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The affordances of social media, have significantly transformed how patients seek and process health information online, including those with chronic diseases like irritable bowel disease (IBD). Few studies have explored how information processing may impact symptom management. Guided by social cognitive theory, this study investigates how Chinese and U.S. patients ( N  = 838) process health information in a cross-cultural setting and the impact on symptom management. It finds that efficient information processing improves treatment understanding and symptom management for IBD patients, regardless of their cultural backgrounds. It also reveals a U-shaped quadratic relationship between IBD severity and emotional and peer support, indicating varying support needs at different IBD stages. These findings provide valuable insights for healthcare professionals, patients, and caregivers in designing interventions for chronic diseases. The study underscores the importance of recognizing the dynamics of health information processing and the need for a more nuanced approach to patient support and care.

The impact of external factors on the human gut microbiota and how gut microbes contribute to human health is an intriguing question. Here, the gut microbiome of 3,224 individuals (496 with serum metabolome) with 109 variables is studied. Multiple analyses reveal that geographic factors explain the greatest variance of the gut microbiome and the similarity of individuals' gut microbiome is negatively correlated with their geographic distance. Main food components are the most important factors that mediate the impact of host habitats on the gut microbiome. Diet and gut microbes collaboratively contribute to the variation of serum metabolites, and correlate to the increase or decrease of certain clinical indexes. Specifically, systolic blood pressure is lowered by vegetable oil through increasing the abundance of Blautia and reducing the serum level of 1-palmitoyl-2-palmitoleoyl-GPC (16:0/16:1), but it is reduced by fruit intake through increasing the serum level of Blautia improved threonate. Besides, aging-related clinical indexes are also closely correlated with the variation of gut microbes and serum metabolites. In this study, the linkages of geographic locations, diet, the gut microbiome, serum metabolites, and physiological indexes in a Chinese population are characterized. It is proved again that gut microbes and their metabolites are important media for external factors to affect human health., (© 2024 The Authors. Advanced Science published by Wiley‐VCH GmbH.)

Background: The morbidity and mortality of heart disease are increasing in middle-aged and elderly people in China. It is necessary to explore relationships and interactive associations between heart disease and its risk factors in order to prevent heart disease., Objective: To establish a Bayesian network model of heart disease and its influencing factors in middle-aged and elderly people in China, and explore the applicability of the elite-based structure learner using genetic algorithm based on ensemble learning (EN-ESL-GA) algorithm in etiology analysis and disease prediction., Methods: Based on the 2013 national tracking survey data from China Health and Retirement Longitudinal Study (CHARLS) database, EN-ESL-GA algorithm was used to learn the Bayesian network structure. Then we input the data and the learned network structure into the Netica software for parameter learning and inference analysis., Results: The Bayesian network model based on the EN-ESL-GAalgorithm can effectively excavate the complex network relationships and interactive associations between heart disease and its risk factors in middle-aged and elderly people in China., Conclusions: The Bayesian network model based on the EN-ESL-GA algorithm has good applicability and application prospect in the prediction of diseases prevalence risk.

Objectives: To evaluate the evolution and challenges of China's post-acute care (PAC) system over the past 20 years and suggest actionable policy recommendations for its improvement., Design: A retrospective review of policies and initiatives aimed at PAC system development, analyzed alongside unsolved challenges in light of global PAC practices, informed by literature reviews and collaborative discussion., Setting and Participants: PAC in China involves diverse settings such as general hospitals, inpatient rehabilitation centers, skilled nursing facilities, community health centers, and homes. The patients are mainly those discharged from acute hospitals with functional impairment and in need of continuous care., Method: An extensive search of government policy documents, statistical sources, peer-reviewed studies, and the gray literature. The research team conducted literature reviews and discussions regularly to shape the findings., Results: China has strengthened its PAC system through improved rehabilitation and nursing infrastructure, establishment of tiered rehabilitation networks, and adoption of innovative payment methods. However, challenges persist, including a lack of clinical consensus, resource constraints in PAC facilities and among professionals, the need for integrated care coordination, and the unification of PAC assessment tools and payment mechanisms., Conclusions and Implications: Although China has made substantial progress in its PAC system over 2 decades, continued efforts are needed to address its lingering challenges. Elevating awareness of PAC's significance and instituting policy adjustments targeting these challenges are essential for the system's optimization., Competing Interests: Disclosure The authors declare no conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

As the emergence of digital finance is relatively short, research results on digital finance mainly focus on products, services, coverage, policies, etc. The mechanism and role of digital finance in influencing green development are still lacking attention. In the above context, this paper used spatial analysis methods to describe spatiotemporal characteristics in detail, and empirically tested the mechanism and path of digital finance affecting green development through spatial econometric models and intermediary models. The results showed that: (1) During the study period, digital finance and green development have been improved to varying degrees, but the inter-provincial differences are still obvious. (2) The spatial trends of digital finance and green development are similar, and the overall performance is "high in the east, low in the west, high in the south, and low in the north". (3) The empirical tests found that digital finance is an effective force to reduce energy consumption per unit of GDP and improve the level of green development. It validates Hypothesis 1. Meanwhile, the Heterogeneity effect is noteworthy due to different regions, types, and levels. (4) The promotion of green development by digital finance is mainly concentrated in the local region and has not yet shown a significant green spillover effect for surrounding areas. It validates Hypothesis 2. (5) Energy structure, industrial upgrading, and technological progress are three paths for digital finance affecting green development. Hypothesis 3 is verified. Finally, the innovation of this paper lies in the design of the research framework, diversity of research methods, and policy implications. The main contribution is to enrich and expand the environmental finance theory and provide detailed empirical evidence. In addition, we put forward effective measures and suggestions including local governments, financial institutions, and enterprises based on the empirical results. Local governments should pay attention to policy implementation and operation effects, financial institutions constantly need to strengthen the supply of advanced digital financial products and services, and enterprises should attach importance to the use of digital financial tools to achieve green and low-carbon development in the future.

Aims: To evaluate the level of patient satisfaction with nursing care in China's major tertiary hospitals, and to explore patient and hospital level factors associated with patient satisfaction, in order to provide policy implications for the evaluation and improvement of nursing care, toward a patient-centered healthcare system., Background: Patient satisfaction with nursing care has been designated as a key measure of the quality of nursing care and is one of the main focuses of the current healthcare improvement campaign in China., Methods: We participated in the 2021 China National Patient Survey and designed and administered a survey instrument with five domains, to evaluate patient satisfaction with nursing care among 24,971 inpatients from 143 tertiary hospitals across 31 provinces in China. Descriptive analysis and binary logistic regressions were utilized to assess the level of satisfaction and identify key factors related to nursing satisfaction., Results: The overall satisfaction level is high, but satisfaction with health guidance is relatively low. Patients' sociodemographic characteristics, including age, income, and education, are significantly associated with their satisfaction. Hospital characteristics, such as geographic location, type, and nurse-to-doctor ratio, significantly impact inpatient satisfaction with nursing care. Patients of hospitals in the eastern region, general hospitals, and hospitals with higher nurse-to-doctor ratios are more satisfied with nursing care., Conclusion: More attention should be paid to equitably allocating healthcare resources among different regions, improving the management and competence of non-general hospitals, and strengthening the recruitment and retention of the nursing workforce. Moreover, patient characteristics should be considered when evaluating patient satisfaction across hospitals. Patient and Public Contribution: These findings will help us better understand patients' satisfaction regarding nursing care in Chinese tertiary hospitals and develop targeted interventions, to establish a patient-centered healthcare system.

Background: There are disparities of in-hospital non-clinical nursing care delivered by the nursing assistant under different management models in China. This study aimed to identify the best management model of the nursing assistant from the patient perspective., Methods: This is a cross-sectional study. The inpatient satisfaction with in-hospital non-clinical nursing care delivered by the nursing assistant under different management models was measured and analyzed based on a national inpatient survey Likert the 5-point scale questionnaire conducted in 144 public tertiary hospitals across 31 provinces of China. The study conducted univariate analysis and binary Logistic regression analysis to examine which management model of the nursing assistant and any other key determinants would lead to a positive satisfaction rating by the inpatient who experienced non-clinical nursing care., Findings: The overall satisfaction rating of 6211 inpatients received non-clinical nursing care was 4.73 out of 5, among which 96.09% of the responded inpatients had a positive satisfaction rating. By controlling of the other variables, the likelihood of having a positive inpatient satisfaction rating of non-clinical nursing care delivered by the nursing assistant under the direct commercial company management model, the self-employed model, the commercial company and hospital joint management model accounted for only 14.8%, 20.3% and 35.7% of the nursing assistant under the direct hospital management model., Conclusions: The direct hospital management model of the nursing assistant might be the best one to deliver the non-clinical nursing care that mostly satisfied the inpatient of Chinese public hospitals., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Ustekinumab (UST), a newly-used biologic targeting p40 subunit of IL12 and IL23 in China, exerts a confirmed therapeutic effect on the induction and maintenance therapies for refractory Crohn's disease (CD). Therapeutic drug monitoring based on trough and antibody concentration is of core importance when treating patients who lose response to UST. We aimed to analyze the UST exposure-response relationship in CD treatment in the real-world setting., Methods: We retrospectively enrolled patients with CD who received UST between March 1, 2020 and May 31, 2021, at the inflammatory bowel disease (IBD) center of the Sun Yat-Sun Affiliated Sixth Hospital. Baseline characteristic information, biomarker examination, clinical outcomes determined by the Crohn's disease activity index (CDAI), and endoscopic outcomes evaluated using a simple endoscopic score for Crohn's disease (SES-CD) at week 16/20 were collected. The optimal UST cut-off trough concentration was identified using receiver operating characteristic curve (ROC) analysis., Results: Nineteen eligible patients were included in the study, the mean age was 29.1 ± 9.1 years and the mean disease duration was 5.5 ± 4.7 years. At the initiation of the study, 89.5% of the patients had been exposed to prior biologics, 42.1% had previous CD-related surgeries, and 52.6% had perianal diseases. At week 16/20 after the UST initiation, clinical response, clinical remission, endoscopic response, and endoscopic remission were 89.5%, 84.2%, 42.2%, and 73.7%, respectively. The cut-off optimal trough concentration for UST was 1.12 μg/mL, as determined by the ROC with an area under the curve (AUC) of 0.78, sensitivity of 87.5%, and specificity of 72.7%. Patients with a UST trough concentration > 1.12 μg/mL had a significantly higher rate of endoscopic remission than those without (70.0% vs. 11.1%, P = 0.02)., Conclusions: UST is an effective therapeutic option for refractory CD treatment. A UST trough concentration above 1.12 μg/mL was associated with endoscopic remission at week 16/20 after UST initiation. Trial registration This study was approved and retrospectively registered by the Ethics Committee of Sun Yat-Sen University (2021ZSLYEC-066, March 29, 2021) and the Clinical Trial Registry (NCT04923100, June 10, 2021)., (© 2021. The Author(s).)

In Lake Erhai, water quality was affected by the basin nutrient discharge and climate change. To analyze the relationships between the water quality (total nitrogen [TN], total phosphorus [TP], chemical oxygen demand [CODmn], ammonia [NH 4 ], and trophic level index [TLI]) and basin nutrient discharge (TNd, TPd, and CODd) combined with climate changes (air temperature [AT], precipitation [pre], wind speed [wind], and sunshine hours [SHs]), the generalized additive model (GAM) was employed to explore the nonlinear relationships with their interactions using data sets ranging from 1999 to 2012. Our findings revealed that the water quality in Lake Erhai deteriorated in the early twentieth century, and the basin discharge and AT appeared significant (p < 0.05) rising trends in a long time, while the precipitation decreased significantly (p < 0.05) in the study period. Single-factor GAM results indicated that the basin nutrient discharge was the main explanatory factor for the variations of TN and TP in lake, while precipitation was the main driver for CODmn and NH 4 . Besides, the water quality displayed nonlinear responses to the basin discharge, but all of the water quality variables went up as the emission levels increased in the lower range. The results showed that the water quality deteriorated in the lower rainfall, and TN rose as the AT increases, while TP was elevated accompanied by the ascending SHs there. The GAM interaction results suggested that the increase of AT and TPd had a promoting effect on TP in Lake Erhai. Stricter nutrient management measures should be implemented when the impacts of climate change are taken into account.

Background: The high price is a critical barrier of access to new direct-anting-antiviral (DAA) therapies for hepatitis C for both the patients and the society. Many countries continue to face the challenge of financing such expensive medicines. Such examples include both high-income and middle-income countries. Existing evidence about the efforts of China to address this challenge is limited. To our knowledge, this is the first detailed description of a novel financing model and comprehensive analysis of its impact on patient financial burden of hepatitis C treatment in China., Objective: To examine the evolution of approaches to navigating patients' barriers of access to DAA-based treatment of hepatitis C in Tianjin City, China., Methods: Review of publicly available literature, including published and grey literature. Conduct on-site data extraction and key informant interview. The patient financial burden of hepatitis C treatment was analyzed. The financial burden of hepatitis C patients with different treatment models and health insurance financing models was measured by calculating the number of annual income to cover patient out-of-pocket (OOP) expenditure for the standard treatment course accordingly., Findings: Tianjin is the first area to pilot a capitated provider payment program for the treatment of hepatitis C. Through which, the retirees and employees spend 0.7 and 1.0 months of their salary, and residents spend 5.6-6.8 months of their salary for the treatment, the financial burden of patients were much relieved. By the end of March 2019, the first-year pilot program had 876 hepatitis C patients registered the new insurance coverage and treated in Tianjin., Conclusions: The study showed that the financial barriers of access to new hepatitis C treatment for patients could be unblocked with government commitment and novel financing models. International experiences demonstrated that centralized bulk procurement is a good leverage for price negotiation, primarily when using innovative payment approaches. To replicate the initial success of Tianjin, continued efforts are needed for stronger strategic price negotiation, preferably at central level. The case of Tianjin brings implications to the other areas of China and even other developing countries that government commitment, novel financing model and pooled procurement are critical elements of stronger purchasing power and a better secure of treatment., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2020 The Author(s).)

Context: The annual consumption of opioid analgesics in the U.S. was more than 10 times the world average, whereas that in China was at a moderate level within Asia but much lower than the worldwide average. The opposite situations of opioid use in the U.S. and China revealed totally different problems in the developed versus developing world, that is, overuse versus underuse of opioids., Objectives: This study analyzed the clinical consumption, estimated the needs of pain treatment, and evaluated the adequacy of opioid analgesic consumption in mainland China and its seven regions., Methods: A retrospective analysis of the national and regional consumption of opioid analgesics in mainland China during 2006-2016 was conducted. The adequacy of consumption measure was used to gauge the overall adequacy of opioid analgesic consumption in morphine equivalents (MEs) for the treatment of moderate-to-severe pain in mainland China and compared with international data. Annual per capita consumption was adopted to measure the clinical consumption of opioid analgesics in MEs at a national level and across seven regions of mainland China. Needs of morphine for cancer pain treatment in mainland China and in its seven regions were estimated and compared with the clinical consumption of opioid analgesics in MEs., Results: The adequacy of consumption measure of mainland China ranged from 0.0041 to 0.0088 during 2006-2016, which was less than 1% of that in the reference countries. The poor North East region had only 10.85% of the cancer pain morphine needs fulfilled. The highest fulfillment rate was 36.02% in rich Southern China, which was 25.9% at the national level., Conclusion: The clinical consumption of opioid analgesics for the treatment of moderate-to-severe pain in mainland China was far below the international level. The annual per capita of clinical consumption was lower, and the adequacy of cancer pain treatment was poorer in less developed areas. All these findings call for actions to strengthen pain management., (Copyright © 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: With the wide implementation of the universal two-child policy in China, the number of pregnant women in advanced maternal age (AMA) will increase gradually. We aimed to assess the association between age at menarche (AAM) and insulin resistance (IR) before delivery in AMA. Methods: A total of 80 pregnant women in AMA were consecutively enrolled before delivery in Zhongda hospital. Pregnant women were stratified into early menarche group and late menarche group according to the age of regular menstruation (about 13 years). At delivery, serum glucose and lipid levels were measured. IR was calculated by the method of homeostasis model assessment 2(HOMA2). Results: The fasting blood insulin (17.68(9.72-36.71) and 10.35(7.76-15.10), respectively; p  = .006) and HOMA-IR (2.08(1.18-4.37) and 1.24(0.89-1.78), respectively; p  = .005) were higher in early menarche group than in late menarche group. AAM was inversely associated with HOMA-IR in AMA ( r = -0.27, p  = .014). In the multivariable analysis, AAM in late menarche group was negatively related to the level of HOMA-IR compared to those in early menarche group ( β = -2.275, p ≤.0001). Conclusions: Taken together, our findings suggest that AAM was inversely associated with HOMA-IR in AMA. Furthermore, pregnant women in AMA with early menarche might have higher HOMA-IR levels than those with late menarche. Clinical trial registration: Chinese Clinical Trial Registry (No. ChiCTR-RRC-16008714), retrospectively registered.

Five novel H5N6 influenza viruses, including four highly pathogenic avian influenza viruses and one low pathogenic avian influenza virus, were isolated from migratory birds in Ningxia, China, in November 2017. To understand the genetic origination of the novel H5N6 virus, and the infectivity and pathogenicity of the four highly pathogenic avian influenza viruses in mammals, phylogeographic analyses and infection studies in mice were performed. The phylogenetic and phylogeographic analyses showed that the H5N6 isolates, which are closely related to the viruses from Korea, Japan and the Netherlands, originated from reassortant virus between H5N8 and HxN6 viruses from western Russia. The animal study revealed that the SBD-87 isolate presented moderate virulence in mice, suggesting a potential public risk to humans and a potential threat to public health., (© 2019 Blackwell Verlag GmbH.)

Objective: The prevalence of inflammatory bowel disease (IBD) has been increasing worldwide, and the risk of infection has increased due to the use of immunosuppressive and biologic medications. Some of these infections can be prevented with vaccinations. The aim of this study was to evaluate the vaccination practices of Chinese gastroenterologists for patients with IBD., Methods: Questionnaires based on quick response codes were sent using email and the WeChat platform to gastroenterologists at 20 hospitals in China. The vaccination practices of the gastroenterologists, including vaccinating for hepatitis B, hepatitis A, and varicella, were assessed., Results: Of the 468 gastroenterologists who received the questionnaire, 307 (65.6%) completed it. Of the gastroenterologists who were most concerned about hepatitis B; 83.4% always or frequently asked about an infection history, 53.7% took an immunization history, and 73.6% tested patients for hepatitis B infection. However, few gastroenterologists did so for hepatitis A or varicella. The proportion of patients who were asked about an infection and immunization history and tested for varicella infection was 16.0%, 15.0%, and 9.4%, respectively. Only a few gastroenterologists recommended vaccination for patients without an infection before IBD medical treatment (26.7% for hepatitis A, 45.6% for hepatitis B, and 28% for varicella vaccination)., Conclusion: Vaccination practices for patients with IBD used by Chinese gastroenterologists vary greatly, suggesting that education about immunization is needed., (© 2019 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)

BACKGROUND Although 90 susceptibility loci of Crohn's disease (CD) have been confirmed in the Asian population, susceptibility genes for perianal fistula of CD (pCD) in this population remain unknown. This study explored susceptibility genes for CD and pCD in the Han population from South China. MATERIAL AND METHODS In total, 490 patients diagnosed with CD between July 2012 and June 2016 at the Sixth Affiliated Hospital of Sun Yat-sen University were included and divided into the CD group (n=240) and the pCD group (n=250). The healthy control group was composed of 260 volunteers. Peripheral blood samples were taken, and single nucleotide polymorphism (SNP) locus sequencing was used to screen for susceptibility loci. SNPs were sequenced using matrix-assisted laser desorption ionization time-of-flight mass spectrometry. RESULTS Nine SNPs in TNFSF1 on chromosome 9 were associated with CD. Among them, the rs6478106 locus is a risk locus for CD. The distribution frequency of the T allele of the rs6478106 SNP was significantly different between cases and controls (32.49% versus 18.27%, P<0.001). Rs72553867, located in the IRGM gene on chromosome 5, rs4409764, located in the NKX2-3 gene on chromosome 10, and rs3731772, located in the AOX1 gene on chromosome 2, were susceptibility factors for pCD. Nine SNPs located in TNFSF15 on chromosome 9 were related to CD in Han individuals from Southern China. CONCLUSIONS The rs6478106 T allele is associated with the risk of CD in the investigated population. SNPs rs72553867 (IRGM gene), rs4409764 (NKX2-3 gene), and rs3731772 (AOX1 gene) increase the risk of pCD.

Colorectal cancer is common in China, and studies on the sexuality of patients with an ostomy are limited, particularly information about the relationship between sexual experience and stigma., Purpose: A study was conducted to assess the association between sexual experience and stigma in Chinese patients with an enterostomy., Method: A cross-sectional, descriptive study was conducted between May 2017 and August 2018 among patients with an ostomy at 3 general hospitals. Patients 18 to 70 years old with a history of ostomy surgery more than 1 month prior, who had a regular sexual partner, and were willing to provide informed consent were eligible to participate; persons with mental illness, preoperative sexual dysfunction (SD), or tumor recurrence or metastasis were excluded. Study participants completed a paper-and-pencil questionnaire including demographic (gender, educational level, occupation, geographic place of residence, and monthly family income) and ostomy-related (type of ostomy, time since ostomy surgery, insurance coverage, ostomy-related complications, and sexual guidance) information. Sexual experience was assessed using the 5-item Chinese version of the Arizona Sexual Experience Scale (C-ASEX) (range 5 to 30; scores >19 reflect sexual dysfunction). Stigma (internalization of perceived shameful experience) was assessed using the 24-item, Likert-type Chinese version of the Social Impact Scale (C-SIS) (score range 24 to 96; lower scores indicate less stigma). Quantitative data from the questionnaires were deindentified and entered into statistical software for analysis by 2 researchers. Multivariate regression analysis was used to assess the associations among sexual experience, stigma, and other factors., Results: Of the 240 questionnaires distributed, 187 (77.9%) were completed and included in the final analysis. The average C-ASEX score was 22.77 ± 6.78, and 118 participants (63.1%) had SD. The average C-SIS score was 59.36 ± 11.20, indicating a moderate level of stigma. A significant association was found between sexual experience and stigma (B = 0.101, P = .006). Sexual experience perceptions were determined by sexual guidance needs (B = 3.179, P <.001), geographic area of residence (B = -2.087, P = .014), receipt of sexual guidance (B = -2.989, P = .001), and insurance coverage (B = 1.822, P = .015)., Conclusion: Health care workers should strive to reduce the stigma of having a stoma and offer sexual guidance as a means to improve quality of sexual life. Particular attention should be paid to the sexual well-being of persons living in rural areas and those paying for medical expenses out of pocket.

Background: Currently, WeChat is widely used in disease education for patients with Crohn's disease (CD) in China. It is beneficial for the patients to actively engage in their disease management., Methods: In this study, we examined the source and expectations of disease information for Chinese CD patients, analysing the content of popular WeChat public accounts and their potential association with medication adherence., Results: Between November 24th, 2017 and April 10th, 2018, online questionnaires were sent to CD patients from eight different large urban hospitals in China. In all, 436 patients with CD were surveyed, and 342 patients responded. Patients most frequently visited Baidu (65%), WeChat (61%) and medical websites such as Haodaifu (35%) when searching for IBD-related information. Among ten WeChat IBD public accounts, the China Crohn's and Colitis Foundation (CCCF) (73%), "IBD Academic Officer" (21%) and "IBD in love" (21%) were the most popular. CD patients were most interested in information from the internet about diet and day-to-day health-related living with IBD (83%), an introduction to the disease (80%), and medication advances and side effects (80%). The correlation between the information provided by the top five WeChat public accounts and patients' expectations was low. Additionally, most patients (64%) had greater confidence in overcoming the disease after learning about CD through their internet searches. Medical adherence was also related to internet access and income (p < 0.05)., Conclusions: WeChat has become a major source of information for IBD education in China, but the content of WeChat didn't fully meet patients' expectations. Therefore, future initiatives should aim to provide high-quality information that based on patients' demands.

This study provides a comprehensive description of chondrocranial development before, during and after larval metamorphosis in the tongue sole Cynoglossus semilaevis, a commercially valuable flatfish in China. Samples were collected at regular intervals ranging from 1 to 23 days post hatching (dph). Based on observations of cleared and double-stained specimens and images from sections stained with safranin O-fast green, major morphological events during early development were described. No cartilaginous structure was visible at hatching. From 2 dph onwards, cartilaginous structures such as the trabecular bar and some elements of the mandibular, hyoid and branchial arches appeared. At this time also, cartilaginous structures of the neurocranium started to form. Hypertrophic chondrocytes could be observed in many splanchnocranium elements at 5 dph. The start of ossification was indicated by alizarin red stain visible at 14 dph. At 17 dph, most of the cartilaginous skeleton was ossified. Soon after, the right eye started to migrate and pass through a slit beneath the dorsal-fin base and above the skull. Metamorphosis was complete at 20 dph, at which time the dorsal-fin base cartilage extended onto the anterior region of the head. Meanwhile, extremities of the hyoid and branchial arch elements remained cartilaginous. At 23 dph, endochondral ossification of the splanchnocranium was nearly complete. Unlike previous observations of other Pleuronectiformes, our study indicates that endochondral ossification of C. semilaevis skull cartilage occurs before metamorphosis., (© 2018 The Fisheries Society of the British Isles.)

Background: Chronic rhinosinusitis (CRS) is one of the most common diseases in China. The incidence of CRS in the Chinese urban population is between 5 and 15%. It is difficult to cure with traditional surgery. Endoscopic sinus surgery is the first choice for the treatment of CRS. Compared with developed countries, the development of the clinical pathway of endoscopic sinus surgery in China is still unclear., Objectives: The aim is to explore whether the clinical pathway of endonasal sinus surgery is better than the traditional one in the Chinese population., Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, ClinicalTrials.gov, SinoMed, China National Knowledge Internet, Wanfang database of Chinese Journals, and VIP database of Chinese Journals. The last retrieval date was August 24, 2018. Review Manager 5.3 software was used for comprehensive quantification data analysis., Results: Fourteen papers involving 1,882 patients were included in this study. The results showed that compared with the traditional pathway, the clinical pathway can effectively shorten the average number of hospitalization days (mean difference, MD = -2.00, 95% CI: -2.50, -1.49). In total, 10 of the 14 papers, with a total of 1,500 patients, proved that the clinical pathway can effectively reduce the hospitalization costs of patients (standard mean difference, SMD = -3.15, 95% CI: -4.20, -2.10); 11 of the 14 papers, with a total of 1,488 patients, proved that the clinical pathway can effectively improve patients' knowledge of health (95% CI:1.03, 1.09); and 7 of the 14 papers, with a total of 810 patients, proved that the clinical pathway can effectively improve patient satisfaction (95% CI:1.10, 1.20)., Conclusions: Our systematic review and meta-analysis support the use of the clinical pathway in patients with endoscopic sinus surgery in China., (© 2019 S. Karger AG, Basel.)

Aims: To evaluate the prevalence of associated risk factors of over active bladder (OAB) in people ≥40 years old in mainland of China., Methods: A randomized community-based, cross-sectional study was performed on 10,160 residents (≥40 years old) in the mainland of China using a questionnaire. The overactive bladder symptom score (OABSS) was filled upon site. The chi-square test was used to determine the differences of prevalence between sex, age groups, body mass index (BMI) and people with and without diabetes mellitus (DM)., Results: A total of 9,805 (96.5%) subjects qualified for the final statistical analysis. The overall prevalence of OAB was 2.1% (209/9,805), of whom 1.0% had OABdry and 1.1% had OABwet . The prevalence of OAB was more common in men than in women over the age of 60 (4.6% vs. 2.6%, P < 0.05). The prevalence of OAB in subjects with DM was significantly higher than those without DM in patients with BMI ≥ 25 (P < 0.05). The subjects with a BMI over 29 were more likely to have OAB (3.2% vs. 1.8%, P < 0.05)., Conclusions: In this population, the prevalence of OAB increased with age for both sexes, but was higher for males over 60 years of age. The study also showed that diabetics with BMI ≥ 25 and people suffering from obesity are more likely to have OAB., (© 2013 Wiley Periodicals, Inc.)

To investigate knockdown resistance (kdr)-like mutations associated with pyrethroid resistance in Anopheles sinensis (Wiedemann, 1828), from Guangxi province, southwest China, a segment of a sodium channel gene was sequenced and genotyped using three new genotyping assays. Direct sequencing revealed the presence of TTG-to-TCG and TG-to-TTT mutations at allele position L1014, which led to L1014S and L1014F substitutions in a few individual and two novel substitutions of N1013S and L1014W in two DNA templates. A low frequency of the kdr allele mostly in the heterozygous state of L1014S and L1014F was observed in this mosquito population. In this study, the genotyping of An. sinensis using three polymerase chain reaction-based methods generated consistent results, which agreed with the results of DNA sequencing. In total, 52 mosquitoes were genotyped using a direct sequencing assay. The number of mosquitoes and their genotypes were as follows: L/L = 24, L/S = 19, L/F = 8, and F/W = 1. The allelic frequency of L1014, 1014S, and 1014F were 72, 18, and 9%, respectively.

Objective: To understand whether human metapneumovirus (hMPV) is one of the pathogens leading to the children's respiratory infections in Urumqi., Methods: A total number of 209 samples were collected in the People's General Hospital of Xinjiang Uygur Autonomous Region from November 2006 to April 2007 with some from the hospitalized children, while the others from outpatient clinic. Specimens included nasopharyngeal aspirates (NPA) and swabs were analyzed. Samples were all tested hMPV M gene by RT-PCR while the two positive PCR amplicons were sequenced and compared with other hMPV in GenBank by Blast and DNAstar., Results: Of all the 209 samples, two positive ones were tested. The identities between them were 83.8%. Results from Phylogenetic analysis showed that they might belong to two different clusters., Conclusion: hMPV was one of the pathogens leading to the children's respiratory tract infections in Urumqi, with two different hMPV groups existed in the same season.