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Purpose: The purpose of the present study was to examine the impact of a student teaching internship program on the self-efficacy of pre-service teachers in China. Design/methodology/approach: With 1,367 participants, structural equation modelling was used to evaluate the fit of the hypothetical model and a latent path analysis was conducted to identify the relationship among various variables. Findings: The results suggested that the program had a significant impact on efficacy in terms of personal skills, general teaching skills and personal qualities of the student interns concerned. Although this study was set in rural China, the findings of this study offered insights for teacher education in other places. Originality/value: To the best of our knowledge, no research studies have been conducted on this in-service teacher training program in a systematic and comprehensive way using a large sample size and involving all major stakeholders. The aim of the present study is to fill this gap, by exploring the experience of a large cohort of pre-service teachers participating in this student teaching internship program. Studying the experiences of these student teachers will illuminate some of the key challenges faced and how they impacted their teaching and learning during their teaching practices in rural areas. The findings may help teacher education institutions to review and enhance their existing approaches to teaching practices and professional development initiatives not only in rural China but in similar contexts in other countries.

BACKGROUND: Myofascial pain syndrome (MPS) is a common disease with easy persistence and recurrence. In clinical practice, although many methods have been adopted to prevent and treat MPS, the control of MPS is still not satisfactory. OBJECTIVE: To compare the safety and effectiveness of buccal acupuncture, inactivation of trigger points (MTrPs), and their combination in the treatment of MPS. METHODS: Two hundred MPS patients in the pain clinic were randomly divided into four groups (n = 50) to receive oral drugs (Group A), oral drugs + buccal needle (Group B), oral drugs + MTrP inactivation (Group C), or oral drugs + buccal needle + MTrP inactivation (Group D). RESULTS: The visual analogue scale (VAS) and cervical range of motion (ROM) of Group D were significantly lower than those of the other three groups, and the pressure pain threshold (PPT) value of labelled MTrPs was significantly higher than those of the other three groups (P < 0.05). The excellent rate and total effective rate of Group D were significantly higher than those of the other three groups. Group C had the highest pain score and the lowest acceptance score. The results showed that buccal acupuncture combined with ultrasound-guided dry needle-evoked inactivation of MTrPs can significantly reduce the VAS score of MPS patients, improve the range of motion of the cervical spine, and improve patient satisfaction. CONCLUSIONS: This study provides a highly accepted and satisfactory treatment for MPS, which is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

Introduction: Understanding the impact of deep groundwater depth on vegetation communities and soil in sand dunes with different underground water tables is essential for ecological restoration and the conservation of groundwater. Furthermore, this understanding is critical for determining the threshold value of groundwater depth that ensures the survival of vegetation. Method: This paper was conducted in a semi-arid region in eastern China, and the effects of deep groundwater depth (6.25 m, 10.61 m, and 15.26 m) on vegetation communities and soil properties (0-200 cm) across three dune types (mobile, semi-fixed, and fixed dunes) were evaluated in a sand ecosystem in the Horqin Sandy Land. Results: For vegetation community, variations in the same species are more significant at different groundwater depths. For soil properties, groundwater depth negatively influences soil moisture, total carbon, total nitrogen, available nitrogen, available phosphorus concentrations, and soil pH. Besides, groundwater depth also significantly affected organic carbon and available potassium concentrations. In addition, herb species were mainly distributed in areas with lower groundwater depth, yet arbor and shrub species were sparsely distributed in places with deeper groundwater depth. Discussion: As arbor and shrub species are key drivers of ecosystem sustainability, the adaptation of these dominant species to increasing groundwater depth may alleviate the negative effects of increasing groundwater depth; however, restrictions on this adaptation were exceeded at deeper groundwater depth. [ABSTRACT FROM AUTHOR]

Objective: To investigate the factors related to renal impairment in patients with diabetic kidney disease (DKD) from the perspective of integrated Chinese and Western medicine. Methods: Totally 492 patients with DKD in 8 Chinese hospitals from October 2017 to July 2019 were included. According to Kidney Disease Improving Global Outcomes (KDIGO) staging guidelines, patients were divided into a chronic kidney disease (CKD) 1–3 group and a CKD 4–5 group. Clinical data were collected, and logistic regression was used to analyze the factors related to different CKD stages in DKD patients. Results: Demographically, male was a factor related to increased CKD staging in patients with DKD (OR=3.100, P=0.002). In clinical characteristics, course of diabetes >60 months (OR=3.562, P=0.010), anemia (OR=4.176, P<0.001), hyperuricemia (OR=3.352, P<0.001), massive albuminuria (OR=4.058, P=0.002), atherosclerosis (OR=2.153, P=0.007) and blood deficiency syndrome (OR=1.945, P=0.020) were factors related to increased CKD staging in patients with DKD. Conclusions: Male, course of diabetes >60 months, anemia, hyperuricemia, massive proteinuria, atherosclerosis, and blood deficiency syndrome might indicate more severe degree of renal function damage in patients with DKD. (Registration No. NCT03865914) [ABSTRACT FROM AUTHOR]

Background: Endometrial carcinoma (EC) is one of the most common gynecological malignancies in China and globally, accounting for the fourth-prevalent cancer in women. Although numerous studies have confirmed prognostic value of The Cancer Genome Atlas (TCGA) molecular subgroups, it is unclear how they are combined with histological features. The main objective of this study was to compare ProMisE and TCGA classification for the rapid and accurate prediction of prognosis within EC patients, together with the provision of a revised strategy for individualized diagnosis and treatment of patients. Methods: Within this study, 70 patients with EC from Beijing Tsinghua Changgeng Hospital (affiliated to Tsinghua University) were retrospectively examined between July 2015 and December 2021. Samples were processed for determination of clinical markers, together with ProMisE and TCGA classification. Results: Comparative analysis across four TCGA types (POLE, Low-CN, High-CN, and MSI-H) and age, was statistically significant (χ²= 7.000, p = 0.029). There was no significant difference observed among the four TCGA types and FIGO stage, vascular invasion and depth of invasion, or lymph node metastasis and tumor area. There was no significant association between the expression of Vimentin, Ki-67, PTEN, MSH2, PAX-8, β-catenin, CD10, ER, PR, P16, MLH1, and PMS2 with the four TCGA types. In addition, p63 expression (χ²= 11.09, p = 0.029) and p53 expression (χ²= 11.585, p = 0.005) were statistically significant. Numerous models demonstrated that patients with POLE mutations and low-CN had higher progression free survival (PFS) and overall survival (OS), whereas those with high-CN had lowest values. The log-rank test revealed that the survival rate of PR-positive and ER-positive patients was significantly higher (p < 0.001). Conclusion: Overall, these results can be of additional benefit for clinical applications, in comparison to the ProMisE classification method. In addition, PR, ER, vascular infiltration, hyperlipidemia and atherosclerosis were found to be the key factors affecting EC prognosis. Highlights: TCGA molecular classification has advantages over ProMisE classification for accurate diagnosis of endometrial carcinoma. Comparison among the four TCGA types (POLE, Low-CN, High-CN, and MSI-H) and age was statistically significant. Patients with POLE mutations and low-CN had higher PFS and overall survival, whereas those with high-CN had the lowest overall survival periods. [ABSTRACT FROM AUTHOR]

Hospitality programs have relatively heavier hands-on components, and many subjects (if not all) are conventionally taught face-to-face. However, the recent COVID-19 pandemic has forced teaching and learning activities onto online platforms, in theoretical and practical components. Considering that hospitality students are used to the uniformed and face-to-face interaction dominant environment, how are they coping with their online classes? The current study explores hospitality students' online learning experience, taking into consideration their personality differences, learning skill levels, and perceived difficulty of learning tasks. A questionnaire was designed and distributed among hospitality students in Macao and Mainland China. Data were collected online from mid-May to early August 2020 using the platform Sojump. Over 700 students from all over the country responded to the survey, and 643 valid responses were included in the data analysis by using multiple regression models. Results suggest that the perceived level of challenge poses a good level of influence over students' learning experience, and personality differences add complications. Theoretical development and managerial implications are discussed, and suggestions regarding online teaching for hospitality students are provided. [ABSTRACT FROM AUTHOR]

Tertiary relict flora in East Asia can be divided into northern and southern regions. North China is a diversity hotspot because it can be the secondary contact zone of ancient lineages from the two regions. To test the extent of ancient lineages hybridization and distinguish between the putative species pair Acer pictum subsp. mono and Acer truncatum, we conducted genetic and ecological studies within a maple hybrid zone in North China. Our results suggest that the two lineages of Acer coexist in the hybrid zone and that adult and offspring populations show typical bimodal genetic patterns. Hybrid individuals are established at intermediate altitudes between the two parental lineages. Flowering phenology is divergent between lineages, whereas the complex sexual system of Acer may ensure pollination among lineages. Leaf and fruit morphologies are different between the northern and southern origin lineages, corresponding to A. pictum subsp. mono and A. truncatum, respectively. Reduced gene flow between lineages suggests that they should be considered as two species. However, large morphological variations within each species and the existence of hybrids offer low reliability of species identification based solely on morphological traits. Our study underscores North China as an overlooked diversity hotspot that requires further study in the future. [ABSTRACT FROM AUTHOR]

Objective: To systematically summarize the landscape and characteristics of all approved new anticancer drugs for the last 10 years in China and the United States (US) to further inform the trend, current state, and existing gap in the availability and affordability of cancer medicine between the two countries. Methods: Mainly based on the Pharmcube database, a list and detailed information of anticancer drugs approved in China and the United States were acquired. The annual number, time lag, and basic characteristics, including drug type, mechanism, enterprise type, indication population, drug target, and cancer type of approved drugs were compared. Results: Eighty-seven and 118 new anticancer drugs were approved in China and the US, respectively, showing a stable trend in the US, while a significant increase was observed after 2016 in China. Of the 42 cancer medicines launched in both countries, the US took precedence, and the median time lag markedly decreased, from 6.53 years in 2012 to 0.88 years in 2020. A total of 14.4% of drugs were applicable to children in the US, while only 2.3% were applicable in China, and there was no difference in drug type and enterprise. Thirty-one and 43 targets were explored, with respect to 27 and 36 cancer types in China and the US, respectively, during the period. In addition, the expenditure of drugs on PD-1 and PD-L1 in China was generally lower than that in America. Conclusion: The availability of new anticancer drugs has increased dramatically in the past decade, particularly in China. Compared with the US, the launch of new anticancer drugs in China lags behind, but the time lag has been shortened significantly, and better affordability is observed in immune drugs. More attention should be given to differentiated innovation, and unmet medical needs in special populations like childhood tumors, which are important directions of new drug R&D in China. [ABSTRACT FROM AUTHOR]

aimed to analyze the status of human papillomavirus (HPV) infections in women in Yunnan in the south of China and their correlation with the grade of cervical intraepithelial neoplasia (CIN). Methods: A total of 281 patients with CIN and HPV infection, diagnosed at Kunming Kingmed Institute for Clinical Laboratory between January 2019 and June 2021, were enrolled as the subjects of the study and underwent HPV genotyping and cervical histopathology. Results: The mean age of the 281 patients was 42.3 years, and the median age was 42 years. There were 79 patients in the low-grade squamous intraepithelial lesion (LSIL) group, and 202 patients in the high-grade squamous intraepithelial lesion (HSIL) group. The proportion of 30– 45 years old in HSIL group was 58%. Overall, single infections accounted for 76%, and HR-HPV infections accounted for 90.1%. The most common HR-HPV subtypes in the two CIN groups were almost the same, including HPV16, HPV58 and HPV52. The most common LR-HPV subtype in the two CIN groups was HPV43. There were no significant differences in ethnic and single or multiple infection rates among different CIN groups. Single infection of HPV43 and HPV81 was found in minority HSIL patients. Conclusion: HPV infection in Yunnan was dominated by single infection and HR-HPV. Patients aged 30 to 45 years were in the high incidence of HSIL, and the most common HR-HPV subtypes were HPV16, HPV58, and HPV52. Single LR-HPV infection exists in minority HSIL patients. [ABSTRACT FROM AUTHOR]

Environmental regulation has obvious externality on technological innovation. How to protect the environment without exerting negative effects on technological innovation activities carried out by enterprises is an important realistic proposition in economic development. Taking the panel data of 21 cities in Guangdong Province from 2005 to 2018 as the research object, the paper empirically studies the impact of environmental regulation on technological innovation, as well as the moderating effect and threshold effect of the industrial structure upgrading on the relationship between them. The results show that there is an inverted U-shaped effect of environmental regulation on technological innovation, and a moderate intensity of environmental regulation is conducive to promoting the development of technological innovation. The industrial structure upgrading plays a significant negative moderating effect in the inverted U-shaped relationship on the whole, causing the curve of the inverted U-shaped relationship to move to the left. Furthermore, through the threshold regression model, we find that the moderating effect of industrial structure upgrading has significant nonlinear characteristics. The level of upgrading lower than the first threshold or higher than the second threshold is not conducive to the effect of environmental regulation on technological innovation. In the implementation process of environmental regulation, more attention should be paid to promoting the rationalization of industrial structure in combination with industrial policies. [ABSTRACT FROM AUTHOR]

Background: Malignant melanoma (MM) arises predominantly after adolescence and is uncommon in children. Congenital MM in newborns is even rarer with a dearth of published literature; as a consequence, there is no uniform standard for the pathogenesis and treatment for neonatal malignant melanoma. Herein we report a case of giant congenital nodular MM in a newborn, including its clinical, imaging, pathological and molecular pathological features. This case is the largest giant congenital primary nodular malignant melanoma in utero in neonates currently reported in China.Case Presentation: A female neonatal patient was found to have a 2.97 cm× 1.82 cm×1.50 cm mass with a clear boundary at the right acromion in color Doppler ultrasound examination at 24 weeks of gestation. The mass increased to 3.0 cm×5.0 cm×9.0 cm at birth, and local ulceration was seen. MRI demonstrated that the mass was located on the right shoulder and underarm in a lobulated appearance, and surrounded the right scapula which was deformed. Clinical stage:IV(AJCC 8th Edition (2017)). α-Fetoprofein (AFP) by hematological examination: 1210ng/ml, NSE: 21.28ng/ml, LDH: 842U/L. The patient underwent surgical resection of the tumor, and was pathologically diagnosed as neonatal congenital malignant melanoma; immunohistochemistry (IHC): S-100 (+), HMB45 (+), Melan A (+), and Tyrosinase (+). Molecular pathological examination for BRAF V600E showed no mutations (Quantitative Real-time PCR, qPCR); And so were NRAS, C-kit (exons 9,11,13,14,17,18), and TERT (promoter locus, C228T and C250T) (Sanger sequencing). Non-surgical therapies were not carried out after the surgical resection of the tumor. After 6 months of follow-up, the child developed normally, and color Doppler ultrasound showed no obvious tumor growth or abnormality in the original tumor site.Conclusions: It is extremely rare to see giant congenital primary nodular MM in utero in neonates. The pathogenesis, treatment and prognosis of congenital MM need further research. The diagnosis mainly depends on histopathology and immunohistochemistry, and it needs to be differentiated from malignant lymphoma and primitive neuroectodermal tumor. The current treatment strategy for MM relies on the surgical excision of the mass. Research directed at molecular detection for genetic mutations would contribute to targeted therapy and better prognosis. [ABSTRACT FROM AUTHOR]

Aim: To explore the relationships among self‐efficacy, information literacy, social support and career success of clinical nurses and identify factors influencing clinical nurses' career success in northwestern China. Background: Understanding the influencing factors of career success is important for the professional development of nurses and the improvement of clinical nursing quality. Many influencing factors of career success have been identified, but there is no large‐scale research on the relationships among self‐efficacy, information literacy, social support and career success of clinical nurses based on Kaleidoscope Career Model. Studies examining the association of the four factors remain limited. Methods: A total of 3011 clinical nurses from 30 hospitals in northwestern China were selected in the cross‐sectional survey, and the response rate was 94.71%. The clinical nurses completed the online self‐report questionnaires including self‐efficacy, information literacy, social support rating scale and career success scale. The data were analysed by SPSS23.0 statistical software using t test, analysis of variance, Pearson's correlation and multiple linear regression. Structural equation model (SEM) was used to analyse the influencing factors of career success using Mplus 8.3. Results: The career success of clinical nurses in northwestern China was at a medium level. The linear multivariate regression analysis showed that self‐efficacy (β =.513), social support (β =.230), information support (β =.106), information consciousness (β = −.097), information knowledge (β =.067), information ethics (β = −.053), hospital grade (β =.118), marital status (β = −.071) and age (β = −.037) entered regression equation of clinical nurses' career success (all P <.05). SEM results showed that the career success was negatively correlated with demographic characteristics and positively correlated with social support and self‐efficacy. Conclusion: Demographic characteristics, self‐efficacy, social support and information literacy are the influencing factors of nurses' career success, which should be considered in the process of promoting nurses' career success. Implications for nursing management: Nursing managers need to acknowledge the significance of nurses' career success both for the realization of their own value and for the improvement of clinical nursing quality. They should encourage nurses to enhance self‐efficacy and render more social support through incentive policies and foster nurses' information literacy through information technology training so as to improve their career success. [ABSTRACT FROM AUTHOR]

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This issue is special for interpreting 2021 WHO Classification of Tumors of the Central Nervous System (fifth edition). To standardize and unify the usage of terminology in this special issue, this article elaborately translates simplified table of 2021 WHO Classification of Tumors of the Central Nervous System (fifth edition) into Chinese. At the beginning paragraph, this article also explains the principles of Chinese translation and propose translation for some terminologies. [ABSTRACT FROM AUTHOR]

Background and objective The clinical trials of new anti-tumor drugs are prospering in China. The acceptance of clinical trials in patients is an important factor affecting the speed and quality of clinical trials. Previous studies have investigated the acceptance of clinical trials in those cancer patients, who have never participated in a trial. This study is designed to investigate and compare the acceptance and related causes of clinical trials in cancer patients who have once participated in a clinical trial or not. Methods From June 2018 to April 2019, a standardized questionnaire-based survey was conducted among two groups of cancer patients classified by history of clinical trial participation in Cancer hospital, Chinese Academy of Medical Science, mainly focusing on their overall acceptance of clinical trials and related considerations, including the role of attending doctors, as well as group differences between the two participants. Results A total of 538 patients were enrolled with an average age of 53.5 years old, 51.1% of whom were males, and 43.3% of whom have never participated in a clinical trial. Overall, 502 patients (93.3%) were willing to or recommend their relatives or friends to participate in clinical trials, and patients with history of clinical trial participation had higher willingness (96.6% vs 90.8%, P=0.008). Patients were most likely to be motivated by expectation of optimal treatment (100.0% vs 99.3%) for both those who had once participated in a clinical trial or those not, respectively followed by financial burden reduction (56.0%) and recommendation by attending doctor (43.7%). The main reasons for unwillingness-to-participate for those who had once participated in a clinical trial were abandoning other treatment options, divided into control group or additional visits, while for those who had never participated in a clinical trial, ineffective treatment or serious adverse reactions were their main concerns. In the decision-making of clinical trial participation, 88% patients highly valued the role of recommendation by attending doctors. Among patients without trial participation history, 60.9% of those had no unwillingness-to-participate expressed that recommendation by attending doctors would change their decisions. The study also reported patients' preferences for information and access to clinical trials. Conclusion The acceptance of clinical trials in cancer patients in our hospital is generally high, especially in patients who had a history of trial participation. It's of substantial significance to give full play to the role of doctors in improving the acceptance of clinical trials of cancer patients in China. [ABSTRACT FROM AUTHOR]

Background and objective Early investigation suggested patients' level of awareness regarding clinical trials was related with willingness to participation. This study was intended to evaluate the level of awareness of cancer patients regarding clinical trials and related influencing factors, and to compare the differences of awareness between patients who attended clinical trials before and not. Methods From Jun, 2018 to April, 2019, standardized question-naires were gathered from cancer patients (attended clinical trials vs not attended clinical trials) in our hospital regarding basic information and 10 other questions about awareness. The level of awareness was evaluated and patients were classified into "low cognition" and "high cognition" groups. Logistic regression analysis was performed to determine whether certain characteristics would predict for awareness. Results Of the 617 participants, 38.6% have attended clinical trials before. 338 (54.6%) patients had a correct overall understanding of clinical trials, while 44 (7.1%) patients still thought participants were the victim of scientific research. Except for the compensation of medical expenses (51.5% vs 48.7%) and related laws of clinical trials (52.3% vs 45.5%), other parts of understanding were elevated in patients attended clinical trials before comparing with patients who didn't, including significance (86.2% vs 77.6%), risk disclosure (91.2% vs 71.6%), confidentiality (73.2% vs 59.7%), voluntariness (95.8% vs 76.3%), withdrawal (86.6% vs 68.2%) and expenses (62.8% vs 39.2%). The proportion of participants who understand these components did not increase even in 239 patients who had attended clinical trials before. Participants who attended clinical trials before (OR=1.83, 95%CI: 1.11-3.00), unmarried/divorced (OR=5.04, 95%CI: 1.73-14.66), retired (OR=2.53, 95%CI: 1.16-5.50) had a higher level of awareness, while patients who had bad impression with doctors (OR=0.43, 95%CI: 0.26-0.72) had lower awareness. Conclusion The current level of awareness for clinical trials of cancer patients in our hospital was relatively low, even in patients who had attended clinical trials before. It's necessary to improve patients' awareness of clinical trial by promoting harmony relationship between patients and doctors, as well as by enhancing related propagation. Strengthening the adequacy and efficacy of informed consent in clinical trials also needs to be achieved in the future. [ABSTRACT FROM AUTHOR]

Abstract Based on long-term monitoring conducted in Chang-ning county, a pilot site of the ‘Grain for Green Program’ (GFGP), an integrated emergy and economic method was applied to evaluate the dynamic ecological-economic performance of 3 kinds of bamboo systems planted on sloping farmland. The results confirmed the positive effects of all 3 kinds of bamboo systems on water conservation and soil erosion control. The benefits gained progressively increased during the first 8 years after conversion, going from 4639 to 16127 EMyuan/ha/yr on average. All three bamboo plantations were much more sustainable than common agricultural crops planted on sloping land (CP) on both the short and long-term scales with their Emergy Sustainability Index (ESI) and Emergy Index for Sustainable Development (EISD), respectively, being 14.07–325.71 and 80.35–265.80 times that of CP. However, all 3 bamboo plantations had a Net Economic Benefit (NEB) less than that of CP during the first 8 years after conversion. Even with the government-mandated ecological compensation applied, the annual NEB EC s of the Bambusa rigida (BR) and Phyllostachys pubescense (PP) plantations were, respectively, 3922.03 and 7422.77 yuan/ha/yr lower than the NEB of CP. Emergy-based evaluation of ecosystem services provides an objective reference for applying ecological compensation in strategy-making, but it cannot wholly solve the economic viability problem faced by all bamboo plantations. Inter-planting annual herbs or edible fungus, such as Dictyophora echinovolvata, within bamboo forests, especially in young bamboo plantations, might be a direction for optimizing bamboo cultivation that would improve its economic viability. [ABSTRACT FROM AUTHOR]

The novel coronavirus pneumonia (COVID-19) has created huge demands for medical masks that need to be delivered to a lot of demand points to protect citizens. The efficiency of delivery is critical to the prevention and control of the epidemic. However, the huge demands for masks and massive number of demand points scattered make the problem highly complex. Moreover, the actual demands are often obtained late, and hence the time duration for solution calculation and mask delivery is often very limited. Based on our practical experience of medical mask delivery in response to COVID-19 in China, we present a hybrid machine learning and heuristic optimization method, which uses a deep learning model to predict the demand of each region, schedules first-echelon vehicles to pre-distribute the predicted number of masks from depot(s) to regional facilities in advance, reassigns demand points among different regions to balance the deviations of predicted demands from actual demands, and finally routes second-echelon vehicles to efficiently deliver masks to the demand points in each region. For the subproblems of demand point reassignment and two-batch routing whose complexities are significantly lower, we propose variable neighborhood tabu search heuristics to efficiently solve them. Application of the proposed method in emergency mask delivery in three megacities in China during the peak of COVID-19 demonstrated its significant performance advantages over other methods without pre-distribution or reassignment. We also discuss key success factors and lessons learned to facilitate the extension of our method to a wider range of problems. • Combine machine learning and heuristic optimization to solve two-echelon vehicle routing. • Deep learning is used to predict demand to enable pre-distribution. • Variable neighborhood tabu search is proposed for reassignment and routing. • The method has been applied to mask delivery in three megacities in China in COVID-19. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) has been suggested to increase the risk of cancers. The aim of this study was to investigate the risk of common cancers in Chinese patients with T2DM.Methods: A population-based retrospective cohort study including 36,379 T2DM patients was conducted in Minhang District of Shanghai, China, during 2004 to 2010. All T2DM patients were enrolled from the standardized management system based on local electronic information system. Newly-diagnosed cancer cases were identified by record-linkage with the Shanghai Cancer Registry. Standardized incidence ratios (SIR) and 95% confidence interval (CI) were used to estimate the risk of cancers among T2DM patients.Results: Overall crude incidence rate (CIR) of cancers was 955.21 per 105 person-years in men and 829.57 per 105 person-years in women. Increased risk of cancer was found in both gender, with an SIR being 1.28 (95% CI = 1.17-1.38) in men and 1.44 (95% CI =1.32-1.55) in women. Increased risk of colon (SIR = 1.97; 95% CI = 1.49 to 2.46), rectum (1.72; 1.23 to 2.21), prostate (2.87; 2.19 to 3.56), and bladder cancers (1.98, 1.28 to 2.68) were observed in men and elevated risk of colon (1.67; 1.25 to 2.08), breast (1.66; 1.38 to 1.95), and corpus uteri cancers (2.87; 2.03 to 3.71) were observed in women.Conclusions: Our results indicate that Chinese patients with T2DM may have an increased risk of some cancers, and the increase may vary by sub-sites of cancers. [ABSTRACT FROM AUTHOR]

Aim:To investigate specific changes in metabolites and proteins of Kidney-Yin Deficiency Syndrome (KYDS) patients with diabetes mellitus (DM) in China.Methods:KYDS (n=29) and non-KYDS (n=23) patients with DM were recruited for this study. The KYDS was diagnosed by two senior TCM clinicians separately. The metabonomic and proteomic profiles of the patients were assessed using a metabonomic strategy based on NMR with multivariate analysis and a proteomic strategy based on MALDI-TOF-MS, respectively.Results:Eighteen upregulated peptides and thirty downregulated peptides were observed in the plasma of the KYDS patients. Comparing the proteomic profiles of the KYDS and non-KYDS groups, however, no significantly differentially expressed peptides were found. At the same time, major metabolic alterations were found to distinguish the two groups, including eight significantly changed metabolites (creatinine, citrate, TMAO, phenylalanine, tyrosine, alanine, glycine and taurine). The levels of creatinine, citrate, TMAO, phenylalanine and tyrosine were decreased, whereas the levels of alanine, glycine and taurine were increased in the KYDS patients. These biochemical changes were found to be associated with alterations in amino acid metabolism, energy metabolism and gut microflora.Conclusion:The identification of distinct expression profiles of metabolites and signaling pathways in KYDS patients with DM suggests that there are indeed molecular signatures underlying the principles of 'Syndrome Differentiation' in traditional Chinese medicine. [ABSTRACT FROM AUTHOR]

Objective: The antioxidant vitamin E has been extensively employed to treat chronic liver diseases. The aim of this study was to assess the effect of vitamin E supplementation in lowering alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in patients with nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), and chronic hepatitis C (CHC). Methods: We searched all publications in PubMed, Web of Science, and Cochrane Library databases up to June 2013. In total, eight articles met the eligibility criteria, among which, two studies about NAFLD, four studies about NASH, and three studies about CHC, were identified and included in the meta-analysis. Results: According to standardized mean difference and 95% confidence interval, 12.19 (-4.08 to 28.46) for ALT and 6.84 (-3.18 to 16.86) for AST in patients with NAFLD, 4.54 (1.62-7.46) for ALT and 3.55 (1.39-5.71) for AST in patients with NASH, and 0.61 (0.20-1.02) for ALT and 0.68 (0.07-1.29) for AST in patients with CHC, vitamin E supplementation could optimize ALT and AST levels in patients with NASH and CHC, although it was not statistically significantly associated with reduced ALT and AST levels in patients with NAFLD. Conclusion: To summarize, the evidence currently available supported the theory that vitamin E supplementation can optimize aminotransferase levels for patients with NAFLD, NASH, and CHC, and more well-designed, large-scale clinical trials are encouraged to examine the therapeutic effect of vitamin E for these disorders. [ABSTRACT FROM AUTHOR]

In order to find an appropriate thermodynamic model of rectisol process, the SRKH model of low-temperature methanol absorption was established and parameter regression was used to abtain all binary interaction parameters of the NRTL equation for rectisol system. The correctness of the arguments was verified by the vapor-liquid equilibrium calculations. An industrial absorber in China was simulated and the CO2, and H2S concentration distribution in the absorber was obtained. The results show that the SRKH model is suitable for rectisol system. The effects of operating conditions on rectisol system were investigated and the concentration variations of CO2 and H2S in purified gas caused by the changes of operating conditions were obtained. The acidic gas concentration in purified gas decreases along with the increase of pure methanol flow or/and the decrease of methanol temperature and the concentration of H2S can be reduced to less than 0.1x106 quickly. Therefore, qualified gas with different CO2 concentrations can be produced by changing the flow of pure methanol or methanol temperature. The effect of crude gas flow on pure methanol flow was also investigated when the concentration requirements of acidic gases in purufied gas of coal gasification methanol synthesis process were meet; and results show that the flow of pure methanol increased with the augment of crude gas flow and the extent of growth decreases gradually, which indicates that it is beneficial to enlarge the scale so as to reduce operating cost in advanced coal chemical industry. [ABSTRACT FROM AUTHOR]

Abstract: Emergy and economic methods were used to evaluate and compare a traditional tropical fruit cultivation system, for bananas, and three newly introduced fruit cultivation systems, for papaya, guava and wampee, on reclaimed wetlands of the Pearl River Estuary, China. The goal of this study was to apply ecological engineering principles to fruit production system designs to maximize total emergy benefits and sustainability. The evaluations considered input structure, production efficiency, environmental impacts, economic viability and sustainability. The market effects on emergy exchange were assessed both for purchasing the inputs to production and for selling the fruit. These market effects were also considered in the evaluation of sustainability by using the Emergy Index for Sustainable Development (EISD), which was evaluated with and without taking the change in natural capital (i.e., soil organic matter) into consideration. The results showed that all three of the newly introduced systems are much more sustainable than the traditional banana production system. The guava production system had the highest value of the Emergy Sustainability Index (ESI=0.40). The high price of wampee gave it the highest economic yield/cost ratio (4.87) and EISD (0.73). Emergy and economic evaluations are complementary methods, with emergy analysis shedding more light on environmental support and impacts of the production systems not considered in the market value, and economic analysis focusing on the effects of markets on fruit production. The Emergy Exchange Ratio (EER) was proposed as a bridge between emergy and economic evaluations for specific systems and/or processes. [Copyright &y& Elsevier]

Abstract: The low subtropical zone is the most populated and seriously degraded area in China; therefore, highly efficient restoration of degraded lands is the key to sustainable development of this region. An agro-forest restoration mode consisting of an Acacia mangium forest, a Citrus reticulata orchard, a Pennisetum purpureum grassland, and a fishpond has been applied widely in this region. Emergy synthesis was performed at the system and subsystem levels of organization to clarify the structural and functional attributes of this restoration system for further optimization. Emergy indices, including four new indices, the emergy restoration ratio (ERR), the ecological economic product (EEP), the emergy benefit ratio (EBR), and the emergy benefit after exchange (EBE), were formulated to evaluate the ecological and economic benefits of this restoration mode. Benefits were determined for the separate subsystems and for the system as a whole, based on the classification of human services into management and harvest costs. The emergy sustainability index (ESI) of the agro-forest restoration system was 16 and the emergy index for sustainable development (EISD) was 122, demonstrating that this system produces high ecological and economic benefits and that it is a good alternative for the restoration of hillside areas in subtropical China. [Copyright &y& Elsevier]

The environmental effect of degraded ecosystem's vegetation restoration in low subtropical China was studied. Results indicated that the vegetation recovery on degraded lands significantly ameliorates surrounding environment, increases species diversity, improves soil structure, raises soil fertility, enhances productivity, and promotes regional agricultural production and social economic development dramatically. Through the combining engineering and biological measures, the restoration of degraded ecosystem in low subtropical area in possible and economical. The restoration experience in Xiaoloiang, Wuhua and other sites are valuable for other degraded subtropical area was introduced. [ABSTRACT FROM AUTHOR]

The removal of litterfall in the Eucalyptus plantations in South China affected the plant biodiversity in these ecosystems was found based on the field observation and lab analysis. The protection times of species diversity of three Eucalyptus communities were different (Community I with no protection, Community II with 7-year-protection, Community III with 35-year-protection). The total numbers of species in these communities (from Community I to II to III) are 1, 6, and 17, respectively. The results showed that the protection of litterfall from being taken out of the ecosystem is important and can increase plant species diversity. This study combined biomass data, the chemical and physical properties of the soil, and the diversity of microbes in the communities. It is concluded that the mechanism of the effects of litter removal on biodiversity includes three factors: removing the suitable habitat of microbe and animal, decreasing the soil nutrient, and changing the special habitat for the germination and growth of invading plants. These results should have important implications for managing these Eucalyptus forest ecosystems in South China. [ABSTRACT FROM AUTHOR]

Luehdorfia chinensis is a poorly known species restricted to certain eastern provinces in China. We have determined the complete mitochondrial genome of a species of grouse locust, L. chinensis. The 13,860 bp long L. chinensis genome contained 12 protein-coding genes: ATP6, ATP8, COI-COIII, partial ND2, ND3-ND6, ND4L, and Cytb; 2 ribosomal RNAs (rRNAs) (partial 12S rRNA and 16S rRNA); and 18 transfer RNAs. These genes identified are present in the same order and orientation as the completely sequenced mitogenomes of other lepidopteran species. The sequence for COI in L. chinensis starts with ATTTAG and ends with TAA. [ABSTRACT FROM AUTHOR]

An integrated emergy and economic evaluation of a 7-step ecological engineering system (7-step EES) located in Jiangsu Province, China was carried out. This 7-step EES was constructed to fully utilize existing S. alterniflora production through a low waste, clean production process and to help control the expansion of this invasive grass. First, the above ground S. alterniflora biomass removed for invasion control is used as the feedstock for the extraction of a bio-mineral liquid and its encapsulation, both of which provide a health supplement to treat gout and angiocardiopathy patients. Next, the residues left after extraction are used as a medium for mushroom cultivation, and then for raising earthworms. Finally, the remaining residues become the main component of a microbe enriched organic fertilizer, which is then returned to the soil. A suite of emergy indices were constructed on multiple temporal and spatial scales to examine the operation of the whole system and its subsystems. The results showed that the temporal sustainability of the 7-step EES was relatively high at different spatial scales, especially at the local scale as indicated by its EISD LS (1.55E+03). Full implementation of the 7-step EES for S. alterniflora currently residing on the coast of China can result in a potential economic output that is greater than 2% of the national GDP, with an economic output/input ratio over 29. In addition, the 7-step EES had an environmental loading ratio lower than that of the regional system. Sensitivity analysis showed that decreasing the cost of the purchased inputs needed to make the capsules is the key problem that needs to be solved to optimize the system, both for its sustainability and economic viability, on all spatial and temporal scales. • Indices were developed on multiple temporal and spatial scales for use in emergy evaluation. • The efficacy of a 7-step EES to utilize exotic S. alterniflora with low waste was evaluated. • Specific optimization points for the process were explored by sensitivity analysis. [ABSTRACT FROM AUTHOR]

To explore the evolution of maize landraces from southwest China, we conducted a population genetic analysis of DNA sequence variation in globulin1 ( Glb1) gene from 71 individuals representing the maize landrace, common maize, parviglumis, Zea luxurians , and Tripsacum dactyloides . We tested 477 variable, 800 conserved, and 253 informative sites in the Glb1 gene sequences. On the basis of π ˆ per base pair and θ ˆ per base pair, the highest level of sequence variation was detected in parviglumis, followed by maize landraces and common maize. Z . luxurians and T . dactyloides retained a low level of variation. For Glb1 gene, negative or almost zero estimates for Tajima's D and Fu and Li's statistics in the 8 taxa, show that neutral evolution can be accepted. A large number of shared polymorphisms existed with no fixed differences between parviglumis and both the maize landrace and common maize. Maximum Likelihood (ML) analysis showed that sequences from maize landraces, common maize, parviglumis, and Z . luxurians were separated into two well-supported clades, and sequences from T . dactyloides constituted a distinct group. Excluding T . dactyloides and Z . luxurians , median-joining (MJ) network analysis clustered the remaining taxa into five haplotypes, revealing a higher level of haplotype diversity in the landrace. The findings suggest that the maize landrace in southwest China was domesticated from parviglumis and first introduced to Sichuan from India via Tibet. [ABSTRACT FROM AUTHOR]

One of the most studied aspects of ecosystems in recent years has been the relationship between plant species diversity and ecosystem functions; however, the relationship with one such ecosystem function, soil conservation, has been less well studied. We established forest plots in the secondary succession phases of a semihum.id evergreen broadleaf forest in China. The plots differed in plant species richness but had otherwise similar soil-erosion £1ctors, observed surface runoff, sediment, and total phosphorus (P) loss. We analyzed the relationship between plant diversity and soil conservation and stability. Results indicated that the fi:equency and volume of surface runoff, sediment, and total P loss in the test plots, as well as their CV (coefficients of variation), present significant negative correlations with increasing species richness. The plot with the lowest richness in Yunnan pine, African boxwood, and running mountaingrass (Ass. Pinus yrmn.an.ensis, Myrsine african.a, and Oplismenus compositus [APMO]) yielded the highest runoff rates, with nmoff occurring a total of 77 tim.es: 23, 32, and 22 times in 2001, 2002, and 2003, respectively. The average values for surface runoff, sediment, and total P loss over the three-year study period were, respectively, 960.20 m3 ha-1 y-1 (13.72 thousand fc3 ac-1 yr-1), 11.40 t ha-1 y-1 (4.54 tn ac-1 yr-1), and 127.69 kg ha-1y-1(113.82 lb ac-1 yc1) . The CVvalues for the three parameters were, respectively, 287 .6, 534.21, and 315.47. However, in the plot with the highest riclu1ess in a native oak species, Evelyn keteleeria, and a species of viola (Ass. Cyclobalanopsis glaucoides, Keteleeria e11elyniana, and Viola duelouxii [ACKV]), surface runoff only occurred 9 times: 2, 4, and 3 times, respectively in the three years. The average values for surface runoff, sediment, and total P loss were 75.55 m3 ha-1 y-1 (1.08 thousand fc3 ac1 yr-1), 0.28 t ha-1 y-1 (0 .11 tn ac-1 yr-1), and 4.71 kg ha-1 y-1 (4.20 lb ac-1 yr-1) . The CV values for the three parameters were, respectively, 57.93, 187.94, and 59.2. Plant density increased linearly in herb, shrub, and tree layers with increasing plant species richness, whereas plant cover increased logarithmically. Plant species diversity can enhance soil conservation, but this effect was comparatively weak relative to the contributions of plant cover and density to soil conservation . Plant species diversity increases plant density and cover in the local conununity, indirectly regulating and enhancing soil conservation. Competition and niche theories can explain, to some extent, the increases in plant density and cover. Our results challenge the view of a negative relationship between plant species diversity and productivity. [ABSTRACT FROM AUTHOR]

The article presents a study which determined the microbicide acceptability rate of female sex workers (FSW) and male clients in Yunnan, China. It says that a large percentage of FSW are willing to accept changes. It also mentions that the efficacy, safety, and affordability of microbicides are among the major factors that influence acceptability among FSW and their clients. Thus, it suggests that development of microbicides can possibly contribute to control HIV epidemic transmission in China.

Background: Vasovagal syncope (VVS) is the most common type of orthostatic intolerance in children. We investigated whether platelet-related factors related to treatment efficacy in children suffering from VVS treated with metoprolol., Methods: Metoprolol-treated VVS patients were recruited. The median duration of therapy was three months. Patients were followed and divided into two groups, treament-effective group and treatment-ineffective group. Logistic and least absolute shrinkage selection operator regressions were used to examine treatment outcome variables. Receiver-operating characteristic (ROC) curves, precision-recall (PR) curves, calibration plots, and decision curve analyses were used to evaluate the nomogram model., Results: Among the 72 patients who complete the follow-up, treatment-effective group and treatment-ineffective group included 42 (58.3%) and 30 (41.7%) cases, respectively. The patients in the treatment-effective group exhibited higher mean platelet volume (MPV) [(11.0 ± 1.0) fl vs. (9.8 ± 1.0) fl, P < 0.01] and platelet distribution width [12.7% (12.3%, 14.3%) vs. 11.3% (10.2%, 12.2%), P < 0.01] than those in the treatment-ineffective group. The sex ratio was significantly different (P = 0.046). A fit model comprising age [odds ratio (OR) = 0.766, 95% confidence interval (CI) = 0.594-0.987] and MPV (OR = 5.613, 95% CI = 2.297-13.711) might predict therapeutic efficacy. The area under the curve of the ROC and PR curves was computed to be 0.85 and 0.9, respectively. The P value of the Hosmer-Lemeshow test was 0.27. The decision curve analysis confirmed that managing children with VVS based on the predictive model led to a net advantage ranging from 0.01 to 0.58. The nomogram is convenient for clinical applications., Conclusion: A novel nomogram based on age and MPV can predict the therapeutic benefits of metoprolol in children with VVS., (© 2024. The Author(s).)

Comprehending the phylogeography of invasive organisms enhances our insight into their distribution dynamics, which is instrumental for the development of effective prevention and management strategies. In China, Pomacea canaliculata and Pomacea maculata are the two most widespread and damaging species of the non-native Pomacea spp.. Given this species' rapid spread throughout country, it is urgent to investigate the genetic diversity and structure of its different geographic populations, a task undertaken in the current study using the COI and ITS1 mitochondrial and ribosomal DNA genes, respectively. The result of this study, based on a nationwide systematic survey, a collection of Pomacea spp., and the identification of cryptic species, showed that there is a degree of genetic diversity and differentiation in P. canaliculata, and that all of its variations are mainly due to differences between individuals within different geographical populations. Indeed, this species contains multiple haplotypes, but none of them form a systematic geographical population structure. Furthermore, the COI gene exhibits higher genetic diversity than the ITS1 gene. Our study further clarifies the invasive pathways and dispersal patterns of P. canaliculata in China to provide a theoretical basis., (© 2024. The Author(s).)

Thalassemia is a highly prevalent hematologic disease in Guizhou, China. This study aimed to determine the epidemiological characteristics of thalassemia in couples at childbearing age and assess the neonatal risk of thalassemia in this subpopulation. A cohort of 4481 couples at childbearing age were recruited for thalassemia carrier screening by both traditional hematological tests and next-generation sequencing. Of them, 1314 (14.66%) thalassemia carriers were identified, including 857 (9.76%) α-thalassemia, 391 (4.36%) β-thalassemia, and 48 (0.54%) composite α and β-thalassemia. A total of 12 α-globin gene alterations and 16 β-globin mutations were detected, including four novel thalassemia mutations. SEA was the most common α-thalassemia genotype (26.86%), CD41-42 the most common β-thalassemia genotype (36.57%), and αα/- α3.7 + CD41-42 the most common composite α- and β-thalassemia genotype (18.75%). Ethnically, the Zhuang had the highest rate of thalassemia gene carriers among the ethnic groups. Geographically, Qiannan had the highest rate of thalassemia gene carriers. In addition, 38 of the 48 couples with composite α- and β-thalassemia were high-risk thalassemia carriers, and 4 carrying the -SEA/αα gene needed fertility guidance., (© 2024. Japanese Society of Hematology.)

Background: This study aimed to conduct a comparative analysis of the efficacy and safety of neoadjuvant chemotherapy combined with endocrine therapy against the backdrop of single neoadjuvant chemotherapy or endocrine therapy, specifically in the context of hormone receptor-positive (HR+) breast cancer treatment., Methods: We conducted a thorough literature search across several databases, including China National Knowledge Infrastructure, Wanfang, Weipu, Chinese Journal Full-text Database, PubMed, Web of Science, Cochrane Library, and EMBASE, adhering to the guidelines outlined in the PRISMA statement. Our specific focus was on identifying randomized controlled trials that directly compared the combined approach of neoadjuvant chemotherapy and endocrine therapy with single chemotherapy or endocrine therapy in the context of treating HR+ breast cancer. Subsequently, we utilized statistical packages implemented in R software to perform comparative analyses of key clinical indicators, encompassing the complete response, objective response rate (ORR), disease control rate, pathological complete response (pCR), and adverse reactions., Results: A total of 11 randomized controlled trials, involving 1359 patients, all of whom met our inclusion criteria and were thus included in our comprehensive analysis. Within this cohort, 688 patients (50.63%) administered neoadjuvant chemotherapy combined with endocrine therapy (NCET), 642 patients (47.24%) received neoadjuvant chemotherapy (NCT) alone, while 29 patients (2.13%) underwent neoadjuvant endocrine therapy (NET) alone. The results of our meta-analysis revealed that NCET exhibited a statistically significant enhancement in both ORR and pCR (P < .05). Nonetheless, when compared to NCT or NET, NCET did not yield a significant impact on complete response, disease control rate, and safety (P > .05). In addition, NCET demonstrated a significant improvement in ORR among patients with HR+, HER2-negative breast cancer (P < .05). However, it was also linked to a heightened incidence of serious adverse reactions within this particular patient subgroup (P < .05)., Conclusion: The combination of Neoadjuvant chemotherapy and endocrine therapy stands out as a significant contributor to enhancing the ORR and pCR for HR+ breast cancer patients. For breast cancer patients with HER2- status, NCET demonstrates a remarkable improvement in ORR but is also associated with the emergence of adverse reactions., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: The aim of this study was to analyze the epidemiological characteristics of the causes of chronic kidney disease (CKD) stage 5 patients in North China and to investigate the economic burden of those on hemodialysis (HD) or peritoneal dialysis (PD), as well as the associated influencing factors., Methods: General clinical information, etiological categories, and hospitalization costs for HD or PD were collected from 1,515 patients hospitalized with stage 5 CKD at the Affiliated Hospital of Hebei University from 2016 to 2018. Logistic regression analysis was used to analyze the independent influencing factors affecting patients' financial burden., Results: The highest rate of DN was found in patients aged 70 years or older (27.0%) and the highest incidence of primary glomerulopathy was found in patients aged <50 years (24.3%). Age, type of dialysis, and type of health insurance were independent influences on the total financial burden of patients, and the results of multifactorial logistic regression analysis showed that age [OR (95% CI): 1.009 (1.002, 1.020)] and type of dialysis [OR (95% CI): 1.746 (1.149, 2.659)] would increase the total financial burden. The type of health insurance would reduce the total financial burden [OR (95% CI): 0.222 (0.108, 0.418)]., Conclusion: Chronic kidney disease, with its complex etiology and the heavy financial burden required for treatment, remains a more serious public health problem globally, and it is therefore necessary to further improve medical coverage for dialysis patients, increase management efforts, broaden pro-poor policies and increase the accessibility of medical services in low- and middle-income areas., 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 © 2022 Guo, Gou, Li, Zhang, Huang, Zheng, Chen and Sui.)

Objective: It has been reported that papillary thyroid carcinoma (PTC) patients with lymph node metastasis (LNM) are largely associated with adverse outcomes. The present study aimed to assess the correlation between the number of metastatic lymph nodes (NMLNs) and clinical prognosis in patients with PTC., Methods: We retrospectively reviewed the medical records of patients with PTC who underwent initial thyroid cancer surgery in Renmin Hospital of Wuhan University between 2017 and 2019. A total of 694 patients with PTC and cervical lymph node dissection as well as a total checked number of lymph nodes ≥ 5 were involved in this study. The clinicopathological characteristics of patients were compared according to NMLNs, the number of central cervical lymph nodes (CLNs) and the number of lateral lymph nodes (LLNs)., Results: NMLNs > 5, CLNs > 5 and LLNs > 5 were 222 (32.0%), 159 (24.3%) and 70 (10.1%) seen in the analyzed samples, respectively. Young patients, patients with larger tumor diameter, bilaterality, multifocality and gross extrathyroidal extension (ETE) were more inclined to NMLNs > 5, CLNs > 5 and LLNs > 5 (P < 0.05). It was found that the recurrence-free survival among pN1 patients was significantly discrepant between different groups (NMLNs ≤ 5/5: P = 0.001; LLNs ≤ 5/5: P < 0.001). In multivariate logistic regression analysis, patients aged < 55 years (OR = 1.917), primary tumor size > 10 mm (OR = 2.131), bilaterality (OR = 1.889) and tumor gross ETE (OR = 2.759) were independent predictors for high prevalence of total NMLNs > 5 (P < 0.05). Specially, patients aged < 55 years (OR = 2.864), primary tumor size > 10 mm (OR = 2.006), and tumor gross ETE (OR = 2.520) were independent predictors for high prevalence of CLNs > 5 (P < 0.01); Bilaterality (OR = 2.119), CLNs > 5 (OR = 6.733) and tumor gross ETE (OR = 4.737) were independent predictors for high prevalence of LLNs > 5 (P < 0.05)., Conclusions: In conclusion, it is evident that NMLNs is related to the invasive clinicopathological features and adverse outcome of patients with PTC which should be correctly evaluated to provide an appropriate guidance for reasonable treatment and careful follow-up., (© 2022. The Author(s).)

Background: Infantile hydrocephalus (IHC) is commonly related to other central nervous system diseases, which may have adverse effects on prognosis. The causes of IHC are heterogeneous, and the genetic etiologies are not fully understood. This study aimed to analyze the genetic etiologies of an IHC cohort., Methods: The data for 110 IHC patients who had received exome sequencing at the Clinical Genetic Center of the Children's Hospital of Fudan University between 2016 and 2019 were reviewed and analyzed retrospectively. An exome-wide association analysis (EWAS) was performed within this cohort using IHC as the study phenotype., Results: Of the 110 IHC patients, a pathogenic or likely pathogenic variant was identified in 16 (15%) patients, spanning 13 genes. The genes were mainly associated with metabolic disorders, brain abnormalities, and genetic syndromes. IHC patients who had unclear clinical etiology were more likely to possess a genetic etiology. Based on previous studies and on our EWAS results, ZEB1, SBF2, and GNAI2 were over-represented among IHC patients and might affect the signaling pathways involved in IHC formation., Conclusions: Our study showed heterogeneous genetic etiologies in an IHC cohort. It is essential to perform genetic testing on IHC patients who have unclear clinical etiology, and genes associated with metabolic disorders, brain abnormalities, and genetic syndromes should be noted. In addition, when aiming to discover IHC susceptibility genes, genes that might influence the signaling pathways involved in IHC formation should be prioritized.

Background: Malignant melanoma (MM) arises predominantly after adolescence and is uncommon in children. Congenital MM in newborns is even rarer with a dearth of published literature; as a consequence, there is no uniform standard for the pathogenesis and treatment for neonatal malignant melanoma. Herein we report a case of giant congenital nodular MM in a newborn, including its clinical, imaging, pathological and molecular pathological features. This case is the largest giant congenital primary nodular malignant melanoma in utero in neonates currently reported in China., Case Presentation: A female neonatal patient was found to have a 2.97 cm× 1.82 cm×1.50 cm mass with a clear boundary at the right acromion in color Doppler ultrasound examination at 24 weeks of gestation. The mass increased to 3.0 cm×5.0 cm×9.0 cm at birth, and local ulceration was seen. MRI demonstrated that the mass was located on the right shoulder and underarm in a lobulated appearance, and surrounded the right scapula which was deformed. Clinical stage:IV(AJCC 8th Edition (2017)). α-Fetoprofein (AFP) by hematological examination: 1210ng/ml, NSE: 21.28ng/ml, LDH: 842U/L. The patient underwent surgical resection of the tumor, and was pathologically diagnosed as neonatal congenital malignant melanoma; immunohistochemistry (IHC): S-100 (+), HMB45 (+), Melan A (+), and Tyrosinase (+). Molecular pathological examination for BRAF V600E showed no mutations (Quantitative Real-time PCR, qPCR); And so were NRAS, C-kit (exons 9,11,13,14,17,18), and TERT (promoter locus, C228T and C250T) (Sanger sequencing). Non-surgical therapies were not carried out after the surgical resection of the tumor. After 6 months of follow-up, the child developed normally, and color Doppler ultrasound showed no obvious tumor growth or abnormality in the original tumor site., Conclusions: It is extremely rare to see giant congenital primary nodular MM in utero in neonates. The pathogenesis, treatment and prognosis of congenital MM need further research. The diagnosis mainly depends on histopathology and immunohistochemistry, and it needs to be differentiated from malignant lymphoma and primitive neuroectodermal tumor. The current treatment strategy for MM relies on the surgical excision of the mass. Research directed at molecular detection for genetic mutations would contribute to targeted therapy and better prognosis.

In the present study, a total of 7793 samples from 5 different types of hosts were collected and tested, with a seroprevalence of 2.4% (184/7793). Although the seroprevalence of human and animal brucellosis is relatively low, numbers of human brucellosis cases reported have increased continuously from 2004 to 2018. A total of 118 Brucella strains containing 4 biotypes were obtained, including Brucella melitensis bv.1 ( n  = 8) and bv.3 ( n  = 106), Brucella abortus bv.3 ( n  = 3) and bv.7 ( n  = 1). Twenty-one shared MLVA-16 genotypes, each composed of 2 to 19 strains obtained from different hosts, suggest the occurrence of a brucellosis outbreak epidemic with multiple source points and laboratory infection events. Moreover, 30 shared MLVA-16 genotypes were observed among 59.6% (68/114) B. melitensis isolates from Zhejiang and strains from other 21 different provinces, especially northern provinces, China. The analysis highlighted the imported nature of the strains from all over the northern provinces with a dominant part from the developed areas of animal husbandry. These data revealed a potential transmission pattern of brucellosis in this region, due to introduced infected sheep leading to a brucellosis outbreak epidemic, and eventually causing multiple laboratory infection events. It is urgent to strengthen the inspection and quarantine of the introduced animals.

Ethnopharmacological Relevance: GeGen Decoction, a well-known Chinese herbal formula, is widely used in China and other Asian countries to treat gynecological diseases, including primary dysmenorrhea. Pharmacological studies have confirmed that GeGen Decoction is able to inhibit spasmodic contractions of the uterus in vivo and in vitro., Aim of the Study: The objective of this study is to examine the efficacy and safety of GeGen Decoction on primary dysmenorrheic patients., Methods: This was a randomized, double-blinded, placebo-controlled trial. GeGen Decoction or placebo was administered a week before the expected start of each cycle for three consecutive menstrual periods. Between-group differences in pain intensity were detected by visual analogue scale (VAS). In addition, serum levels of arginine vasopressin (AVP) and estrogen (E) were examined by enzyme-linked immunosorbent assay. Metabolomic analysis was further used to evaluate the influence of GeGen Decoction on the metabolomics of primary dysmenorrheic patients., Results: A total of 71 primary dysmenorrheic women were recruited and 30 participants met the criteria were randomized into GeGen Decoction or placebo group. After three consecutive menstrual cycles' treatments, the VAS score of the GeGen Decoction group was significantly lower than that of the placebo group. Both serum levels of AVP and E decreased after GeGen Decoction administration, while the placebo seemed to have little effect on either of the index. Moreover, after GeGen Decoction treatment, seven important metabolites were identified by metabolomic analysis compared to the placebo group. No abnormalities in blood biochemical and routine physical examination pre and post GeGen Decoction intervention were observed., Conclusions: GeGen Decoction can remarkably relieve the severity of menstrual pain without obvious adverse effects. Its therapeutic effect on primary dysmenorrhea might be related to the regulation of pituitary hypothalamic ovarian hormones, and interfering with the metabolic change., (Copyright © 2020 Elsevier B.V. All rights reserved.)

This study aimed to investigate diabetes distress, happiness, and its associated factors of patients with type 2 diabetes mellitus (T2DM) treated by different therapies, and to analyze the related impact factors. A total of 1512 patients with T2DM were randomly selected from 18 tertiary hospitals in Hunan province from January 2016 to April 2016 who has been treated with oral antidiabetics monotherapy, insulin monotherapy, and combination therapy. Use the general information questionnaire, WHO-5 (the World Health Organization 5 well-being index) and PAID (the problem areas in diabetes scale) to collect the data. There are 846 (55.95%) patients that have serious emotional disorders, and the diabetes related distress in insulin treatment group was higher than that in combination treatment group (P < .05). Happiness of T2DM patients in combination therapy was higher than oral antidiabetic drug monotherapy and insulin monotherapy (P < .05). There was a negative correlation between diabetic suffering and happiness in patients with different treatments (R ranged from -0.335 to -0.436, P < .001). Age and happiness experience could explain 14.8% of the variance. Acute and chronic complications, controlled blood glucose level, lifestyle, therapies, and school education can explain 18.3% variance. Under different therapies, the suffering and happiness of T2DM patients differed from each other. The suffering and happiness of T2DM were related to different therapies, age, complications, glycaemic control, lifestyle, school education, and so on.

Objective: To investigate the epidemiological characteristics, phenotype, genotype, and prognosis of medium-chain acyl-CoA dehydrogenase deficiency (MCADD) in the Chinese population., Methods: A retrospective analysis was performed for the clinical data of the neonates who underwent screening with high-performance liquid chromatography-tandem mass spectrometry from January 2009 to June 2018 and were diagnosed with MCADD by gene detection., Results: A total of 2 674 835 neonates underwent neonatal screening, among whom 12 were diagnosed with MCADD. Gene detection was performed for 10 neonates with MCADD and found 13 mutation types at 16 mutation sites of the ACADM gene, among which there were 7 reported mutations (p.T150Rfs*4, p.M1V, p.R206C, p.R294T, p.G310R, p.M328V, and p.G362E), 5 novel mutations (p.N194D, p.A324P, p.N366S, c.118+3A>G, and c.387+1del G), and 1 exon 11 deletion; p.T150Rfs*4 was the most common mutation (4/16). The detection rate of mutation sites in the ACADM gene was 80%. No phenotype-genotype correlation was observed. Dietary guidance and symptomatic treatment were given after confirmed diagnosis. No acute metabolic imbalance was observed within 4-82 months of follow-up. All neonates had good prognosis except one who had brain dysplasia., Conclusions: MCADD is relatively rare in southern China, and p.T150Rfs*4 is a common mutation in the Chinese population. Cases with positive screening results should be evaluated by octanoylcarnitine C8 value and gene detection.

The present study aims to analyze sperm concentration trends among young and healthy Chinese adults in Wuhan, Central China, from 2010 to 2015. Semen analysis data from 9357 participants were collected and analyzed using a general linear model and the Cochran-Armitage trend test. A significant decline was observed in sperm concentration (β [standard deviation]: -1.53 [0.16]; P < 0.001). In addition, a decline in sperm density was observed by stratifying student versus nonstudent sperm donors and by analyzing the year of birth or birth year cohort of the participants. Furthermore, the percentage of participants with sperm densities of over 40 × 10 6 ml -1 significantly decreased with year. Notably, a dramatic decline in sperm density was recorded over the first 5 years of study. This research reported a decline in sperm concentration among young adults in Wuhan, Central China, in 2010-2015., Competing Interests: All authors declared no competing interests

Objective: To investigate the effects of 4-week moderate aerobic exercise plus diet control on serum levels of total insulin-like growth factor 1(IGF-1) and IGF-1 binding protein-3 (IGFBP-3) as well as IGF-1 activity (reflected by molar ratio of IGF-1/IGFBP-3) in female obese adolescents and youths, and their possible role on fat loss, and improvement of glucose and lipid metabolism., Methods: Nine female obese youths (age:18~19 y) and 30 female obese adolescents (age:14~16 y) were recruited and undertook 4-week aerobic exercise such as swimming and jogging (6 days/week, twice a day, 2 h/time with 5 min rest per 30 min exercise) with gradual increase of intensity from low (heart rate immediately post-exercise of 1st week:100~120 beats/min) to moderate (heart rate immediately post-exercise of 2 nd -4 th weeks:120~140 beats/min) level, combined with a diet intervention (total daily energy intake of 1 400 or 1 600 kcal according to basal metabolism rate) in Shanghai Dianfeng weight loss enclosed camp. Nine normal weight young women and 9 female children matched at age and nationality were recruited as the normal control. Before and after the experimental period, anthropometric index (body weight, body mass index(BMI) and waist circumference), glucose and lipid metabolism parameters including fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride (TG); total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL), and serum levels of total IGF-1 and IGFBP-3 were measured, and IGF-1 activity was calculated in the obese and normal control female adolescents., Results: ①Compared with normal control, the serum levels of total IGF-1 and IGFBP-3 were decreased in the female obese youths and adolescents, and IGF-1 activity was reduced only in the obese female adolescents. ②The serum level of IGFBP-3 was down-regulated and IGF-1 activity was up-regulated while no change of serum total IGF-1 was induced by 4-week moderate aerobic exercise plus diet control, accompanied with significant decreases of body weight, BMI and waist circumference as well as improvement of glucose and lipid metabolism in the female obese youths and adolescents. Except for a positive association between the increased IGF-1 activity and the decreased waist circumference was found in the female obese youths by Pearson's correlation analysis, there was no relation of the decreased IGFBP-3, the increased IGF-1 activity with the improvements of anthropometric index and glucose and lipid metabolism in female obese youths and adolescents., Conclusions: The serum level of IGFBP-3 was down-regulated and the IGF-1 activity was up-regulated by 4-week moderate aerobic exercise plus diet control in female obese youths and adolescents. The increase of IGF-1 activity might be associated with the exercise-plus-diet-induced decrease of waist circumstance in female obese youths.

Objective: To analyze the result and follow-up data of screening for newborn amino acid metabolic disorders in Zhejiang province., Methods: A total of 1 861 262 newborns were screened for amino acid metabolic disorders during January 2009 and December 2016 in Zhejiang province. The screening results and the follow-up data were analyzed retrospectively., Results: One hundred and sixty four cases were diagnosed as amino acid metabolic disorders with a prevalence of 1:11 349, including 83 with hyperphenylalaninaemia (1:22 400), 29 with neonatal intrahepatic cholestasis caused by citrin deficiency (1:64 138), 16 with methionine S-adenosyltransferase deficiency (1:116 250), 9 with maple syrup urine disease (1:206 667), 8 with argininemia (1:232 500), 7 with citrullinemia type Ⅰ (1:265 700), 6 with hyperprolinemia type Ⅰ (1:310 000), and 2 with carbamylphosphate synthetase Ⅰ deficiency(1:930 000). In addition, ornithine transcarbamylase deficiency, cystathionine β-synthase deficiency, argininosucoinate aciduria and tyrosinemia type Ⅰ were detected in one patient for each, respectively. Two patients had developmental delay, 7 patients were dead, and 2 cases of maple syrup urine disease were lost to follow-up., Conclusions: Hyperphenylalaninaemia is the most common amino acid metabolic disease in newborns in Zhejiang province. Patients with amino acid metabolic disorders identified in newborn screening program can have chance for normal growth development by intervention.

Objective: To analyze the results and follow up data of screening for newborn organic aciduria in Zhejiang province., Methods: The results and follow-up data of 1 861 262 newborns from Zhejiang province undergoing screening for organic aciduria during January 2009 and December 2016 were retrospectively analyzed. The acylcarnitine spectrum in urine samples was detected by tandem mass spectrum (MS/MS) and the positive patients were confirmed by urine gas chromatography mass spectrometry and/or gene analysis., Results: Ninety two cases of organic aciduria were confirmed with a prevalence of 1:20 200. Among 40 cases of methylmalonic academia (MMA), 13 (32.5%) were of MMA simple type and 27 (67.5%) were combined type. Genetic analysis showed 6 cases of MUT type and 1 case of CblB type out of 7 patients with MMA simple type, 10 cases of CblC and 1 case of CblF out of 11 patients with combined type, respectively. Six patients had propionic academia with a prevalence of 1:310 200, 7 had isovaleric academia (1:265 900), 6 had glutaric academia type 1 (1:310 200), 27 had 3-methylcrotonyl-CoA carboxylase deficiency (MCC, 1:68 900), 1 had 3-hydroxy-3-methylglutaric aciduria (1:1 861 300), 2 had β-ketothiolase deficiency (1:960 600), and 3 had biotinidase deficiency/holocarboxylase synthetase deficiency (1:620 400). Thirty-one patients had a disease onset at neonatal period, and 15 at post-neonatal period. Thirty-three patients had brain involvements or cranial imaging disorders. Three patients with MMA had kidney diseases or heomlytic uremic syndrome, and 3 had myocardial impairments. Twenty patients died during the follow-up., Conclusions: MMA is the most common newborn organic aciduria in Zhejiang province. Except MCC, most organic aciduria may lead to metabolism decompensation, complications or even death.

Objective: To screen fatty acid oxidation disorders (FAOD) in newborns in Zhejiang province., Methods: A total of 1 861 262 newborns were screened for FAOD in Neonatal Screening Center of Zhejiang Province during January 2009 and December 2016. The blood samples from newborns were screened by tandem mass spectrometry, and diagnosis of FAOD was confirmed by urine organic acid measurement combined with genetic analysis. The prognosis and follow-up of patients with FAOD were also evaluated., Results: Of 1 861 262 newborns screened, 121 cases of FAOD were diagnosed. Among 121 cases of FAOD, primary carnitine deficiency (PCD) was the most common type ( n =78, 64.5%), which was followed by short-chain acyl-CoA dehydrogenase deficiency (SCADD, n =27, 22.3%), medium-chain acyl-CoA dehydrogenase deficiency ( n =5, 4.1%), multiple acyl-CoA dehydrogenase deficiency (MADD, n =4, 3.3%), very long-chain acyl-CoA dehydrogenase deficiency ( n =3, 2.5%), carnitine palmitoyltransferase Ⅰ deficiency( n =2, 1.7%)and carnitine palmitoyltransferase Ⅱ deficiency (CPTⅡD, n =2, 1.7%). During 2-82 month follow-up, 15 patients were lost, 4 were dead (1 PCD, 1 MADD, and 2 CPTⅡD), and the remaining 102 subjects had normal intelligence and physical development without any clinical symptoms., Conclusions: PCD and SCADD are the most common FAODs in newborns in Zhejiang province. Most of FAOD patients are asymptomatic, and have normal growth and development after early intervention and management.