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Background: Underlying causes in Chinese children with recurrent acute liver failure (RALF), including liver crises less than full acute liver failure, are incompletely understood. We sought to address this by searching for genes mutated in such children.Methods: Five unrelated Chinese boys presenting between 2012 and 2015 with RALF of unexplained etiology were studied. Results of whole exome sequencing were screened for mutations in candidate genes. Mutations were verified in patients and their family members by Sanger sequencing. All 5 boys underwent liver biopsy.Results: NBAS was the only candidate gene mutated in more than one patient (biallelic mutations, 3 of 5 patients; 5 separate mutations). All NBAS mutations were novel and predictedly pathogenic (frameshift insertion mutation c.6611_6612insCA, missense mutations c.2407G > A and c.3596G > A, nonsense mutation c.586C > T, and splicing-site mutation c.5389 + 1G > T). Of these mutations, 3 lay in distal (C-terminal) regions of NBAS, a novel distribution. Unlike the 2 patients without NBAS mutations, the 3 patients with confirmed NBAS mutations all suffered from a febrile illness before each episode of liver crisis (fever-related RALF), with markedly elevated alanine aminotransferase and aspartate aminotransferase activities 24-72 h after elevation of body temperature, succeeded by severe coagulopathy and mild to moderate jaundice.Conclusions: As in other countries, so too in China; NBAS disease is a major cause of fever-related RALF in children. The mutation spectrum of NBAS in Chinese children seems different from that described in other populations. [ABSTRACT FROM AUTHOR]

Animal husbandry is a major source of global greenhouse gas emissions. To address this problem, the low-carbon characteristics of the circular economy provide a theoretical basis for reducing carbon emissions in this sector. Using a life cycle assessment approach, in the present study, we compared the differences in traditional and biogas-based circular economic models of pig farming by analyzing the carbon footprint inventories. Based on the carbon emission reduction in the circular economic model, we estimated the environmental and economic benefits under carbon trading. Using pig farming in Liaoning Province, China, as an example, the circular economic model could effectively reduce the global warming potential of large-scale pig farming by 3,091,891.8 t carbon dioxide equivalents by diverting otherwise-heaped pig excrement for biogas generation. Under carbon trading, the reduction in carbon emissions under the circular model could generate an economic benefit of USD 30.92 million. Therefore, the carbon emission reductions of this model could have major environmental and economic benefits. Based on micro-parameters examined at the provincial scale in China, the findings of this analysis can serve as a reference for the formulation of government policies to realize global environmental benefits and develop a circular economy in livestock and poultry farming. Image 107 • Pig farm carbon emission cuts were investigated by comparing two life cycle models. • From carbon footprints, the biogas-based circular model can reduce greenhouse gases. • This model can also confer economic benefits via carbon trading. • Livestock manure management is key to carbon emission reductions. • Carbon calculation and pricing are key to realizing economic benefits. [ABSTRACT FROM AUTHOR]

Background: To explore the inadequacies of health service and its impact on clinical outcomes of patients with systemic lupus erythematosus (SLE) in China.Methods: A total of 210 SLE patients were randomly recruited between January 2017 and January 2018. Each patient received self-report questionnaires to assess medication adherence [Compliance Questionnaire for Rheumatology (CQR)], beliefs about medicines [Beliefs about Medicines Questionnaire (BMQ)] and satisfaction about medicine information [the Satisfaction with Information about Medicines Scale (SIMS)]. Associations between SLE disease activity index (SLEDAI-2 K) and observed factors were analyzed by multiple logistic regression.Results: Based on CQR, only 28.10% patients were adherent. The score of BMQ was 2.85 ± 5.42, and merely 32.38% patients were satisfied with the information about their prescribed medicines. Disease activity was associated with SIMS, EuroQol five-dimensions [EQ5D], Systemic Lupus International Collaborating Clinics (SLICC), depression, use of NSAID (P ≤ 0.05). Remission of disease was positively correlated with SIMS (OR = 0.16, 95% CI: [0.06, 0.40]), and BMQ (OR = 0.64, 95%CI: [0.43, 0.94]).Conclusion: In this study, the scores of BMQ and SIMS were low, implying defects in the patient education of health service system, which led to disease flare in Chinese SLE patients.Trial Registration: ClinicalTrials.gov ID: NCT03024307 . Registered January 18, 2017. [ABSTRACT FROM AUTHOR]

Abstract Ungulate bocaparvoviruses (UBoV) 2–5 are recently discovered porcine bocaparvoviruses belonging to the family Parvoviridae , and are considered to be a potentially major cause of swine diseases. In order to detect local UBoV2 epidemics in China, we developed a TaqMan-based real-time PCR (qPCR) assay targeting the UBoV2 VP1 gene and compared the results of qPCR with conventional PCR (cPCR). The qPCR reproducibly detected a recombinant DNA plasmid containing the VP1 gene over a range of eight orders of magnitude, from 9.97 × 10−1–106 copies/μL, with a lower limit of detection of 9.97 copies/μL, compared with approximately 9.97 × 102 copies/μL for cPCR. The qPCR assay showed no cross-reactivity with other UBoVs or other porcine viruses. This qPCR assay detected UBoV2 in 18.1% (84/463) of pig samples collected from Chinese swine herds, with the highest infection rate of 35.3% (53/150) in loose stools. UBoV2 was not detected in liver samples. The TaqMan-based qPCR assay established in this study was highly sensitive and specific for the diagnosis and quantification of UBoV2. The results of this study will further our understanding of the etiology, epidemiology, and pathogenesis of UBoV2 infection. [ABSTRACT FROM AUTHOR]

Objective: This survey investigated the relationship between social isolation, depression, nutritional status and quality of life among community-dwelling older adults during COVID-19., Design: This was a cross-sectional survey study., Setting: Communities in Pudong New Area, Shanghai, China that have contracted with Renji Hospital, affiliated with Shanghai Jiao Tong University School of Medicine., Participants: From May to July 2022, 406 community-dwelling older adults were selected by convenience sampling in Shanghai, China., Primary and Secondary Outcome Measures: The Lubben Social Network Scale, Geriatric Depression Scale, 36-item Short Form Health Survey Scale and risk assessment of malnutrition were used in older adults. Mediation models were constructed to determine the mediating role of depression and nutritional status on social isolation and quality of life among older adults., Results: The prevalence of social isolation among older adults in the community was 44.3%. The total social isolation score in community-dwelling older adults was positively associated with the total malnutrition risk and quality of life scores, and negatively associated with depression (p<0.01). Logistic regression demonstrated that living alone, loss of families or friends during COVID-19 and depression were risk factors for social isolation among community-dwelling older adults (p<0.05). Social isolation could directly affect the quality of life (β=0.306). In addition, depression (β=0.334) and nutritional status (β=0.058) had a significant mediating effect on the relationship between social isolation and quality of life., Conclusions: Our findings showed that the prevalence of social isolation among older adults increased during COVID-19. Depression and nutritional status played parallel mediating roles on the effect of social isolation on quality of life. Community workers and healthcare providers should develop intervention plans to improve the status of social isolation in older adults, eliminating existing and ongoing adverse effects., 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.)

Objective: This study explores the relationship between nutritional status and oral health quality of life, the self-efficacy of older inpatients and the correlative factors., Methods: In this study, the convenience sampling method was used to select 307 older inpatients in the southern section of the Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from October to December 2020 as the main research participants. A mini nutritional assessment questionnaire was used to assess nutritional status, and the Chinese version of a geriatric oral health assessment index questionnaire was used to determine the oral health quality of life. Self-efficacy was assessed by a general self-efficacy scale questionnaire. Descriptive statistics were used to analyse data using the SPSS 22.0 software. Pearson correlation and multiple linear regression analysis were applied to explore the correlation between variables and factors concerned with nutritional status, respectively., Results: The results of this study showed that the self-efficacy and oral health quality of life of older inpatients were at a moderate level. Among the patients, 263 had one or more tooth defects, and only 128 had oral restorations or wore dentures. The risk of malnutrition in hospitalised older patients was 37.1%, and the incidence of malnutrition was 13.4%. The risk factors of nutritional status of older patients were age, oral-related quality of life, prealbumin index, self-efficacy, chronic disease, monthly income and tooth defect (P < 0.05)., Conclusion: The incidence of malnutrition and malnutrition risk in hospitalised older patients is relatively high. The main associated factors include age, tooth defect, oral health quality of life, self-efficacy, chronic disease status and monthly income. Therefore, older inpatients, especially those with prosthodontic problems, should carry out nutritional assessments, intervention and graded management as soon as possible to improve their self-efficacy, improve their nutrition and health status and reduce the incidence of a poor prognosis., (© 2022. The Author(s).)

Background: Suicide rates among hospital inpatients increase with age. Choosing a simple and appropriate suicide risk assessment tool can assist medical staff to identify high-risk individuals in time, and reduce the inpatient suicide rates., Methods: A total of 1,841 elderly inpatients in the Renji Hospital South Campus, Shanghai Jiaotong University of Medicine from April to August 2020 were randomly selected as the participants for a cross-sectional study. Their conditions were assessed by BSRS-5, Barthel index (BI), and numeric rating scale (NRS). Then, the software SPSS 23.0 (IBM Corp., Armonk, NY, USA) was applied to create a database and statistically analyze the results., Results: According to the BSRS-5 score, 1,825 participants (99.1%) had no suicide risk (0-3 points) and 16 participants (0.9%) had suicide risk (4-24 points). Subsequently, univariate analysis was performed with the BSRS-5 score as the dependent variable and participant gender, age, self-care ability, and pain intensity as independent variables. The results showed that self-care ability (F=3.195, P=0.000) and pain intensity (F=3.247, P=0.001) were the main risk factors for suicide. Finally, to investigate the relationship of suicide risk with self-care ability and pain intensity, the scores of the 3 scales (BSRS-5, BI, NRS) were assigned, and then the data were analyzed by logistic regression. The results showed that self-care ability assignment was statistically significant (P=0.009<0.05, B=-0.657), suggesting that self-care ability score affected the suicide risk in elderly inpatients. Specifically, the weaker their self-care ability, the higher the suicide risk., Conclusions: Suicide prevention strategies should take self-care ability into account, which is a crucial influencing factor of suicide risk in elderly inpatients. The BSRS-5 assessment tool is recommended to assess suicide risk in elderly inpatients, which can then contribute to the establishment of a 3-level safety system for suicide prevention in elderly inpatients.

Background: Patients following radical prostatectomy will encounter various symptoms that may vary depending on the recovery of surgery and the use of adjuvant treatments. However, few studies have used the scale developed for prostate cancer to longitudinally assess the course of symptoms in Chinese patients. This study aimed to identify the symptom trajectories and the influencing factors in the prostate cancer patients of our area., Methods: A prospective observational study was conducted, and 155 patients with prostate cancer from 3 hospitals in Shanghai were recruited. Demographic and disease-related information was collected during the hospitalization. Further information on symptoms, adjuvant treatment, and functional exercise was collected across 4 time points. Growth mixture modeling was used to identify the trajectory patterns of symptoms, and logistic regression was used to determine the predictors., Results: A total of 143 patients completed the investigation of all points, with a lost-to-follow-up rate of 7.7%. Urinary incontinence, urinary tract irritation, sexual dysfunction, pelvic pain, and hormone related symptoms all had group heterogeneity, and the number of latent category trajectories obtained was 4, 3, 3, 4, and 3 respectively. There were differences in demographic, disease, and treatment-related information between the groups., Conclusions: Patients with prostate cancer have different symptom levels across different periods after radical prostatectomy. Medical staff can predict these changes based on the initial level of symptoms and related factors such as age, prostate volume, medical comorbidities, drug of adjuvant treatment to clarify the critical points, populations, and symptoms that require monitoring during follow-up.

Background: The health levels of young elderly individuals are generally low due to multiple factors. This study sought to analyze factors that affect the health of the young elderly to provide a reference for improving their level of health., Methods: We used cluster sampling to survey 1,000 young elderly residents aged between 60 and 69 and living in Town P, District M, Shanghai. Health levels were assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Social Support Rate Score (SSRS), General Self-Efficacy Scale (GSES), and Health Promoting Lifestyle Profile II (HPLP II) instruments. Demographic characteristics were compared based on the SF-36 score and coupled with one-way analysis and stepwise regression analysis, to determine factors affecting health., Results: The young elderly in this community have a high morbidity of chronic disease and score low in the SF-36, SSRS, GSES, and HPLP II. One-way analysis reveals that gender, education, marriage, current work, total social support score, total general self-efficacy score, and total health promoting score are factors affecting the scoring of the SF-36 and the results of stepwise regression analysis. Marriage, current working condition, age, total score of social support, total score of health promotion behavior, type of work, presence of chronic disease, and the number of children are positively correlated with the SF-36 score and can predict it., Conclusions: To improve the health of community living elderly young it is necessary to adopt appropriate health promotion measures which motivate their self-efficacy and health responsibility. Such measures include increasing interactions between the young elderly and medical resources and offering them public participation opportunities to ensure that they receive adequate social support.

Purpose: To evaluate the association between spousal diabetes status and the prevalence of diabetic retinopathy in Chinese patients with type 2 diabetes., Methods: A cross-sectional community-based study was performed in 1510 patients with type 2 diabetes in Shanghai, China. Non-mydriatic digital fundus photography was used to detect diabetic retinopathy. Spousal diabetes status was assessed using a standardised interview questionnaire., Results: The prevalence of diabetic retinopathy was significantly lower in patients who had diabetic spouses, compared with those who did not (20.2% vs 29.1%, p  ⩽ 0.01). The fully adjusted odds ratio for diabetic retinopathy in those had diabetic spouses was decreased by 36% (odds ratio = 0.64, 95% confidence interval = 0.42-1.00, p  = 0.048). The negative correlation between spousal diabetes status and diabetic retinopathy was presented in patients with the duration of diabetes ⩾ 10 years, those with HbA1c ⩾ 7% and those not using lipid-lowering drugs (odds ratio = 0.31, 95% confidence interval = 0.13-0.74, p  = 0.0082; odds ratio = 0.50, 95% confidence interval = 0.27-0.94, p  = 0.031; odds ratio = 0.58, 95% confidence interval = 0.37-0.92, p  = 0.021, respectively)., Conclusion: We demonstrated that spousal diabetes was associated with a lower diabetic retinopathy prevalence in Chinese patients with type 2 diabetes.

Background: Underlying causes in Chinese children with recurrent acute liver failure (RALF), including liver crises less than full acute liver failure, are incompletely understood. We sought to address this by searching for genes mutated in such children., Methods: Five unrelated Chinese boys presenting between 2012 and 2015 with RALF of unexplained etiology were studied. Results of whole exome sequencing were screened for mutations in candidate genes. Mutations were verified in patients and their family members by Sanger sequencing. All 5 boys underwent liver biopsy., Results: NBAS was the only candidate gene mutated in more than one patient (biallelic mutations, 3 of 5 patients; 5 separate mutations). All NBAS mutations were novel and predictedly pathogenic (frameshift insertion mutation c.6611&#95;6612insCA, missense mutations c.2407G > A and c.3596G > A, nonsense mutation c.586C > T, and splicing-site mutation c.5389 + 1G > T). Of these mutations, 3 lay in distal (C-terminal) regions of NBAS, a novel distribution. Unlike the 2 patients without NBAS mutations, the 3 patients with confirmed NBAS mutations all suffered from a febrile illness before each episode of liver crisis (fever-related RALF), with markedly elevated alanine aminotransferase and aspartate aminotransferase activities 24-72 h after elevation of body temperature, succeeded by severe coagulopathy and mild to moderate jaundice., Conclusions: As in other countries, so too in China; NBAS disease is a major cause of fever-related RALF in children. The mutation spectrum of NBAS in Chinese children seems different from that described in other populations.

The heat shock protein 70 (Hsp70) family is widely expressed in eukaryotic cells as the major chaperone protein. In this study, the full-length complementary DNA (cDNA) of a novel inducible cytosolic Hsp70 family member (FcHsp70) was cloned from Fenneropenaeus chinensis. FcHsp70 full-length cDNA consists of 2,511 bp with a 1,890-bp open reading frame encoding 629 amino acids. Three Hsp70 protein family signatures, IDLGTTYS, IIDLGGGTFDVSIL, and IVLVGGSTRIPKVQK, were found in the predicted FcHsp70 amino acid sequence. Phylogenetic analysis showed that FcHsp70 was categorized together with the inducible HSP70s reported in other crustaceans. Compared to the previously identified cognate Hsp70 (FcHsc70) in F. chinensis, the expression of FcHsp70 showed quite different expression profiles when the shrimp were subjected to different stresses including heat shock and heavy metal treatments. Under heat shock treatment, the expression of FcHsp70 showed much higher up-regulation than FcHsc70. Copper treatment also induced higher up-regulation of FcHsp70 than FcHsc70. Cadmium treatment did not induce the expression of FcHsp70, but caused down-regulation of FcHsc70. The different expression profiles of FcHsp70 and FcHsc70 in shrimp may indicate their different reactions to different stresses. Therefore, Hsp70 or Hsc70 could be developed as a biomarker to indicate different stresses in shrimp.