow-up. A series of measures were implemented including improving the health education content of virtual bed patients, standardizing the way of communication between the Admission Management Center and the patients, improving the timing of anesthesia evaluation, optimizing the process of operation notice with an information system, and implementing the regulations of virtual bed management. The incidence of USC reduced from 10.21% in Jan. 2016 to 3.8% in Dec. 2016, and the Z -score increased from 1.25 to 1.68, which improved patient safety and demonstrated that Lean Six Sigma was an effective method to solve cross-department issues in hospital.

In shallow eutrophic lakes, benthic bioclastic deposits accumulate abundant organic carbon derived from macrophyte detritus. Taking the typical macrophyte-dominated Xukou Bay as the study area, field investigations were performed using sediment cores to evaluate benthic phytodetritus accumulation. Specifically, nutrient contents, TOC/TN ratios, pigmentation, and biodegradable compounds were measured as descriptive parameters. The results show that the benthic bioclastic deposit had accumulated abundant pigments, nutrients, and biodegradable compounds derived from macrophytes detritus. These were mainly localized in the top 15 cm of sediments. Nitrogen loading in the sediments was significantly higher than phosphorous loading, with a distinct spatial difference; the total nitrogen content ranged from 127.2-2092.8 mg·kg -1 and total phosphorous content ranged from 222.1-528.4 mg·kg -1 . Moreover, nitrogen loading (1033.6 mg·kg -1 ) in the vegetated zones were higher than in the unvegetated zones (325.2 mg·kg -1 ). In addition, carbohydrate (3.7 mg·g -1 ) was the dominant component of sedimentary bioclastic material, with lipids (2.8 mg·g -1 ) being the second most abundant of the biodegradable compounds. The major sources of nutrients and biodegradable compounds in the sediment were massive aggregates of macrophyte detritus. The pigment, nutrient, and biodegradable compound contents in the vegetated zones were significantly higher than in unvegetated zones ( P <0.01). The benthic eutrophic state showed a trend from mesotrophic to eutrophic in Xukou Bay, which should be given more attention in the future management of freshwater lake ecosystems.

Background: The treatment failure for oral squamous cell carcinoma (SCC) frequently takes the form of local and regional recurrences. We investigated the role of lingual lymph nodes (LLNs) in the recurrence of SCC of the tongue and the floor of the mouth., Methods: A total of 111 patients with SCC of the tongue and the floor of the mouth who received treatment between 2012 and 2017 were included in this study. The patients with lingual lymph nodes that were confirmed to be metastasis on pathological examination were classified into the LNN group. The demographic and clinical data differences between the No-LLN group and the LLN group were compared. Statistical analyses were performed using the Pearson chi-square test RESULTS: The total incidence of LLNs was 17.12% (19/111) and 5 patients (4.5%) demonstrated LLN metastases. All the patients with LLN metastases had a neck lymph node status of N2 classification. The incidence and metastasis of the LLNs were associated with pathological classifications of SCC of the tongue and the floor of the mouth., Conclusions: LLNs are rare in patients with SCC of the tongue and the floor of the mouth, and they would be ready to be omitted. The dissection of these LLNs would be of benefit to those patients with advanced pathological grade., (© 2018 Wiley Periodicals, Inc.)

Natural selection is thought to be a driving force that can cause the evolution of reproductive isolation. The genus Aquilegia is a model system to address how natural selection promotes the process of speciation. Morphological differences between A. oxysepala, A. japonica and their hybrids were quantified for two vegetative (plant height and leaf area) and three floral morphological (sepal area, corolla length and diameter) traits. We also evaluated the genetic variability of the two species and their hybrids based on two chloroplast (1225 bp), four nuclear (5811 bp) genes and 15 microsatellites. Our results revealed that differentiation of A. japonica and A. oxysepala at the ecological and morphological levels also involved divergence at the genetic level. In addition, the analysis of nucleotide variation patterns showed that the two species possessed numerous fixation sites at nuclear genes gAA4, gA7 and gAA12. Furthermore, we found that all of the phenotypic hybrids also showed a genetically admixed ancestry. These findings suggest that natural selection has indeed facilitated the formation of distinct genetic variation patterns in the two Aquilegia species and habitat adaptation has been driving the ecologically based evolution of reproductive isolation., (© 2014 The Authors. New Phytologist © 2014 New Phytologist Trust.)

Insulin-like growth factor-I (IGF-I) is a mitogenic and anti-apoptotic factor. Serum IGF-I concentration is related to some cancer risk and tumor progression. The aim of this research was to study the association of preoperative serum IGF-I concentration with clinicopathological parameters and prognosis of non-small cell lung cancer (NSCLC). Preoperative serum IGF-I concentration was measured in 80 consecutive patients with NSCLC who underwent radical lung cancer resection, and 45 patients with benign pulmonary lesion (BPL) by using enzyme linked immunosorbent assay (ELISA). The results showed that the serum IGF-I concentration was elevated and correlated with clinicopathological parameters and overall survival (OS) in NSCLC patients. Serum IGF-I concentration was significantly higher in patients with NSCLC than in those with BPL. The IGF-I concentrations were significantly higher in NSCLC patients with ≥T2, N1-3, and in IIIA-IV but not in those with

Compiling 198 pieces of literature related to TCM diagnostic method in 210 kinds of medical periodicals during the republican period of China, they can be divided into three categories by different characteristics: theoretical research, popular common sense, works and lectures etc. Taking a look at the contents of the articles, there were 74 pieces of comprehensive literature (37%) 20 pieces of inspection literatures (10%) 6 pieces of auscultation and olefaction literature (3%) 11 pieces of inquiry literature (6%) 87 pieces of palpation literature (44%) Pulse diagnosis is a traditional distinguishing diagnostic method which involves much research. The literature on pulse diagnosis was in the majority The articles about theoretical research mostly explained the TCM principles with western medical knowledge and advocated diagnosing the disease with western medical apparatus, which was the characteristic of that time.

Based on field survey, the effects of artificial Ulmus pumila forest on the species diversity of temperate grassland in Siziwang Banner of Inner Mongolia were studied. The results showed that U. pumila forest had obvious effects on the species diversity of grassland. With increasing density of U. pumila, the Patrick's richness, Pielou's evenness and Shannon-Wiener index of grass species under the forest had a decreasing trend, and were higher nearby the forest than far from the forest. The habitat inside the forest was favorable to Silene jenisseensis, while that nearby the forest was favorable to Heteropappus altaicus, Pocockia ruthenia, Potentilla bifurca, Leymus secalinus and Cleistogenes squarrosa, suggesting that to blindly exclude forestation on grassland could be less scientific, while properly afforesting U. pumila on the sides with relatively abundant soil moisture should be available to the conservation of plant diversity in temperate grassland regions.

Dissolved organic matter (DOM) and its potential to form disinfection by-products (DBPs) during water treatment are of great public health concern. Understanding the seasonal changes in DOM composition and their reactivity in DBP formation could lead to a better treatment of drinking water and a more consistent water quality. DOM from the East-Lake, a reservoir in the south-China, was fractionated and characterized by XAD resin adsorption (RA) and ultrafiltration (UF) techniques during different seasons within a year. The properties of chemical fractions (isolated by RA) appeared more stable than those of physical fractions (separated by UF) throughout the sampling period. The relative contribution of each chemical fraction to the total dissolved organic carbon (DOC), UV(254) absorbance and trihalomethane formation potential (THMFP) remained relatively constant across the sampling period. However, the physical (molecular weight) fractions of the DOM exhibited large seasonal changes in UV(254) and THMFP. Compared to the parameter of DOC, the THMFP and specific THMFP (STHMFP) of either chemical or physical fractions were more variable. In terms of DOC concentration, the hydrophobic acids (HoA) and hydrophilic matter (HiM) dominated in the DOM in most of the seasons; while the components with molecular weight of 10-30 kDa and less than 1 kDa were the predominant physical fractions.

Systematic studies on enhancing normal treatment processes were performed in order to remove aquatic organic matter economically and efficiently. Enhanced coagulation and polymer coagulant-aid coagulation were compared through jar tests and on-spot experiment (Pilot-scale and full-scale experiment). Fractionations of raw water and water after treatments of above two strategies were performed based on selective adsorption of resin DAX-8. It was found that matters causing UV absorbance at 254 nm were well removed by above two treatments; removals of which could be achieved 90% or more. Hydrophobic bases and acids fractions were more removed under enhanced conditions with removals 66% and 35% respectively; while hydrophilic fraction could be better removed by about 45% using polymer coagulant aids. But the whole removals of the two strategies were almost equal.

Ozone plays an important role as a disinfectant and oxidant in potable water treatment practice and is increasingly being used as a pre-oxidant before coagulation. The purpose of this study is to obtain insight into the mechanisms that are operative in pre-ozonized coagulation. Effects ofpre-ozonation on organic matter removal during coagulation with IPF-PACl were investigated by using PDA (photometric disperse analysis), apparent molecular weight distribution and chemical fractionation. The dynamic formation of flocs during coagulation process was detected. Changes of aquatic organic matter (AOM) structure resulted from the influence of pre-ozonation were evaluated. Results show that dosage of O3 and characteristics of AOM are two of the major factors influencing the performance of O3 on coagulation. No significant coagulation-aid effect of O3 was observed for all experiments using either AlCl3 or PACl. On the contrary, with the application of pre-ozonation, the coagulation efficiency of AlCl3 was significantly deteriorated, reflected by the retardation of floc formation, and the removal decreases of turbidity, DOC, and UV254. However, if PACl was used instead of AlCl3, the adverse effects of pre-ozonation were mitigated obviously, particularly when the O3 dosage was less than 0.69 (mg O3/mg TOC). The difference between removals of UV254 and DOC indicated that pre-ozonation greatly changed the molecular structure of AOM, but its capability of mineralization was not remarkable. Only 5% or so DOC was removed by pre-ozonation at 0.6-0.8 mg/L alone. Fractionation results showed that the organic products of pre-ozonation exhibited lower molecular weight and more hydrophilicity, which impaired the removal of DOC in the following coagulation process.

Systematic investigation on enhancing removal of natural organic matter (NOM) using inorganic polymer flocculant (IPF), polyaluminum chloride (PACl) and polyacrylamide (PAM) was performed in a typical south-China source water. Enhanced coagulation and applying polymer flocculant-aid were compared through jar tests and pilot tests. Raw water and settled water were characterized and fractionated by resin adsorption. The results show that DOC composes major part of TOC. The DOC distribution keeps relatively stable all around the year with typical high amounts of the hydrophilic matter around 50%. The distribution between HoB, HoA and HoN varies and undergoes fluctuation with the year round. During the summer season, the HoN becomes gradually the major part in hydrophobic parts. PACI with the species being tailor-made shows little pH effect during coagulation. The enhanced coagulation dosage for PACI could be 4.5 mg/L for the typical source water. The highest TOC removal achieved 31%. To be economically, 3 mg/L dose is the optimum dosage. Although hydrophilic fractions of NOM of both treatment strategies are removed about 30%, NOM causing UV254. absorbance were well removed(about 90%). Hydrophobic bases and acids fractions are much more removed under enhanced conditions. The hydrophilic fraction could be better removed using PAM, the polymer coagulant aid.

Typical sediments from Taihu Lake, a meso-to-hypereutrophic lake, were collected and examined on the basis of P-fractionation by sequential extraction scheme. Sedimentary inorganic phosphorus were fractioned into four forms and the rank order according to the mean concentration of P-fractions in Taihu Lake was NaOH-P > BD-P > HCI-P > NH4Cl-P. The concentrations of BD-P were linearly correlated with the content of active Fe (R2 = 0.96). Also, the linear relationship between the sum of BD-P and NaOH-P and the sum of active Fe and active Al content was observed within the six sediments investigated (R2 = 0.96). Moreover, the bio-available phosphorus (BAP) content was estimated by the sum of NH4 Cl-P, BD-P, and NaOH-P, viz. BAP = NH4 Cl-P + NaOH-P + BD-P. In Taihu Lake, the BAP contents are ranging from 0.10 mg/g dw to 1.25 mg/g dw, and average 0.40 mg/g dw for all sediment samples. The relative contributions of BAP to total sedimentary phosphorus (TP) and inorganic sedimentary phosphorus (IP) range from 18.67% to 50.79% (33.61% on average) and from 52.82% to 82.09% (67.81% on average), respectively.

The overall objective of this research is to investigate competitive adsorption between atrazine (AT) and dye compounds in the natural aquatic sediment. The sorbent was sediment obtained from Guanting Reservoir (Beijing, China), which contained 25% sand, 67% silt, 8% clay, and 2.06% organic carbon. Batch adsorption experiments were conducted at various Ca2+ concentration, pH levels, temperatures, and introducing conditions of dye compounds. Compared with the dye-free system, both of dyes including Congo red (CR) and methylene blue (MB) reduce the adsorption of atrazine over the range of dye concentrations examined, with the adsorption percentage of atrazine decreasing about 14-30%. And the competition between AT and MB is much stronger than that between AT and CR. The adsorption experimental data points have been fitted to the Freundlich equation in order to calculate the adsorption capacities (Kf) of the samples; Kf values range from 1.669 micromol/kg for the MB-AT sample up to 3.738 micromol/kg for the AT-alone sample. By contrast with the single-solute adsorption isotherm, both simultaneous adsorption and dye preloading inhibit the adsorption of atrazine. As for AT preloading, the impacts of CR and MB are different on the desorption of atrazine. As compared to the atrazine desorption without dye compounds, a certain amounts of atrazine molecules are replaced by MB in AT preloading system, while in CR solution AT is adsorbed strongly on the sediment and could not be replaced by CR. The result suggests that micropore constriction by CR reduces the desorption rate of atrazine., (Copyright 2004 Elsevier Ltd.)

Water samples collected from early March 2001 to the end of April 2002 at the branch of Pearl River around the Guangzhou City were analyzed for its micro-polluted characteristics. The coagulation behavior of polyaluminum chlorides (PACls) was then examined focusing on the effect of primary water quality and speciation distribution. The results showed that PACls exhibit better coagulation efficiency than alum in accordance with the different speciation. The turbidity removal property of PACls is evidently better than alum at low dosage. While in neutral zone (about 6.5-7.5), the turbidity removal of PACls decreases owing to the restabilization of particles at higher dosage. The organic matters in raw water exhibit marked influence on coagulation. In acidic zone, organic matters complex with polymer species and promote the formation of flocs. With an increase in pH, the complexation of organics with polymer species gradually decreases, and the removal of organics mainly depends on adsorption. The effect is evidently improved with the raise of B value.