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Graphical abstract, We formulated a traditional Chinese medicine (TCM) prescription, Hanshiyi Formula (HSYF), which was approved and promoted by the Wuhan Municipal Health Commission for treating mild and moderate coronavirus disease 2019 (COVID-19). We aimed to evaluate the effect of HSYF on the progression to severe disease in mild and moderate COVID-19 patients. We conducted a retrospective cohort study of patients with mild and moderate COVID-19 in a quarantine station in Wuchang District, Wuhan. Using the real-time Internet information collection application and Centers for Disease Control for the Wuchang District, patient data were collected through patient self-reports and follow-ups. HSYF intervention was defined as the exposure. The primary outcome was the proportion of patients who progressed to a severe disease status, and a stratification analysis was performed. Univariate and multivariate regression analyses were performed to identify influencing factors that may affect the outcome. Further, we used propensity score matching (PSM) to assess the effect of HSYF intervention on the conversion of mild and moderate to a severe disease status. Totally, 721 mild and moderate COVID-19 patients were enrolled, including 430 HSYF users (exposed group) and 291 non-users (control group). No cases in the exposed group and 19 (6.5 %, P < 0.001) cases in the control group progressed to severe disease, and the difference between the two groups (exposed group-control group) was −6.5 % [95 % confidence interval (CI): (−8.87 %, −4.13 %)]. Univariate regression analysis revealed sex (male), age, fever, cough, and fatigue as risk factors for progression to severe disease. After PSM, none of the HSYF users and 7 (4.7 %, P = 0.022) non-users transitioned to severe disease, and the difference between the two groups (exposed group-control group) was −4.7 % [95 % CI: (−8.2 %, −1.2 %)]. Multivariate regression analysis revealed that sex (male) [OR: 3.145; 95 % CI: 1.036–9.545; P = 0.043] and age (> 48 years) [odds ratio (OR): 1.044; 95 % CI: 1.001–1.088; P = 0.044] were independent risk factors for conversion to severe disease. Therefore, HSYF can significantly reduce the progression to severe disease in patients with mild and moderate COVID-19, which may effectively prevent and treat the disease. However, further larger clinical studies are required to verify our results.

The aim of this study is to investigate the knowledge, attitude, and practice (KAP) on Coronavirus Disease 2019 (COVID-19) care among nursing staff and analyze its influencing factors. The survey was conducted on February 18, 2020, among 7,716 voluntary participants from 143 medical institutions in Zhejiang, China. The findings indicated that KAP of nursing staff scored well. However, the accuracy of psychological nursing knowledge was much lower, 14.3% only. Nursing staff working in isolation wards have higher knowledge (OR = 1.776, 95% CI: 1.491–2.116), attitude (OR = 1.542, 95% CI: 1.298–1.832), and practice (OR = 1.902, 95% CI: 1.590–2.274) scores than those in general wards. In terms of KAP, nursing staff with working experience ≤ 10 years scored lower than those with working experience ≥ 20 years, with OR values of 0.490 (95% CI: 0.412–0.583), 0.654 (95% CI: 0.551–0.775), and 0.747 (95% CI: 0.629–0.886), respectively. It is necessary to take measures to enhance the training on COVID-19, especially for KAP of junior nurses in general wards.

The TCM protocol in the Diagnosis and Treatment Protocol for corona virus disease 2019 (COVID-19) (Trial Version 7) has been updated from previous versions. The protocol was formulated under the direct leadership of the National Administration of Traditional Chinese Medicine, based on the experience of a panel of experts, supported by evidence from fever clinics and from the outcomes of emergency (EM) observation rooms and inpatients throughout China (especially in Wuhan, Hubei Province) in combination with the latest scientific research results and data. The present interpretation of the TCM protocol is based on an overall understanding of the revised content, and aims to guide and standardize its clinical application to provide a reference for clinicians.

Propensity score analysis (PSA) is widely used in medical literature to account for confounders. Conventionally, the propensity score (PS) is calculated by a binary logistic regression model using time-fixed covariates. In the presence of time-varying treatment or exposure, the conventional method may cause bias because subjects with early and late exposure are treated as the same. In effect, subjects who are treated latter can be different from those who are treated early. Thus, the conventional PSA must be modified to address this bias. In this paper, we illustrate how to perform analysis in the presence of time-dependent exposure. We conduct a simulation study with a known treatment effect. In the simulation study, we find the PSA method that directly adjust PS estimated by either a binary logistic regression model or a Cox regression model using time-fixed covariates still introduce significant bias. On the other hand, the time-dependent PS matching can help to achieve a result approaching the true effect. After time-dependent PS matching, the matched cohort can be analyzed with conventional Cox regression model or conditional logistic regression (CLR) model with time strata. The performance is comparable to the correctly specified Cox regression model with time-varying covariates (i.e., adjusting the exposure in a multivariable model as a time-varying covariate). We further develop a function called TDPSM() for time-dependent PS matching and it is applied to a real world dataset.

This study aimed to evaluate the efficacy of Chinese herbal medicine (CHM) in patients with severe/critical coronavirus disease 2019 (COVID-19). In this retrospective study, data were collected from 662 patients with severe/critical COVID-19 who were admitted to a designated hospital to treat patients with severe COVID-19 in Wuhan before March 20, 2020. All patients were divided into an exposed group (CHM users) and a control group (non-users). After propensity score matching in a 1:1 ratio, 156 CHM users were matched by propensity score to 156 non-users. No significant differences in seven baseline clinical variables were found between the two groups of patients. All-cause mortality was reported in 13 CHM users who died and 36 non-users who died. After multivariate adjustment, the mortality risk of CHM users was reduced by 82.2% (odds ratio 0.178, 95% CI 0.076–0.418; P < 0.001) compared with the non-users. Secondly, age (odds ratio 1.053, 95% CI 1.023–1.084; P < 0.001) and the proportion of severe/critical patients (odds ratio 0.063, 95% CI 0.028–0.143; P < 0.001) were the risk factors of mortality. These results show that the use of CHM may reduce the mortality of patients with severe/critical COVID-19.

Background: An outbreak of 2019 novel coronavirus (COVID-19) started in December 2019 in Wuhan, China and spread rapidly across the globe In light of most COVI

In a cloud environment, the primary way to optimize physical resources is to reuse a physical machine (PM) by consolidating complementary multiple virtual machines (VMs) on it. When considering VMs' dynamically changing resource demands, one hot research topic revolves around reusing VM migration resources more efficiently. The challenge here is finding the best tradeoff between the VM migration optimization performance and complexity. On one hand, to improve the migration efficiency, VM migration planning is adopted to achieve efficient resource reuse while minimizing the number of VM migrations. On the other hand, the huge number of PMs and VMs in a cloud datacenter often adds considerable complexity to migration planning, which hampers the decision-making process in VM migration. To address these issues, this paper proposes a hybrid resource pool model to reduce the complexity of VM migration planning by limiting the scope of VM migration decisions. Then, based on this model, we use our novel resource-reuse optimization mechanism (called HirePool) to improve efficiency by maximizing resource usage with only a few VM migrations. Finally, we perform simulation tests and actual experiments running on a real cloud platform to evaluate HirePool. Results show that HirePool improves average resource usage by 13%, saves the number of PMs used by 12%, and reduces the average number of migrations (compared with contrast mechanisms) by 31%.

Typhoid and paratyphoid are two common enteric infectious diseases with serious gastrointestinal symptoms. Data was collected of the registered cases in Zhejiang Province from 2005 to 2015. The epidemiological characteristics were investigated and high-risk regions were detected with descriptive epidemiological methods and in-depth spatio-temporal statistics. A sharp decline in the incidences of both diseases was observed. The seasonal patterns were identified with typhoid and paratyphoid, one in summer from May to September was observed from 2005 to 2010 and the other lesser one in spring from January to March only observed from 2005 to 2007. The men were more susceptible and the adults aged 20 to 60 constituted the major infected population. The farmers were more likely to get infected, especially to typhoid. The Wilcoxon sum rank test proved that the incidences in the coastal counties were significantly higher than the inland. Besides, a positive autocorrelation was obtained with typhoid fever in global autocorrelation analysis but not with paratyphoid fever. Local autocorrelation analysis and spatio-temporal scan statistics revealed that high-risk clusters were located mainly in the coastal regions with typhoid fever but scattered across the province with paratyphoid fever. The spatial risks were evaluated quantitatively with hierarchical Bayesian models.

The microstructure in the fusion zone (FZ) was determined to be full lath martensite because of the high cooling rate. The heat-affected zone (HAZ) of DP600 was divided into coarse-grained, fine-grained, and inter-critical zones, and the volume fraction of martensite in HAZ was higher than that in the DP600 base metal (BM). The HAZ of DC54D was characterized by the presence of intensive ferrite. As the welding current, welding time, and electrode force increased, the tensile-shear strength of the welded spot experienced two stages of a notable increase and a subsequent decrease. The maximum value of 6.59 kn was obtained at a welding current of 9 kA, welding time of 14 cycles, and electrode force of 2.6 kn. Interfacial fracture occurred because of the small nugget diameter. Plug failure took place along the plastic deformed DC54D dominated by abnormally grown grains discovered from the interface of HAZ/BM through electron back-scattered diffraction.

Resistance spot welding of 22MnB5/HSLA350 and its weldability are investigated. From base material to the nugget, the microstructure of 22MnB5 side can be expressed as M/tempered M+ granular carbides/F+M/fine M/lath M, and on HSLA350 side, F+M/F+flocculent P+tempered M/F+flocculent P+M/F+M/lath M are observed. The heat-affected zone (HAZ) of 22MnB5 exhibits obvious softening region and strengthening region caused by the tempered M and quite fine M, respectively. The peak load of welded joints undergoes two stages of a dramatic increase and a subsequent decrease with increases in the welding current. The maximum value (13.82 kN) of peak load is achieved at a welding current of 8 kA. The failure modes involving interfacial failure (IF), pullout failure from the galvanized steel (PFG), pullout failure from boron steel and tearing of the galvanized steel (PFB-TG) and pullout failure from the boron steel (PFB) are discussed in detail.

Several studies analysed the associations between dietary carbohydrate intake, glycaemic index (GI) and glycaemic load (GL) and digestive system cancers; however, the results remain controversial. This study was to perform a meta-analysis evaluating the quantitative and dose–response associations between carbohydrate intake, GI and GL, and risk of digestive system cancers. We searched medical and biological databases up to June 2018 and identified twenty-six cohort studies and eighteen case–control studies. Meta-analytic fixed or random effects models were applied to process data. We also performed dose–response analysis, meta-regression and subgroup analyses. We found that high levels of GI were significantly associated with the risk of digestive system cancers at the highest compared with the lowest categories from cohort studies (summary relative risk (RR)=1·10, 95 % CI 1·05, 1·15). Similar effects were observed from case–control studies of the comparison between the extreme categories, but the difference did not reach statistical significance (summary OR=1·28, 95 % CI 0·97, 1·69). We also observed significant dose–response association between GI and digestive system cancers, with every 10-unit increase in GI (summary RR=1·003; 95 % CI 1·000, 1·012 for cohort studies; summary OR=1·09; 95 % CI 1·06, 1·11 for case–control studies). In addition, both cohort studies and case–control studies indicated that neither dietary carbohydrate intake nor GL bore any statistical relationship to digestive system cancers from the results of the highest compared with the lowest categories analyses and dose–response analyses. The results suggest a moderate association between high-GI diets and the risk of digestive system cancers.

Depression pertains to the category of ''Emotional Diseases'' in traditional Chinese medicine (TCM). Its clinical symptoms are similar to the manifestations of ''lily disease'' from the TCM classics Synopsis of the Golden Chamber written by Zhang Zhongjing in the Han Dynasty. Also in this book, Lily Bulb and Rehmannia Decoction (LBRD) is the formula for the treatment of ''lily disease''. The classical herbal formula LBRD is composed of two herbs lily bulb and fresh rehmannia juice, with the function of nourishing yin and replenishing heart and lung. It has been clinically applied to treat ''lily disease'' for two thousand years. In this review, we focused on recent evidence linking LBRD and depression extracting data from animal and clinical studies, summarizing the primitive dosage and producing area of genuine medicinal materials of LBRD, clinical application, pharmacological mechanism and the effective substance basis for the treatment of depression. In conclusion, we discussed existing problems and future perspective. This systematic review will seek to enhance our understanding about pharmacology mechanism, herb-prescribing and recipe-constructing, and the development of novel formula for depression treatments.

Epidemiological evidence suggests that prior exposure to cigarette smoke (CS) or habitual smoking increases the risk of influenza A virus (IAV)-triggered respiratory failure. Although emerging evidence supports the role of thrombo-inflammation in the development of CS and IAV-triggered lung injury, the innate immune mechanism remains poorly understood. We have developed a two-hit model of CS-induced severe flu in mice. Mice were exposed to four weeks of room air (air) or CS followed by intra-nasal administration of A/PR/8/34 IAV. The body weight was measured every day for two weeks after IAV administration followed by assessment of lung injury at day 7. Lungs were harvested for histological assessment and viral titration by qPCR. Quantitative fluorescence intravital lung microscopy (qFILM) was conducted at 2-, 3- and 4-days post IAV-infection to visualize dynamics of neutrophil and platelet recruitment in the lung of mice IV administered with fluorescent dextran, anti-Ly6G Ab and anti-CD49Abs. Mice exposed to CS+IAV manifested significantly more weight loss, lung injury, lung congestion, hemorrhage and hypoxemia compared to mice administered IAV only. QFILM revealed that severity of lung injury was associated with significantly larger area with impaired blood flow and more vascular leakage secondary to vascular occlusion by platelet-rich neutrophil-platelet aggregates in the lung of CS+IAV than IAV administered mice. These initial results suggest that CS primes innate immune signaling in neutrophils and platelets to promote their recruitment in the lung following flu, leading to severe acute lung injury. Currently, studies are underway to identify innate immune pathways that drive hyper thrombo-inflammatory response.

Highlights • Mental disorders in COVID-19 patients and survivors revealed that the COVID-19 had immune dysfunction. • Analysing the symptoms of COVID-19, TCM syndrome of the depression, anxiety and PTSD was interpreted as internal heat and Yin deficiency. • Depression, anxiety and PTSD pertains the category of “lily disease”, “hysteria” and “deficient dysphoria” in TCM. • Lily Bulb and Rehmannia Decoction, Lily Bulb and Anemarrhenae Decoction and Ganmai Dazao Decoction were used to treat the depression., Purpose The aim of this study is to explore the possible benefits of traditional Chinese medicine on the pathogenesis of psychological and mental health of COVID-19 survivors. Methods A literature search was conducted to confirm the effects of COVID-19 on psychological and mental health of survivors. In addition to this, on the basis of signs and symptoms, TCM were used on treat mental disorder as per suggested clinical and animal experimental data plus relevant records in classical Chinese medicine books written by Zhang Zhongiing during Han Dynasty. A series of treatment plans were prescribed for COVID-19 survivors with psychological and mental disorders. Results According to previous extensive studies focusing on effects on mental health of survivors, high incidence was observed in severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) survivors. During investigations of mental health of COVID-19 patients and survivors, it is observed that they also had symptoms of mental disorders and immune dysfunction. Furthermore, it was also proposed that depression, anxiety and post-traumatic stress disorder (PTSD) were most common mental disorders requiring special attention after the recovery from COVID-19. The symptoms of COVID-19 were analyzed, and the TCM syndrome of the depression, anxiety and PTSD after recovered from COVID19 was interpreted as internal heat and Yin deficiency. These three mental disorders pertains the category of “Lily disease”, “hysteria” and “deficient dysphoria” in TCM. Conclusion Lily Bulb, Rhizoma Anemarrhena Decoction and Ganmai Dazao Decoction were used to treat depression. Suanzaoren Decoction, Huanglian Ejiao Decoction and Zhizi Chi Decoction were suggested for anxiety. Moreover, Lily Bulb, Rehmannia Decoction and Guilu Erxian Decoction were the formula for PTSD.

Aim The present study was intended to establish the reference intervals of β-C-terminal telopeptide of type I collagen, procollagen type I N-terminal propeptide and osteocalcin for very elderly (aged 80 years or more) Chinese men. Methods A total of 1316 very elderly Chinese men were recruited into the study, and subjected to a survey of clinical characteristics, measurements of bone mineral density and assays of bone turnover markers. The relationships between underlying diseases and bone turnover markers were investigated, and the reference intervals of β-C-terminal telopeptide of type I collagen, procollagen type I N-terminal propeptide and osteocalcin for very elderly Chinese men were established through defining the central 95% range of all observations. Results We found that type 2 diabetes mellitus, chronic obstructive pulmonary disease and abnormal bone mass were associated with serum bone turnover markers (P

Graphical abstract, Background With the global epidemic of coronavirus disease (COVID-19), China has made progress in the prevention and control of the epidemic, and traditional Chinese medicine (TCM) has played a key role in dealing with the disease’s effects on the respiratory system. This randomized controlled clinical trial evaluated the clinical efficacy and prognosis of Huoxiang Zhengqi dropping pills and Lianhua Qingwen granules in patients with COVID-19. Methods A total of 283 patients participated in this clinical trial, and participants were randomly assigned to receive either 1) Huoxiang Zhengqi dropping pills and Lianhua Qingwen granules or 2) Linahua granules, both combined with western medicine, or 3) western medicine alone for 14 days. At the end of the trial, the improvement and resolution rates of clinical symptoms and the rate of patients who progressed to severe disease status were evaluated. Results After 14 days of treatment, there was no significant difference in the improvement rate of clinical symptoms among the three groups (P > 0.05). Huoxiang Zhengqi dropping pills combined with Lianhua Qingwen granules has advantages in the treatment of nausea, vomiting and limb soreness. During treatment, all participants were treated with western medicine, and there was a significant difference in the use of macrolides among the three groups (P 0.05). However, the proportion of patients who progressed to severe disease in the Huoxiang + Lianhua group was the lowest, suggesting that the combination of TCM with western medicine has a potential advantage in improving the prognosis of patients with COVID-19. Conclusion The use of Huoxiang Zhengqi dropping pills and Lianhua Qingwen granules combined with western medicine may have clinical advantages for COVID-19 patients in improving clinical symptoms, reducing utilization rate of anti-infective drugs, and improving patient prognosis, which could pave the way for the use of complementary medicine in treating this infection.

Summary Background and objective Indoxyl sulphate (IS) and p-cresyl sulphate (PCS), which are difficult to excrete adequately out of the body, are closely related to the progression of chronic kidney disease (CKD) and various deuteropathy. Better than peritoneal dialysis (PD) and haemodialysis (HD), dietary fibre has been considered to reduce IS and PCS levels. In view of the absence of formal recommendations on fibre intake in CKD nutritional guidelines, we conducted this meta-analysis to assess the effects of dietary fibre on IS and PCS for CKD patients. Methods The effects were pooled and expressed in terms of weighted mean difference (WMD) with 95% confidence interval (95% CI). Q test and I2 statistics were used to assess the heterogeneity. Results A total of 12 relevant estimates from 7 reports, including 203 CKD patients, showed that dietary fibre significantly reduced their PCS level (WMD = −16.160, 95% CI: −23.824, −8.495). Conclusions The meta-analysis produced a strong corroboration that dietary fibre intake does have a good therapeutic effect on patients with CKD. The conclusions need to be validated by randomised controlled experiments (RCT) with better design, larger samples, longer course of treatment and higher quality.

Brazing of a titanium alloy and an aluminum alloy was performed in a vacuum furnace with a pure tin foil interlayer. The microstructure and mechanical property of the brazed joint were investigated as functions of parameters including post bonding heat treatment. The results indicated that Al-Ti-Sn secondary phases were present in the joining region. These secondary phases coarsened clearly with increasing temperature from 450°C to 500°C. At 450°C, the unbonded zone appeared in the interface area between the Ti alloy and the joining zone. At 500°C, some cracks and coarsened secondary phases were observed in the joint. From 450°C to 500°C, the strength of the joint gave a hill-shaped curve change. The fracture was mainly brittle fracture. As the post bonding heat treatment was applied, the interdiffusion region with about 6 μm was found in the interface zone between the Ti alloy and the joining area, the secondary phases distributed with a small and dispersed pattern, and the tensile strength of the joint was improved to a higher value. Failure mode with lots of dimples was a ductile pattern.

The objective of this study was to investigate the associations between potassium and obesity/metabolic syndrome. We identified eight relevant studies and applied meta-analysis, and nonlinear dose-response analysis to obtain the available evidence. The results of the pooled analysis and systematic review indicated that high potassium intake could not reduce the risk of obesity (pooled OR = 0.78; 95% CI: 0.61–1.01), while serum potassium and urinary sodium-to-potassium ratio was associated with obesity. Potassium intake was associated with metabolic syndrome (pooled OR = 0.75; 95% CI: 0.50–0.97). Nonlinear analysis also demonstrated a protective effect of adequate potassium intake on obesity and metabolic syndrome. Adequate intake of fruits and vegetables, which were the major sources of potassium, was highly recommended. However, additional pertinent studies are needed to examine the underlying mechanism.

To evaluate the reliability and validity of SF-36 scale in urban residents, and provide reference for the selection of suitable health measure tools for urban residents.Multi-stage cluster stratified sampling was conducted to select the residents aged ≥18 years in three urbanized communities of Hangzhou. SF-36 scale was used for the measurement of the quality of life and Spearman-Brown and Cronbach' s α coefficients were used for the evaluation of split-half reliability and internal consistency reliability. The convergent and discriminative validity were evaluated by using the success rate of experiments and the criterion-related validity was evaluated with correlation analysis and non-parameter test. Structural equation modeling was used in the evaluation of contract validity.SF-36 scale had good split-half reliability (R=0.94) and internal-consistency reliability (except for bodily pain and vitality, Cronbach's α range: 0.70-0.91). The convergent validity (88.57%), discriminate validity (successful rates 90.61%) and the criterion-related validity (γs=0.56, the score was consistent with the self-reported health status) were good. Second-order confirmatory factor analysis model was not well-fitted (GFI= 0.721, AGFI= 0.682, CFI= 0.731, RMR= 0.084, RMSEA= 0.098), indicating that the construct validity was poor.The reliability, consolidation validity, discrimination validity and criterion-related validity of SF-36 scale were good, while the construct validity was poor. Improvement is needed when the scale is used for urban residents.

The objective of this study was to investigate the associations between selenium exposure and cancer risk. We identified 69 studies and applied meta-analysis, meta-regression and dose-response analysis to obtain available evidence. The results indicated that high selenium exposure had a protective effect on cancer risk (pooled OR = 0.78; 95%CI: 0.73–0.83). The results of linear and nonlinear dose-response analysis indicated that high serum/plasma selenium and toenail selenium had the efficacy on cancer prevention. However, we did not find a protective efficacy of selenium supplement. High selenium exposure may have different effects on specific types of cancer. It decreased the risk of breast cancer, lung cancer, esophageal cancer, gastric cancer and prostate cancer, but it was not associated with colorectal cancer, bladder cancer and skin cancer.

The Advanced Spaceborne Thermal Emission and Reflection Radiometer ASTER Global Digital Elevation Model GDEM has generated one of the most complete high-resolution digital topographic data sets of the world to date. The ASTER GDEM covers land surfaces between 83° N and 83° S at a spatial resolution of 1 arc-second approximately 30 m at the equator. As an improvement over Shuttle Radar Topography Mission SRTM coverage, the ASTER GDEM will be a very useful product for many applications, such as relief analysis, hydrological studies, and radar interferometry. In this article, its absolute vertical accuracy in China was assessed at five study sites using ground control points GCPs from high-accuracy GPS benchmarks and also using a DEM-to-DEM comparison with the Consultative Group on International Agriculture Research Consortium for Spatial Information CGIAR-CSI SRTM DEM Version 4.1. It is demonstrated that the vertical accuracy of ASTER GDEM is 26 m root mean square error RMSE against GPS-GCPs, while for the SRTM DEM it is 23 m. Furthermore, height differences in the GDEM-SRTM comparison appear to be overestimated in the areas with a south or southwest aspect in the five study areas. To a certain extent, the error can be attributed to variations in heights due to land-cover effects and undefined inland waterbodies. But the ASTER GDEM needs further error-mitigating improvements to meet the expected accuracy specification. However, as for its unprecedented detail, it is believed that the ASTER GDEM offers a major alternative in accessibility to high-quality elevation data.

The freely available ASTER GDEM ver2 was released by NASA and METI on October 17, 2011. As one of the most complete high resolution digital topographic data sets of the world to date, the ASTER GDEM covers land surfaces between 83°N and 83°S at a spatial resolution of 1 arc-second and will be a useful product for many applications, such as relief analysis, hydrological studies and radar interferometry. The stated improvements in the second version of ASTER GDEM benefit from finer horizontal resolution, offset adjustment and water body detection in addition to new observed ASTER scenes. This study investigates the absolute vertical accuracy of the ASTER GDEM ver2 at five study sites in China using ground control points (GCPs) from high accuracy GPS benchmarks, and also using a DEM-to-DEM comparison with the Consultative Group for International Agriculture Research Consortium for Spatial Information (CGIAR-CSI) SRTM DEM (Version 4.1). And then, the results are separated into GlobCover land cover classes to derive the spatial pattern of error. It is demonstrated that the RMSE (19m) and mean (-13m) values of ASTER GDEM ver2 against GPS-GCPs in the five study areas is lower than its first version ASTER GDEM ver1 (26m and -21m) as a result of the adjustment of the elevation offsets in the new version. It should be noted that the five study areas in this study are representative in terms of terrain types and land covers in China, and even for most of mid-latitude zones. It is believed that the ASTER GDEM offers a major alternative in accessibility to high quality elevation data.

Research on the potential impact of high salt intake on health has grown rapidly over the last decades. Recent studies have suggested that high salt intake could also be associated with adverse effects on cardiovascular system. The review evaluated the current level of epidemiologic evidence on the association between the level of habitual salt intake and stroke outcome. We also suggest further research direction. There were 21 independent samples from 12 studies, with 225,693 participants (follow‐up, 3–19 years) and 8135 stroke events. High salt intake was associated with risk of stroke event (pooled odd ratio [OR], 1.34; 95% confidence interval [CI], 1.19–1.51), stroke death (1.40; 1.21–1.63) and stroke onset (1.11; 1.00–1.24), ischemic stroke death (2.15; 1.57–2.95), not associated with risk of ischemic stroke onset (1.07, 0.95–1.2), with no significant evidence of publication bias. High salt intake is associated with significantly increased risk of stroke event. Further research should be directed toward clarifying and quantifying these possible effects and generating testable hypotheses on plausible biologic mechanisms.

Background: The incidences of typhoid and paratyphoid remain high and these diseases still pose a public health problem in China and in Zhejiang Province in particular. This study aimed to investigate the trend of typhoid and paratyphoid in Zhejiang Province from 1953 to 2014 and to provide a theoretical basis for the prevention and control of these diseases. Methods: Included in this study were compiled epidemiological data of typhoid and paratyphoid cases in Zhejiang from 1953 to 2003 and epidemiological data of those from 2004 to 2014 registered in the China Information System for Diseases Control and Prevention. Description methods were employed to explore the epidemiological characteristics, including long-term trend, gender distribution, age distribution, and occupation distribution. Incidence maps were made to represent the annual average incidences for each municipality. Spearman&rsquo, s rank correlation was performed to detect the correlation between incidence and average elevation, and circular distribution was calculated to identify the seasonality and peak days of the diseases. A p-value of &lt, 0.05 was considered statistically significant. Results: A total of 182,602 typhoid and paratyphoid cases were reported in Zhejiang Province from 1953 to 2014, and the average annual incidence was 7.89 per 100,000 population. The incidence in 2014 decreased by 93.82% compared with that in 1953 and by 95.00% compared with the highest incidence rate. The average incidence before 2003 was negatively correlated with the average elevation of each region in Zhejiang province (r &lt, 0, p &lt, 0.05), but there was no statistically significant correlation from 2003. The peak period of diseases fell in the months from April to October every year. The incidence among the population group aged over 35 rose gradually but declined sharply among those between 20 and 34. Conclusions: The incidence of typhoid and paratyphoid decreased in Zhejiang Province from 1953 to 2014 but remained high in some regions. Proper measures for prevention and control are warranted in the southeast coast areas and for high-risk populations.

Atmospheric particulate matter (PM) is hypothesized to increase the risk of myocardial infarction (MI). However, the epidemiological evidence is inconsistent. We identified 33 studies with more than 4 million MI patients and applied meta-analysis and meta-regression to assess the available evidence. Twenty-five studies presented the effects of the PM level on hospitalization for MI patients, while eight studies showed the effects on mortality. An increase in PM10 was associated with hospitalization and mortality in myocardial infarction patients (RR per 10 μg/m(3) = 1.011, 95% CI 1.006-1.016; RR per 10 μg/m(3) = 1.008, 95 % CI 1.004-1.012, respectively); PM2.5 also increased the risk of hospitalization and mortality in MI patients (RR per 10 μg/m(3) = 1.024, 95% CI 1.007-1.041 for hospitalization and RR per 10 μg/m(3) = 1.012, 95% CI 1.010-1.015 for mortality). The results of the cumulative meta-analysis indicated that PM10 and PM2.5 were associated with myocardial infarction with the addition of new studies each year. In conclusion, short-term exposure to high PM10 and PM2.5 levels revealed to increase risk of hospitalization and mortality for myocardial infarction. Policy support of pollution control and individual protection was strongly recommended.

Objective This study was designed to identify factors associated with the femoral neck bone mineral density (FNBMD) of the very elderly (aged 80 or more) Chinese males. Methods A total of 1177 very elderly Chinese males were recruited into the study, and subjected to FNBMD, biochemical parameters, bone turnover markers, and serum sex steroids assays. Univariate and multivariate regression analyses were performed to identify factors independently related to FNBMD. Results It was demonstrated that age (β = −0.003, P = 0.035), concomitant chronic obstructive pulmonary disease (COPD, β = −0.027, P = 0.009), serum β-C-telopeptide of type 1 collagen (β-CTX, β = −0.097, P

TRIAL DESIGN In the double-blind, randomized, controlled trial, we aimed to evaluate the effects of compound tufuling oral liquid (CoTOL) on serum uric acid (sUA) levels and recurrence of acute gouty arthritis in intercritical and chronic gout treatment. METHODS A total of 210 patients with gout were screened from 8 hospitals to observe the sUA and acute gouty arthritis recurrence rate-reducing effects of CoTOL in intercritical and chronic gout during a 12-week treatment. We treated 139 and 71 patients with CoTOL and the placebo, respectively, and evaluated their sUA levels, acute gouty arthritis recurrence rate, and adverse events at week 0, 6, and 12. RESULTS Twenty-five and 12 patients in the treatment and control groups, respectively, had interrupted treatments, whereas 114 and 59 cases, respectively, completed their treatments. At the end of the 12-week treatment, the average decrease in sUA was 74.26 (95% confidence interval [CI]: 56.74-91.77 μmol/L) and 28.81 μmol/L (95% CI: 4.91-52.71 μmol/L) in the treatment and control groups, respectively (P = 0.004). The average decrease rate of sUA was 12.76% (95% CI: 9.82%-15.70%) and 4.57% (95% CI: 0.42%-8.71%) in the treatment and control groups, respectively (P = 0.004), and the gouty arthritis recurrence rate of the treatment group was lower than that of the control group (from week 6 to 12, 21.93% and 50.88% in the treatment and control group, respectively, P

Chronic low back pain is one of the most common reasons that people seek medical treatment, and the consequent disability creates a great financial burden on individuals and society. The etiology of chronic low back pain is not clear, which means it is often refractory to treatment. Acupuncture has been reported to be effective in providing symptomatic relief of chronic low back pain. However, it is not known whether the effects of acupuncture are due to the needling itself or nonspecific effects arising from the manipulation. To determine the effectiveness of acupuncture therapy, a meta-analysis was performed to compare acupuncture with sham acupuncture and other treatments. Overall, 2678 patients were identified from thirteen randomized controlled trials. The meta-analysis was performed by a random model (Cohen's test), using the I-square test for heterogeneity and Begg's test to assess for publication bias. Clinical outcomes were evaluated by pain intensity, disability, spinal flexion, and quality of life. Compared with no treatment, acupuncture achieved better outcomes in terms of pain relief, disability recovery and better quality of life, but these effects were not observed when compared to sham acupuncture. Acupuncture achieved better outcomes when compared with other treatments. No publication bias was detected. Acupuncture is an effective treatment for chronic low back pain, but this effect is likely to be produced by the nonspecific effects of manipulation.

Aims We conducted systematic review as well as meta-analyses on the association between particulate matter and daily stroke attack from a number of epidemiologic studies. Methods Twelve quantitative studies about the associations between particulate matter and stroke attack met the inclusive criteria. We evaluated the odds ratio (OR) of stroke attack associated with per 10 μg/m(3) increase of the concentration of PM(10) (particulate matter with aerodynamic diameter ≤ 10 μm) or PM(2.5) (particulate matter with aerodynamic diameter ≤ 2.5 μm) as effect scale, and a sensitivity analysis for the results was conducted. Results In the time-series design, PM(10) exposure wasn't related to an increased risk of daily stroke attack [OR per 10 μg/m(3) = 1.002, 95% confidence interval (CI): 0.999~1.005], PM(2.5) exposure were related to an increased risk of daily stroke attack (OR per 10 μg/m(3) = 1.006, 95%CI: 1.002~1.010]; but in the case-crossover studies, PM(10) exposure was related to increase in risk of daily stroke attack (OR per 10 μg/m(3) = 1.028, 95%CI: 1.001~1.057). PM(2.5) exposure was not significant association with daily stroke attack (OR per 10 μg/m(3) = 1.016, 95%CI: 0.937~1.097). Sensitivity analysis showed that the results for PM(10) , PM(2.5) and daily stroke attack were robust in the time-series design. Conclusions We found some evidence for an effect of air pollutants on stroke attack risk.

The Chinese formula Tang-Min-Ling (TML), an improved product of the decoction of Dachaihu which has a history of more than 2000 years, has main constituents of Coptis chinensis Franch, Scutellaria baicalensis Georgi, Rheum officinale Baill and Bupleurum chinense DC. A multi-central randomized controlled investigation performed previously by us has showed that TML has positive effects on regulating glycometabolism in type 2 diabetes (T2DM) patients, but the mechanisms remain unclear. Using Otsuka Long-Evans Tokushima Fatty (OLETF) rats as an animal model with rosiglitazone as a positive control, we were able to detect TML's effect on the serum glucose, serum lipid, serum leptin and adiponcetin after oral administration for 12 weeks. We were also able to detect the insulin resistance level by a glucose clamp test and study the mechanisms of TML in improving insulin resistance by detecting skeletal muscle AMP-activated protein kinase (AMPK) and glucose transporter 4 (GLUT4). Results showed that TML significantly reduced the glucose area under a curve of the oral glucose tolerance test, and had a positive effect in regulating serum lipid metabolism. TML treatment also significantly reduced the serum leptin level, but it had no effect on the serum adiponectin level. The AMPK enzymatic activity and GLUT4 expression in Skeletal Muscle were also upregulated in the TML group. The results suggest that the Chinese medicine TML, which contains Coptis chinensis Franch as one of its components, improves glycometabolism and its possible mechanisms may involve in improvement of insulin resistance of OLETF rats.