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The teaching of foreign students in China has become an important part of online teaching and one of the implementation problems during the epidemic. In order to better understand the online teaching situation and quality of foreign students in China, and to better carry out the online teaching of foreign students in China, this article firstly constructs the online teaching quality evaluation index system based on the investigation and analysis of the current situation of online teaching for foreign students in China. Secondly, further uses the analytic hierarchy process to determine the weight of each index, and finally uses the fuzzy comprehensive evaluation method to comprehensively evaluate the online teaching quality of foreign students in China. The research results show that the quality of online teaching for foreign students from Zhejiang Province is good. This research provides a model that can be used for reference for the follow-up online teaching of international students in China.

Maternal antenatal depression (AD) is a nonpsychotic depressive episode during pregnancy that can harm both the pregnant woman and the fetus. This study aimed to investigate the intrinsic interrelationships between AD and its influencing factors by constructing a path model. This survey-based cross-sectional study included 1071 pregnant women who underwent pregnancy examinations in three hospitals in Nantong City, China, between February and June 2023. General information and information regarding maternal AD, pregnancy stress, prenatal anxiety, social support, marital satisfaction, sleep quality, and resilience were collected. Multiple linear regression analysis using SPSS 25.0 was employed to determine the factors influencing pregnancy depression, and Amos25.0 was used to construct a structural equation model. AD incidence was 19.4% (208/1071). The independent risk factors affecting AD in pregnant women have been integrated into the established path analysis model. The model demonstrated a good fit (χ2/DF = 1.238, comparative fit index = 0.999, goodness-of-fit index = 0.998, normed fit index = 0.996, adjusted goodness-of-fit index = 0.990, incremental fit index = 0.999, and root mean square error of approximation = 0.015). While prenatal anxiety (0.230) and hyperthyroidism (0.048) only had direct effects on AD, mental resilience was the biggest factor affecting AD, followed by pregnancy stress, marital satisfaction, prenatal anxiety, sleep quality, social support, and hyperthyroidism. Improved mental resilience, social support, sleep quality, and marital satisfaction; reduced pregnancy stress and prenatal anxiety; and effective hyperthyroidism treatment might reduce AD. This study underscored the significance of delivering actionable strategies and tangible assistance to pregnant women to reduce AD. [ABSTRACT FROM AUTHOR]

Background: Prenatal stress is a highly prevalent mental disorder experienced by pregnant women. This study assessed the prevalence and influencing factors of prenatal stress and investigated the mediating role of social support and resilience between self-efficacy and prenatal stress among pregnant women in China. Methods: A convenience sample comprising 1071 pregnant women from three hospitals in Nantong, Jiangsu Province, China, was recruited between February and June 2023. These participants completed a set of general survey questionnaires and were assessed using the Pregnancy Pressure Scale, Perceived Social Support Scale, the 10-item Connor–Davidson Resilience Scale, and the Chinese version of the General Self-Efficacy Scale. Furthermore, a hierarchical multiple regression model was employed to investigate the relevant factors and mediators of prenatal stress symptoms. A structural equation model was used to examine the mediating role of social support and resilience in the relationship between self-efficacy and prenatal stress. Results: The results of the multivariate regression analysis indicated significant associations between prenatal stress and parity, self-efficacy, social support, and resilience (P < 0.001). Self-efficacy accounted for 35.33% of the total effect, with a direct effect of -2.5306 (95% confidence interval [CI]: -4.0309 to -1,0303). Further examination through mediation analysis revealed the mediating roles of social support and resilience in the relationship between self-efficacy and prenatal stress. The mediating effect of social support was − 1.5933 (95% CI: -2.2907 to -0.9496), accounting for 22.24% of the total effect. Similarly, resilience exhibited a mediating effect of -3.0388 (95% CI: -4.3844 to -1.7135), accounting for 42.43% of the total effect. Conclusion: The mediation analysis revealed that among pregnant women in China, the influence of self-efficacy on prenatal stress is channelled through social support and resilience. Therefore, enhancing social support, resilience, and self-efficacy might alleviate prenatal stress. [ABSTRACT FROM AUTHOR]

This study examines the changes in the outer size distribution of landfalling tropical cyclones (TCs) over the Chinese mainland from 1977 to 2020. The period was divided into two epochs: 1977–98 and 1999–2020. The results show that the size distribution of landfalling TCs over South China has no apparent change, while that of landfalling TCs over East China (LTCEC) is narrower in the second epoch, and the difference in the median sizes between East China and South China become more significant. Furthermore, it is found that LTCEC formed over the western part of the western North Pacific (W-WNP) shifted to a larger size range (300–500 km) at landfall, while those formed over the eastern part of the western North Pacific (E-WNP) rarely grew to extremely large size (>500 km). Further investigation revealed that over the W-WNP, the genesis position of LTCEC migrated equatorward during the second epoch, leading to a longer TC lifetime before landfall. Also, the increase of background relative vorticity and moisture associated with the southward migration is conducive to larger initial vortices. For TCs originating from the E-WNP, the change in the active area of TC passages reduced the frequency of TCs affecting the Chinese coast. Moreover, the growth of TC size during the intensification stage was significantly suppressed, lowering the occurrence probability of extremely large TCs. Changes in the large-scale thermodynamic environments between the two epochs were explored. Increased static stability and decreased convective available potential energy are possible factors limiting TC size increase. [ABSTRACT FROM AUTHOR]

Background: Multiple factors may be responsible for the development of postpartum stress, including perceived social support, marital satisfaction, and maternal postnatal attachment. However, the underlying mediation mechanisms remain unclear. This study examined the complex relationships between perceived social support and postpartum stress among Chinese women. Methods: A convenience sample comprising 406 postpartum women was recruited from six hospitals in Nantong, Jiangsu Province, China. The participants completed general survey questionnaires and were evaluated using the Maternal Postpartum Stress Scale, the Perceived Social Support Scale, the Maternal Postnatal Attachment Scale, and the Marital Satisfaction Scale. Furthermore, we evaluated the relationship between postpartum stress and the various influencing factors by performing a multiple linear regression analysis. The potential mediating roles of marital satisfaction and maternal and infant attachment in the association between perceived social support and postpartum stress were explored by performing a mediation analysis. Results: According to the multivariate regression analysis, perceived social support, marital satisfaction, and maternal postnatal attachment contributed to postpartum stress levels (P < 0.05). The mediation analysis revealed that marital satisfaction and maternal postnatal attachment played parallel mediating roles in the association between perceived social support and postpartum stress, and the mediating effect of marital satisfaction was − 0.1125 (95% confidence interval [CI]: -0.1784 to -0.0520), accounting for 33.20% of the total effect, and the mediating effect of maternal postnatal attachment was − 0.0847 (95% CI: -0.1304 to -0.0438), accounting for 25.00% of the total effect. Conclusion: Our study revealed that perceived social support could influence postpartum stress not only through direct effect (41.80% of the total effect), but also through the indirect effect (mediation effect) of marital satisfaction and maternal postnatal attachment (58.20% of the total effect), suggesting that improving postpartum women's social support, enhancing maternal and infant attachment, and improving their marital satisfaction could help lower postpartum stress. [ABSTRACT FROM AUTHOR]

A record-breaking precipitation event occurred in the Henan province of China in July 2021 (217HP). To identify the moisture source of the event, ensemble experiments with 120 members were conducted in this study. Results show that the precipitable water during this extreme event was primarily contributed by the low-level southeasterly (LLSE) water vapor transport. The LLSE was largely enhanced by the pressure gradient force maintained by the western Pacific subtropical high and further amplified by the latent heat release in the rainfall system over Henan. The positive moisture advection by the LLSE and evaporative water occurred below 950 hPa and was redistributed into higher levels by the LLSE jet-enhanced subgrid vertical turbulent transport. As a result, the combination of the enhanced LLSE centered around 950 hPa and the increase of moisture below 850 hPa were the main drivers for the continuous strengthening of LLSE moisture transport, with the former playing the dominant role. It is also found that not only the presence but also the intensity of the LLSE jet were important for reproducing the extreme rainfall. The impact of binary tropical cyclones In-Fa and Cempaka on the low-level moisture transport was also examined. We found that In-Fa (2021) presented an uncertain impact on 217HP, while Cempaka (2021) was found to be unfavorable for 217HP. Different from the LLSE water vapor transport, Cempaka mainly acted to weaken the southwesterly wind to the southwest of Henan by reducing the pressure gradient and impeding the water vapor transport toward Henan. [ABSTRACT FROM AUTHOR]

Accurate estimation of crop evapotranspiration (ETc) is crucial for effective irrigation and water management. To achieve this, support vector regression (SVR) was applied to estimate the daily ETc of spring maize. Random forest (RF) as a data pre-processing technique was utilized to determine the optimal input variables for the SVR model. Particle swarm optimization (PSO) was employed to optimize the SVR model. This study used data obtained from field experiments conducted between 2017 and 2019, including crop coefficient and daily meteorological data. The performance of the innovative hybrid RF–SVR–PSO model was evaluated against a standalone SVR model, a back-propagation neural network (BPNN) model and a RF model, using different input meteorological variables. The ETc values were calculated using the Penman–Monteith equation, which is recommended by the FAO, and used as a reference for the models' estimated values. The results showed that the hybrid RF–SVR–PSO model performed better than all three standalone models for ETc estimation of spring maize. The Nash–Sutcliffe efficiency coefficient (NSE), root mean square error (RMSE), mean absolute error (MAE) and coefficient of determination (R2) ranges were 0.956–0.958, 0.275–0.282 mm d−1, 0.221–0.231 mm d−1 and 0.957–0.961, respectively. It is proved that the hybrid RF–SVR–PSO model is appropriate for estimation of daily spring maize ETc in semi-arid regions. [ABSTRACT FROM AUTHOR]

Background: Treatment of functional dyspepsia (FD) in children is generally symptomatic and unsatisfactory. Traditional Chinese medicines, such as Shenqu Xiaoshi Oral Liquid (SXOL), have been recommended to alleviate dyspeptic symptoms. However, evidence of their safety and efficacy remains limited to date. AIM: To assess whether 2 weeks of therapy with SXOL was non-inferior to domperidone syrup in children with FD. Methods: In this randomized, double-blind, double-simulated, non-inferiority, multi-center clinical trial, we recruited children (3–14 years) with FD according to the Rome IV criteria from 17 tertiary medical centers across China. Patients were randomly allocated (1:1) to receive SXOL or domperidone syrup for 2 weeks. We compared the participants' clinical scores from both groups based on the severity and frequency of dyspepsia symptoms according to Rome IV criteria (0, 1, 2, and 4 weeks after randomization). The primary endpoint was the total response rate, which was defined as the proportion of patients with a decrease of 30% or more in the FD symptoms clinical score from baseline, at the end of the 2-weeks treatment. A non-inferiority margin of -10% was set. Secondary endpoints and adverse events were assessed. This trial is registered with www.Chictr.org.cn, number ChiCTR1900022654. Results: Between February 2019 and March 2021, a total of 373 patients were assessed for eligibility, and 356 patients were enrolled and randomized. The clinical response rate at week two was similar for SXOL [118 (83.10%) of 142] and domperidone [128 (81.01%) of 158]; difference 2.09; 95% CI −6.74 to 10.71, thereby establishing non-inferiority. The total FD symptom scores were significantly improved in the two groups at 1-, 2-, and 4-weeks follow-up periods (p < 0.005). The decrease in symptom score compared with the baseline were similar between these two groups. Over the total study period, 10 patients experienced at least one treatment-related adverse event [six (3.37%)] in the SXOL group, four [(2.25%) in the domperidone group], although no serious adverse event was noted. Conclusion: Treatment with SXOL effectively improves dyspeptic symptoms and is well tolerated. In addition, it is not inferior to domperidone syrup and leads to sustained improvement in Chinese children with FD. [ABSTRACT FROM AUTHOR]

The teaching of foreign students in China has become an important part of online teaching and one of the implementation problems during the epidemic. In order to better understand the online teaching situation and quality of foreign students in China, and to better carry out the online teaching of foreign students in China, this article firstly constructs the online teaching quality evaluation index system based on the investigation and analysis of the current situation of online teaching for foreign students in China. Secondly, further uses the analytic hierarchy process to determine the weight of each index, and finally uses the fuzzy comprehensive evaluation method to comprehensively evaluate the online teaching quality of foreign students in China. The research results show that the quality of online teaching for foreign students from Zhejiang Province is good. This research provides a model that can be used for reference for the follow-up online teaching of international students in China. [ABSTRACT FROM AUTHOR]

Background: Two-line hybrid wheat system using thermo-photo sensitive genic male sterility (TPSGMS) is currently the most promising approach for wheat heterosis utilization in China. However, during past 20 years only few TPSGMS lines were developed in hybrid wheat breeding, which has been the main limiting factor to create heterotic hybrids. Application of doubled haploid (DH) breeding provides a useful strategy to efficiently develop practically usable TPSGMS lines. Results: F1s and selected F2 and F3 sterile plants of eight crosses made from two commercial TPSGMS lines were used to produce DH lines. We developed a total of 24 elite DH sterile lines with stable sterility, good outcrossing and yield potential, resistance to yellow rust and powdery mildew, as well as desirable plant height (50–60 cm). These DH lines were developed within 4 years through at least 1 year of evaluation. The stability of male sterility was confirmed for most (20/24) of these elite DH sterile lines by multiple tests in two or 3 years. These lines are expected to be used in hybrid wheat breeding. The percentage of elite lines developed from the tested DH lines produced from filial generations was in the order of F2 > F3 > F1. Conclusions: We demonstrate that coupling DH techniques with conventional breeding is an efficient strategy for accelerating the development of more practical wheat TPSGMS lines. Generation of DHs from F2 generation appeared to be the better choice considering the balance of shortening breeding time and overall breeding efficiency. [ABSTRACT FROM AUTHOR]

Ports are an important driving force for world economic growth, but they consume considerable energy. The marine sector has proposed the development of green ports to achieve low-carbon sustainable development. This paper presents a green project scheduling model of port construction to optimize comprehensive economic and environmental efficiency. Various realistic constraints are considered, including investment scale, energy savings, emissions reduction, and project priority. Comprehensive efficiency involves cost reduction, energy savings, emissions reduction, and other efficiency goals. The problem is formulated as an integer program and is solved using CPLEX in a general algebraic modeling system (GAMS). We use a representative port in China as a case port in solving its green project scheduling. The results show that the port can save 6,527 tons of standard coal, reduce 40,875 tons of CO2, and save 49 million yuan per year in the five-year implementation period. The payback in investing in these green projects is less than six years. From an economic and environmental perspective, the comprehensive efficiency achieved is significant. [ABSTRACT FROM AUTHOR]

Thousand Island Lake (TIL) is a fragmented landscape consisting of more than 1000 land-bridge islands isolated during reservoir formation. To evaluate the effects of fragmentation and island attributes on insect populations, we examined the genetic structure ofLoxoblemmus aomoriensis, a species of cricket widely distributed in TIL, and compared genetic diversity between islands samples. Population genetic analyses was conducted based on mitochondrial DNA haplotype frequencies of 10 sample islands. By comparing three island attributes with population genetic diversity reveals that island area influenced population genetic diversity (r2 = 0.5094,p = 0.00204). Using Pairwise Fst values, we also found that long-distance isolation increased the genetic differentiation, while short-distance isolation can be offset by dispersal. These results indicate that fragmentation can impact populations on a genetic level. [ABSTRACT FROM AUTHOR]

Background: No study has reported the status and chronological trend of prophylactic recombinant factor VIII (rFVIII) use in Chinese pediatric patients with hemophilia A (HA).Objective: We aimed to analyze the status and trend of rFVIII-containing prophylaxis in Chinese pediatric patients with HA.Methods: ReCARE (Retrospective study in Chinese pediatric hemophilia A patients with rFVIII contained REgular prophylaxis) was a retrospective study conducted in 12 hemophilia treatment centers across China. The trend of prophylaxis was evaluated by determining the mean duration of prophylaxis, mean injection frequency (per week), mean dose of each injection (IU/kg), mean total dose injected/week (IU) and proportion of rFVIII consumption relative to factor VIII (FVIII) consumption over the study period.Results: We analyzed 183 male pediatric patients with HA (mean age, 7.1 ± 4.23 years), who received intermittent prophylaxis between 1 November 2007 and 31 May 2013. The mean duration of prophylaxis with rFVIII increased from 16.72 weeks in 2008 to 32.77 in 2012. Per injection dose of rFVIII increased significantly from 2008 to 2013 (25.89 to 28.31 IU/kg, p < .001). An increase was also reported in the mean total FVIII consumed (699.97 ± 173.25 IU in 2008 and 891.30 ± 730.341 in 2013) and mean proportion of rFVIII used (33.33 ± 57.73% in 2008 to 85.50 ± 29.077% in 2013).Conclusion: Our data revealed an overall improvement in treatment dosage and duration with an increase in the number of patients receiving prophylaxis. The total proportion of rFVIII also increased gradually indicating the development of economy and safety awareness.Trial Registration: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT02263066). [ABSTRACT FROM AUTHOR]

Background: The first recombinant factor VIII (rFVIII) product was launched in China in 2007. However, until now, no study has been conducted to describe the efficacy and safety of prophylaxis with rFVIII in Chinese pediatric patients with hemophilia A (HA).Objective: To summarize the efficacy and safety data on prophylaxis with rFVIII in Chinese pediatric patients with HA.Methods: ReCARE (Retrospective study in Chinese pediatric hemophilia A patients with rFVIII contained regular prophylaxis) was a retrospective study conducted in 12 hemophilia treatment centers (HTCs) across China. The primary endpoints included reduction in annualized bleeding rate (ABR); the secondary endpoints included evaluation of joint function (number and sites of target joints) using Gilbert score and Hemophilia Joint Health Score (HJHS), quality of life (QoL) and factors affecting treatment choices. Safety assessment of rFVIII was also conducted.Results: We analyzed a total of 183 male pediatric patients (mean age, 7.1 ± 4.23 years) who received prophylaxis between 1 November 2007 and 31 May 2013. Compared with baseline, prophylaxis with rFVIII significantly reduced overall annualized joint bleed rate (AJBR) (p < .001) and ABR (p < .001). Inhibitor formation was reported in 5 (2.7%) patients and hemarthrosis was reported in 1 patient. The mean number of target joints was positively related to age (p < .001) and weight (p = .003) at baseline. Responses from survey questionnaires reported that effective bleeding control, joint protection, improvement in quality of life, favorable medical insurance policies, and economic capability were reasons for choosing prophylaxis.Conclusion: Prophylaxis with rFVIII reduced bleeding and number of target joints, even with a low-dose regimen, in Chinese pediatric patients with HA. Other than the efficacy and safety, factors such as poor disease control, improved economic stability and stable financial support made prophylaxis as an attractive treatment option. ClinicalTrials.gov ID: NCT02263066. [ABSTRACT FROM AUTHOR]

Background: The National Health and Family Planning Commission of China has issued more than 400 clinical pathways to improve the effectiveness and efficiency of medical care delivered by public hospitals in China. The aim of our study is to determine whether patient care is compliant with national clinical pathways in public general hospitals of Pudong New Area in Shanghai.Methods: We identified the clinical pathways established by the National Health and Family Planning Commission of China for 5 common conditions (community-acquired pneumonia, acute myocardial infarction (AMI), heart failure, cesarean section, type-2 diabetes). We randomly selected patients with each condition admitted to one of 7 public general hospitals in Pudong New Area in China in January, 2013. We identified key process indicators (KPIs) for each pathway and, based on chart review for each patient, determined whether the patient's care was compliant for each indicator. We calculated the proportion of care which was compliant with clinical pathways for each indicator, the average proportion of indicators that were met for each patient, and the proportion of patients whose care was compliant for all measures. For selected indicators, we compared compliance rates among hospitals in our study with those from other countries.Results: Average compliance rates across the KPIs for each condition ranged from 61 % for AMI to 89 % for pneumonia. The percent of patient receiving fully compliant care ranged from 0 for AMI and heart failure to 39 % for pneumonia. Compared to the compliance rate for process indicators in the hospitals of other countries, some rates in the hospitals that we audited were higher, but some were lower.Conclusions: Few patients received care that complied with all the pathways for each condition. The reasons for low compliance with national clinical pathways and how to improve clinical quality in public hospitals of China need to be further explored. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We analyzed the efficacy of continuous renal replacement therapy (CRRT) combined with blood transfusion for patients with crush syndrome from an earthquake. Methods: Eight patients with crush syndrome were included. CRRT were performed in six of eight patients with crush syndrome, and transfusion was performed in all eight patients. Routine blood tests, urea nitrogen, creatinine, blood coagulation function, electrolyte levels, and serum myoglobin were determined and analyzed. Results: Two patients regained their health completely, four patients required amputation but recovered well, and two patients died. The total amount of red blood cells transfused in the eight cases was 521U (mean volume=68.25U). CRRT was performed 164 times in six patients (mean 27.33 times per person). The routine blood test results and coagulation and renal function parameters improved obviously (P <0.05) in the six surviving patients. Conclusions: Sufficient blood transfusion and early dialysis treatment effectively improved the conditions of patients with crush syndrome. [Copyright &y& Elsevier]

The simplification of Chinese characters is always concerned by philology world. Seen from the expressiveness of simplification of Chinese characters, the-rhetorical thought for practicability can be found hidden behind the simplification of Chinese characters. Chinese characters come into being for the sake of expression, and it is simplified also for the sake of expression, which is the basis of rhetoric. Therefore, simplified Chinese characters are the reflection of moderate principle of rhetoric in the process of simplification. [ABSTRACT FROM AUTHOR]

Abstract: Songliao Basin in NE China developed the most productive oilfield in the world sourced from terrestrial rocks. The main source rock of the basin includes member 1 of the Qingshankou (K2qn1) and members 1 and 2 of the Nenjiang Formation (K2nj1–2). However the exact reasons for the formation of the source rock, especially the K2qn1 are still controversial. Former paleontological and organic geochemical research suggested that organic matter was deposited during marine incursion events of K2qn1 but further geochemical evidence is needed. This paper explores the distinct sulfate levels that distinguish marine from fresh waters of the Songliao paleo-lake. We undertook a systematic investigation the sulfur geochemistry of the sediments from top of member 4 of the Quantou Formation (K1q4) to top of member 1 of the Qingshankou (K2qn1). The ratio of organic carbon to the pyrite sulfur (TOC/PYS) proved the previously suggested saline conditions during the deposition of K2qn1; and the pyrite sulfur isotope indicated that marine incursion may not only have occurred for K2qn1, but also for top of K1q4. The exact time for the beginning of marine incursion is to be determined. The marine incursion within K2qn1 is not strong and partially controlled by the fluctuation of paleo-lake level. The present study will be helpful for understanding the contribution of marine incursion events to the burial of organic carbon in the Songliao paleo-lake, although further studies are still needed. [Copyright &y& Elsevier]

Amur cork-tree bark is a natural medicine in China with a large market, whereas confusion about its origin limits its cultivation and commercial value. To trace the origin, the stable isotope ratios (δ 13C, δ 15N, δ 2H, and δ 18O) and multiple elements (As, Hg, Al, Ca, Fe, K, Mg, Na, Cr, Cd, Pb, Be, Cu, Zn, Sr, and Ba) of 83 batches of Amur cork-tree bark samples from 7 habitats were determined by stable isotope mass spectrometry and inductively coupled plasma mass spectrometry. The results showed that the two-dimensional combination of δ 13C and δ 15N in the scatter diagram of stable isotopes could obviously distinguish Amur cork-tree bark from Sichuan Province from other producing areas, and multielement radar map analysis could also be used to distinguish Amur cork-tree bark from different geographical sources. In this article, the data of stable isotope ratios and multielement content were combined for principal component analysis (PCA), linear discriminant analysis (LDA) and orthogonal partial least square discriminant analysis (OPLS-DA). The results of principal component analysis showed that all samples could be preliminarily distinguished. The prediction model established and verified by linear discriminant analysis realized 100% accurate classification for known samples. The correct rate of analysis and prediction for unknown samples was 94.5%. The effective feature discriminant markers of Amur cork-tree bark caused by VIP > 1 (Ca, K, Pb, Mg, Cr, As) were found by orthogonal partial least square discriminant analysis. It could accurately identify Amur cork-tree bark from different producing areas. [Display omitted] • The stable isotopes and multi-elements of Amur Cork-tree Bark were first determined. • The method was fisrt used to study the traceability of Amur Cork-tree Bark. • A set of traceability model was established for traceability of Amur Cork-tree Bark. • The method has guiding significance for the cultivation and clinical application. [ABSTRACT FROM AUTHOR]

Meconopsis bhutanica Tosh.Yoshida & Grey-Wilson (Meconopsis Vig., fam: Papaveraceae), is a Critically Endangered species utilized in Tibetan medicine. Due to the very limited numbers of wild individuals, the chemical and biological basis of its medicinal value has not been studied. The objective of this study was to explore the chemical constituents of Meconopsis bhutanica and to determine the antityrosinase activity and influence on human melanoma cell lines A375. The chemical constituents were mainly isolated through column chromatography and semipreparative high performance liquid chromatography, and the structures were elucidated by nuclear magnetic resonance spectra. The inhibition on tyrosinase was examined by microplate reader. High performance liquid chromatography, spectrofluorophotometer, and molecular docking were used to analyze the effects on the function and structure of tyrosinase. The influence on A375 cells were measured by the Cell Counting Kit. Finally, a total of eleven phenolic compounds were isolated and identified from Meconopsis bhutanica. All of these compounds were found in this plant for the first time. The results of antityrosinase activity assay showed that compound 9 exhibited tyrosinase inhibition obviously. Furthermore, compound 9 could decrease the oxidation products and fluorescence emission intensity of tyrosinase. However, compound 9 had no effect on the proliferation of human melanoma A375 cells at high concentrations. The present paper uncovered the chemical composition of Meconopsis bhutanica and assessed the tyrosinase inhibition activity, which will provide data for comparing bioactive chemical constituents between the wild and cultivated ones. This study paved the way for the conservation, cultivation, and application of Meconopsis bhutanica. [Display omitted] • The tyrosinase inhibition constituents of Meconopsis bhutanica were first studied. • (E)-2-(β- D -glucopyranosyloxy)-4-methoxycinnamic acid exhibited tyrosinase inhibition. • Meconopsis bhutanica had application value as regulators of tyrosinase activity. • The distribution of endangered Meconopsis bhutanica in China was first discovered. • Meconopsis bhutanica demonstrated potential to be cultivated. [ABSTRACT FROM AUTHOR]

Objectives: The objective is to to explore the longitudinal change trajectories of postpartum stress and its related factors., Design: A longitudinal study with follow-ups from 42 days to 6 months after delivery., Settings and Participants: A total of 406 postpartum women were recruited at baseline (42 days after delivery) from 6 hospitals in Nantong, Jiangsu Province, China, and followed up at 3 and 6 months. After the follow-ups, 358 postpartum women were retained for further analysis., Methods: Postpartum stress was evaluated using the Maternal Postpartum Stress Scale (MPSS) at baseline (42 days) and 3 and 6 months after delivery. MPSS has three dimensions, such as: personal needs and fatigue, infant nurturing and body changes and sexuality. Postpartum depression and anxiety were measured using the Edinburgh Postnatal Depression Scale and the short-form Depression, Anxiety and Stress Scale, respectively. The MPSS scores were normalised using a rank-based inverse normal transformation., Results: Postpartum stress decreased significantly after 3 months, and postpartum stress reduced further after 6 months. Additionally, the scores for all three dimensions reduced after 6 months, while infant nurturing reduced after both 3 and 6 months. Older age (β=0.028, p=0.049), higher education level (β=0.153, p=0.005) and higher body mass index (BMI) (β=0.027, p=0.008) of the postpartum women were significantly associated with higher postpartum stress levels in corresponding dimensions at 42 days. Older age was also associated with higher postpartum stress at 3 (β=0.030, p=0.033) and 6 months (β=0.050, p<0.001) in the dimension of personal needs and fatigue. Postpartum stress levels were significantly higher in women with depression or anxiety symptoms., Conclusions: Postpartum stress continuously declined from 42 days to 6 months after delivery. Postpartum women with older age, higher education levels, higher BMI and anxiety or depression symptoms should be the target population for early intervention., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Abstract: The outbreak and widely spread of coronavirus disease 2019 (COVID-19) has become a global public health concern. COVID-19 has caused an unprecedented and profound impact on the whole world, and the prevention and control of COVID-19 is a global public health challenge remains to be solved. The retrospective analysis of the large scale tests of SARS-CoV-2 RNA may indicate some important information of this pandemic. We selected 12400 SARS-CoV-2 tests detected in Wuhan in the first semester of 2020 and made a systematic analysis of them, in order to find some beneficial clue for the consistent prevention and control of COVID-19.SARS-CoV-2 RNA was detected in suspected COVID-19 patients with real-time fluorescence quantitative PCR (RT-qPCR). The patients' features including gender, age, type of specimen, source of patients, and the dynamic changes of the clinical symptoms were recorded and statistically analyzed. Quantitative and qualitive statistical analysis were carried out after laboratory detection.The positive rate of SARS-CoV-2 was 33.02% in 12,400 suspected patients' specimens in Wuhan at the first months of COVID-19 epidemics. SARS-CoV-2 RT-qPCR test of nasopharyngeal swabs might produce 4.79% (594/12400) presumptive results. The positive rate of SARS-CoV-2 RNA was significantly different between gender, age, type of specimen, source of patients, respectively (P < .05). The median window period from the occurrence of clinical symptom or close contact with COVID-19 patient to the first detection of positive PCR was 2 days (interquartile range, 1-4 days). The median interval time from the first SARS-CoV-2 positive to the turning negative was 14 days (interquartile range, 8-19.25 days).This study reveals the comprehensive characteristics of the SARS-CoV-2 RNA detection from multiple perspectives, and it provides important clues and may also supply useful suggestions for future work of the prevention and treatment of COVID-19., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Clinical practice guidelines or recommendations often require timely and regular updating as new evidence emerges, because this can alter the risk-benefit trade-off. The scientific process of developing and updating guidelines accompanied by adequate implementation can improve outcomes. To promote better management of patients receiving vancomycin therapy, we updated the guideline for the therapeutic drug monitoring (TDM) of vancomycin published in 2015., Methods: Our updated recommendations complied with standards for developing trustworthy guidelines, including timeliness and rigor of the updating process, as well as the use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. We also followed the methodology handbook published by the National Institute for Health and Clinical Excellence and the Spanish National Health System., Results: We partially updated the 2015 guideline. Apart from adults, the updated guideline also focuses on pediatric patients and neonates requiring intravenous vancomycin therapy. The guideline recommendations involve a broadened range of patients requiring TDM, modified index of TDM (both 24-hour area under the curve and trough concentration), addition regarding the necessity and timing of repeated TDM, and initial dose for specific subpopulations. Overall, 1 recommendation was deleted and 3 recommendations were modified. Eleven new recommendations were added, and no recommendation was made for 2 clinical questions., Conclusions: We updated an evidence-based guideline regarding the TDM of vancomycin using a rigorous and multidisciplinary approach. The updated guideline provides more comprehensive recommendations to inform rational and optimized vancomycin use and is thus of greater applicability., (© 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.)

Cases of coronavirus disease 2019 (COVID-19) have been breaking out around the world recently. However, the dynamic changes in the clinical symptoms and prognosis of COVID-19 patients remain unknown. According to the onset time of initial clinical symptoms, 843 COVID-19 patients admitted between Jan 22 and Feb 14, 2020 were divided into three groups: group A (Jan 21 to Jan 25, n = 324), group B (Jan 26 to Jan 31, n = 358) and group C (Feb 1 to Feb 10, n = 161). Data on the demographics, symptoms, first laboratory results, treatments and outcomes (within 12 days of hospitalization) were collected. The results showed that the median duration from symptom onset to admission shortened over time (13, 10 and 5 days, respectively, p < 0.05). Fewer patients had fever symptoms and bilateral pneumonia in group C than in the group A and B. Laboratory results showed that white blood cell, neutrophil, and platelet counts, lactic acid and D-dimer levels were lower, while lymphocyte, CD3, and CD8 counts were higher in group C. In addition, group C had more mild-moderate cases and fewer severe cases than the other two groups. More importantly, the incidence of complications (18.5%, 14.2% and 11.2%, respectively, p < 0.05) and all-cause mortality (11.7%, 8.4%, and 5.6%, respectively, p < 0.05) decreased over time. The clinical characteristics and prognosis of COVID-19 patients changed over time. Improved prognosis was found at a later stage., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Hypertension is one of the most common comorbidities in patients with coronavirus disease 2019 (COVID-19). This study aimed to clarify the impact of hypertension on COVID-19 and investigate whether the prior use of renin-angiotensin-aldosterone system (RAAS) inhibitors affects the prognosis of COVID-19. A total of 996 patients with COVID-19 were enrolled, including 282 patients with hypertension and 714 patients without hypertension. Propensity score-matched analysis (1:1 matching) was used to adjust the imbalanced baseline variables between the 2 groups. Patients with hypertension were further divided into the RAAS inhibitor group (n=41) and non-RAAS inhibitor group (n=241) according to their medication history. The results showed that COVID-19 patients with hypertension had more severe secondary infections, cardiac and renal dysfunction, and depletion of CD8 + cells on admission. Patients with hypertension were more likely to have comorbidities and complications and were more likely to be classified as critically ill than those without hypertension. Cox regression analysis revealed that hypertension (hazard ratio, 95% CI, unmatched cohort [1.80, 1.20-2.70]; matched cohort [2.24, 1.36-3.70]) was independently associated with all-cause mortality in patients with COVID-19. In addition, hypertensive patients with a history of RAAS inhibitor treatment had lower levels of C-reactive protein and higher levels of CD4 + cells. The mortality of patients in the RAAS inhibitor group (9.8% versus 26.1%) was significantly lower than that of patients in the non-RAAS inhibitor group. In conclusion, hypertension may be an independent risk factor for all-cause mortality in patients with COVID-19. Patients who previously used RAAS inhibitors may have a better prognosis.

The novel Coronavirus SARS-CoV-2 caused an outbreak of pneumonia in Wuhan, Hubei province of China in January 2020. This study aims to investigate the effects of different temperature and time durations of virus inactivation on the results of PCR testing for SARS-CoV-2. Twelve patients at the Renmin Hospital of Wuhan University suspected of being infected with SARS-CoV-2 were selected on February 13, 2020 and throat swabs were taken. The swabs were stored at room temperature (20-25°C), then divided into aliquots and subjected to different temperature for different periods in order to inactivate the viruses (56°C for 30, 45, 60 min; 65, 70, 80°C for 10, 15, 20 min). Control aliquots were stored at room temperature for 60 min. Then all aliquots were tested in a real-time fluorescence PCR using primers against SARS-CoV-2. Regardless of inactivation temperature and time, 7 of 12 cases (58.3%) tested were positive for SARS-CoV-2 by PCR, and cycle threshold values were similar. These results suggest that virus inactivation parameters exert minimal influence on PCR test results. Inactivation at 65°C for 10 min may be sufficient to ensure safe, reliable testing.

Background: Information about the clinical characteristics and mortality of patients with coronavirus disease 2019 at different ages is limited., Results: The older group had more patients with dyspnea and fewer patients with fever and muscle pain. Older patients had more underlying diseases, secondary infection, myocardial injury, renal dysfunction, coagulation dysfunction, and immune dysfunction on admission. More older patients received immunoglobulin therapy and mechanical ventilation. The proportions of patients with multiple organ injuries, critically ill patients and death increased significantly with age. The older groups had higher cumulative death risk than the younger group. Hypertension, cerebrovascular disease, comorbidities, acute cardiac injury, shock and complications are independent predictors of death., Conclusions: The symptoms of the elderly patients were more atypical, with more comorbidities, secondary infection, organ injuries, immune dysfunction and a higher risk of critical illness. Older age was an important risk factor for mortality., Methods: 1000 patients diagnosed with coronavirus disease 2019 from January 1, 2020 to February 14, 2020 were enrolled. According to age, patients were divided into group 1 (<60 years old), group 2 (60-74 years old) and group 3 (≥75 years old). The clinical symptoms, first laboratory results, CT findings, organ injuries, disease severity and mortality were analyzed.

Purpose: This study was conducted to investigate the relation of HP infection to peripheral arterial stiffness and 10-year cardiovascular risk in diabetes mellitus (DM)., Methods: DM subjects who underwent the C13-breath test were enrolled and divided into DMHP+ and DMHP- groups. Peripheral arterial stiffness was measured using brachial to ankle pulse wave velocity (baPWV). Framingham score (FRS) and Chinese evaluation method of ischemic cardiovascular diseases (ICVD) were used to clarify 10-year cardiovascular risk., Results: A total of 6767 subjects were included, baPWV and proportion of subjects with severe peripheral arterial stiffness were lower in DMHP- group than DMHP+ group (1556.68 ± 227.54 vs 2031.61 ± 525.48 cm/s, p  < 0.01; 21.9% vs 62.7%, p  < 0.01). Multivariate logistic regression analysis demonstrated that HP infection was independently associated with baPWV. Furthermore, cardiovascular risk score and the proportion of subjects with high risk were lower in DMHP- group than DMHP+ group (FRS: 12.09 ± 3.77 vs 13.91 ± 3.77, 17.2% vs 38.8%; ICVD: 8.56 ± 2.99 vs 10.22 ± 3.16, 43.9% vs 65.4%, with all p  < 0.05)., Conclusion: DM subjects with HP infection had more severe peripheral arterial stiffness compared those without HP infection, a higher cardiovascular risk score and 10-year cardiovascular risk stratification were observed in those subjects.

A new HPV-16/18 bivalent vaccine expressed by the Escherichia coli has been proven to be efficacious in adult women. A randomized, immunogenicity noninferiority study of this candidate vaccine was conducted in December 2015 in China. Girls aged 9-14 years were randomized to receive 2 doses at months 0 and 6 (n=301) or 3 doses at months 0, 1 and 6 (n=304). Girls aged 15-17 years (n=149) and women aged 18-26 years (n=225) received 3 doses. The objectives included noninferiority analysis of the IgG geometric mean concentration (GMC) ratio (95% CI, lower bound>0.5) to HPV-16 and HPV-18 at month 7 in girls compared with women. In the per-protocol set, the GMC ratio of IgG was noninferior for girls aged 9-17 years receiving 3 doses compared with women (1.76 (95% CI, 1.56, 1.99) for HPV-16 and 1.93 (95% CI, 1.69, 2.21) for HPV-18) and noninferior for girls aged 9-14 years receiving 2 doses compared with women (1.45 (95% CI, 1.25, 1.62) for HPV-16 and 1.17 (95% CI, 1.02, 1.33) for HPV-18). Noninferiority was also demonstrated for neutralizing antibodies. The immunogenicity of the HPV vaccine in girls receiving 3 or 2 doses was noninferior compared with that in young adult women.

The historical preparation methods of Glycyrrhizae Radix et Rhizoma were summarized and analyzed by consulting relevant literatures of herbal medicines and medical classics. This study also reviewed the records of Glycyrrhizae Radix et Rhizoma processing methods in previous editions of the Chinese Pharmacopoeia and the regulations on processing technology of Glycyrrhizae Radix et Rhizoma decoction pieces in China. This paper summarized the processing history of Glycyrrhizae Radix et Rhizoma and defined the development process of Glycyrrhizae Radix et Rhizoma processing. According to textual research from ancient times to today, there are many ways to process Glycyrrhizae Radix et Rhizoma. The processing methods without auxiliary materials include braising, frying, cooking, simmering and adding such auxiliary materials as wine, vinegar, salt, oil, ginger, honey, water and bile. There are 9 editions of the published Chinese Pharmacopoeia that document the processing of Glycyrrhizae Radix et Rhizoma, and 24 provinces and cities nationwide record the processing of Glycyrrhizae Radix et Rhizoma. At present, the 2015 edition of the Chinese Pharmacopoeia only records the processing technology of Glycyrrhizae Radix et Rhizoma honey, and the honey processing method is still widely usedtoday. Whether or not Zhigancao should be used uniformly for honey-processed Zhigancao today should be based on the processing methods of Chinese herbal medicine and its clinical use in previous ancient medical books. This paper provides a reference and historical basis for subsequent studies on other processing techniques of Glycyrrhizae Radix et Rhizoma, the rational selection of Glycyrrhizae Radix et Rhizoma varieties and the further development and utilization of corresponding medicinal materials.

To reveal the coupling effect of water and fertilizer on the yield of spring maize under shallow-buried drip irrigation in semi-arid area of western Liaoning, a field experiment was conducted with the quadratic regression orthogonal design of three factors (water, nitrogen and potassium) crossed with five levels in 2017-2018. A quadratic regression model was established with yield (Y) as the dependent variable and irrigation amount (W), nitrogen (N) and potassium (K) application amounts as independent variables to analyze the coupling relationships between Y and W, N and K, respectively. The results showed that the shallow-drip irrigation water-fertilizer coupling had significant impact on yield. The single factor of W, N and K promoted the yield, with their effects ranking as W>N>K. The effect of two-factor interaction on yield increased first and then decreased which ranked as WN>WK>NK. Considering the three-factor coupling effect on yield, the combination of abundant water, nitrogen and potassium was the highest, followed by high water, nitrogen and potassium, and low water, nitrogen and potassium the lowest. As the optimal treatments found by the model, we obtained the suitable water-fertilizer application range of shallow-buried drip irrigation with higher target yield of 8000-8810 kg·hm -2 , that was, the irrigation amount was 43-61 mm, nitrogen 138-343 kg·hm -2 and potassium 79-163 kg·hm -2 under the ambient natural rainfall. The results provided a referable basis for application of water-fertilizer integrated cropping pattern under shallow-buried drip irrigation in semi-arid area of northern China.

Introduction: Disseminated intravascular coagulation (DIC) is a severe complication of critical conditions. There are several scoring systems used for the diagnosis of DIC, including the International Society on Thrombosis and Hemostasis (ISTH) Overt-DIC criteria, the Japanese Ministry of Health and Welfare (JMHW) criteria and the Chinese Society of Thrombosis and Hemostasis scoring system for DIC (CDSS). The objective of this prospective study was to evaluate the accuracy and predictive value of the CDSS., Materials and Methods: 1318 patients, aged 18-70 years old and suspected of DIC were enrolled from 18 hospitals across China. Participants were divided into two groups for analysis (group 1, non-hematological diseases; group 2, hematological diseases). 242 patients were excluded because of incomplete data collection and failure to follow-up., Results and Conclusions: The rates of concordance of diagnosis of DIC between the CDSS and two other scoring systems were close to 80%. The area under ROC curves of CDSS had a slight advantage when using the ISTH, JMHW criteria or prognosis as gold standard, respectively. The CDSS DIC was an independent predictor of mortality, and its odds-ratio was superior or comparable to that of the ISTH and JMHW criteria in the two groups. The CDSS DIC score also had a significant correlation with the APACHE II and SOFA score (p < 0.05). In summary, as a quantification standard of the Chinese experts' consensus, the CDSS is conducive to the standardized diagnosis of DIC because of its favorable diagnostic and prognostic utility., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Disseminated intravascular coagulation (DIC) is a common life-threatening complication in critically ill patients. The diagnostic scoring systems of DIC enable a more prompt and accurate diagnosis of DIC, such as the International Society on Thrombosis and Haemostasis (ISTH), the Japanese Association for Acute Medicine (JAAM) and the Japanese Ministry of Health and Welfare (JMHW). This study prospectively evaluated the newly proposed Chinese DIC Scoring System (CDSS), which was conducted at 18 centers in China during a one-year period. Receiver operating characteristic (ROC) curves showed that, for diagnosis of DIC and for prediction of the 28-day all-cause mortality, the CDSS had larger areas under the ROC curve (AUCs) than the ISTH and the JAAM in different groups. The CDSS also had larger AUC than the JMHW for the ISTH DIC in non-infectious diseases. All of the AUCs of the CDSS were greater than 0.8, accompanied with both high sensitivity and high specificity. Furthermore, the CDSS score was an independent predictor of mortality (odds ratio, 1.882; p < 0.001), and could reflect the illness severity (p < 0.001 for Spearman's rank correlations with the scores of severity). In conclusion, the CDSS is worthy of promotion with a better diagnostic and prognostic value for DIC.

As the most prevalent form of birth defect in humans worldwide, congenital heart disease (CHD) is responsible for substantial morbidity and is still the leading cause of birth defect-related demises. Increasing evidence demonstrates that genetic defects play an important role in the pathogenesis of CHD, and mutations in multiple genes, especially in those coding for cardiac core transcription factors, have been causally linked to various CHDs. Nevertheless, CHD is a genetically heterogeneous disease and the genetic determinants underpinning CHD in an overwhelming majority of patients remain elusive. In the current study, genomic DNA was extracted from venous blood samples of 165 unrelated patients with CHD, and the coding exons and splicing junction sites of the HAND1 gene, which encodes a basic helix-loop-helix transcription factor essential for cardiovascular development, were sequenced. As a result, a novel heterozygous mutation, p.R118C, was identified in a patient with tetralogy of Fallot (TOF). The missense mutation, which was absent in 600 referential chromosomes, altered the amino acid that was completely conserved evolutionarily. Biological assays with a dual-luciferase reporter assay system revealed that the R118C-mutant HAND1 protein had significantly reduced transcriptional activity when compared with its wild-type counterpart. Furthermore, the mutation significantly decreased the synergistic activation of a downstream target gene between HAND1 and GATA4, another cardiac core transcription factor associated with TOF. To our knowledge, this is the first report on the association of a HAND1 loss-of-function mutation with enhanced susceptibility to TOF in humans. The findings provide novel insight into the molecular etiology underlying TOF, suggesting potential implications for the improved prophylactic and therapeutic strategies for TOF.

Carotid atherosclerosis is associated with many serious cardiovascular diseases; hence, it is necessary to identify factors related to its occurrence in order to develop preventive and therapeutic strategies. This study was conducted to identify risk factors associated with carotid atherosclerosis among the population residing in Northeast China.This epidemiological survey was conducted in a representative group of relatively healthy community residents. All participants answered questions about their medical histories and underwent physical examination, blood biochemical analysis, and ultrasonography examinations of their necks and abdomens. The prevalence rates of carotid atherosclerosis under different factors and conditions were then analyzed.The results of this study showed that age, gender, and diabetes significantly affected the prevalence of carotid atherosclerosis in this Northeast Chinese population. In addition, gender-based subgroup analysis revealed additional factors correlated with the prevalence of carotid atherosclerosis in men or women, although their correlations were not significant in the overall population. While high serum TC and LDL-C levels were risk factors for carotid atherosclerosis in men, it showed no clear correlation with the prevalence of carotid atherosclerosis in women. In contrast, the prevalence of carotid atherosclerosis in female participants with high serum TG level, hypertension, obesity and nonalcoholic fatty liver disease were higher than that of the control population, a trend not observed in male participants.Older age, male sex, and diabetes were independently associated with increased risk of carotid atherosclerosis in Northeast China. These findings could lead to improved screening for carotid atherosclerosis for better disease management., Competing Interests: The authors have no conflict of interest to disclose.

Aim: To study the clinical efficacy of traditional Chinese medicine (TCM) intervention "tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment" ("TTK") for treating liver failure due to chronic hepatitis B., Methods: We designed the study as a randomized controlled clinical trial. Registration number of Chinese Clinical Trial Registry is ChiCTR-TRC-12002961. A total of 144 patients with liver failure due to infection with chronic hepatitis B virus were enrolled in this randomized controlled clinical study. Participants were randomly assigned to the following three groups: (1) a modern medicine control group (MMC group, 36 patients); (2) a "tonifying qi and detoxification" ("TQD") group (72 patients); and (3) a "tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment" ("TTK") group (36 patients). Patients in the MMC group received general internal medicine treatment; patients in the "TQD" group were given a TCM formula "tonifying qi and detoxification" and general internal medicine treatment; patients in the "TTK" group were given a TCM formula of "TTK" and general internal medicine treatment. All participants were treated for 8 wk and then followed at 48 wk following their final treatment. The primary efficacy end point was the patient fatality rate in each group. Measurements of various virological and biochemical indicators served as secondary endpoints. The one-way analysis of variance and the t-test were used to compare patient outcomes in the different treatment groups., Results: At the 48-wk post-treatment time point, the patient fatality rates in the MMC, "TQD", and "TTK" groups were 51.61%, 35.38%, and 16.67%, respectively, and the differences between groups were statistically significant (P < 0.05). However, there were no significant differences in the levels of hepatitis B virus DNA or prothrombin activity among the three groups (P > 0.05). Patients in the "TTK" group had significantly higher levels of serum total bilirubin compared to MMC subjects (339.40 μmol/L ± 270.09 μmol/L vs 176.13 μmol/L ± 185.70 μmol/L, P = 0.014). Serum albumin levels were significantly increased in both the "TQD" group and "TTK" group as compared with the MMC group (31.30 g/L ± 4.77 g/L, 30.72 g/L ± 2.89 g/L vs 28.57 g/L ± 4.56 g/L, P < 0.05). There were no significant differences in levels of alanine transaminase among the three groups (P > 0.05). Safety data showed that there was one case of stomachache in the "TQD" group and one case of gastrointestinal side effect in the "TTK" group., Conclusion: Treatment with "TTK" improved the survival rates of patients with liver failure due to chronic hepatitis B. Additionally, liver tissue was regenerated and liver function was restored.

Maize grain yield varies highly with water availability as well as with fertilization and relevant agricultural management practices. With a 311-A optimized saturation design, field experiments were conducted between 2006 and 2009 to examine the yield response of spring maize (Zhengdan 958, Zea mays L) to irrigation (I), nitrogen fertilization (total nitrogen, urea-46% nitrogen,) and phosphorus fertilization (P2O5, calcium superphosphate-13% P2O5) in a semi-arid area environment of Northeast China. According to our estimated yield function, the results showed that N is the dominant factor in determining maize grain yield followed by I, while P plays a relatively minor role. The strength of interaction effects among I, N and P on maize grain yield follows the sequence N+I >P+I>N+P. Individually, the interaction effects of N+I and N+P on maize grain yield are positive, whereas that of P+I is negative. To achieve maximum grain yield (10506.0 kg · ha(-1)) for spring maize in the study area, the optimum application rates of I, N and P are 930.4 m(3) · ha(-1), 304.9 kg · ha(-1) and 133.2 kg · ha(-1) respectively that leads to a possible economic profit (EP) of 10548.4 CNY · ha(-1) (CNY, Chinese Yuan). Alternately, to obtain the best EP (10827.3 CNY · ha(-1)), the optimum application rates of I, N and P are 682.4 m(3) · ha(-1), 241.0 kg · ha(-1) and 111.7 kg · ha(-1) respectively that produces a potential grain yield of 10289.5 kg · ha(-1).

Background: Few population-based studies have examined the relationship between glycemic status and chronic kidney disease (CKD) in China. We examined the prevalence of CKD across categories of glycemia [diagnosed diabetes, undiagnosed diabetes (fasting plasma glucose [FPG] ≥ 126 mg/dL), prediabetes (FPG 100-126 mg/dL) and normal glycemia (FPG <100 mg/dL)] among Chinese adults and assessed the relative contribution of dysglycemia (prediabetes and/or diabetes) to the burden of CKD., Methods: 5,584 Chinese adults aged 20-79 years were selected from the Pudong New Area of Shanghai through a multistage random sampling. Demographic and lifestyle characteristics, anthropometry and blood pressure were measured. Biochemical assays included FPG, serum creatinine and lipids, urinary creatinine and albumin. Prevalence of albuminuria [urine albumin-to-creatinine ratio (ACR) ≥ 30 mg/g], decreased kidney function and CKD (either decreased kidney function or albuminuria) across levels of glycemia were estimated., Results: The prevalence of albuminuria, decreased kidney function and CKD each increased with higher glycemic levels (P < 0.001). Based on the MDRD Study equation, the unadjusted CKD prevalence was 30.9%, 28.5%, 14.1% and 9.2% in those with diagnosed diabetes, undiagnosed diabetes, prediabetes and normoglycemia, respectively. The corresponding age-, gender- and hypertension-adjusted CKD prevalence were 25.8%, 25.0%, 12.3% and 9.1%, respectively. In a multivariable analysis, the factors associated with CKD were hypertension (Odds ratio [OR] 1.70, 95% confidence interval [CI]: 1.42-2.03), dysglycemia (OR 1.65, 95% CI: 1.39-1.95), female gender (OR 1.48, 95% CI: 1.25-1.75), higher triglycerides (OR 1.14, 95% CI: 1.08-1.20 per mmol/L), higher body mass index (OR 1.08, 95% CI: 1.05-1.10 per kg/m2), and older age (OR 1.02, 95% CI: 1.01 -1.03 per year). The population attributable risks (PARs) associated with diabetes, prediabetes, dysglycemia (diabetes and prediabetes) and hypertension were 18.4%, 19.7%, 30.3% and 44.5% for CKD as defined by the MDRD study equation, and 15.8%, 24.4%, 29.2% and 10.0% with the CKD-EPI equation. Estimates of prevalence and ORs of the relative contribution of various risk factors to CKD obtained with the CKD-EPI equation were similar., Conclusions: As much as 30% of the CKD burden may be associated with dysglycemia among Chinese adults, independent of age, gender and hypertension status. Prevention and control of diabetes and prediabetes should be a high priority in reducing the CKD burden in China.

We investigated the dynamics of the microfauna community in activated sludge, with special reference to sludge bulking, in two parallel municipal wastewater treatment systems in Beijing, China over a period of 14 months. Annual cyclic changes in microfauna community structures occurred in both systems. RELATE analysis based on Spearman's Rank correlation indicated that microfauna community structures were highly correlated with the sludge volume index (SVI) (p<0.001), which indicates sludge settleability. Nutrient conditions of raw sewage (p<0.01) and hydraulic retention time (HRT) (p<0.05) were also related to microfauna community structures. Abundances of the species Epistylis plicatilis and Vorticella striata increased significantly with an increase in SVI (p<0.001) and decrease in water temperature (p<0.001), suggesting that sludge bulking may have created favorable conditions for the two species, even under unfavorable temperature conditions. Sludge de-flocculation primarily due to the excessive growth of Microthrix parvicella-like filaments could be an important driving force for the microfauna community changes. The release of flocculated non-filamentous bacteria may represent a suitable food source for these species. The two species may be considered as potential bioindicators for sludge bulking., (Copyright © 2013 Elsevier GmbH. All rights reserved.)

Background: Hereditary angioedema (HAE), caused by C1 inhibitor deficiency, is characterized by recurrent subcutaneous or submucosal swelling. Because it is rare, data on clinical features, especially in Chinese patients, are not comprehensive., Objective: Our aim was to identify the characteristics of HAE in a Chinese population and enhance clinical knowledge of this disease., Methods: One hundred and fifty-eight symptomatic patients were studied retrospectively. Data were obtained from medical records. Statistical analyses were performed using statistical software package: R version 2.14.0., Results: The majority of patients first experienced attacks during the second (42%) and third (32%) decades: the mean onset of symptoms was at the age of 21.25 years. The percentage of patients having experienced a swelling at least once for the following sites were: extremities (83.54%); pharyngolarynx (58.86%); face (55.06%); gastrointestinal tract (34.17%); trunk (18.35%) and genitalia (15.33%). Rare manifestations included melaena, swollen gastric mucosa inverting into the oesophagus, pleural effusion, dysuria and syncope. For patients who first experienced swelling in pre-adolescence, 41.67% noted intensified attack rates when they entered puberty. In pregnancy, 61.70% did not note a change in HAE attack frequency., Conclusion: Compared with previous studies, the mean age of symptom onset is older. The frequencies of abdominal attacks occurring in patients on the Chinese Mainland, as well as in Taiwan and Japan, appears much lower than in western countries. Ethnic or environmental differences may contribute to this finding. Melaena and gastric mucosa inverting into the oesophagus secondary to edema are first reported here.

Background: Stereotactic surgery has been used to treat heroin abstinence in China since 2000 by ablating the amygdaloid nucleus (AMY) and the nucleus accumbens (NAc), which also provides opportunity to identify the relationship between these nuclei and addiction. Our study aimed to explore the physiological and psychological effects of electrically stimulating the AMY and the NAc in heroin addicts after detoxification by observing changes of heart rate, arterial pressure and occurrence of euphoria similar to heroin induced euphoria., Methods: A total of 70 heroin addicts after detoxification were recruited, and 61 of them were eligible to be given stereotactic surgery for heroin abstinence. The operation was carried out after determining the coordinates of all target nucleuses, and stimulation was performed at the AMY and the NAc solely or jointly. Heart rate, arterial pressure and occurrence of euphoria similar to heroin induced euphoria were recorded and analyzed., Results: The average heat rate was (66 ± 10) beats/min before electric stimulation, and significantly increased to (84 ± 14) beats/min during stimulation, and changed to (73 ± 12) beats/min 10 minutes after stimulation. There was a significant elevation of the average arterial pressure from 83 mmHg before stimulation to 98 mmHg during the stimulation, and it then decreased to 90 mmHg after stimulation. Forty-three of the 61 patients showed intense euphoria similar to heroin induced euphoria. The largest number (118/186) of euphoric responses occurred when the AMY and the NAc were stimulated at the same time. Odds ratio was 5.4 (95%CI: 2.4 - 11.9, P < 0.0001) to quantify the association. Results from a Logistic regression model showed a positive correlation between unilateral stimulation of either the AMY or NAC and induction of euphoria (OR > 1), especially when the left AMY or left NAc was stimulated (P < 0.05)., Conclusions: Our data are consistent with existing results that the AMY and the NAc are related to addiction. Different roles in drug dependence would be suggested according to the location of the AMY and NAc.

Background: The prevalence of metabolic syndrome (MS) has been increasing in China in recent years. The aim of this study is to estimate and compare the prevalence of MS among Chinese adults in Shanghai, one of the most economic developed areas in China, using definitions proposed by World Health Organization (WHO), National Cholesterol Education Program Adult Treatment Panel (modified ATP III) and International Diabetes Federation (IDF)., Methods: This cross-sectional study included 5,584 adults at age 20-79 randomly selected from Pudong New Area of Shanghai, China, through a three-stage sampling. All participants were interviewed in-person between April and July of 2008 to collect information on demographic and lifestyle characteristics. At the interview, anthropometry and blood pressure were measured and bio-specimens were collected., Results: The prevalence estimates for the MS increased with age for each definition in men and women, but the estimates varied greatly between the definitions and by sex. The prevalence of the MS was higher in men (20.2%) than in women (18.7%) using WHO definition but this sex difference was reversed when using the modified ATP III (28.4% for men vs. 35.1% for women) and the IDF (15.9% for men vs. 26.7% for women) criteria. The most common metabolic disorder in this population was dyslipidaemia, regardless of the definition used. Substantial agreement, estimated using the kappa statistic, was found between the modified ATP III and IDF definition, whereas the lowest agreement was observed between the WHO and ATP III criteria., Conclusions: The MS is highly prevalent among Chinese adults in Pudong New Area of Shanghai and the most prevalent component was dyslipidemia. These findings underscore the importance of prevention and control efforts for the MS in this area and the need for a unified predictive definition for the syndrome for use by clinical practitioners and public health agencies.

Objective: To investigate the genetic polymorphism of five miniSTR loci (D9S2157, D9S1122, D10S1435, D12ATA63, D2S1776) in Hebei Han population and to construct standard allelic ladders., Methods: Polymorphism of the five miniSTR loci in 120 unrelated individuals was analyzed by fluorescence PCR and ABI 310 Genetic Analyzer. Molecular cloning technique was employed to construct standard allelic ladder of the 5 loci., Results: Of the five miniSTR loci, 8, 8, 7, 5 and 8 alleles were found, respectively. The polymorphism information component were 0.790, 0.720, 0.750, 0.630 and 0.850, respectively., Conclusion: The five loci have relatively abundant polymorphic information and their standard allelic ladders constructed by molecular cloning technique are useful in forensic science.

Objective: To investigate the common characteristics of the patients, relapse reasons of patients before and after surgery, evaluate the relapse rate and its impact factors, and therapeutic effect of patients accepted stereotactic surgery to treat opiate dependence in Sichuan., Methods: An investigation, using uniform questionnaires by face-to-face and telephone interview, and gaining data from medical records of patients, was conducted in Mar to Jun 2005, in Sichuan Province. 208 patients (total 212 patients participated in surgery) were invited to gather information about their common characteristics, drug-taking history and the surgery. Statistical methods including t-test, chi2 test and logistic regression were used to analyze the data., Results: (1) 181 male patients and 27 female patients participated in this study, and their mean age was (29.5 +/- 5.5) years. Most of the respondents were in Sichuan and some peripheral province, graduated from senior high school and over, and with various occupations. (2) All patients abused opiate before the surgery, and the average duration of drug-taking was (7.6 +/- 3.4) years. All patients were detoxified by unconstraint or compulsory abstinence before surgery, with mean drug abstinence of 13.9, but relapse occurred after each detoxification. (3) Suffering with no drugs and abstinence syndrome were the two main reasons of relapse before surgery. Compared with relapse before surgery, validating the effect of the surgery treating drug dependence and temptation by drug surroundings were the two main reasons of relapse after surgery. (4) The complication rate was 38.0% (79/208), no severe complications occurred in patients, and most of the complications disappeared or were healed before they were discharged from hospital. Relapse rate within 7 months after surgery was 22.1% (46/208). A significant decrease of relapse time, relapse dose, subjective feel on drugs and relapse euphoria appeared in patients who relapsed after surgery when compared with those before surgery. The univariate and multivariate analysis shows potential significant predictors of relapse rate after surgery to include education (OR = 3.259), operative time (OR = 2.451), social support (OR = 23.256) and doing simple work (OR = 3.328)., Conclusion: This investigation showed that the stereotactic surgery can eliminate psychological desire for drugs and abstinence syndrome among most of the patients. Satisfactorily short-term therapeutic effect and substantial decline in relapse rate as well as no severe complications were appeared in these patients. Relapse was greatly associated with education, operative time, neuropsychological factors, and social conditions of patients. Therefore, patients' family and the society should strengthen their care, comprehension as well as support, and create better living and working surroundings to facilitate the complete drug abstinence to occur in patients. average duration of drug-taking was (7.6 +/- 3.4) years. All patients were detoxified by unconstraint or compulsory abstinence before surgery, with mean drug abstinence of 13.9, but relapse occurred after each detoxification. (3) Suffering with no drugs and abstinence syndrome were the two main reasons of relapse before surgery. Compared with relapse before surgery, validating the effect of the surgery treating drug dependence and temptation by drug surroundings were the two main reasons of relapse after surgery. (4) The complication rate was 38.0% (79/208), no severe complications occurred in patients, and most of the complications disappeared or were healed before they were discharged from hospital. Relapse rate within 7 months after surgery was 22.1% (46/208). A significant decrease of relapse time, relapse dose, subjective feel on drugs and relapse euphoria appeared in patients who relapsed after surgery when compared with those before surgery. The univariate and multivariate analysis shows potential significant predictors of relapse rate after surgery to include education (OR = 3.259), operative time (OR = 2.451), social support (OR = 23.256) and doing simple work (OR = 3.328)., Conclusion: This investigation showed that the stereotactic surgery can eliminate psychological desire for drugs and abstinence syndrome among most of the patients. Satisfactorily short-term therapeutic effect and substantial decline in relapse rate as well as no severe complications were appeared in these patients. Relapse was greatly associated with education, operative time, neuropsycological factors, and social conditions of patients. Therefore, patients' family and the society should strengthen their care, comprehension as well as support, and create better living and working surroundings to facilitate the complete drug abstinence to occur in patients.

Objective: To investigate the relationship between allergic rhinitis and allergic asthma in the patients with autumnal pollinosis., Methods: 1120 patients with autumnal pollinosis, aged 5 - 75, excluding those with typical symptoms of seasonal rhinitis or asthma but with positive skin test and serum IgE specific to dustmite and fungi, underwent standardized clinical questionnaire survey, including the onset age, onset time, and symptoms as well as the severity of asthma, skin tests, and examination of serum IgE specific to autumnal pollens., Results: The average onset age of the allergic rhinitis patients induced by autumnal pollens was 27.9 years, significantly younger than that of the allergic asthma patients (32.6 years, P < 0.001). Out of the 1120 patients 1096 (97.9%) had allergic rhinitis, 602 (53.8%) had asthma, 507 (45.3%) had allergic rhinitis only, and 10 (0.9%) had allergic asthma only. Among the 1096 patients with allergic rhinitis 585 (53.4%) suffered from seasonal asthma. Among the 602 patients with asthma 585 (97.2%) suffered from seasonal rhinitis, and 183 of the 602 patients (30.8%) needed emergency treatment., Conclusion: Autumnal pollens are very important causes which induce asthma during autumnal season in northern China.

Objective: To study the infectious status of seven species of Mycoplasma, three species of Chlamydia, Neisseria gonorrhoeae and Garderella vaginalis in the 76 male sexual transmitted disease (STD) patients in Yangzhou city., Methods: Twelve species of pathogens including Ureaplasma urealyticum (Uu), Mycoplasma hominis (Mh), Mycoplasma pneumoniae (Mpn), Mycoplasma genitalium (Mg), Mycoplasma fermentans (Mf), Mycoplasma penetrans (Mpe), Mycoplasma prium (Mpi), Chlamydia trachomatis (Ct), Chlamydia pneumoniae (Cpn), Chlamydia psittaci (Cps), Neisseria gonorrhoeae (Ng) and Garderella vaginalis (GV) were detected by nested polymerase chain reaction including PPNG., Results: The positive rates of Uu, Mh, Mpn, Mg, Mf, Mpe, Ct, Ng were 64.5%, 27.6%, 26.3%, 18.4%, 2.6%, 2.6%, 31.6%, 36.8%, in which Penicillinase-producing neisseria gonorrhoeae (PPNG) accounted for 14.3%, GV 15.8%. No Mpi, Cpn or Cps were found. There was more significant therapeutic effects on the detectable rate of Mycoplasma nucleic acid between positive gonococcus and negative gonococcus in male STDs patients (chi(2) = 3.848, P < 0.05)., Conclusion: The infection rates of Mycoplasma, Chlamydia, Ng and GV were high among male STD patients in Yangzhou city. In clinical practice, more attention should be paid on correct diagnosis and treatment for patients, with Gonococcus, Chlamydia, Mycoplasma and GV.