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With the advent of the Internet era in recent years, social music education has gradually shifted from the original entity education mode to the mode of entity plus network teaching. No matter for school music education, professional music education or social music education, the teaching quality is the most important evaluation index. This research firstly found out the basic dimensions that accord with the teaching quality required by the three parties, constructing the quality evaluation index system; and then, on the basis of expounding the connotation of each index, it determined the weight of each index by using method of fuzzy analytic hierarchy process, providing ideas and methods for scientific, objective and comprehensive evaluation of the teaching quality of network education APP. [ABSTRACT FROM AUTHOR]

Typhoon-induced rockslide-debris avalanches are among the most dramatic geohazard in coastal mountainous regions, which commonly result in serious casualties and economic loss. In September 2016, typhoon "Catfish" attacked the Su Village in Southeastern China and triggered a devastating rockslide-debris avalanche. The detached mass traveled 1000 m, generated a powerful air blast, and resulted in 27 deaths. In this study, we performed a thorough survey to investigate the avalanche characteristics and damages caused by air blasts. Meanwhile, numerical modeling and video analysis were conducted to investigate the avalanche dynamics and impacts of the air blast. Results indicated that the avalanche movement lasted for approximately 60 s with a maximum velocity of 42 m/s. The entrainment effect greatly enlarged the avalanche volume and extended the avalanche runout. Moreover, the generated air blast indicated a maximum pressure of 2.5 kPa and caused tree breakage beyond the avalanche runout. [ABSTRACT FROM AUTHOR]

Typhoon‐induced landslides are widespread, damaging and deadly. In this study, we elucidated their spatiotemporal features through investigations in Southeast coastal China and proposed a numerical model that involves typhoon wind load, preferential infiltration and root reinforcement. The wind load is calculated through a combination of the autoregressive method and a multi‐degree‐of‐freedom tree swaying mode, transmitting to the slope through the wind–tree interaction. Taproots of trees are modelled as piles, and root–soil interfaces are modelled as preferential infiltration boundaries. Using the numerical model, we quantitatively assessed the impacts of wind load, rainfall infiltration and root reinforcement on the slope stability and compared results with cases in Waipaoa and Wairoa (New Zealand). Results suggest that the impacts of trees depend heavily on meteorological and geological conditions. Trees play a destabilizing role in Southeast China during a typhoon but a stabilizing role in the cases in New Zealand. For slopes in Southeast China with a thick soil layer (>root depth), strong wind load and preferential flow resulting from root–soil interfaces, rather than slope surface infiltration, significantly decrease the slope stability in a short time. Slope failure occurred in all scenarios that account for the preferential infiltration, and its combination with a Force 14 typhoon wind load can fail the slope at 10 h after the typhoon initiation. Differently, tree roots in cases in New Zealand can penetrate through the thin soil layer (<1 m) and provide considerable additional resistance to stabilize the slope. [ABSTRACT FROM AUTHOR]

Rock collapse with large volumes can attain high speeds during their freefall motion. The impact of such a falling mass on the ground surface can initiate a powerful air blast with far-field destructive impact. To investigate the formation, disaster-causing mechanism and dynamic characteristics of rock collapse-induced air blasts, an existing coupled discrete-element method (DEM)–computational fluid dynamics (CFD) approach is employed on a rock collapse-generated air blast in Zengziyan, China (ZRC). The generated air blast shows a maximum velocity of over 50 m/s and subsequently dissipated rapidly. The high consistency between the simulated air blast dynamics and the video verified the DEM–CFD coupled method in the air blast modeling. Combined with the ZRC-induced air blast analysis, a simplified generalized model was designed to observe the potential effect of geomorphology. Results highlight the great contribution of geomorphology, to both air blast initiation and propagation. Collapsed rock mass with a free fall motion is prone to generate significant air blasts when colliding with the slope surface. Tremendous energy was transferred to the surrounding air at the moment. Compared with falling straight down, air blasts resulting from an airborne trajectory case show a longer propagation because the collapsed materials impart air a higher initial momentum parallel to the slope surface. In addition, air blast propagation in wide distribution areas in comparison to narrow valleys shows greater attenuation. This study will aid in understanding the mechanism of a rock collapse-induced air blast as well as the forward simulation of similar events for risk assessment. Highlights: DEM-CFD coupled method provides good performance in simulating the air blast dynamics. Large rock collapse with a free fall motion is prone to generate powerful air blasts when colliding with the slope surface. Geomorphology is greatly influential in both air blast initiation and propagation. [ABSTRACT FROM AUTHOR]

Typhoon-induced deep-seated landslides are prone to cause mass casualties to coastal regions once they occur. On 10th August 2019, typhoon "Lekima" triggered the deadliest landslide in recent decades in Southeast coastal China (32 deaths). To investigate the possible failure mechanism of this catastrophic event, we conducted in situ investigations and image analysis to determine the geological characteristics and performed numerical modelling of transient variation in slope stability throughout the typhoon. Generalized modelling analysis was further designed to research the impacts of some landslide settings and forcing factors on this type of geohazard. Our findings show that cracks within the weathered rock played vital roles in the landslide initiation. Cracks-induced strength reduction made the saturated rock provide insufficient resistance to stabilize the slope. Preferential infiltration promotes the saturation of sliding mass within a short-duration typhoon, responsible for the rapid failure. Furthermore, the impact of trees on slope stability depends heavily on landslide settings. Constrained by the limited growth depth of roots, though both beneficial and detrimental mechanisms of trees show minor impacts on the development of a deep-seated sliding surface, trees and geological settings converged to produce the failure mode of the Yongjia landslide. Roots significantly enhanced the shallow soil layer and the soil–rock interface is simulated to be the potential sliding surface in the absence of trees. Results suggest future landslide risk assessments in Southeast coastal China to specify the meteorological and geological conditions, which would greatly improve the aim to predict the spatiotemporal distribution of landslides throughout a typhoon. [ABSTRACT FROM AUTHOR]

Investment and construction of energy and transport-related infrastructure are closely linked to the achievement of sustainable development goals. China's infrastructure-led foreign investment, technical integration, and tourism with Belt and Road Initiative (BRI) countries have maintained exponential growth. This growth certainly has an impact on economic development mode and environmental sustainability. Therefore, this study examines the impact of infrastructure-led Chinese outward foreign direct investment, tourism development, and technology innovation on carbon emissions across the selected BRI node countries and respective regions. This study employs cross-sectional autoregressive distributive lag model to deal with parameters and cross-sectional heterogeneity. The results exhibit that foreign direct investment and technology innovation reduces carbon emissions in the long run, while tourism development and its interaction with foreign direct investment led to higher emissions in the overall BRI sample. In contrast, the regional estimates show significant variations in the magnitude and direction of the relationship, where foreign direct investment produces an emissions-increasing effect in South Asian and MENA countries. Moreover, the results support the validity of the Environmental Kuznets Curve hypothesis in overall and regional samples. These results are also endorsed by common correlated effects means group estimator and imply relevant policies. [ABSTRACT FROM AUTHOR]

On 28 August 2017, a large catastrophic rock avalanche occurred in Nayong, Guizhou Province, China. It claimed 35 lives and caused large property losses. The Nayong rock avalanche provides a rare opportunity to infer the dynamic fragmentation of rock masses from deposits. Field surveys combined with an uncrewed aerial vehicle image analysis system were performed to investigate the particle size and shape distribution along the runout path of the Nayong rock avalanche. The Weibull particle size distribution (PSD) model was tested and possesses the highest accuracy and capability over the entire range of the Nayong rock PSD, and it shows that the median size (D50) values of the particles range from 0.16 to 16.31 m along the runout path. Moreover, the evolution of D50 along the runout path confirms that the degree of rock fragmentation varies greatly in different regions. Additionally, the relative breakage (BR) of particles in the deposition area is 0.191. Particle R values increase significantly from 0.55 to 0.78 along the runout path, which indicates that the rock grinding (shape change) process continuously occurs throughout the avalanche path. The image analysis results confirm that the dominance of rock fragmentation and grinding alternates during granular flow transport. Based on these results, the classic fragmentation‐spreading model for long‐runout rock avalanches is optimized by taking into account the method by which grinding rocks increases the speed of avalanches. Plain Language Summary: On 28 August 2017, a large catastrophic rock avalanche occurred in Nayong, Guizhou, China. In this paper, a field survey based on High‐resolution uncrewed aerial vehicle technology and image‐analysis system was performed to study the characteristics of particle size and shape distribution and the long‐runout behavior of large rock avalanches. A fragmentation‐spreading model for long‐runout behavior of rock avalanches proposed by Davies was optimized by incorporating the mechanisms involving internal friction reduction caused by dynamic grinding process. The internal friction of particles dropped correspondingly during transport and resulted in the increase of spreading distance. Key Points: An image analysis system for the large‐scale field investigation has been applied to morphometric measurements of rock avalanchesThe degree of rock fragmentation gradually decreases with the travel distance of rock mass in a rock avalancheRock grinding gradually replaces the role of rock fragmentation and reshapes the particles as the travel distance increases [ABSTRACT FROM AUTHOR]

On 24 June 2017, a rockslide-debris avalanche occurred in Xinmo Village, Maoxian County, Sichuan Province, China. The displaced materials traveled approximately 2.6 km and caused 83 casualties. Combined with the field investigation, seismic signal, and numerical simulation, the dynamic process and deposit characteristics of the Xinmo landslide were analyzed. Based on the Arias intensity and Hibert time–frequency analysis of the seismic signal, the Xinmo landslide is determined to have a total duration of 120 s and with three-stage dynamic processes, namely, the initial accelerating stage (50 s), erosion impact stage (50 s), and accumulation stage (20 s). Then, taking the field investigation results, the total duration, and kinetic parameters inverted from the seismic signal as criteria, the DAN3D (Dynamic Analysis of Landslides) was employed to reconstruct the dynamic process of the Xinmo landslide. The results show that the erosion and deposit depth distributions obtained from the simulation are in agreement with the pre- and post-landslide DEM (digital elevation model) data and field results. Further, the three-stage dynamic processes (40 s, 60 s, 20 s) obtained from the numerical simulation are also close to the seismic analysis results. In this study, the results of the field investigation and seismic analysis provide a more detailed set of inversion criteria for the numerical simulation work, which contributes to reconstructing the dynamic processes of the Xinmo landslide more accurately. Based on the approach of multi-source data collaboration in this paper, those landslides that lack direct observation data can be better understood and the numerical parameters used for landslide dynamics inversion are better calibrated, which can be applied to predict the runout behavior and disaster scope of potential landslides in the immediate area. [ABSTRACT FROM AUTHOR]

On January 27, 2021, a small-scale loess landslide occurred in Dangchuan Village, Yongjing County, Gansu Province, China. Timely monitoring and warning helped to prevent any casualties. The sliding mass of the Dangchuan landslide fell in two stages with an interval of 24 s and lasted for a total of 31 s. Eventually, the Dangchuan landslide had a descent height of approximately 120 m and a sliding portion stretching approximately 350 m. The landslide volume was approximately 3 × 104 m3. Based on the investigation of different stages of the Dangchuan landslide and the characteristics of the deposition area, the induction of this landslide was attributed to the effect of frozen stagnant water. Following field investigation of the landslide source and crack areas, a potential sliding mass model with a volume of 5 × 104 m3 was obtained via calculation. To predict the disaster scope of potential landslides, we first used DAN3D software to invert this Dangchuan landslide. Then, based on the numerical model parameters obtained from the inversion, the sliding accumulation process of the potential slide mass was simulated. The results showed that the maximum disaster scope of the potential slide mass would be larger than that of the Dangchuan landslide. The new deposit would cover an area of approximately 3.5 × 104 m2, with a thickness in the range of 0–6 m. The new deposition area would expand by approximately 50 m in the long-axis direction compared to the Dangchuan landslide, impacting the houses and roads. The DAN3D prediction results of the disaster scope will help residents in the potential danger zone evacuate in advance, reducing unnecessary damage. [ABSTRACT FROM AUTHOR]

A rock avalanche that destroyed 23 houses and killed 35 people occurred on 28 August 2017, Nayong, SW China. Combined with the dynamic parameters from seismic signal inversion, a discrete element model, MatDEM was used to determine the rock avalanche's kinematic behavior. Although the dynamic process obtained through inversion will be disturbed by factors, such as rockfall from the source area, by comparing the velocity of rock avalanche versus horizontal distance traveled, the best combination of parameters was selected from different values given. The dynamic process obtained by modeling was compared with the nearest seismometer frequency distribution spectrum, showing that the dynamic process is in good agreement with those parameters inverted from seismic signals. The simulation results show that the movement process lasted for nearly 40 s, with a maximum speed of 40 m/s. This model of selecting parameters contributes to explain the dynamic processes of similar rock avalanche more accurately and is of great significance to the hazard prediction in the karst area. [ABSTRACT FROM AUTHOR]

A catastrophic loess flow slide was triggered by the 2013 Minxian–Zhangxian earthquake in Yongguang village, Minxian County, Gansu Province, China. The landslide destroyed eight houses and killed 12 persons. The landslide involved the failure of 14.0 × 104 m3 of loess deposits from the source area. The displaced materials traveled 1000 m with an elevation descent of 180 m, covering an area of 4.2 × 104 m2. A numerical model (DAN3D) is used to simulate the post-failure behavior of the landslide based on a detailed field investigation. A combination of the frictional model and Voellmy model provides the best performance in simulating the landslide using trial and error. The simulation results indicate that the landslide lasted approximately 120 s and had an average velocity of 8.3 m/s. The final runout distance and deposit distribution are in a good agreement with the actual situation, indicating the accuracy of the simulated results. Therefore, it is expected that the models and parameters could improve the precision of hazard zonation for areas with geological, topographical, and climatic features similar to the Yongguang landslide area. [ABSTRACT FROM AUTHOR]

Background: Golgi protein 73 (GP73) is a potential serum marker for the diagnosis of hepatocellular carcinoma (HCC). However, the diagnostic value of GP73 for HCC remains controversy, and little is known about the relationship between serum GP73 concentration and clinical characteristics of HCC. This study was designed to analyze the clinical values of GP73 in diagnosing HCC and the relationship between GP73 level and clinical characteristics in HCC patients.Materials and Methods: In this study, a total of 443 serum samples including 180 patients with HCC, 61 patients with liver cirrhosis (LC), 99 chronic hepatitis patients, and 103 healthy individuals were enrolled from November 2011 to April 2013. Enzyme-linked immunosorbent assay and chemiluminescent immunoassay were used to detect the serum level of GP73 and other biomarkers.Results: GP73 level in HCC group was significantly higher than LC group, chronic hepatitis B group, and healthy control group. In HCC group, GP73 level significantly increased in patients with lymphatic metastasis; moreover, GP73 level in Child-Pugh Class B and C groups was statistically significantly higher than that in Child-Pugh Class A group (P < 0.05). The area under the receiver operating characteristic (AUROC) curve of GP73 and alpha-fetoprotein (AFP) was 0.840 and 0.718, respectively, when diagnosing HCC. Moreover, the AUROC curve by use of the combination of GP73 and AFP was 0.903. The differences among these three aspects were statistically significant (P < 0.05).Conclusion: GP73 was better than AFP for the diagnosis of HCC, and the expression of serum GP73 is related with the clinical characteristics of HCC patients. [ABSTRACT FROM AUTHOR]

Aim: The knowledge on multimorbidity and its impact on healthcare systems is lacking in low‐ and middle‐income countries. We aimed to estimate the prevalence of multimorbidity, and analyze the health service use of middle‐aged and older persons with multimorbidity in urban China. Methods: Study participants included 3737 urban residents aged ≥45 years from the China Health and Retirement Longitudinal Study 2011. A total of 16 pre‐specified self‐reported chronic conditions were used to measure multimorbidity, which was defined as having two or more conditions. Logistic regression was used to analyze the characteristics and health service use of persons with multimorbidity. Analyses were weighted to adjust for sampling design and non‐response. Results: Of the study population, 51.9% were men and 20.1% were aged >70 years. Hypertension (33.1%) was the most prevalent condition, followed by arthritis (25.4%), digestive disease (18.7%), dyslipidemia (18.3%) and heart disease (17.7%). The prevalence of multimorbidity was 45.5% (95% CI 41.4–49.7%). Multivariate analyses showed that the prevalence of multimorbidity was significantly higher in respondents who are older and socioeconomically disadvantaged than that in their counterparts. Multimorbid patients used 72.7% of outpatient services and 77.3% of inpatient services. After controlling for demographic, socioeconomic, health behavior and health insurance factors, condition counts still had a positive relationship with outpatient or inpatient service use. Conclusions: The burden of multimorbidity is high among the middle‐aged and older urban Chinese population. Management of multimorbidity therefore deserves more attention from health policymakers, providers and educators of health professionals in China and in other low‐ and middle‐income countries. Geriatr Gerontol Int 2018; 18: 1447–1452. [ABSTRACT FROM AUTHOR]

Typhoon-induced landslides are the primary natural hazard in hilly coastal regions of South East Asia and can potentially devastate coastal communities and infrastructure. They occur at approximately the same time as typhoon strikes, showing complex failure mechanisms under the coupled action of wind, rainfall and trees. Therefore, special assessments should be performed for such geohazards. Here we elucidated the general features of typhoon-induced landslides in southeast coastal China in terms of their geological characteristics, spatial and temporal distribution, and vegetation cover characteristics. We further established a framework to investigate their possible failure mechanisms coupled to wind, rainfall and trees. Specifically, the mechanical response of trees in a typhoon was estimated through a combination of the autoregressive method (AR) and a multi-degree-of-freedom tree swaying model, while the trees and rainfall contributions were determined by calculating the cohesion attributable to roots and the soil shear strength reduction caused by the water content variation. Our results suggest that the root reinforcement disappears when the sliding surface is below the root embedded depth, and the impact of wind load is significant during the slope stability analysis. The Force 14 wind (mean wind velocity up to 45 m/s) reduces the factor of safety (F s) of the slope by 20% when blowing downhill, and its combined contribution with rainwater infiltration will lead to a higher risk of slope failures (F s reduction of 45% at the base of the root-soil composite). Additionally, typhoon-induced shallow slope failures are prone to develop at the base of the root-soil composite or the rock-soil interface. Our model results suggest that the impacts of wind and vegetation on the generation of landslides during a typhoon can be significant and deserve more attention in hazard assessment studies. • There is a limited slope stabilization effect of vegetation during a typhoon event. • Strong wind load and preferential flow increase the risk of slope failure. • Typhoon causes landslides at the base of root-soil composite or rock-soil interface. [ABSTRACT FROM AUTHOR]

Background: Cancer-associated fibroblasts (CAFs) represent the predominant stromal component within the tumour microenvironment (TME), exhibiting considerable heterogeneity and plasticity that significantly impact immune response and metabolic reprogramming within the TME, thereby influencing tumour progression. Consequently, investigating CAFs is of utmost importance. The objective of this study is to employ bibliometric analysis in order to evaluate the current state of research on CAFs and predict future areas of research and emerging trends., Methods: Conduct a comprehensive search for scholarly publications within the Web of Science Core Collection database, encompassing the time period from January 1, 2001, to December 31, 2022. Apply VOSviewer, CiteSpace, R software and Microsoft Excel for bibliometric analysis and visualisation., Results: This study involved a comprehensive analysis of 5,925 publications authored by 33,628 individuals affiliated with 4,978 institutions across 79 countries/regions. These publications were published in 908 journals, covering 14,495 keywords and 203,947 references. Notably, there was a significant increase in articles published between 2019 and 2022. China had the highest count of articles, while the United States emerged as the most frequently cited country. The primary research institutions in this field were Shanghai Jiao Tong University, Harvard University, and the University of Texas MD Anderson Cancer Center. Sotgia, Federica and Lisanti, Michael P from the University of Manchester, and Martinet, Wim from the University of Antwerp were the most prolific and highly cited authors. The journal Cancers had the highest number of publications, while Cancer Research was the most frequently cited journal. Molecular, biology, immunology, medicine and genetics were the main research disciplines in the field of CAFs. Key directions in CAFs research encompassed the study of transforming growth factor-β, Fibroblast Activation Protein, breast cancer, as well as growth and metastasis. The findings from the analysis of keyword co-occurrence and literature co-citation have revealed several emerging hotspots and trends within the field of CAFs. These include STAT3, multidrug resistance, pancreatic ductal adenocarcinoma, pan-cancer analysis, preclinical evaluation, ionizing radiation, and gold nanoparticles., Conclusion: Targeting CAFs is anticipated to be a novel and effective strategy for cancer treatment. This study provides a comprehensive overview of the existing research on CAFs from 2001 to 2022, utilizing bibliometric analysis. The study identified the prominent areas of investigation and anticipated future research directions, with the aim of providing valuable insights and recommendations for future studies in the field of CAFs., 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 Yuan, Zhang, Chen, Yuan, Zhuang, Zhou, Li, Qiu and Zhou.)

Background: Valvular heart disease (VHD) is a leading cause of heart diseases and death, and heart valve replacement (HVR) plays a fundamental role in treating valve disease and improving the function of valves. The lack of continuity of care (CC, also known as transitional care) for postoperative patients after discharge often results in a variety of complications, bringing severe pain to the patients and diminishing their quality of life., Methods: We systematically searched for relevant randomized controlled trials (RCTs) in Cochrane databases, PubMed, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Chongqing VIP, and Wanfang Data. The methodological quality of the included articles was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. The meta-analysis was conducted with RevMan 5.2 software., Results: A total of 14 RCTs (involving 1,825 patients), all in Chinese language, were included in the analysis, including 920 patients in the CC group and 905 patients in the control group (receiving the routine care). Meta-analysis showed that, compared with the control group, the CC group had significantly higher anticoagulation therapy adherence [RR =1.36, 95% CI: (1.25,1.48), P<0.00001], higher awareness of anticoagulation [RR =1.14, 95% CI: (1.09, 1.18), P<0.0001], and lower incidences of anticoagulation complications and adverse events [RR =0.24, 95% CI: (0.17, 0.35), P<0.00001]. In addition, the 5 domains reflecting quality of life including physical domain [MD =2.38, 95% CI: (1.30, 3.46), P<0.0001], psychological domain [MD =2.92, 95% CI: (1.47, 4.37), P<0.0001], levels of independence [MD =4.03, 95% CI: (1.04, 7.01), P=0.008], social relationships [MD=2.56, 95% CI: (1.81, 3.32), P<0.00001], and environment [MD =4.15, 95% CI: (1.16,7.14), P=0.007] were also significantly improved., Discussion: Our results showed CC can effectively improve patients' anticoagulation therapy adherence and raise their awareness about medications, reduce the incidences of complications and adverse events, and thus improve the patients' quality of life. However, only a limited number of high-quality RCTs were included in our current analysis, and studies with more rigorous designs are warranted to further validate the impacts of CC on anticoagulation therapy adherence and quality of life after HVR.

Introduction: Dizziness is one of the most common symptoms seen in chronic vestibular syndrome, which has been linked to an increased risk of falls, substantial disability and negative psychological consequences. Recent evidence demonstrated that vestibular rehabilitation therapy (VRT) is effective for treating chronic vestibular symptoms. However, the delivery of VRT remains challenging because of lack of facility, insufficient qualified physiotherapist resources, as well as being in the actual situation of the pandemic. WeChat, the most widely used mobile app in China, offers a more viable way of delivering VRT than traditional office-based approaches do. This study aimed to evaluate the effectiveness of the WeChat-VRT programme for patients with chronic vestibular syndrome., Methods and Analysis: This is a parallel-group, assessor-blinded randomised controlled trial. Fifty patients who experienced chronic vestibular symptoms longer than 3 months will be randomised into either the WeChat-VRT group or the usual care (UC) group. Participants in the WeChat-VRT group will receive 8-week VRT mainly through the WeChat app. Participants in the UC group will receive once-weekly VRT in the clinic for 8 weeks and remaining time home-based exercise. Outcome assessments will take place at baseline and at the 8th, 12th and 24th weeks after randomisation. The primary outcome will be the change from baseline to the eighth week on the patients' functional improvements quantified by the Functional Gait Assessment (FGA). The secondary outcomes will include dynamic balance function, emotional well-being, and vestibular activity and participation level. Intention-to-treat analysis will be performed using generalised estimation equation modelling., Ethics and Dissemination: The trial has been reviewed and approved by the Institutional Review Board of Eye and Ear Nose Throat Hospital of Fudan University (reference number 2017047/1). The study findings will be disseminated via peer-reviewed journals and conferences., Trial Registration Number: ChiCTR2000029457; Pre-results., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Systemic inflammation is an important feature of post-cardiac arrest syndrome (PCAS). This study was designed to determine whether the plasma concentrations of some circulating pro-inflammatory cytokines (interleukin-17 [IL-8], IL-22, IL-23 and IL-33) are of value in predicting the outcome of patients after return of spontaneous circulation (ROSC) during the post-cardiac arrest period., Methods: This was a prospective observational clinical study. In total, 21 patients (survivors, n = 10; non-survivors, n = 11) who experienced cardiac arrest and successful ROSC with expected survival of at least 7 days were consecutively enrolled from January 2016 to December 2017. Of the 21 enrolled patients, ten survived were designated "survivors". The other eleven patients died between 2 days and 1 months post ROSC. Venous blood was drawn at three time-points: baseline (< 1 h post ROSC), 2 days post ROSC and 7 days post ROSC. Plasma IL-8, IL-22, IL-23 and IL-33 were determined using commercial enzyme-linked immunosorbent assays., Results: Plasma creatinine levels, but aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, were elevated in non-survivors compared with survivors. Plasma levels of IL-17, IL-22, IL-23 and IL-33 of the 21 total patients did not change at 2 or 7 days post ROSC compared to baseline. In survivors, the plasma levels of IL-17 and IL-23 at 2 or 7 days post ROSC were lower than baseline. In non-survivors, plasma levels of IL-17 increased compared with baseline. Receiver operating characteristic curve analysis showed that the plasma levels of IL-17 and IL-23 at 2 or 7 days post ROSC were able to predict the mortality of PCAS patients, and positively correlated with Acute Physiology and Chronic Health Evaluation (APACHE)-II score and time to ROSC., Conclusion: These results provide the first evidence that the elevated plasma IL-17 and IL-23 levels are associated with poor outcome in PCAS patients. The role of IL-17/IL-23 axis post ROSC is worth paying attention to in PCAS patients., Trial Registration: Clinicaltrial.govNCT02297776, 2014-11-21.

Concurrent indoor-outdoor fine particulate matter (PM 2.5 ) measurements were conducted at urban, suburban, and rural sites in Harbin, a megacity in the northeast of China. Chemical constituents of indoor-outdoor PM 2.5 were determined. Infiltration factors (F INF ) of all sites were calculated according to the indoor to outdoor (I/O) ratios of PM 2.5 based on the regression analysis. Linear discriminant analysis (LDA) is applied to determine the indoor-outdoor relationship. Secondary organic carbon (SOC) was calculated on the basis of organic carbon to elemental carbon (OC/EC) ratios. The mean concentrations of indoor and outdoor PM 2.5 were 166.4 ± 32.5 μg/m 3 and 228.4 ± 83.7 μg/m 3 , respectively, during the heating period. OC/EC and potassium ion to elemental carbon (K + /EC) ratios verified that biomass was an important source in Harbin especially for rural sites. The nitrate to sulfate (NO 3 - /SO 4 2- ) ratio indicates the higher contribution of traffic emissions in urban sites. Cr was the only species that exceeded the guidelines of WHO 2002, which was mainly emitted from coal and oil combustion. SOC/OC and NO 3 - /SO 4 2- ratios, and ion-balanced acidity (the ratio of cation to anion, R +/- ) showed a large urban-rural and indoor-outdoor difference. The highest SOC/OC ratio was found at urban sites, up to 38.3% for indoors. SOC/OC ratios and R +/- values of indoor environments were higher, which is attributed to the conducive condition of forming the secondary pollutants during the heating period. The results of LDA indicated that the distributions of the chemical components of PM 2.5 at three sites were statistically dissimilar. Graphical abstract.

Objectives: Melanoma-associated antigen A1 (MAGEA1) is a potential target for immunotherapy and has been associated with poor survival rate in several cancers. However, little is known about the prognostic predictive value of MAGEA1 in oesophageal squamous cell carcinoma (OSCC). This study aims to determine whether the expression of MAGEA1 is an independent predictor of survival in patients with resectable OSCC., Methods: A retrospective analysis was performed on a large cohort of 197 patients with OSCC who underwent radical surgical treatment in the Department of Thoracic Surgery between January 2006 and December 2012. The expression of MAGEA1 in OSCC and matched normal oesophageal mucosa specimens from these patients was detected by immunohistochemistry with tissue microarray technology., Results: The MAGEA1 protein was expressed in the cytoplasm and nucleus of tumour cells. The positive expression rate of MAGEA1 was significantly higher in OSCC tissue than in normal oesophageal mucosa (73.6% vs 5.6%, P < 0.001). MAGEA1 expression had no correlations with sex, age, history of smoking, alcohol consumption, family history of upper gastrointestinal cancer, T stage, lymph node metastasis, grade/location of the tumour or TNM stage (all at P > 0.05). Compared with those with negative MAGEA1 expression, patients with positive MAGEA1 expression were associated with a reduced overall survival rate (5-year survival rate: 53.8% vs 37.2%; P = 0.018). The multivariable analysis revealed that MAGEA1 expression is an independent predictor of prognosis (P = 0.007, hazard ratio 1.85, 95% confidence interval 1.19-2.89)., Conclusions: The expression of MAGEA1 is abundant in Chinese patients with OSCC and is related to a worse clinical outcome. MAGEA1 may be a useful prognostic factor in patients with resectable OSCC., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Objective: To study the prevalent characteristics in children with hand-foot-mouth disease (HFMD) in the Kunming area in 2010., Methods: The clinical data of 13286 outpatient and inpatient children with HFMD in Kunming Children's Hospital between January and December, 2010, including 8 death cases, 715 serious cases and 12563 non-serious cases, were retrospectively studied., Results: Human enterovirus was detected in 8200 children (61.72%). Children infected with EV71 and CoxA16 accounted for 29.49% (2418/8200) and 53.21% (4363/8200), respectively. Seventy-five children (0.91%) were found to have a mixed infection of the two viruses. Other types of human enterovirus were detected in 1344 children (16.39%). There were significant differences in the total positive rate of human enterovirus in the four quarters of the year (P<0.01). The total positive rate in the second quarter represented the highest proportion (71.56%), and the number of patients was also highest, accounting for 52.94% of the total number of patients in the whole year. EV71 infection was common in the serious case group while CoxA16 was found to be the main pathogen in the non-serious case group. Serious cases were common in children under three years old. In the positive EV71 cases, the viral load of EV71 was not statistically different between the death cases, serious and non-serious cases., Conclusions: In 2010, children with HFMD in the Kunming area were mainly infected with CoxA16. Serious cases of HFMD were more common in those who were infected with EV71, and the majority of serious infections were suffered by children who were less than three years old. The viral load was not associated with disease severity. The highest morbidity rate was in the second quarter of the year.

Objective: To compare the early outcomes of coronary artery bypass grafting (CABG) in aged diabetic patients, and evaluate the affection of diabetes on the early outcomes of CABG in aged patients., Methods: The study took place in the Department of Cardiovascular Surgery, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai, China, between January 2000 and July 2008. Five hundred and ninety-three elderly patients (age > or = 70-years-old), undergoing isolated CABG were retrospectively divided into diabetic group and non-diabetic group. We analyzed the pre-operative, intra-operative, and post-operative variables of the 2 groups. The t-test, Chi-square test, and multivariate logistic regression were used to determine the differences between the 2 groups of patients., Results: There was no statistical difference of pre-operative and intraoperative variables between the 2 groups, except that there were more left main coronary artery diseases in the diabetic group. Values in the post-operative period such as morbidity, complications, and blood infusion had no differences between the 2 groups. Diabetes mellitus and age are not the risk factors for in-hospital mortality., Conclusion: Coronary artery bypass grafting in elderly patients is plausible. Furthermore, diabetic patients could get the same surgical results as those non-diabetic patients.