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Background As China's Traditional medicine is included in the ICD-11 code, the rational allocation of basic TCM medical resources is the guarantee to promote the integration of traditional Chinese medicine and western medicine and the universal coverage of high-quality medical resources. The uneven layout and service capabilities of grassroots medical institutions have led to a widespread imbalance in the supply and demand of medical resources in urban and rural areas. Objective Understand the development status of traditional Chinese medicine services in rural areas of China, scientifically evaluate the coverage and accessibility of grassroots traditional Chinese medicine diagnosis and treatment, provide new ideas for optimizing the spatial resource allocation of grassroots traditional Chinese medicine services, and propose optimization strategies accordingly. Methods Based on the seventh national population census data and path planning data, the concept of medical service radius is introduced to calculate the diagnosis and treatment scope of different levels of traditional Chinese medicine medical institutions under walking mode. Using methods such as spatial kernel density index and spatial standard deviation ellipse to reveal the spatial fairness of the supply and demand capacity of traditional Chinese medicine medical services. Based on the above results, propose types and measures for optimizing the layout of traditional Chinese medicine medical resources. Results As of 2022, there are a total of 699 medical institutions in Zengcheng District, including 18 traditional Chinese medicine medical institutions with beds. There were significant differences in the distribution of beds in traditional Chinese medicine medical institutions in different townships and streets. Meanwhile, the number of beds per thousand population in Zhongtan Town was 14.31, ranking first among all streets. The number of beds per thousand people in Yongning Street ranks last, with only 0.89 beds. Traditional Chinese medicine medical institutions in Zengcheng District had shown a clear dual center pattern, with weak accessibility to traditional Chinese medicine services for residents in the central part of Zhongxin Town, the northern part of Paitan Town, and the southwestern part of Shitan Town. The supply capacity of traditional Chinese medicine services varies greatly among different townships. There was still a certain degree of inconsistency between the spatial distribution of traditional Chinese medicine medical institutions and the overall spatial clustering of urban residents. There were differences in the radius of traditional Chinese medicine services between different townships. Conclusion Since the implementation of the development strategy of traditional Chinese medicine, China's Traditional medicine has been protected and developed. We should adopt a more scientific strategy to closely integrate traditional Chinese medicine services with the development of the city and the needs of residents. We should actively adopt a differentiated strategy of increasing facility points, combining resource transfer and sinking, and integrating traditional Chinese medicine information technology for diagnosis and treatment across regions, gradually achieving a true strategy of full coverage and equal emphasis on traditional Chinese and Western medicine.

Burden of disease measurement based on the International Statistical Classification of Diseases and Related Health Problems (ICD) codes have been widely used worldwide. However, most of the current studies are based on Western medical codes of ICD. As the internationalization of Traditional Chinese Medicine (TCM) , the inclusion of TCM codes in ICD-11 will facilitate the improvement of TCM disease diagnosis, the calculation of prevalence, survival, medication use, and treatment levels of TCM disease, which can further evaluate the disease burden of TCM diseases, promote medical decision making and rational allocation of health resources, thus further promoting the internationalization of TCM. However, the imperfection of TCM codes in ICD-11 and inadequate mapping between it and Western medicine codes, our national standards for TCM has also brought new challenges to the measurement of TCM disease burden. Based on the coding system of disease burden, this paper reviewed the deficiencies in the current research on the calculation of disease burden of TCM, and the impact of ICD-11 inclusion of TCM codes on the calculation of disease burden of TCM, made a preliminary comparison among the TCM codes and Western medical codes in ICD-11 and new national standard codes in China, to provide reference for the improvement of the calculation and coding of TCM disease burden. It is proposed that in the future, big data technologies can be used to facilitate the mapping between standardized TCM terms and ICD-11 TCM codes, ICD-11 TCM codes and Western medical codes, thus facilitating research on the burden of disease in TCM.

Background The disease burden of esophageal cancer is high in China, more and more studies have shown that tobacco has a greater adverse effect on the development of esophageal cancer. Objective To understand trends in esophageal cancer deaths and burden of disease attributable to tobacco in China from 1990 to 2019, and provide data to inform the development of public health policies and interventions. Methods Global burden of disease 2019 (GBD 2019) data were used to extract the age-specific and sex-specific data on esophageal cancer deaths attributable to tobacco in China from 1990 to 2019. Mortality, disability adjusted life years (DALYs) , years of life lost (YLLs) , and disability adjusted life years (YLDs) were used to assess the disease burden of esophageal cancer attributable to tobacco in China. Joinpoint regression software and age-period-cohort modeling methods were applied to analyze the trends of disease burden and mortality with age, period and cohort. the Bayesian-period-cohort analysis (BAPC) was applied to predict the mortality rate of esophageal cancer attributable to tobacco in China from 2020 to 2030. Results From 1990 to 2019, the number of deaths caused by esophageal cancer attributable to tobacco among Chinese residents rose from 76 400 to 123 900, with an increase of 62.17%, and the standardized mortality rate declined from 9.30/100 000 to 6.20/100 000, with a decrease of 33.33%; the DALYs rose from 1 972 500 person-years to 2 822 600 person-years, with an increase of 43.10%, and the DALYs rate decreased from 220.50/100 000 to 134.47/100 000, with a decrease of 39.02%. In terms of gender, the disease burden of esophageal cancer attributable to tobacco was mainly caused by males, with 117 700 deaths and a standardized mortality rate of 12.82/100 000 in 2019 due to tobacco-attributable esophageal cancer in males, compared to 0.62 million deaths number and a standardized mortality rate of 0.63/100 000 in females. In 2019, the number of esophageal cancer deaths attributable to tobacco among Chinese residents peaked in the age group of >69-74 years, while DALYs peaked in the age group of >64-69 years, at 23 000 and 510 300 cases, respectively. The mortality rate continued to increase with age, especially after 50 years of age. The results of Joinpoint regression analysis showed that the average annual percent change (AAPC) of esophageal cancer mortality attributable to tobacco was -1.4%〔95%CI (-1.6%, -1.2%) 〕 in China from 1990 to 2019, with -3.3%〔95%CI (-3.6%, -2.9%) 〕 for females, and -1.3%〔95%CI (-1.4%, -1.1%) 〕 for males; the AAPC for DALYs rate was -1.7%〔95%CI (-1.9%, -1.5%) 〕, with -3.7%〔95%CI (-4.0%, -3.4%) 〕 for females and -1.5%〔95%CI (-1.7%, -1.3%) 〕 for males. Analysis of the age-period-cohort model of mortality from esophageal cancer attributable to tobacco showed a negative net offset of -1.690%〔95%CI (-2.024%, -1.354%) 〕. It is expected that the number of deaths and mortality rate from tobacco-attributable esophageal cancer among Chinese residents will be relatively stable with a small decrease from 2020 to 2030, with mortality rates declining from 12.64/100 000 in 2020 to 12.63/100 000 in 2030 for males, and from 0.6/100 000 in 2020 to 0.46/100 000 for females. Conclusion Mortality rate and DALYs rate due to tobacco-attributable esophageal cancer among Chinese residents increased and then declined from 1990 to 2019. The burden of disease due to tobacco-attributable esophageal cancer is mainly caused by males in term of gender, by middle-aged and elderly people by age, which should be given sufficient attention. It is expected that the number of deaths and mortality rates from tobacco-attributable esophageal cancer will be stable and slightly decreasing from 2020 to 2030.

The source of macrophages that contribute to human liver disease remains poorly understood. The purpose of this study is to investigate the functional mechanism of peritoneal macrophages in the development of hepatic immunopathology. By performing the natural infection with the blood fluke Schistosoma japonicum (S. japonicum) and the chemically carbon tetrachloride (CCl4)‐induced liver injured mouse model, we identified the peritoneal cavity as an essential source of hepatic macrophages. Here, we show that a large number of F4/80+ macrophages was accumulated in the peritoneal cavity during liver injury. An unknown source population of macrophages, which highly expressed GATA6 that is specific to peritoneal macrophages, was found to exist in the injured livers. Peritoneal macrophage deletion by injection with clodronate‐containing liposomes led to an attenuated hepatic pathology and the inflammatory microenvironment, while adoptive transfer of macrophages into the abdominal cavity, by contrast, results in restoring liver pathology. Importantly, there are set genes of monocyte chemoattractant protein (MCP)‐1, ‐2, and ‐3 that are highly related to recruit GATA6+ macrophages during S. japonicum infection, while administration of bindarit, a selective inhibitor of MCPs synthesis, dramatically decreased the hepatic expression of GATA6+ macrophages and thus attenuated hepatic pathology. Furthermore, in vivo study showed that peritoneal macrophages promote hepatic immunopathology is dependent on the accumulation of regulatory T cells (Tregs) in the liver. Altogether, these data provide the first clear evidence that GATA6+ peritoneal macrophages play critical roles in both the formation of hepatic immunopathology and the accumulation of Tregs cells. [ABSTRACT FROM AUTHOR]

Although fossil evidence suggests the existence of an early muscular system in the ancient cnidarian jellyfish from the early Cambrian Kuanchuanpu biota (ca. 535 Ma), south China, the mechanisms underlying the feeding and respiration of the early jellyfish are conjectural. Recently, the polyp inside the periderm of olivooids was demonstrated to be a calyx-like structure, most likely bearing short tentacles and bundles of coronal muscles at the edge of the calyx, thus presumably contributing to feeding and respiration. Here, we simulate the contraction and expansion of the microscopic periderm-bearing olivooid Quadrapyrgites via the fluid-structure interaction computational fluid dynamics (CFD) method to investigate their feeding and respiratory activities. The simulations show that the rate of water inhalation by the polyp subumbrella is positively correlated with the rate of contraction and expansion of the coronal muscles, consistent with the previous feeding and respiration hypothesis. The dynamic simulations also show that the frequent inhalation/exhalation of water through the periderm polyp expansion/contraction conducted by the muscular system of Quadrapyrgites most likely represents the ancestral feeding and respiration patterns of Cambrian sedentary medusozoans that predated the rhythmic jet-propelled swimming of the modern jellyfish. Most importantly for these Cambrian microscopic sedentary medusozoans, the increase of body size and stronger capacity of muscle contraction may have been indispensable in the stepwise evolution of active feeding and subsequent swimming in a higher flow (or higher Reynolds number) environment., Competing Interests: YZ, XW, JH, JX, YY, CY, NY, JS, KH, WH, TZ, BW, DW, XY No competing interests declared, (© 2023, Zhang, Wang et al.)

Background: Dermatophagoides farinae (DFA) is an important species of house dust mites (HDMs) that causes allergic diseases. Previous studies have focused on allergens with protein components to explain the allergic effect of HDMs; however, there is little knowledge on the role of microRNAs (miRNAs) in the allergic effect of HDMs. This study aimed to unravel the new mechanism of dust mite sensitization from the perspective of cross-species transport of extracellular vesicles-encapsulated miRNAs from HDMs., Methods: Small RNA (sRNA) sequencing was performed to detect miRNAs expression profiles from DFA, DFA-derived exosomes and DFA culture supernatants. A quantitative fluorescent real-time PCR (qPCR) assay was used to detect miRNAs expression in dust specimens. BEAS-2B cells endocytosed exosomes were modeled in vitro to detect miRNAs from DFA and the expression of related inflammatory factors. Representative dfa-miR-276-3p and dfa-novel-miR2 were transfected into BEAS-2B cells, and then differentially expressed genes (DEGs) were analyzed by RNA sequencing. Protein-protein interaction (PPI) network analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Gene Ontology (GO) terms enrichment analyses were performed on the first 300 nodes of DEGs., Results: sRNA sequencing identified 42 conserved miRNAs and 66 novel miRNAs in DFA, DFA-derived exosomes, and DFA culture supernatants. A homology analysis was performed on the top 18 conserved miRNAs with high expression levels. The presence of dust mites and miRNAs from HDMs in living environment were also validated. Following uptake of DFA-derived exosomes by BEAS-2B cells, exosomes transported miRNAs from DFA to target cells and produced pro-inflammatory effects in corresponding cells. RNA sequencing identified DEGs in dfa-miR-276-3p and dfa-novel-miR2 transfected BEAS-2B cells. GO and KEGG enrichment analyses revealed the role of exosomes with cross-species transporting of DFA miRNAs in inflammatory signaling pathways, such as JAK-STAT signaling pathway, PI3K/AKT signaling pathway and IL-6-mediated signaling pathway., Conclusion: Our findings demonstrate the miRNAs expression profiles in DFA for the first time. The DFA miRNAs are delivered into living environments via exosomes, and engulfed by human bronchial epithelial cells, and cross-species regulation may contribute to inflammation-related processes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 He, Yang, Yu, Zang, Jiang, Xu, Liu, Xu, Wang and Hong.)

Atrial fibrillation (AF) is the most common arrhythmia in clinic, which can cause hemodynamic changes, heart failure and stroke, and seriously affect human life and health. As a self-promoting disease, the treatment of AF can become more and more difficult with the deterioration of the disease, and the early prediction and intervention of AF is the key to curbing the deterioration of the disease. Based on this, in this study, by controlling the dose of acetylcholine, we changed the AF vulnerability of five mongrel dogs and tried to assess it by analyzing the electrophysiology of atrial epicardium under different states of sinus rhythm. Here, indices from four aspects were proposed to study the atrial activation rule. They are the variability of atrial activation rhythm, the change of the earliest atrial activation, the change of atrial activation delay and the left-right atrial dyssynchrony. By using binary logistic regression analysis, multiple indices above were transformed into the AF inducibility, which were used to classify the signals during sinus rhythm. The sensitivity, specificity and accuracy of classification reached 85.7%, 95.8% and 91.7%, respectively. As the experimental results show, the proposed method has the ability to assess the AF vulnerability of atrium, which is of great clinical significance for the early prediction and intervention of AF.