Search

The Guangdong Lightning Mapping Array (GDLMA), as the first LMA in China, was deployed in Guangzhou, Guangdong Province, China, in November 2018 by the Chinese Academy of Meteorological Sciences and New Mexico Institute of Mining and Technology. An evaluation was conducted using Monte Carlo and an aircraft track. The average timing uncertainty of GDLMA is 35 ns based on the distributions of reduced chi‐square values. Based on the aircraft track, the average horizontal error is 13 m and the average vertical error is 41 m at an altitude of 4–5 km over the network, consistent with the Monte Carlo results. Location errors outside the network exhibit noticeable directionality. The ability to characterize lightning channels varies with different location errors. In locations that are far from the network center, only the basic structure of lightning flash can be presented, while closer to the network, the flash channel structure can be mapped well. Compared with Low‐to‐Mid Frequency E‐field Detection Array (MLFEDA), they were generally similar in overall structure, and some lightning flash characteristics such as flash duration and coverage area exhibited consistency. However, GDLMA demonstrated better flash channel structure characterization capability, while MLFEDA performed better in processes such as leader/return strokes. In addition, based on the comparison of spatial positions of one‐on‐one discharge events, we found that very high frequency sources were more located ahead of low frequency sources in the direction of lightning channel development. Key Points: The detection performance of Guangdong Lightning Mapping Array has been evaluated using Monte Carlo and an aircraft track, and both methods showed good consistencyLocation errors over the network are within 18 m horizontally and 50 m vertically, when outside the network they show directionalityVery high frequency (VHF) and low frequency lightning location results are similar, but VHF sources are more located ahead along the channel [ABSTRACT FROM AUTHOR]

A denoising algorithm utilizing a hybrid Chi-square distribution was proposed to differentiate the effective light points generated by human activities from noise points and enhance the accuracy of feature target extraction in LJ1-01 nightlight imagery. The assumption was made that both LJ1-01 data and noise subsets consist of multiple superimposed Chi-square components. Utilizing the principle of least squares, an indirect adjustment equation was derived by combining the effective statistical lighting values. The equation solved the proportions of each superimposed state. Subsequently, a continuous probability density curve was constructed, which accurately fit the proportions. Lastly, the abundance function was developed. By considering the offset of weight centers in the original image, the noise was effectively removed. Four regions in China were selected as experimental targets based on the distinct reflective characteristics of discrete objects to assess the universality and robustness of the algorithm. The images exhibit feature similarity greater than 0.82 and structure similarity exceeding 0.94 after the elimination of noise. Additionally, three regions in the Beibu Gulf were chosen to extract the number of ships and assess the denoising effect. The results indicate that the hybrid Chi-square denoising algorithm achieves ship extraction accuracy exceeding 90%. [ABSTRACT FROM AUTHOR]

In this paper, we first proposed a statistical test for the detrended multiple moving average cross-correlation coefficient DMMC (s). The DMMC (s) mainly was used to analyze the correlation between the dependent variable y and other n independent variables x i . We proved that DMMC (s) approximately obeys the chi-square distribution. We studied the statistical properties of the DMMC (s) between normally distributed random sequences and power-law ARFIMA long memory random sequences. Furthermore, we discussed the influence of the cross-correlation among the target variable and independent variables on DMMC (s). Finally, we further study the application of DMMC (s) to China's stock markets and China carbon emission trading markets to investigate multiple cross-correlation. The empirical results show that there is a strong multiple correlation between China's Shanghai, Shenzhen and Hong Kong stock markets, while the correlation between China's carbon markets is not significant. This paper provides new ideas and theoretical support for exploring the correlation between multiple variables, which has implications for investors and policymakers. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have shown that the triglyceride-glucose (TyG) index is a reliable substitute marker for insulin resistance. Nevertheless, its correlation with carotid artery plaques (CAPs) among patients with ischemic stroke (IS) remains to be elucidated., Methods: 9248 IS patients hospitalized at the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine were grouped according to the quartiles of TyG index. Patients were further stratified by blood pressure status, sex, age and hypertension control status. Employing logistic regression to examine the connection between the TyG index and CAPs.Additionally, analyzing the receiver operating characteristic (ROC) curve to evaluate the predictive value of the TyG index for CAPs., Results: Participants with an elevated TyG index had an increased prevalence of CAPs. The TyG index was positively correlated with CAPs (OR: 1.26, CI: 1.14-1.40, P<0.001). Compared with normal blood pressure and prehypertensive patients, the TyG index was markedly correlated with CAPs among hypertensive patients (OR: 1.29, 95% CI: 1.15-1.44, P<0.001). Females had a higher OR value than males(OR: 1.31, 95% CI: 1.11-1.54, P=0.001 versus OR: 1.24, 95% CI: 1.09-1.41, P=0.001). Older patients (>60 years) had a higher OR value than their middle-aged counterparts (≤60 years) (OR: 1.35; 95% CI: 1.16-1.58, P<0.001 versus OR: 1.20; 95% CI: 1.05-1.37, P=0.007). Patients with poorly-controlled hypertension had a higher OR value than patients with well-controlled hypertension(OR: 1.36; 95% CI: 1.14-1.63, P=0.001 versus OR: 1.24; 95% CI: 1.07-1.44, P=0.003). After adjusting for potential confounding factors, the area under the ROC curve (AUC) value in the overall population, sex-stratified group, hypertensive patients and hypertension control status-stratified group were all above 0.7 (P<0.01), demonstrating good forecasting capability., Conclusions: In IS patients, the TyG index was significantly associated with CAPs. Additionally, this correlation was more pronounced in hypertensive patients, females, older individuals and patients with poorly-controlled hypertension., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

With the significant increase in the adoption of environmental management systems (EMSs), it is important to evaluate whether EMSs can improve the business value for organisations that adopt them. However, less is known about whether or not EMSs lead to improved firm performance with only few studies evaluating the broad link between an organisation’s environmental strategies and its business performance. Furthermore, previous studies are inconsistent in their findings about the relationship between environmental strategies and firm performance. We attribute this inconsistency to the misfit between environmental strategies and organisational learning orientation which results in operational inefficiency within the firm. This study tries to find out the proper fit pattern between EMSs and organisational learning orientation by investigating their joint effect on firm performance. Based on survey data from 214 Chinese manufacturing companies, we found that the interactions between EMSs and four dimensions of organisational learning orientation have positive impacts on firm performance. Thus, the proper organisational learning orientation for efficiency and effective EMSs is characterised by high levels of commitment to learning, shared vision, open-mindedness and knowledge sharing. [ABSTRACT FROM PUBLISHER]

Background: Insulin resistance (IR) and obesity are established risk factors for hypertension, with triglyceride-glucose (TyG) serving as a recognized surrogate marker for IR. The aim of this study was to investigate the association between TyG-BMI and hypertension in the general population., Methods: A total of 60,283 adults aged ≥18 years who underwent face-to-face questionnaires, anthropometric measurements, and laboratory examination were included in this study. Multivariable logistic regression models and receiver operating characteristic curve (ROC) were used to determine the association between TyG-BMI and hypertension. The restricted cubic spline model was used for the dose-response analysis., Results: After fully adjusting for confounding variables, multivariate logistic regression model showed a stable positive association between TyG-BMI and hypertension (OR: 1.61 per SD increase; 95% CI: 1.55-1.67; P-trend < 0.001). The multivariate adjusted OR and 95% CI for the highest TyG-BMI quartile compared with the lowest quartile were 2.52 (95% CI 2.28-2.78). Dose-response analysis using restricted cubic spline confirmed that the association between TyG-BMI index and hypertension was linear. Subgroup analyses showed that stronger associations between TyG-BMI index and hypertension were detected in young and middle-aged individuals (P for interaction < 0.05). ROC analysis showed that TyG-BMI index could better predict the risk of hypertension than other parameters (TyG-BMI cut-off value: 207.105, AUC: 0.719, sensitivity 65.5%, specificity 66.8%), particularly among young and middle-aged people., Conclusion: The TyG-BMI index was independently associated with hypertension in the study population. Further studies are required to confirm this relationship., (© 2024. The Author(s).)

Chinese parents exert more control over children than do American parents. The current research examined whether this is due in part to Chinese parents' feelings of worth being more contingent on children's performance. Twice over a year, 215 mothers and children ( Mage = 12.86 years) in China and the United States ( European and African American) reported on psychologically controlling parenting. Mothers also indicated the extent to which their worth is contingent on children's performance. Psychologically controlling parenting was higher among Chinese than American mothers, particularly European (vs. African) American mothers. Chinese (vs. American) mothers' feelings of worth were more contingent on children's performance, with this contributing to their heightened psychological control relative to American mothers. [ABSTRACT FROM AUTHOR]

Researchers have found that mentoring can impact protégés' career outcomes positively or negatively. In this study we explored the mediating effect of mentoring on the relationship between personal learning and career development in Chinese enterprises. Data from 316 employees of Chinese enterprises were collected and analyzed to measure the impact of their personal learning on career development. It was found that personal learning and mentoring had a significantly positive impact on career development. Mentoring mediated the relationship between personal learning and career development. We, therefore, suggest that, when promoting career development benefits, enterprises should enhance the positive effects of personal learning and career development through mentoring mechanisms. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To compare the prevalence, the clinical manifestations, familial aggregation and heritability of Kashin–Beck disease (KBD) and Sayiwak disease (SD) in China. Methods: 10,823 people from 1361 families in 14 villages in Linyou County, Shaanxi Province, were examined for KBD, and 2264 people from 552 families in Sayiwak village, Kashi city, Xinjiang, were examined for SD. The investigation included documentation of individual information and clinical manifestations. Patients were subject to radiographic imaging of the right hand. t-Tests and chi-square tests were used to examine correlations of the diseases with age and gender in each of the two groups. Analysis of familial aggregation was conducted with the chi-square distribution analysis of goodness of fit using the SAS8.0 program. The Li–Mantel–Gart method was employed for the segregation analysis. The Falconer regression method11 was employed to estimate heritability (h 2). Results: The prevalence of KBD in Linyou County was 10.90%, and of SD in Sayiwak village was 0.57%. Of the 21 clinical signs examined, KBD cases exhibited 19 signs (90.48%) and SD cases exhibited 18 signs (85.71%), which indicate similarities between the two diseases. However, different clinical signs were evident between the KBD and SD cases, with different impairment rates among joints of limbs in KBD and similar rates in SD. A comparison of radiological features of limb arthropathy between the two diseases showed differences in several characteristics between the two diseases. In addition, measurements of stature and sitting height showed significant differences in bone development between the two diseases. For KBD cases, the values of h 2 in the first-degree and the second-degree relatives were 41.76% and 37.20% (P <0.05). The CI of h 2 was 31.17–52.38 and 19.86–54.55, with a segregation ratio of P =0.12, SE(P)=0.014, 95%CI 0.09–0.15, less than 0.25(χ 2 =42.36, df =1, P <0.001). For SD cases, the values of h 2 were 155.61%, 273.63% and 236.83%. The 95% CIs of h 2 were 133.20–178.12, 229.83–317.42 and 145.83–327.81, respectively, with a segregation ratio of P =0.34, SE(P)=0.059, and CIs between 0.22 and 0.45(χ 2 =4.9817, df =1, P >0.05). Conclusion: The results indicate both similarities and differences in the clinical manifestations of KBD and SD. However, environmental factors appear to play a major role in KBD, while hereditability is a major factor in SD. [Copyright &y& Elsevier]

Coke-oven workers are exposed to many kinds of pollutants that can cause health damage even lead to carcinogenesis. Therefore, it is critical to identify biomarkers that predict early health damage in these exposed individuals in molecular epidemiological studies. We applied an artificial neural network (ANN) model to the identification of such predictors in a study of coke-oven workers. The study included 330 steel-factory workers who were exposed to different levels of polycyclic aromatic hydrocarbons (PAHs) in the workplace and their levels of early health damage were determined by cytokinesis-block micronuclei (CMN), heat shock protein 70 (Hsp70) expression, benzo(a)pyrene diolepoxide-albumin adduct (BPDE-AA), and olive tail moment (OTM). The ANN model was built to predict the early health damage index, and the receiver operating characteristic (ROC) curve was used to illustrate the judged criteria and the ANN model. Trend Chi-square modeling was also performed. We found that there were 55 subjects with early health damage among 330 workers based on the multibiomarker criteria using the 95 percentile of the control group as the cut-off value, while there were 22-35 positive subjects if screening by any single biomarker. The Cochran-Armitage trend test for these findings were statistically significant ( Z = 3.21, P = 0.0013). Six variables were selected to simulate the ANN model. The area under ROC (AUROC) was 0.726 ± 0.037 ( P < 0.001), and the predictors included workplace, cholesterol, waistline, and others. Therefore, collective using CMN frequency, Hsp70 level, BPDE-AA level, and OTM with equal weights to make an initial screening test for early health damage in coke-oven workers is feasible and superior to any single biomarker. The determinants of the effects of multibiomarker on early health damage screening can be identified by the ANN model and ROC curve method. © 2009 Wiley Periodicals, Inc. Environ Toxicol 26: 1-9, 2011. [ABSTRACT FROM AUTHOR]

Backgrounds: Despite the achievements made in treating lung cancer during the past decades, lung cancer still leads in cancer incidence and mortality worldwide. Compared to lung adenocarcinoma, the gene mutation profiles of Chinese lung squamous cell carcinoma (SQCC) have not been well established yet., Methods: 488 Chinese SQCC patients were enrolled from 2017 to 2020, and 289 of them provided archived tumor specimens for genetic testing, 199 provided plasma instead. All samples were subjected to next-generation sequencing assay (295 took testing of 14 lung cancer-related genes, and the rest took the expanded panel). 120 patients provided blood samples applying for germline mutation testing using expanded panel. Moreover, 144 cases with enough tissue samples underwent PD-L1 immunohistochemical assay., Results: Of the 488 patients with SQCC, 444 (90.98%) were proved to have at least one alteration in the 14 lung cancer-related genes. Compared with SQCC patients in The Cancer Genome Atlas (TCGA) database, a significant higher mutated frequency of EGFR (16.03% vs. 3.35%), ERBB2 (9.06% vs. 1.68%), KRAS (7.76% vs. 1.22%), and ALK (5.92% vs. 2.23%) was found in our cohort. Totally, 37.50% of patients were identified with actionable alterations, and most of them were detected in the testing using expanded panel than only the driver gene panel (49.22% vs. 29.83%, p < 0.01). Meanwhile, TP53, PIK3CA and actionable alterations were more identified in the genotyping on the tissue samples than the blood circulating tumor DNA (ctDNA). However, genes associated with clonal hematopoiesis, including KMT2D and RB1, were more prevalent in the plasma ctDNA samples. Of 120 patients undertook germline genetic testing, 5 (4.17%) patients were identified with six pathogenic/ likely pathogenic (P/LP) germline variants in DNA damage repair genes. Positive PD-L1 expression was identified in 61.27% of patients, presenting with a significantly positive correlation with KRAS alterations (58.33% vs. 16.67%)., Conclusion: Our study identified unique genomic profiles of Chinese SQCC patients and provided novel insights into the detection of additional actionable genes and ctDNA in further genotyping. Genetic testing on expanded panel merits further study to comprehensive understanding the therapeutic value of targetable alterations in Chinses SQCC patients., (Copyright © 2022 Elsevier GmbH. All rights reserved.)

Little is known about the use of antioxidants in the clinical treatment of vitiligo. To investigate the specific use of antioxidants in the treatment of vitiligo and the possible reasons behind its use in China, we conducted a prospective questionnaire-based study using an online questionnaire comprising 26 questions in 5 areas. A total of 323 clinical frontline dermatologists participated in this study. Differences among groups were compared using Pearson's chi-square test. Ordinal logistic regression was used to develop knowledge-use multiple regression models. Among the 323 dermatologists, 293 (90.7%) approved the oxidative stress theory of vitiligo, and 182 (56.3%) encouraged the use of antioxidants for treating vitiligo; nonetheless, only 11.8% frequently treated vitiligo with antioxidants. Insufficient knowledge of antioxidants was a significant predictor of lower frequency of antioxidant usage (adjusted odds ratio, 0.401 [95% confidence interval, 0.256-0.629]; P < .001). The predictors associated with higher antioxidant efficacy included advanced or rapid progression, moderate or moderate-to-severe vitiligo, age of 0-2 years or 13-18 years, segmental vitiligo, oral and topical combination therapy, and course duration of <1 month. The use of antioxidants for treating vitiligo is highly encouraged; however, the rates of their clinical use are considerably low. Insufficient knowledge of antioxidants is associated with a lower frequency of antioxidant usage. The synergistic curative efficacy of antioxidants could be affected by the stage, type, severity, age of patients with vitiligo, and method of using antioxidants., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Ying Zhou et al.)

Background: Oral cancer is the twelfth largest malignant tumor in the world. Oral cancer is prone to lymph node metastasis in the early stages of the disease, and lymph node metastasis will directly affect the treatment and survival rate. Therefore, whether the lymph node metastasis can be accurately evaluated is of great significance to the treatment and prognosis of patients., Objective: The diagnostic efficacy of three methods of preoperative ultrasound, enhanced magnetic resonance (enhanced MR), and ultrasound combined with enhanced MR on cervical lymph node metastasis of oral cancer were compared., Materials and Methods: A retrospective analysis of 399 cases of oral cancer completed by head and neck surgery at Cancer Center of Sun Yat-sen University, China. In all cases, the maxillofacial and neck enhanced MR and cervical lymph node ultrasound examinations were performed before surgery, and imaging diagnosis was made for cervical lymph node metastasis and compared with pathology. All judgment results were statistically processed using the chi-square test., Results: Compared with the above three methods, the diagnostic efficiency of ultrasound alone is better, and the diagnostic efficiency of enhanced MR combined ultrasound is not significantly better than that of ultrasound alone. There are differences in the diagnostic efficacy of the three inspection methods in different clinical sub-periods, all of which are better for the diagnosis of stage I. For patients with stage I, II, and III, there were no differences between the three examination methods. However, for stage IV patients,the diagnostic efficiency of ultrasound alone is better. For patients with stage N0, there was no difference in diagnostic efficacy between the three methods. For the assessment of lymph nodes in the I-III region, there are differences between the three methods of examination: the diagnostic efficiency of ultrasound alone is better, and enhanced MR combined ultrasound is not significantly better than ultrasound alone. For the evaluation of lymph nodes in the IV-VII region, there was no difference in diagnostic efficacy between the three methods., Conclusion: According to the clinical characteristics and prognosis of patients with oral cancer, although enhanced MR can better evaluate the tumor, ultrasound may be considered as the preferred imaging method for cervical lymph node metastasis., Significance: Accurate assessment and proper and timely treatment of lymph node metastasis can help improve the survival rate of patients., (Copyright © 2021 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Given the increasing burden of acute myocardial infarction (AMI) in China, regional cooperative rescue systems have been constructed based on chest pain centers (CPCs). This study evaluated the effects of these regional cooperative rescue systems on reperfusion time and prognosis of AMI patients. This study included 1937 AMI patients, divided into two groups according to the date of admission, group A (July 2017-June 2018) and group B (July 2018-June 2019). Reperfusion time, the fatality rate for any cause during hospitalization, and the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) in the 6 months following discharge were compared between the two groups. The proportion of patients treated within the guideline goals for first medical contact to balloon (FMC-to-B) time showed improvement from 40.7% in group A to 50.4% in group B (P = 0.005). The fatality rate for any cause (5.5% vs. 8.0%, P = 0.026) during hospitalization was lower in the B group compared to the A group. Multivariate logistic regression analysis revealed that the fatality rate for any cause (OR 0.614, 95% CI 0.411-0.918, P = 0.017) was significantly lower in group B compared with group A. No significant differences were detected between the two groups for the incidence of MACCE and death for any cause at 6 months using the log-rank test and multivariate Cox regression analysis. The improvement of regional cooperative rescue systems shortened system delays and reduced in-hospital deaths. Although the system has resulted in some substantial improvements, additional improvement is needed., (© 2021. Società Italiana di Medicina Interna (SIMI).)

Hebei Province was affected by two coronavirus disease 2019 (COVID-19) outbreak waves during the period 22 January 2020 through 27 February 2020 (wave 1) and 2 January 2021 through 14 February 2021 (wave 2). To evaluate and compare the epidemiological characteristics, containment delay, cluster events and social activity, as well as non-pharmaceutical interventions of the two COVID-19 outbreak waves, we examined real-time update information on all COVID-19-confirmed cases from a publicly available database. Wave 1 was closely linked with the COVID-19 pandemic in Wuhan, whereas wave 2 was triggered, to a certain extent, by the increasing social activities such as weddings, multi-household gatherings and church events during the slack agricultural period. In wave 2, the epidemic spread undetected in the rural areas, and people living in the rural areas had a higher incidence rate than those living in the urban areas (5.3 vs. 22.0 per 1 000 000). Furthermore, Rt was greater than 1 in the early stage of the two outbreak waves, and decreased substantially after massive non-pharmaceutical interventions were implemented. In China's 'new-normal' situation, development of targeted and effective intervention remains key for COVID-19 control in consideration of the potential threat of new coronavirus strains.

Objective: The incidence of non-suicidal self-injury (NSSI) behavior in adolescents is increasing year by year. Patients with a history of both depression and NSSI behavior tend to be at greater risk for suicide. At present, the mechanism of adolescent depressive disorder with NSSI behavior is not clear and still in research and exploration. The expression of the Silent Information Regulator 2 Related Enzyme 1 (SIRT1) gene is closely related to the level of serotonin in molecular mechanisms, and may be closely related to the occurrence and development of depressive disorder. This study aimed to explore the relationship between the SIRT1 gene and NSSI behaviors in adolescents with depressive disorder., Methods: A total of 15 adolescent depressed patients with NSSI behavior and 15 healthy controls were enrolled in the study. Bisulfite Sequencing PCR (BSP) was used to test the methylation level of SIRT1 gene promoter region of the participants. The real-time fluorescent quantitative PCR was conducted to measure the mRNA expression level of SIRT1 gene., Results: Our study found that the methylation level of SIRT1 gene promoter region at cytosine-guanine dinucleotide 5 (CpG5) site in depression group was higher than that of control group. Compared with that of control group, the plasma concentration of Sirt1 protein significantly decreased in depression group., Conclusion: Our study investigated the methylation level and the mRNA expression of SIRT1 gene in adolescent depressive patients with NSSI behavior. The study points towards finding an in vivo molecular marker for those adolescent patients., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Abstract: This study to analyze the clinical characteristics of patients with invasive pulmonary aspergillosis (IPA) following influenza A (H1N1) infection.We retrospectively analyzed 10 cases with IPA following H1N1 infection. The clinical manifestations, laboratory examination results, chest computed tomography, and treatments were analyzed.Clinical manifestations: all 10 cases had typical flu-like symptoms at the onset of the disease, among which 7 patients developed dyspnea in the late stage, and 8 patients had hemoptysis. Laboratory examination: the absolute and percentage of peripheral blood lymphocytes in all 10 patients were declined, among which 5 cases were with decreased CD3+ CD4+ T cells/lymphocytes; 9 cases with increased bronchoalveolar lavage fluid galactomannan; 6 cases with increased serum galactomannan; 1 case with bronchoalveolar lavage fluid cultured aspergillus fumigatus; and 2 cases with aspergillus by second-generation sequencing. Chest computed tomography: all patients showed multiple diffused ground-glass opacities at the beginning, along with linear or reticular interstitial changes. Two cases had multiple subarachnoid nodules with halo signs, 3 cases had consolidation in multiple segments of both lungs, 2 cases had cavities, and 4 cases were with pleural effusion. Treatment: 10 patients were treated with antiviral and anti-Aspergillus drugs after admission. Four patients received respiratory support. All 10 cases were cured and discharged.Early diagnosis of IPA in influenza A (H1N1) patients is the key to successful treatment., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Sperm morphology was once believed as one of the most predictive indicators of pregnancy outcome in assisted reproductive technology (ART). However, the impact of teratozoospermia on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes and its offspring remains inconclusive. In order to evaluate the influence of teratozoospermia on pregnancy outcome and newborn status after IVF and ICSI, a retrospective study was conducted. This was a matched case-control study that included 2202 IVF cycles and 2574 ICSI cycles and was conducted at the Reproductive and Genetic Hospital of CITIC-Xiangya in Changsha, China, from June 2013 to June 2018. Patients were divided into two groups based on sperm morphology: teratozoospermia and normal sperm group. The pregnancy outcome and newborn outcome were analyzed. The results indicated that couples with teratozoospermia had a significantly lower optimal embryo rate compared to those with normal sperm morphology in IVF (P = 0.007), while there were no statistically significant differences between the two groups in terms of the fertilization rate, cleavage rate, implantation rate, and pregnancy rate (all P > 0.05). Additionally, teratozoospermia was associated with lower infant birth weight in multiple births after IVF. With regard to ICSI, there was no significant difference in both pregnancy outcome and newborn outcome between the teratozoospermia and normal groups (both P > 0.05). Furthermore, no increase in the risk of birth defects occurred in the teratozoospermia group after IVF/ICSI. Consequently, we believe that teratozoospermia has limited predictive value for pregnancy outcomes in IVF/ICSI, and has little impact on the resulting offspring if multiple pregnancy is avoided., Competing Interests: None

Background: Tuberculosis (TB) remains a significant global public health problem. China has the second highest TB burden in the world. With a growing TB population with diabetes mellitus (DM), the TB control system faces mounting challenges. To date, evidence remains inconclusive regarding the association between TB-DM co-morbidity and delayed diagnosis of TB patients. This study aims to assess the diagnostic delay of TB patients with known DM and identify the factors associated with this delay., Methods: Data was collected from China's Tuberculosis information management system in two counties of Zhejiang province, China. Patient delay, health system delay and total diagnostic delay are defined as follows: 1) the interval between the onset of TB symptoms and first visit to any health facility; 2) from the first visit to the health facility to the confirmed TB diagnosis in the designated hospital; 3) the sum of patient and health system's respective delays. Comparison of these delays was made between TB patients with and without DM using Mann-Whitney U test and Chi-square test. Univariate and multivariate regression analysis was used to identify factors influencing delays among TB patients with DM., Results: Of 969 TB patients, 67 (7%) TB patients had DM co-morbidity. Compared with TB patients without DM, TB patients with DM experienced significantly shorter health system delays (p < 0.05), and there was a significantly lower proportion of patients whose health system delayed> 14 days (7.0% vs. 18%, p < 0.05). However, no significant difference was observed between both patient categories regarding patient delay and total diagnostic delay. The multivariate regression analysis suggested that TB patients with DM who were aged < 60 years (AOR = 3.424, 95%CI: 1.008-11.627, p < 0.05) and non-severe cases (AOR = 9.725, 95%CI: 2.582-36.626, p < 0.05) were more likely to have a total diagnostic delay of> 14 days., Conclusions: Our study suggests that DM does not contribute to further diagnostic delay as expected. Instead, we observed significantly improved health system delay among TB patients with DM. The findings indicate the importance of early screening and diagnosis for TB among diabetic patients and of strengthening the integrated control and management of TB and diabetic programs.

Background: Galectin-3 (Gal-3) is a pleiotropic glycan-binding protein shown to be involved in sepsis and acute kidney injury (AKI). However, its role has never been elucidated in sepsis-associated AKI (S-AKI). We aimed to explore Gal-3's role and its potential utility as a therapeutic target in S-AKI., Methods: In 57 patients admitted to the intensive care unit (ICU) with sepsis, serum Gal-3 was examined as a predictor of ICU mortality and development of AKI. In a rat model of S-AKI induced by cecal ligation and puncture (CLP), 7-day mortality and serum Gal-3, Interleukin-6 (IL-6), and creatinine were examined at 2, 8, and 24 hours (h) post-CLP. Two experimental groups received the Gal-3 inhibitor modified citrus pectin (P-MCP) at 400 mg/kg/day and 1200 mg/kg/day, while the control group received water only (n = 18 in each group)., Results: Among 57 patients, 27 developed AKI and 8 died in the ICU. Serum Gal-3 was an independent predictor of AKI (OR = 1.2 [95% CI 1.1-1.4], p = 0.01) and ICU mortality (OR = 1.4 [95% CI 1.1-2.2], p = 0.04) before and after controlling for age, AKI, and acute physiology and chronic health evaluation (APACHE II) score. In the CLP rat experiment, serum Gal-3 peaked earlier than IL-6. Serum Gal-3 was significantly lower in both P-MCP groups compared to control at 2 h post-CLP (400 mg: p = 0.003; 1200 mg: p = 0.002), and IL-6 was significantly lower in both P-MCP groups at all time points with a maximum difference at 24 h post-CLP (400 mg: p = 0.015; 1200 mg: p = 0.02). In the Gal-3 inhibitor groups, 7-day mortality was significantly reduced from 61% in the control group to 28% (400 mg P-MCP: p = 0.03) and 22% (1200 mg P-MCP: p = 0.001). Rates of AKI per RIFLE criteria were significantly reduced from 89% in the control group to 44% in both P-MCP groups (400 mg: p = 0.007; 1200 mg: p = 0.007)., Conclusions: This translational study demonstrates the importance of Gal-3 in the pathogenesis of S-AKI, and its potential utility as a therapeutic target.

Background: The mechanism of rapidly increased non-small cell lung cancer (NSCLC) among never-smoking Chinese women has not been elucidated. Ovarian sex steroid hormones have been suggested to counteract lung cancer development, and sex hormone-binding globulin (SHBG) is essential in sex hormones regulation. This study aims to exploring single nucleotide polymorphisms (SNPs) in genomic regions associated with SHBG concentrations that contributed to never-smoking female NSCLC., Methods: Candidate genes were selected by a genome-wide association (GWAS) meta-analysis and gene expression profiles of never-smoking NSCLC of Chinese women. The candidate SNPs limited to common minor allele frequency (MAF), missense variant, ethnic heterogeneous distribution, and SNPs were genotyped using the TaqMan method. A two-stage case-control design was adopted for exploration and validation of associations between candidate SNPs and risk of NSCLC. All participants were never-smoking Chinese women. Chi-square test and multivariate logistic regression were applied., Results: Beginning with 12 genomic regions associated with circulating SHBG concentrations and gene expression profiles from never-smoking NSCLC in Chinese women, candidate SNP rs12233719 and rs7439366 both located in candidate gene UGT 2 B 7, which may be related to circulating SHBG concentrations and cancer risk, were identified. A two-stage case-control study was conducted in Shenyang and Tianjin represented as the training stage and validation stage, respectively. Under the dominant model, compared to individuals with the wild G/G genotype, the adjusted OR of those with the T allele was 1.58 (95% CI: 1.15-2.16) in Chinese Shenyang training set, and was 1.49 (95% CI: 1.02-2.18) in Chinese Tianjin validation set, both accompanied with a significant trend relationship consistently. UGT2B7 was upregulated in female NSCLC patients' tumor tissues and was associated with a poor prognosis in NSCLC., Conclusion: Our findings indicated that a sex hormones regulation-related SNP rs12233719 was associated with never-smoking female lung cancer risk, which might partially explain NSCLC-susceptibility in Chinese women., (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

This study aims to estimate the free sugars intake, identify the primary food sources of free sugars, and explore the relationship between free sugars intake and dental caries among Chinese adolescents. This cross-sectional study included 1517 middle-school students aged 12-14 years in Changsha city, China. Adolescents completed a 12-item Food Frequency Questionnaire (FFQ) and oral health assessment. The students' dental caries experience was available as DMFT score (number of decayed, missing, and filled permanent teeth). Statistical analyses included the Mann-Whitney test, Kruskal-Wallis test, Chi-square test, and binary logistic regression model. The average intake of free sugars was 53.1 g/d in adolescents, and 43.2% of the students consumed more than 50 g of free sugars daily. The primary contributor to free sugars was sugar-sweetened beverages (SSBs). Age, boarders, and high family income were risk factors for excessive free sugars intake ( p < 0.05), and increased free sugars intake was a risk factor for dental caries (odds ratio, OR = 1.446, 95% confidence interval: 1.138-1.839). Both the free sugars intake and dental caries prevalence in Chinese adolescents were high. Targeted interventions are urgently needed to address the excessive consumption of free sugars and improve Chinese adolescents' oral health.

We conducted an epidemiological study to identify the demographics and pre-operative characteristics of patients undergoing primary anterior cruciate ligament (ACL) reconstruction in a multi-ethnic Asian population. A retrospective study was performed on 696 patients who registered in our ACL reconstruction registry from January 2013 to August 2016. Important inter-ethnic differences were found. Indian patients were significantly older compared to Malay and Chinese patients. Malay and Indian patients were more likely to be male, overweight, and obese compared to Chinese patients. Soccer was the predominant sport involved, although ethnic predominance in specific sports exists. Novel findings from this study include increased prevalence of concomitant chondral injuries in the Chinese population compared to Malays and Indians, and significantly higher rates of concomitant intra-articular injuries in soccer and basketball compared to netball. Identification of these high-risk subgroups would serve useful in guiding the formulation of prevention strategies within our multi-ethnic community.

The present study aimed to culturally adapt the Canadian Assessment of Physical Literacy, Second Edition (CAPL-2) and examine its validity and reliability among Chinese children aged 8 to 12 years. The original manual of CAPL-2 was translated and culturally adapted from English into Chinese. A total of 327 children (153 boys, mean age = 10.0) completed CAPL-2 (Chinese) assessments. Internal consistency reliability and construct validity for subscales and total model was explored. Results reported a good fit after adjusting for covariation paths, chi-square ( χ 2 = 70.16, df = 43, p < 0.05), RMSEA = 0.04, 90% CI (0.024 - 0.062), CFI = 0.94, TLI = 0.90. Motivation and Confidence showed a good internal consistency (α = 0.82), compared to Knowledge and Understanding (α = 0.52). In general, there were few significant correlations between age and the subdomains as developmentally expected, and gender differences were observed with boys performing better than girls in total CAPL2 (Chinese) scores. This study was the first to cross-validate the CAPL-2 into the Chinese population. CAPL-2 (Chinese) offers the possibility of assessing physical literacy for researchers and practitioners and Chinese children's physical literacy development could be easily tracked in school settings.

Background: According to the theory of compensating differentials, caregivers with high levels of intrinsic motivation should exhibit a higher-than-average satisfaction with their pay. Whereas studies conducted in Western countries have provided empirical evidence for the theory of compensating differentials in various care settings, few studies have been conducted in China that focus on caregivers employed in residential homes for the elderly (RHE). The sociodemographic characteristics of caregivers in China different significantly from their counterparts in Western countries., Purpose: This study was developed to analyze the mediating role of job burnout to assess the influence of intrinsic motivation on pay satisfaction among caregivers in RHE., Methods: Structural equation modeling was used to examine the influences of intrinsic motivation on pay satisfaction in a sample of 1,212 caregivers employed in RHE in China by analyzing the mediating role of job burnout., Results: Intrinsic motivation was found to relate positively to pay satisfaction (β = .11, p < .05). Negative relationships were identified between intrinsic motivation and job burnout (β = -.46, p < .01) and between job burnout and pay satisfaction (β = -.13, p < .01). Job burnout was found to have a significant mediating effect on the relationship between intrinsic motivation and pay satisfaction (β = .06, p < .01)., Conclusions/implications for Practice: A significant relationship was found between intrinsic motivation and pay satisfaction, with job burnout playing a mediating role in caregivers employed in RHE in China. This research has profound implications for nursing education, practice, and research. First, greater efforts should be focused on instilling nursing values in nursing students to foster intrinsic motivation. Second, nonpecuniary rewards may be offered to caregivers to acknowledge the values of care work and strengthen intrinsic motivation. Third, a supportive working climate should be fostered to reduce job burnout. Fourth, caregivers should be informed of their rights to decent pay and their right to bargain collectively through unions. Fifth, appropriate public policies should be implemented to provide pay for caregivers at levels that recognize and appreciate their intrinsic motivation.

Background: Few studies have focused on cesarean delivery (CD) trends among primipara under the one-child and the two-child policies. This study aimed to explore the trends in CD rates among primipara during 1995-2019 and the associated factors with CD risk., Methods: This study obtained clinical data on primiparous mothers and newborns from 1995 to 2019 at a large tertiary hospital in Wuhan, China. Trends in CD rates were calculated using the joinpoint regression analysis. The Chi-square tests and log-binomial regression analyses were used to evaluate the associations between primary variables and CD risk., Results: CD rates showed a significant upward trend with an average annual percentage change (APC) of 2.2% (95% CI: 0.6, 3.8%) during the study period. In 1995-2006, the CD rates continued to increase with an APC of 7.8% (95% CI: 4.8, 10.9%). After 2006, the CD rates started to decline by an APC of - 4.1% (95% CI: - 5.5, - 2.6%). The CD rates non-significantly increased from 36.2% in 2016 to 43.2% in 2019. Moreover, the highest CD rate during 2015-2019 was observed on August 30 (59.2%) and the lowest on September 1 (29.7%). Primipara of older age and those with >3pregnancies had higher risks of CD. Furthermore, primipara who gave birth to newborns with low birth weight and macrosomia had higher risks of CD., Conclusions: Maternal and fetal as well as social and cultural factors may contribute to the rising trend of CD rates. Effective measures should be taken to control CD under the two-child policy, especially for primipara.

Background: With evidence of sustained transmission in more than 190 countries, coronavirus disease 2019 (COVID-19) has been declared a global pandemic. Data are urgently needed about risk factors associated with clinical outcomes., Methods: A retrospective review of 323 hospitalized patients with COVID-19 in Wuhan was conducted. Patients were classified into 3 disease severity groups (nonsevere, severe, and critical), based on initial clinical presentation. Clinical outcomes were designated as favorable and unfavorable, based on disease progression and response to treatments. Logistic regression models were performed to identify risk factors associated with clinical outcomes, and log-rank test was conducted for the association with clinical progression., Results: Current standard treatments did not show significant improvement in patient outcomes. By univariate logistic regression analysis, 27 risk factors were significantly associated with clinical outcomes. Multivariate regression indicated age >65 years (P < .001), smoking (P = .001), critical disease status (P = .002), diabetes (P = .025), high hypersensitive troponin I (>0.04 pg/mL, P = .02), leukocytosis (>10 × 109/L, P < .001), and neutrophilia (>75 × 109/L, P < .001) predicted unfavorable clinical outcomes. In contrast, the administration of hypnotics was significantly associated with favorable outcomes (P < .001), which was confirmed by survival analysis., Conclusions: Hypnotics may be an effective ancillary treatment for COVID-19. We also found novel risk factors, such as higher hypersensitive troponin I, predicted poor clinical outcomes. Overall, our study provides useful data to guide early clinical decision making to reduce mortality and improve clinical outcomes of COVID-19., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Background: "Doing the month" is a prevalent Chinese postpartum custom which is believed to restore health after delivery. However, some traditional practices are potentially harmful for women's health., Objectives: To examine the effect of an evidence-based health education program on Chinese postpartum women's adherence to traditional practices of doing the month and the effect of adherence to doing the month on maternal physiological and psychological health., Methods: A randomized controlled trial was conducted. During December 2016-July 2017, we recruited postpartum women at a tertiary hospital. Women randomized to the intervention group received evidence-based health education within 1 week after returning home and received a second visit 1 month later. The control group received routine postpartum home visits. Adherence to doing the month was measured by the Adherence to Doing-the-Month Practices questionnaire (ADP). Maternal physical health was measured by the Chair Stand Test and Postpartum Symptom Checklist. Maternal psychological health was measured by the Edinburgh Postnatal Depression Scale (EPDS). Descriptive statistics, t-test, and chi-squared test were used to analyze the differences in scores and symptoms of the two groups., Results: We recruited 124 eligible postpartum women and 108 of them (54 intervention group, 54 control group) completed this study. The ADP score of the intervention group was significantly lower than that of the control group (p < 0.001). The number of participants in the experimental group with poor appetite and indigestion was significantly lower than that of control group. No significant differences were found in numbers of symptoms and average EPDS scores between the 2 study groups (p > 0.05)., Conclusions: Evidence-based health education can reduce postpartum women's adherence to some traditional practices of doing the month and improve women's physical health., Competing Interests: Declaration of Competing Interest There is no interest relationship involved in this study., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: COVID-19 is a public health emergency that is spreading worldwide and seriously affecting the global economy. Data on the effectiveness and safety of the use of methylprednisolone for patients with severe COVID-19 remain limited., Methods: In this retrospective study, epidemiological, clinical, laboratory, treatment and outcomes data of hospitalized patients with severe COVID-19 in Zhongnan Hospital of Wuhan University from January 1 to 7 March 2020, were collected. Binary logistic regression model was used to analyse risk factors for disease progression from severe COVID-19 illness to critical illness. The effectiveness and safety of the use of methylprednisolone for patients with severe COVID-19 disease were evaluated., Results: The results of the multivariate analysis from 175 patients with severe COVID-19 indicate that the use of methylprednisolone was a protective factor against disease progression from severe to critical illness(P < .001; OR: 0.054 95% CI: 0.017-0.173). Among patients with severe COVID-19 aged < 65 years, both the proportion of patients who progressed to critical illness (42.2% vs 90.0%, P = .000) and the mortality(6.7% vs 30.0%, P = .002) were lower for patients in methylprednisolone group, compared with those in the non-methylprednisolone group, whereas no statistical differences between the methylprednisolone group and the non-methylprednisolone group were found among patients with COVID-19 older than 65 years. Moreover, both the levels of CD4 + T lymphocyte counts (646 vs 463/µL, P = .007) and IL-6 (241.9 vs 82.8 pg/mL, P = .025) were higher among patients with severe COVID-19 aged < 65 years, compared with those patients ≥ 65 years old., Conclusion: Data from the limited sample showed that the early use of low or medium doses of methylprednisolone has a positive effect for patients with severe COVID-19 younger than 65 years old, and excessive immune response and cytokine storm may be some of the reasons for the effectiveness., (© 2020 Stichting European Society for Clinical Investigation Journal Foundation.)

Background: Frailty is a natural consequence of the aging process. With the increasing aging population in Mainland China, the quality of life and end-of-life care for frail older people need to be taken into consideration. Advance Care Planning has also been used worldwide in long-term facilities, hospitals and communities to improve the quality of end-of-life care, increase patient and family satisfaction, and reduce healthcare costs and hospital admissions in Western countries. However, it has not been practiced in China., Research Objective: This study aimed to evaluate the effectiveness of a modified Advance Care Planning intervention in certainty of end-of-life care, preferences for end-of-life care, quality of life concerns, and healthcare utilization among frail older people., Research Design: This study used a quasi-experimental design, with a single-blind, control group, pretest and repeated posttest approach., Participants and Research Context: A convenience sample of 74 participates met the eligibility criteria in each nursing home. A total of 148 frail older people were recruited in two nursing homes in Zhejiang Province, China., Ethical Considerations: The study received ethical approval from the Clinical Research Ethics Committee, the Faculty of Medicine, and The Chinese University of Hong Kong, CREC Ref. No: 2016.059., Findings: The results indicated the Advance Care Planning programme was effective at increasing autonomy in decision making on end-of-life care issues, decreasing decision-making conflicts over end-of-life care issues, and increasing their expression about end-of-life care., Discussion: This study promoted the participants' autonomy and broke through the inherent custom of avoiding talking about death in China., Conclusion: The modified Advance Care Planning intervention is effective and recommended to support the frail older people in their end-of-life care decision in Chinese society.

Background: In the current literature, for adult lumbar spondylolisthesis, the direct comparison of clinical outcomes and perioperative complications between transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) is limited. Whether the therapeutic effect of TLIF is better than that of PLIF is still controversial. In this retrospective controlled study, our aim was to compare their clinical outcomes and radiological results of the above two stabilization approaches after 1-year follow-up period., Methods: This investigation was approved via the Institutional Review committee of China-Japan friendship hospital. This was a retrospective single-center analysis of subjects. We reviewed the patients with spondylolisthesis treated with TLIF or PLIF between July 2016 and February 2019 in our hospital. Patients with these conditions will be included: with the radiological evidence of degenerative lumbar spondylolismia with leg pain and/or low back pain, or the neurogenic claudication after failure of conventional conservative treatment for more than 6 months. The patients who received 3 levels or more intervertebral fusion levels were excluded. Patients without a completed medical history were excluded. Patients who had a history of lumbar spine surgery were also excluded. Clinical outcomes in our follow-up included functional outcomes, complications, and radiographic such as spondylolisthesis degree. The radiographs were obtained at 1, 3, 6, and 12 months during the outpatient follow-up., Results: This protocol will provide a solid theoretical basis for exploring which technique is better in treatment of spondylolisthesis., Trial Registration: This study protocol was registered in Research Registry (number: researchregistry6032).

Purpose: To compare a hydroactive dressing to an adhesive tape standard of care in the prevention of nasal ala pressure injuries associated with nasotracheal intubation during orthognathic surgery., Design: Randomized controlled trial., Subjects and Setting: The study took place in a tertiary hospital of stomatology in China. Patients undergoing general anesthesia with nasotracheal intubation during orthognathic surgical procedures were invited to participate., Methods: Participants were divided into 2 groups: in the experimental group, a hydroactive dressing was applied to the nasal ala before the surgical procedures; the control group received standard prevention with a type of tape. Skin assessments were performed on the wards up to 72 hours after the procedures. Demographic information and potential contributing factors associated the development of nasal ala pressure injuries were collected from patients' electronic medical records. Pressure injury development was staged using National Pressure Injury Advisory staging guidelines. Pressure injury incidence was compared between groups using the χ test and odds ratio., Results: The sample comprised 450 participants, 225 in each group. The incidence of nasal ala pressure injuries development was 14.222% and 4.444% in the 2 groups, respectively (P = .000). The odds ratio was 3.565 (95% confidence interval, 1.707-7.443)., Conclusions: The study findings indicate that the incidence of pressure injuries of nasal ala skin protected by hydroactive dressings was lower than the standard preventive method. Hydroactive dressings should be considered as a prevention method to reduce device-related skin injuries associated with nasotracheal intubation.

Novel coronavirus disease (COVID-19) emerged in Wuhan in December 2019, has spread in many countries affected people globally. In response to the economic requirement of the nation and meet the need of patient's, a momentous event was going back to work step by step as fighting against COVID-19. Safety in clinical work is of priority as elective surgery in the department of surgery progressing. We used checklists based on our experiences on COVID-19 control and reality of clinical work from February to March in the West China Hospital, involving events of screening patient, chaperonage, and healthcare workers. Checklist summarized the actual clinical nursing work and management practices, hope to provide a reference for the order of surgery during the epidemic prevention and control, and standardize the clinical nursing work of surgery during pandemic.

Objectives: To describe the prevalence of overweight and obesity among children under 5 years old, assess the indicators of breastfeeding practices, and explore the associations between breastfeeding practices and early childhood overweight/obesity., Methods: The survey was conducted in 20 counties in central and western China in 2016. All children under 5 years old were physically measured for anthropometric data and their breastfeeding practices were obtained through a face-to-face questionnaire interview. We performed logistic regressions to assess the associations of different breastfeeding practices with overweight/obesity., Results: The prevalence of overweight and obesity among children under 5 years old were 8.7% and 2.6%, respectively. Overall, 93.6% of children were breastfed, while only 20.7% had exclusive breastfeeding under 6 months of age and about half of the children under 5 years old were weaned at 12 months. Compared with children with a duration of breastfeeding ≥ 12 months, children who have been breastfed for < 6 months were significantly associated with a 97% increased risk of overweight/obesity (OR 1.97, 95% CI 1.34-2.88, P = 0.001)., Conclusions for Practice: The present study showed that overweight and obesity among children under 5 years old in central and western China remained an important childhood health concern. The rates of most indicators of breastfeeding practices were low, which needed more public attention. Moreover, we found that a shorter duration of breastfeeding was associated with an increased risk of overweight/obesity among children in central and western China.

Nowadays most of the hepatitis B virus (HBV) infected population are adults, among which hepatitis B e antigen (HBeAg) negative infection occupied the largest proportion of HBV infection in China. HBeAg-negative patients are heterogeneous, and the corresponding interventions are different. Therefore, it is worth researching the infection characteristics of HBeAg-negative patients to help guide the interventions.A total of 11,738 treatment-naïve HBeAg-negative adult patients were randomly selected, and their demographic and medical history information were collected. The liver biochemistry, and HBV infection biomarkers including hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), HBeAg, hepatitis B e antibody (anti-HBe), hepatitis B core antibody (anti-HBc), and hepatitis B virus deoxyribonucleic acid (HBV-DNA) levels were tested. The infection characteristics and their influencing factors were explored.Sixty percent of the patients presented HBV-DNA-positive, of which 31.2% had HBV-DNA level higher than 2000 IU/mL, and 16.5% had HBV-DNA level higher than 20,000 IU/mL. HBV-DNA levels tended to increase along with the increasing of age, and the male patients had significant higher HBV-DNA levels than the female patients. Twenty-four percent of the patients had abnormal transaminase. The male patients were more vulnerable to abnormal transaminase (30.0%) than the female patients (18.4%). Fifty-five percent patients with HBV-DNA ≥20,000 IU/mL presented abnormal alanine aminotransferase (ALT) or aspartate transaminase (AST), which was significantly higher than that of patients with HBV-DNA levels below 20,000 IU/mL (19.0-21.7%). Multivariate logistic regression analyses revealed that the male patients and the patients with higher viral load had higher risk of having abnormal liver function.A considerable number of HBeAg-negative patients were virological active and had liver damage. It is necessary and urgent to carry out regular active interventions for the chronic HBV-infected patients.

Background/aims: This study aimed to investigate the differences and relevance of various common duodenal diseases in different parts in the aspects of age, gender, helicobacter pylori (H. pylori) infection, application of nonsteroidal anti-inflammatory drugs (NSAIDs), smoking, or alcohol consumption., Materials and Methods: The medical records of various duodenal diseases were collected and tested for difference using the χ2 test or the Fisher exact probability method., Results: 1) The proportions of duodenal ulcer (DU), inflammation, and duodenal bulb diseases in the adult group (A) (47.98%, 36.70%, and 66.63%) were higher than those in the elderly group (E) (41.38%, 29.83%, and 56.82%), but the proportions of duodenal diverticulum (DD) and tumor diseases in the descending and ascending segments (2.95%, 1.43%, 9.14%, and 0.14%) were lower than those in group E (13.73%, 3.69%, 19.41%, and 0.76%) (p<0.001). 2) The positive rate of H. pylori (63.64%) in the duodenal bulb diseases was higher than that in the bulb-descending segment (53.75%), but the application rate of NSAIDs (16.44%) in the duodenal bulb-descending diseases was lower than that in the descending segment (24.81%) (p<0.001)., Conclusion: 1) DU, inflammation, and duodenal bulb diseases are common in adults, but DD and tumor diseases in the descending and ascending segments are more common in the elderly. 2) Compared with the duodenal bulb-descending diseases, the application of NSAIDs has greater impact on the diseases in the descending segment, and the rate of H. pylori infection is higher in duodenal bulb diseases.

Background: Reports indicate that those most vulnerable to developing severe coronavirus disease 2019 (COVID-19) are older adults and those with underlying illnesses, such as diabetes mellitus, hypertension, or cardiovascular disease, which are common comorbidities among patients undergoing maintenance hemodialysis. However, there is limited information about the clinical characteristics of hemodialysis patients with COVID-19 or about interventions to control COVID-19 in hemodialysis centers., Methods: We collected data retrospectively through an online registration system that includes all patients receiving maintenance hemodialysis at 65 centers in Wuhan, China. We reviewed epidemiologic and clinical data of patients with laboratory-confirmed COVID-19 between January 1, 2020 and March 10, 2020., Results: Of 7154 patients undergoing hemodialysis, 154 had laboratory-confirmed COVID-19. The mean age of the 131 patients in our analysis was 63.2 years; 57.3% were men. Many had underlying comorbidities, with cardiovascular disease (including hypertension) being the most common (68.7%). Only 51.9% of patients manifested fever; 21.4% of infected patients were asymptomatic. The most common finding on chest computed tomography (CT) was ground-grass or patchy opacity (82.1%). After initiating comprehensive interventions-including entrance screening of body temperature and symptoms, universal chest CT and blood tests, and other measures-new patients presenting with COVID-19 peaked at 10 per day on January 30, decreasing to 4 per day on February 11. No new cases occurred between February 26 and March 10, 2020., Conclusions: We found that patients receiving maintenance hemodialysis were susceptible to COVID-19 and that hemodialysis centers were high-risk settings during the epidemic. Increasing prevention efforts, instituting universal screening, and isolating patients with COVID-19 and directing them to designated hemodialysis centers were effective in preventing the spread of COVID-19 in hemodialysis centers., (Copyright © 2020 by the American Society of Nephrology.)

Objective: This study investigated the influence of Coronavirus Disease 2019 (COVID-19) on lung function in early convalescence phase., Methods: A retrospective study of COVID-19 patients at the Fifth Affiliated Hospital of Sun Yat-sen University were conducted, with serial assessments including lung volumes (TLC), spirometry (FVC, FEV1), lung diffusing capacity for carbon monoxide (DLCO),respiratory muscle strength, 6-min walking distance (6MWD) and high resolution CT being collected at 30 days after discharged., Results: Fifty-seven patients completed the serial assessments. There were 40 non-severe cases and 17 severe cases. Thirty-one patients (54.3%) had abnormal CT findings. Abnormalities were detected in the pulmonary function tests in 43 (75.4%) of the patients. Six (10.5%), 5(8.7%), 25(43.8%) 7(12.3%), and 30 (52.6%) patients had FVC, FEV1, FEV1/FVC ratio, TLC, and DLCO values less than 80% of predicted values, respectively. 28 (49.1%) and 13 (22.8%) patients had PImax and PEmax values less than 80% of the corresponding predicted values. Compared with non-severe cases, severe patients showed higher incidence of DLCO impairment (75.6%vs42.5%, p = 0.019), higher lung total severity score (TSS) and R20, and significantly lower percentage of predicted TLC and 6MWD. No significant correlation between TSS and pulmonary function parameters was found during follow-up visit., Conclusion: Impaired diffusing-capacity, lower respiratory muscle strength, and lung imaging abnormalities were detected in more than half of the COVID-19 patients in early convalescence phase. Compared with non-severe cases, severe patients had a higher incidence of DLCO impairment and encountered more TLC decrease and 6MWD decline.

To identify the clinical risk factors and investigate the efficacy of a classification model based on the identified factors for predicting 2-year recurrence after ischemic stroke.From June 2017 to January 2019, 358 patients with first-ever ischemic stroke were enrolled and followed up in Shenzhen Traditional Chinese Medicine Hospital. Demographic and clinical characteristics were recorded by trained medical staff. The outcome was defined as recurrence within 2 years. A multivariate logistic regression model with risk factors and their interaction effects was established and evaluated.The mean (standard deviation) age of the participants was 61.6 (12.1) years, and 101 (28.2%) of the 358 patients were female. The common comorbidities included hypertension (286 patients, 79.9%), diabetes (148 patients, 41.3%), and hyperlipidemia (149 patients, 41.6%). The 2-year recurrence rate was 30.7%. Of the 23 potential risk factors, 10 were significantly different between recurrent and non-recurrent subjects in the univariate analysis. A multivariate logistic regression model was developed based on 10 risk factors. The significant variables include diabetes mellitus, smoking status, peripheral artery disease, hypercoagulable state, depression, 24 h minimum systolic blood pressure, 24 h maximum diastolic blood pressure, age, family history of stroke, NIHSS score status. The area under the receiver operating characteristic curve (ROC) was 0.78 (95% confidence interval: 0.726-0.829) with a sensitivity of 0.61 and a specificity of 0.81, indicating a potential predictive ability.Ten risk factors were identified, and an effective classification model was built. This may aid clinicians in identifying high-risk patients who would benefit most from intensive follow-up and aggressive risk factor reduction.The clinical trial registration number: ChiCTR1800019647.

Introduction: Postoperative pulmonary complications (PPCs) are common and associated with increased morbidity, mortality, and medical cost. They are gaining increasing concerns among patients receiving neurological surgery. Chronic obstructive pulmonary disease (COPD) affect a large section of whole population and is also one of the risk factors of PPCs in the perioperative setting. Ipratropium bromide is the inhalation solution for the treatment of COPD. Studies showed the perioperative nebulization of ipratropium bromide could increase the lung function and decrease the incidence of postoperative pneumonia in COPD patients underwent thoracic surgery. The purpose of this study is to investigate the effect of perioperative nebulization of ipratropium bromide on PPCs in COPD patients underwent neurosurgical surgery., Methods and Analysis: This study is a multicenter retrospective study in China. Patients who meet the inclusion/exclusion criteria are selected from 7 neurosurgical centers in China. According to whether ipratropium bromide is used in perioperative period, the patients are divided into exposure group and control group. The primary outcome is the incidence of postoperative pneumonia. Secondary outcomes are unplanned intubation, postoperative mechanical ventilation ≥ 48 hours, respiratory failure, atelectasis, death, and length of stay., Ethics and Dissemination: This study was approved by the ethics committee (EC) of the School of Public Health, Fudan University, Shanghai, China. Waived by the ethics committee, no written consent form was obtained since we used the registry data. The study results will be communicated via publication., Trial Registration Number: ChiCTR1900022552.

Background: Civilian explosion blast injury is more frequent in developing countries, including China. However, the incidence, casualties, and characteristics of such incidents in China are unknown., Methods: This is a retrospective analysis of the State Administration of Work Safety database. Incidents during a period from January 1, 2000 to April 30, 2017 were included in the analysis. The explosions were classified based on the number of deaths into extraordinarily major, major, serious and ordinary type. Descriptive statistics was used to analyze the incidence and characteristics of the explosions. Correlation analysis was performed to examine the potential correlations among various variables., Results: Data base search identified a total of 2098 explosions from 2000 to 2017, with 29,579 casualties: 15,788 deaths (53.4%), 12,637 injured (42.7%) and 1154 missing (3.9%). Majority of the explosions were serious type (65.4%). The number of deaths (39.5%) was also highest with the serious type (P = 0.006). The highest incidence was observed in the fourth quarter of the year (October to December), and at 9:00-11:00 am and 4:00-6:00 pm of the day. The explosions were most frequent in coal-producing provinces (Guizhou and Shanxi Province). Coal mine gas explosions resulted majority of the deaths (9620, 60.9%). The number of explosion accidents closely correlated with economic output (regional economy and national GDP growth rate) (r = - 0.372, P = 0.040; r = 0.629, P = 0.028)., Conclusions: The incidence and civilian casualties due to explosions remain unacceptabe in developing China. Measures that mitigate the risk factors are of urgently required.

Background: Injuries are of growing public health concern in China, and the trends of urban-rural injury mortality disparity for the last decade are still being explored. This study aims to analyze trends in injury mortality disparity between urban and rural areas of China by region, sex, and age from 2010 to 2016., Methods: Using data from the Disease Surveillance Points system (DSPs) collected by the Chinese Center for Disease Control and Prevention (CDC) from 2010 to 2016, injury age-standardized mortality rates (ASMRs) and rate ratios (RRs) were calculated for different groups. Chi-square tests were used to compare differences in rates between urban and rural residents. The time trends of injury ASMRs were assessed via the annual percentage change (APC), and RRs were used to analyze urban-rural mortality disparity., Results: The crude injury mortality rate of rural areas was 1.5 times higher than that of urban areas. The urban-rural RR of injury ASMR decreased from 1.8 to 1.5 (APC = 5.0%) over time, from 2.0 to 1.7 (APC = 4.7%) for eastern regions, from 1.9 to 1.5 (APC = 5.4%) and from 1.6 to 1.3 (APC = 4.5%) among males and females, respectively. Further decreases were from 2.0 to 1.4 (APC = 7.8%), from 1.9 to 1.6 (APC = 6.4%), and from 1.8 to 1.2 (APC = 5.7%) in the 5-14, 45-64, and 65+ year age groups, respectively. The urban-rural RRs of ASMRs for fall, drowning and suicide decreased from 1.3 to 1.2 (APC = - 3.0%), from 2.3 to 1.6 (APC = - 13.8%) and from 2.1 to 1.6 (APC = - 9.9%,), respectively., Conclusions: The urban-rural injury mortality disparity was large, but showed a significant decreasing trend in China. Residents of eastern regions, males/females, 5-14/45+ year age groups in the urban-rural injury mortality disparity all decreased gradually during the investigated period.

Background: Heart-fatty acid binding protein (HFABP) has been recognized as a highly heart-specific marker. However, it is currently unknown that its HFABP is also closely related to the severity of COVID-19., Methods: We retrospectively screened 46 patients who met our inclusion criteria within 4 weeks. They were tested for HFABP after the diagnosis of COVID-19, and monitored for HFABP during their hospital stay. We tracked the patients during their hospital stay to determine if they had severe COVID-19 or mild-to-severe transition features. We calculated the chi-square test values found for HFABP to predict the correlation between HFABP levels and the severity of the COVID-19., Results: Of these 46 cases, 16 cases with confirmed COVID-19 were tested for HFABP> 7 ng / mL upon admission; among them, 14 cases were diagnosed with severe COVID-19 within the hospitalization. The Odds ratio of the measured HFABP elevation was 6.81(95% confidence interval [CI] 5.23-8.40), and 3 patients with severe COVID-19 progressed in 5 patients with mild HFABP> 7 ng/mL., Conclusion: These data indicate that the elevation of HFABP is closely related to the severity of COVID-19 in the patients, and the elevated HFABP may cause rapid development of patients with mild COVID-19 into severe COVID-19. But serum HFABP negative maybe make patients with mild COVID-19 safer, the current data show no effect on the all-cause mortality., Trial Registration: Our study has been registered with the Chinese Clinical Trial Registry, the registration number: ChiCTR2000029829., Competing Interests: No authors have competing interests.

Objective: This study aimed to identify the important capacities that were most urgently needed during emergency response and factors associated with the Centers for Disease Control and Prevention (CDC) professionals' field coping-capacity for public health emergency., Methods: Professional workers (N = 1854) from 40 CDC institutions were chosen using the stratified cluster random sampling method in all 13 municipalities of Heilongjiang Province, China. Descriptive analysis and multivariate logistic regression were used., Results: Of 10 key capacities, the 3 that were most urgently needed during emergency response fieldwork as identified by respondents were crisis communication capacity, personal protection capacity, and laboratory detection capacity. Overall, 38.1% of respondents self-rated as "poor" on their coping-capacity. The logistic regression found that proficiency in emergency preparedness planning, more practical experiences in emergency response, effectiveness in training and drills, a higher education level, and a higher professional position were significantly associated with the individual's field coping-capacity., Conclusion: This study identified CDC professionals' most urgent capacity need and the obstructive factors and highlighted the importance of enhancing the capacity in crisis communication, personal protection, and laboratory detection. Intervention should be targeted at sufficient fund, formalized, and effective emergency training and drills, more operational technical guidance, and all-around supervision and evaluation.

Background: To explore the role of preoperative prealbumin levels in predicting the prognosis of patients with gastric cancer., Methods: A total of 989 gastric cancer patients in the Affiliated Tumour Hospital of Harbin Medical University who underwent gastrectomy were included in this retrospective study. The preoperative prealbumin level, clinicopathological data, and follow-up data were recorded. According to the maximum chi-square survival correlation value, the survival of patients with low preoperative prealbumin (<140 mg/L) and high preoperative prealbumin (≥140 mg/L) were compared using the log-rank test and the Cox proportional hazard regression model., Results: Based on the best cut-off value of 140 mg/L, we divided the patients into the lower prealbumin group (<140 mg/L) and the higher prealbumin group (≥140 mg/L). Compared with the higher prealbumin group, the lower prealbumin group were older and had larger tumor volumes, lower hemoglobin (Hb) levels, and more upper gastric cancer tumors. The univariate analysis showed that prealbumin and other clinicopathological factors, including age, hemoglobin, tumor size, macroscopic type, cell differentiation, liver metastasis, operation type, N stage, and T stage, were significant prognostic factors. The multivariable analysis showed that age, prealbumin, macroscopic type, location, T stage, and N stage were independent prognostic factors., Conclusions: The preoperative prealbumin level was an independent prognostic factor for patients with gastric cancer. The preoperative prealbumin level can be used to predict the prognosis of patients with gastric cancer and guide clinical practice.

Background: Empathy is a crucial element in fostering a positive relationship between nurses and patients. Recent research indicates that the degree of empathy in nursing students declines as they gain education or experience. A number of teaching strategies have been used to improve nursing students' empathy competence levels. However, little is currently known about how empathy is best taught or enhanced in senior nursing students in China., Objectives: To implement a structured empathy educational program as developed from the Delphi technique, as well as to evaluate its effects on empathy competence among undergraduate nursing interns., Design: This study is quasi-experimental, with two-group comparison., Participants: Undergraduate nursing students in their fourth year (n = 118) were recruited from an affiliated teaching hospital in Wuhan, Central Part of China, between January 2018 and March 2018., Methods: A convenience sample of 118 undergraduate nursing interns were recruited from a teaching hospital in Wuhan and assigned to either the intervention or the control group according to their preference. Participants in the intervention group had received a 2-week, 12-hour structured empathy-related educational program (two sessions per week, 3 h per session), whereas the control group received no intervention. The Jefferson Scale of Empathy-Health Providers (JSE-HPs) was used to assess students' empathy levels before and after the intervention., Results: An independent samples t-test revealed that scores of empathy competence levels in the intervention group were significantly higher than those in the control group following the intervention. Three domains of empathy competence level were also significantly higher in the intervention group after the two weeks' training relative to the control group, namely: perspective taking, compassionate care, and standing in the patient's shoes., Conclusions: This modified empathy educational program may prove beneficial in improving the empathy competence level of undergraduate nursing interns., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: To reveal the ethnic disparity in the pneumonia-specific mortality rates of children under the age of 5 years (PU5MRs) and provide suggestions regarding priority interventions to reduce preventable under-five-years-of-age deaths., Methods: Data were obtained from the Direct Report System of Maternal and Child Health in Sichuan. The Cochran-Armitage trend test was used to assess the time trend. The Cochran-Mantel-Haenszel test and Chi-square test were used to examine the differences in the PU5MRs among different groups., Results: The PU5MRs in the minority and nonminority counties decreased by 53.7 and 42.3% from 2010 to 2017, respectively. The PU5MRs of the minority counties were 4.81 times higher than those of the nonminority counties in 2017. The proportion of pneumonia deaths to total deaths in Sichuan Province increased from 11.7% in 2010 to 15.5% in 2017. The pneumonia-specific mortality rates of children in the categories of 0-28 days, 29 days-11 months, and 12-59 months were reduced by 55.1, 38.8, and 65.5%, respectively, in the minority counties and by 35.5, 43.1, and 43.7%, respectively, in the nonminority counties., Conclusions: PU5MRs declined in Sichuan, especially in the minority counties, while ethnic disparity still exists. Although the PU5MRs decreased more for the minority counties as a fraction of all mortality, the absolute number of such deaths were higher, and therefore more children in these counties continue to die from pneumonia than from the non-minority counties. Priority should be given to strategies for preventing and controlling child pneumonia, especially for postneonates, in the minority counties.

Background: Incarcerated groin hernias are a common presentation as surgical emergencies. Other surgical treatment modalities are becoming more widely accepted including the use of prosthetic mesh and laparoscopy for assessment of hernia content viability and for repair. The aim of this study was to report our current experience with the use of prosthetic mesh in the treatment of incarcerated hernias and to compare the effects of different operative approaches., Methods: This retrospective study included 219 consecutive patients who underwent herniorrhaphy for incarcerated hernia between January 2013 and December 2017 in Beijing Chao-Yang Hospital. Twenty patients who were not used mesh were excluded. Patients who died in the postoperative period due to systemic complications, as well as those who were lost during the follow-up period, were excluded from the study. Demographics, surgical details, short term and long-term outcomes were collected. Mann-Whitney U-test and χ2 test were used for statistical analysis., Results: A total of 156 patients (78.4%) presented with inguinal hernias, 42 with femoral hernia (21.1%), and one with mixed hernia (0.5%), respectively. Mesh was placed in 199 patients (100%), including 15 patients with concomitant bowel resection. Four patients (2.0%) developed surgical site infections (SSI), four patients (2.0%) had foreign body sensation, one patient (0.5%) had hernia recurrence, two patients (1.0%) had chronic pain, 22 patients (11.1%) had seroma, and the mortality was 2.0%. No significant difference was noted concerning the development of surgical site infection, postoperative recurrence, chronic pain, foreign body sensation, and mortality rates between the transabdominal preperitoneal (TAPP) repair and open mesh repair. There was statistically significant difference in the postoperative incidence of seroma between two groups (12 of 49 [24.5%] vs. 10 of 150 [6.7%]; P=0.001)., Conclusions: Our experience demonstrates that acutely incarcerated or strangulated groin hernia in adults is a serious neglected problem. The use of mesh could become current practice even in case of bowel resection. There was no statistically significant difference in the postoperative complications between TAPP repair and open mesh repairs except seroma.

With the development of Web 2.0 technologies, an increasing number of websites are providing online healthcare services, and they have potential to alleviate problems of overloaded medical resources in China. However, some patients are reluctant to trust and continue using online healthcare services, partly due to the immature development of healthcare websites. Previous research has argued that online trust is significantly associated with the risk or benefit perceived by users. This study aims to extend prior research and examine how perceptual factors influence patients' online trust and intention to continue using online healthcare services. We developed a model with the moderating role of purpose of use and tested it with data collected from 283 participants. The results support the validity of the model and most hypotheses. The moderating role of purpose of use between the perceived benefits/risks and patients' online trust is also highlighted. Theoretical and practical implications are also discussed.