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Background: Traditional Chinese Medicinal Plants (CMPs) hold a significant and core status for the healthcare system and cultural heritage in China. It has been practiced and refined with a history of exceeding thousands of years for health-protective affection and clinical treatment in China. It plays an indispensable role in the traditional health landscape and modern medical care. It is important to accurately identify CMPs for avoiding the affected clinical safety and medication efficacy by the different processed conditions and cultivation environment confusion. Results: In this study, we utilize a self-developed device to obtain high-resolution data. Furthermore, we constructed a visual multi-varieties CMPs image dataset. Firstly, a random local data enhancement preprocessing method is proposed to enrich the feature representation for imbalanced data by random cropping and random shadowing. Then, a novel hybrid supervised pre-training network is proposed to expand the integration of global features within Masked Autoencoders (MAE) by incorporating a parallel classification branch. It can effectively enhance the feature capture capabilities by integrating global features and local details. Besides, the newly designed losses are proposed to strengthen the training efficiency and improve the learning capacity, based on reconstruction loss and classification loss. Conclusions: Extensive experiments are performed on our dataset as well as the public dataset. Experimental results demonstrate that our method achieves the best performance among the state-of-the-art methods, highlighting the advantages of efficient implementation of plant technology and having good prospects for real-world applications. [ABSTRACT FROM AUTHOR]

Since the "121" project in 1963, Sinoma Snythetic Crystals Co., Ltd. participated in the research of the first synthetic diamond in China, and went through a difficult and glorious days of 60 years in the research of high temperature and high pressure synthesis of diamond, including belt press, diamond tools and chemical vapor deposition diamond. Through the efforts of several generations of hard works, great achievements have been made in the technology of diamond systhesis and the application of diamond tools in China. Researchers made great contributions to the diamond course in China. Reviewing the 60 years of development of diamond technology of Sinoma Snythetic Crystals Co., Ltd. it is expected to provide inspiration and reference for researchers in the new era in terms of the external environment responds to policy trends, scientific research, transformation of technological achievements, and developmental ideas. [ABSTRACT FROM AUTHOR]

A new anchor-siphon drainage combined method used for slope stabilization is proposed in this paper. It includes an anchoring section and a siphon drainage section. The novelty of the anchor-siphon drainage combined method is the realization of the drainage and anchoring in the one inclined borehole. The engineering cost of drilling and the resulting disturbance to the slope is reduced. To validate the feasibility of the proposed method, a numerical method that combines the pore water pressure distribution after siphon drainage and the anchoring force of the anchoring section is used to evaluate the safety of the slope with the anchor-siphon drainage method. The proposed method was illustrated and validated with the Hongpu Village landslide, in Tonglu County, Zhejiang Province, in China. Compared with the common anchor bar with the same length in the anchoring section, the factor of safety (FOS) for Hongpu Village slope with anchor-siphon drainage is increased by 0.085. The calculation method of the optimal length ratio between the drainage section and the anchoring section and its influencing factors were studied. For the different design parameters, there is always an optimal length ratio of the drainage section. Compared with the siphon drainage and full-length anchor bar with the same borehole length, the anchor-siphon drainage combined method shows better landslide prevention ability. Moreover, when the optimized parameters with a bond strength of 560 kPa, a borehole inclination of 35°, and no reduction in length are used, the calculated safety factor is 1.316, which is significantly higher than the FOS of 1.131 for the slope with siphon drainage. [ABSTRACT FROM AUTHOR]

Zinc (Zn)-regulated and iron (Fe)-regulated transporter-like proteins (ZIP) are key players involved in the accumulation of cadmium (Cd) and Zn in plants. Sedum plumbizincicola X.H. Guo et S.B. Zhou ex L.H. Wu (S. plumbizincicola) is a Crassulaceae Cd/Zn hyperaccumulator found in China, but the role of ZIPs in S. plumbizincicola remains largely unexplored. Here, we identified 12 members of ZIP family genes by transcriptome analysis in S. plumbizincicola and cloned the SpZIP2 gene with functional analysis. The expression of SpZIP2 in roots was higher than that in the shoots, and Cd stress significantly decreased its expression in the roots but increased its expression in leaves. Protein sequence characteristics and structural analysis showed that the content of alanine and leucine residues in the SpZIP2 sequence was higher than other residues, and several serine, threonine and tyrosine sites can be phosphorylated. Transmembrane domain analysis showed that SpZIP2 has the classic eight transmembrane regions. The evolutionary analysis found that SpZIP2 is closely related to OsZIP2, followed by AtZIP11, OsZIP1 and AtZIP2. Sequence alignment showed that most of the conserved sequences among these members were located in the transmembrane regions. A further metal sensitivity assay using yeast mutant Δyap1 showed that the expression of SpZIP2 increased the sensitivity of the transformants to Cd but failed to change the resistance to Zn. The subsequent ion content determination showed that the expression of SpZIP2 increased the accumulation of Cd in yeast. Subcellular localization showed that SpZIP2 was localized to membrane systems, including the plasma membrane and endoplasmic reticulum. The above results indicate that ZIP member SpZIP2 participates in the uptake and accumulation of Cd into cells and might contribute to Cd hyperaccumulation in S. plumbizincicola. [ABSTRACT FROM AUTHOR]

Background: Reaching optimal vaccination rates is an essential public health strategy to control the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to simulate the optimal vaccination strategy to control the disease by developing an age-specific model based on the current transmission patterns of COVID-19 in Wuhan City, China. Methods: We collected two indicators of COVID-19, including illness onset data and age of confirmed case in Wuhan City, from December 2, 2019, to March 16, 2020. The reported cases were divided into four age groups: group 1, ≤ 14 years old; group 2, 15 to 44 years old; group 3, 44 to 64 years old; and group 4, ≥ 65 years old. An age-specific susceptible-exposed-symptomatic-asymptomatic-recovered/removed model was developed to estimate the transmissibility and simulate the optimal vaccination strategy. The effective reproduction number (Reff) was used to estimate the transmission interaction in different age groups. Results: A total of 47 722 new cases were reported in Wuhan City from December 2, 2019, to March 16, 2020. Before the travel ban of Wuhan City, the highest transmissibility was observed among age group 2 (Reff = 4.28), followed by group 2 to 3 (Reff = 2.61), and group 2 to 4 (Reff = 1.69). China should vaccinate at least 85% of the total population to interrupt transmission. The priority for controlling transmission should be to vaccinate 5% to 8% of individuals in age group 2 per day (ultimately vaccinated 90% of age group 2), followed by 10% of age group 3 per day (ultimately vaccinated 90% age group 3). However, the optimal vaccination strategy for reducing the disease severity identified individuals ≥ 65 years old as a priority group, followed by those 45–64 years old. Conclusions: Approximately 85% of the total population (nearly 1.2 billion people) should be vaccinated to build an immune barrier in China to safely consider removing border restrictions. Based on these results, we concluded that 90% of adults aged 15–64 years should first be vaccinated to prevent transmission in China. [ABSTRACT FROM AUTHOR]

Background: Novel coronavirus disease 2019 (COVID-19) causes an immense disease burden. Although public health countermeasures effectively controlled the epidemic in China, non-pharmaceutical interventions can neither be maintained indefinitely nor conveniently implemented globally. Vaccination is mainly used to prevent COVID-19, and most current antiviral treatment evaluations focus on clinical efficacy. Therefore, we conducted population-based simulations to assess antiviral treatment effectiveness among different age groups based on its clinical efficacy. Methods: We collected COVID-19 data of Wuhan City from published literature and established a database (from 2 December 2019 to 16 March 2020). We developed an age-specific model to evaluate the effectiveness of antiviral treatment in patients with COVID-19. Efficacy was divided into three types: (1) viral activity reduction, reflected as transmission rate decrease [reduction was set as v (0–0.8) to simulate hypothetical antiviral treatments]; (2) reduction in the duration time from symptom onset to patient recovery/removal, reflected as a 1/γ decrease (reduction was set as 1–3 days to simulate hypothetical or real-life antiviral treatments, and the time of asymptomatic was reduced by the same proportion); (3) fatality rate reduction in severely ill patients (fc) [reduction (z) was set as 0.3 to simulate real-life antiviral treatments]. The population was divided into four age groups (groups 1, 2, 3 and 4), which included those aged ≤ 14; 15–44; 45–64; and ≥ 65 years, respectively. Evaluation indices were based on outbreak duration, cumulative number of cases, total attack rate (TAR), peak date, number of peak cases, and case fatality rate (f). Results: Comparing the simulation results of combination and single medication therapy s, all four age groups showed better results with combination medication. When 1/γ = 2 and v = 0.4, age group 2 had the highest TAR reduction rate (98.48%, 56.01–0.85%). When 1/γ = 2, z = 0.3, and v = 0.1, age group 1 had the highest reduction rate of f (83.08%, 0.71–0.12%). Conclusions: Antiviral treatments are more effective in COVID-19 transmission control than in mortality reduction. Overall, antiviral treatments were more effective in younger age groups, while older age groups showed higher COVID-19 prevalence and mortality. Therefore, physicians should pay more attention to prevention of viral spread and patients deaths when providing antiviral treatments to patients of older age groups. [ABSTRACT FROM AUTHOR]

Suppressing and removing mine dust from the working face is an important task for underground mines worldwide. In this paper, a numerical study was carried out to investigate the influence of ventilation arrangement on the mechanism of dust distribution. The Woxi Pithead of Hunan Chenzhou Mining Co., Ltd, China, was used as a case study, which adopted a widely used far-pressing-near-absorption (FPNA) ventilation system. Based on the theory of gas-solid two-phase flow, the program ANSYS Fluent was utilized, and the three-dimensional airflow migration and dust diffusion numerical models were simulated. The established computational fluid dynamics (CFD) models were validated using the airflow velocity data and the dust concentration data monitored at different positions from the operating coal mine. A comprehensive sensitivity study was conducted to investigate the influence of four parameters on dust suppression, including the distance of pressure air duct outlet from working face (Lp-outlet), the distance of exhaust air duct inlet from working face (Le-inlet), the ratio of pressing air volume to lab sorption air volume (K), and the installation height of the air duct (H). The optimum ventilation layout parameters were obtained through the simulation of the wind field and dust behaviour. The results show that there were four regions during the airflow field, namely, the jet zone, the recirculation zone, the vortex zone, and the mixing zone of pressure and exhaust airflow. All four parameters were found to have an important influence on the mass concentration of dust, and the optimum ventilation layout parameters were determined to be Lp-outlet = 18 m, Le-inlet = 3 m, K = 1.2, and H = 1.6 m. [ABSTRACT FROM AUTHOR]

[Display omitted] • Magmatism formed during the initial stage (ca. 480Ma) and advanced stage (ca. 450Ma) of exhumation of subducted continental crust have been recognized in South Altyn western China. • Two stages of magmatism exhibits evidence for the partial melting of subducted continental crust during differential exhumation process of South Altyn in Palaeozoic. The early Palaeozoic continental subduction–collisional belt in South Altyn (SA) western China distributes a large amount of (ultra)-high-pressure ((U)HP) metamorphic and granitic rocks associated with subduction, collision, and exhumation. In this study, four granitic rocks were collected from Bashenwake located in eastern SA. The ages of the garnet-bearing alkali-feldspar granite (GAFG), garnet-bearing granitic gneiss (GGG), alkali-feldspar granite (AFG), and syenogranite (SG) are 458.0 ± 4.1, 483.0 ± 4.1, 450.0 ± 2.4, and 482.0 ± 4.9 Ma, respectively. Whole-rock major and trace elements and Sr–Nd–Pb isotope, and zircon Hf isotope compositions for all samples exhibit characteristics of a continental crustal source. Based on partial melting modeling, the source temperature of the GGG, GAFG, AFG and SG was concluded as 750–780 °C, 730–760 °C, 730–770 °C and ca. 800 °C, respectively. The source pressure was estimated as ca. 0.8 GPa for the GGG, GAFG and AFG, and ca. 1.2 GPa for SG. Combined with studies on (U)HP metamorphic rocks in SA, this study reveals that GGG is formed by metamorphism while SG is formed from partial melting of upper crustal rocks heated by upwelling mantle during the initial stage of exhumation (ca. 480 Ma) of subducted continental crust in SA. During further stage of exhumation of the subducted continental crust at ca. 450 Ma, the GAFG and AFG were formed from partial melting of GGG as a result of decreased pressure and further mantle upwelling. Consequently, the exhumation age of subducted continental crust in eastern SA is ca. 30 Myr earlier than that in western SA. Thus, the geochronology and petrogenesis of four granitic samples in this study exhibit one of very few evidence for partial melting of subducted continental crust during the exhumation and also provide magmatism exhibits evidence for the differential exhumation model of eastern SA in Palaeozoic. [ABSTRACT FROM AUTHOR]

The loss of biodiversity from urbanized areas is a major environmental problem challenging policy-makers throughout the world. Solutions to this problem are urgently required in China. We carried out a case study of wintering long-eared owls ( Asio otus) and their main prey to illustrate the negative effects of urbanization combined with ineffective conservation of biodiversity in Beijing. Field monitoring of owl numbers at two roosting sites from 2004 to 2012 showed that the owl population had fallen rapidly in metropolitan Beijing. Analysis of pellet contents identified only seven individuals of two species of shrew. The majority of mammalian prey comprised four bat and seven rodent species, making up 29.3% and 29.5% of the prey items, respectively. Prey composition varied significantly among years at the two sample sites. At the urban site the consumption of bats and rodents declined gradually over time, while predation on birds increased. In contrast, at the suburban site the prey composition showed an overall decrease in the number of bats, a sharp increase and a subsequent decrease in bird prey, and the number of rodent prey fell to a low point. Rapid development of real estate and inadequate greenfield management in city parks resulted in negative effects on the bird and small mammal habitat of urban areas in Beijing. We suggest that measures to conserve biodiversity should be integrated into future urban planning to maintain China's rich biodiversity while also achieving sustainable economic development. [ABSTRACT FROM AUTHOR]

Presents information on a series of experiments with the interactive Chinese information retrieval system named CIRS and an interactive relational thesaurus. Exploration of whether thesauri enhance the retrieval effectiveness of Chinese documents; What is suggested in the statistical recall and precision measures.

[Display omitted] • The mineralization in the Dongbulage deposit occurred at 162.1 ± 1.3 Ma. • The early sulfide minerals were derived mainly from magmatic–hydrothermal fluids. • The late sulfide minerals were strongly affected by the surrounding strata materials. • Fluid boiling and mixing were key factors in ore precipitation. The Dongbulage porphyry Mo–Pb–Zn deposit is located in the Huanggang–Ganzhuermiao polymetallic district (HGD) in the southern part of the Great Hinggan Range in northeast China. The Dongbulage deposit is hosted by granite porphyry, and the wall rock alteration can be divided into quartz–potassic, quartz–sericite, and propylitic zones. The hydrothermal activity in the deposit can be divided into five stages, with molybdenite and Pb–Zn ore occurring mainly as veins and veinlets in stages II and III, respectively. The fluid inclusion (FI) types include liquid-rich (L-type), vapor-rich (V-type), and daughter mineral-bearing (S-type) FIs. Based on the combination of FI types and their temperatures and salinities, it is inferred that fluid boiling and incorporation of meteoric water were key factors in the precipitation of Mo and Pb–Zn, respectively. Hydrogen and O isotope data for quartz, and C and O isotope data for calcite indicate that the ore-forming fluids were primarily magmatic in origin, and were mixed with meteoric waters during their evolution. The S and Pb isotope data, along with the mineral paragenesis, suggest that molybdenite and chalcopyrite which precipitated during stage II were derived mainly from magmatic–hydrothermal fluids, whereas arsenopyrite, sphalerite, and pyrite that precipitated during stage III were strongly affected by the incorporation of surrounding strata materials. Rhenium–Os dating of molybdenite indicates that mineralization in the Dongbulage deposit occurred at 162.1 ± 1.3 Ma (n = 6; MSWD = 1.4). The results, combined with data from other deposits in the region of this age, indicate that important mineralization occurred in the HGD during 165–155 Ma. [ABSTRACT FROM AUTHOR]

[Display omitted] • The large Erdaohe Pb-Zn-Ag deposit is a typical skarn deposit. • Boiling clearly occurred during the evolution of the ore-forming fluid. • The ore-forming fluid was derived from magma and underwent intense degassing. • Sulfur originated from the mixing of magma and surrounding rocks. • Fluid boiling and mixing were key factors in ore precipitation. The large Erdaohe Pb-Zn-Ag deposit is an important and representative skarn deposit in the middle segment of the Great Hinggan Range. The Pb-Zn ore bodies are mainly hosted in and among different lithological layers of volcaniclastic and carbonate rocks. The Si–Ca interface with abrupt changes in rock chemical properties and the bedding detachment faults played important roles in controlling mineralization. The mineralization of the deposit can be divided into three stages: (1) pre-ore skarn stage (I); (2) syn-ore quartz–sulfide stage (II); and (3) post-ore quartz–carbonate stage (III). Here, we present a combined study of geology, fluid inclusions (FIs), laser Raman analysis and H–O–S isotopes to constrain the origin and evolution of ore-forming fluids and the source of ore-forming materials. Four types of FIs are identified in the Erdaohe deposit, including liquid-rich (L-type), vapor-rich (V-type), CO 2 (C-type) and daughter mineral-bearing (S-type) FIs. The L-type, V-type, C-type and S-type FIs appear simultaneously in stages I and II, and their homogenization temperatures (Th) are similar, indicating that boiling of the ore-forming fluids occurred. From stages I to III, Th varies from 338 to 475 °C, 194 to 383 °C and 157 to 323 °C, with salinities ranging from 3.87 to 50.72 wt% NaCl equiv., 0.35 to 39.05 wt% NaCl equiv. and 0.18 to 6.88 wt% NaCl equiv., respectively. The main ore-forming fluid was a H 2 O–NaCl ± CO 2 system. From stages I to III, the variations in δ18O fluid range from −2.3 to 7.2‰, −8.8 to 1.0‰, and −13.6 to −3.8‰; the ranges of δD are −141 to −208‰, −133 to −161‰, and −126 to −142‰, respectively. H–O isotope studies reveal that the initial ore-forming fluid was mainly derived from magma and underwent intense degassing, followed by mixing with meteoric water. The δ34S values of sulfide minerals vary in a small range, are concentrated from 5.2 to 10.0‰, and are characteristic of deep-sourced magmatic sulfur. The high δ34S values in the Erdaohe deposit are probably the result of magmatic sulfur mixing with sulfur from the surrounding Duobaoshan Formation. The alteration style related to mineralization, combined with FIs, laser Raman analysis, and H–O–S isotopes, suggests that the Erdaohe Pb-Zn deposit is a typical skarn deposit associated with magmatic activity. The boiling of ore-forming fluids and mixing with meteoric water played crucial roles in ore precipitation. [ABSTRACT FROM AUTHOR]

Background: Our objective was to investigate the feasibility of laparoscopic inguinal hernia repair during its developmental phases in China. Study Design: The clinical data of 2,056 patients (2,473 hernias) who underwent laparoscopic inguinal hernia repair at Shanghai Minimally Invasive Surgery Center between January 2001 and December 2011 were analyzed retrospectively. The operation priority was used to divide the patients into 7 groups for analysis of the learning curve. Results: There were 1,005 transabdominal preperitoneal patch plastic repairs (TAPP), 1,458 total extraperitoneal repairs (TEP), and 10 intraperitoneal onlay mesh repairs performed on 874, 1,175, and 7 patients, respectively. Median follow-up period was 60 months. The operation time and postoperative hospital stay for TEP were considerably shorter than those for TAPP. The complication rate for TEP, especially seroma, was considerably lower. Transabdominal preperitoneal patch plastic repair was performed in 81.4% of the recurrent inguinal hernias. Seven patients underwent unilateral intraperitoneal onlay mesh repair and 3 others underwent unilateral intraperitoneal onlay mesh repair and TAPP on the opposite. Most of patients with grade I and II hernias underwent TEP. The learning curve has demonstrated that more obstacles occurred in the earlier phase of the laparoscopic inguinal hernia repair training, supported by findings such as fewer cases performed annually, longer operation time, and higher incidence of complications and recurrence. These findings have improved as experience is accumulated through more operations. In addition, the ratios of TEP to TAPP and mesh nonfixation to fixation also evolved throughout the course of the study. Conclusions: Laparoscopic inguinal hernia repair is a feasible technique that can be popularized in China. [Copyright &y& Elsevier]

The Erdaohe deposit is a newly discovered large-sized skarn Pb-Zn-Ag deposit located in the middle segment of the Great Hinggan Range, NE China. Geochronologic and geochemical data for the ore-related diorites in the deposit are presented here to explore the age, petrogenesis and geodynamic setting of these rocks. Zircon U– Pb LA-ICP-MS dating results show that the ore-related diorites were emplaced at 145–142 Ma. Geochemically, the ore-related diorites are generally characterized by high Y (22.5–32.7 ppm) and Yb (2.23–3.28 ppm) contents, low Sr/Y (14–40) ratios, light rare earth element (LREEs) and large ion lithophile element (LILE) (e.g., Rb and K) enrichments, and high field strength element (HFSE) (e.g., Nb, Ta, and Ti) depletions. These geochemical features are similar to those of arc magmas. Furthermore, the diorites have low (87Sr/86Sr) i compositions, fairly variable ε Nd (t) values and positive ε Hf (t) values, corresponding to 0.70604 to 0.70720, −7.8 to +2.6 and +4.5 to +8.0, respectively. These diorites have relatively young Sm– Nd and Hf model ages of 1564 to 721 Ma and 955 to 619 Ma, respectively. The whole-rock Pb isotopes show a narrow range. These isotopic data suggest that the parental magma was sourced mainly from juvenile crustal components, followed by assimilation and fractional crystallization in the crust with limited concomitant input of ancient crustal materials during magma ascent. In the Late Jurassic, the Great Hinggan Range was under compression due to the closure of the Mongol–Okhotsk Ocean, while in the Early Cretaceous, it was under extension related to the influence of the Paleo-Pacific plate. Based on the geochemical evidence and regional geodynamic evolution, we conclude that the formation of the Erdaohe deposit was associated with Paleo-Pacific plate subduction. [Display omitted] • The ore-related diorites from the Erdaohe deposit were emplaced at 145–142 Ma. • The ore-related diorites show an affinity with arc magmas. • The diorites were derived from partial melting of the juvenile lower crust. • The Erdaohe deposit was associated with the subduction of the Paleo-Pacific plate. [ABSTRACT FROM AUTHOR]

Soil dissolved organic matter (DOM) is crucial to atmospheric, terrestrial and aquatic environments as well as human life. Here, by characterizing DOM from 89 grassland soils throughout China, we reveal the spatial association between DOM geochemistry in the dry season vs annual ecosystem exchange and cancer cases. The humic-like and high molecular weight (3.4-25 kDa) fractions with lower biodegradability, decline from the northern to the southern regions of China, and are correlated with lower soil respiration and net ecosystem productivity at the continental scale. The <1.2 kDa and proteinaceous fractions could serve as a geographical indicator of nasopharyngeal cancer incidence and mortality, while the 3.4-25 kDa and humified fractions are potentially associated with pancreatic cancer cases (P < 0.05). Our findings highlight that exploiting the environmental functions of soil DOM and mitigating the negative impacts are necessary, and require actions tailored to local soil DOM conditions., (© 2024. The Author(s).)

Terrestrial dissolved organic matter (DOM) is critical to global carbon and nutrient cycling, climate change, and human health. However, how the spatial and compositional differences of soil DOM affect its dynamics and fate in water during the carbon cycle is largely unclear. Herein, the biodegradation of DOM from 14 spatially distributed grassland soils in China with diverse organic composition was investigated by 165 days of incubation experiments. The results showed that although the high humified fraction (high-HS) regions were featured by high humic-like fractions of 4-25 kDa molecular weight, especially the abundant condensed aromatics and tannins, they unexpectedly displayed greater DOM degradation during 45-165 days. In contrast, the unique proteinaceous and 25-100 kDa fractions enriched in the low humified fraction (low-HS) regions were drastically depleted and improved the decay of bulk DOM but only during 0-45 days. Together, DOM from the high-HS regions would cause lower CO 2 outgassing to the atmosphere but higher organic loads for drinking water production in the short term than that from the low-HS regions. However, this would be reversed for the two regions during the long-term transformation processes. These findings highlight the importance of spatial and temporal variability of DOM biogeochemistry to mitigate the negative impacts of grassland soil DOM on climate, waters, and humans.

Lung cancer is the malignant tumor with the highest morbidity and mortality in China. Non-small cell lung cancer (NSCLC) is the main pathological subtype of lung cancer. On April 13, 2023, the National Comprehensive Cancer Network (NCCN) released the third edition of the 2023 NCCN Oncology Clinical Practice Guidelines: Non-small Cell Lung Cancer, which reflects the latest advances in international lung cancer research. This article will interpret the main updated contents of the new edition of the guidelines, and compare it with the third edition of the NCCN guidelines in 2022, so as to provide references about the diagnosis and treatment of NSCLC for clinical medical personnel in China.
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Phthalates have been shown to have adverse effects on neurodevelopment, which may be gender-specific. However, the association between prenatal mixed exposure to phthalates and children's neurodevelopment remains inconsistent. We measured 15 prenatal serum phthalate levels and evaluated children's neurodevelopmental indicators using Gesell Developmental Schedule (GDS) (n = 750). Generalized linear regression was fitted to examine the association. Among boys, mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP) had adverse effects on gross motor [odds ratio (OR): 7.38, 95% confidence interval (CI):1.42, 38.46]. For gross motor in boys, joint effect was discovered between mono-2-ethylhexyl phthalate (MEHP) and MEHHP. Moreover, synergistic effects were found for MEHP with vanadium and cadmium, and antagonistic effects for MEHP with magnesium, calcium, titanium, iron, copper, selenium, rubidium, and strontium. We did not find statistically significant relationships in girls. In the 1st trimester, adverse effects were identified between mono-2-ethyl-5-oxoyhexyl phthalate (MEOHP) and adaptation (P = 0.024), and monomethyl phthalate (MMP) with social area (P = 0.017). In the 2nd trimester, MEHHP had adverse effects on social area (P = 0.035). In summary, we found boys may be more vulnerable to the neurotoxicity than girls in gross motor, and we also discovered the detrimental effects of phthalates on children's neurodevelopment in the 1st and 2nd trimesters. Therefore, the supplementation of appropriate elements in the 1st and 2nd trimesters may help reduce the adverse effects of phthalates on children's neurodevelopment, especially among boys., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Impaired neurodevelopment of children has become a growing public concern; however, the associations between metals exposure and neurocognitive function have remained largely unknown., Objectives: We systematically evaluated the associations of multiple metals exposure during pregnancy and childhood on the neurodevelopment of children aged 2-3 years., Methods: We measured 22 metals in the serum and urine among703 mother-child pairs from the Guangxi Birth Cohort Study. The neurocognitive development of children was assessed by the Gesell Development Diagnosis Scale (GDDS; Chinese version). Multiple linear regression models were used to evaluate the relationship between the metals (selected by elastic net regression) and the outcomes. The Bayesian kernel machine regression (BKMR) was used to evaluate the possible joint effect between the multiple metal mixture and the outcomes., Results: Prenatal aluminum (Al) exposure was negatively associated with the fine motor developmental quotient (DQ) (β = -1.545, 95%CI: 2.231, -0.859), adaption DQ (β = -1.182, 95%CI: 1.632, -0.732), language DQ (β = -1.284, 95% CI: 1.758, -0.809), and social DQ (β = -1.729, 95% CI: 2.406, -1.052) in the multi-metal model. Prenatal cadmium (Cd) exposure was negatively associated with gross motor DQ (β = -2.524, 95% CI: 4.060, -0.988), while postpartum Cd exposure was negatively associated with language DQ (β = -1.678, 95% CI: 3.227, -0.129). In stratified analyses, infants of different sexes had different sensitivities to metal exposure, and neurobehavioral development was more significantly affected by metal exposure in the first and second trimester. BKMR analysis revealed a negative joint effect of the Al, Cd, and selenium (Se) on the language DQ score; postpartum Cd exposure played a major role in this relationship., Conclusion: Prenatal exposure to Al, Ba, Cd, molybdenum (Mo), lead (Pb), antimony (Sb), and strontium (Sr), and postpartum exposure to cobalt (Co), Cd, stannum (Sn), iron (Fe), nickel (Ni), and Se are associated with neurological development of infants. The first and second trimester might be the most sensitive period when metal exposure affects neurodevelopment., (Copyright © 2021. Published by Elsevier Inc.)

Background: Hepatitis E, an acute zoonotic disease caused by the hepatitis E virus (HEV), has a relatively high burden in developing countries. The current research model on hepatitis E mainly uses experimental animal models (such as pigs, chickens, and rabbits) to explain the transmission of HEV. Few studies have developed a multi-host and multi-route transmission dynamic model (MHMRTDM) to explore the transmission feature of HEV. Hence, this study aimed to explore its transmission and evaluate the effectiveness of intervention using the dataset of Jiangsu Province., Methods: We developed a dataset comprising all reported HEV cases in Jiangsu Province from 2005 to 2018. The MHMRTDM was developed according to the natural history of HEV cases among humans and pigs and the multi-transmission routes such as person-to-person, pig-to-person, and environment-to-person. We estimated the key parameter of the transmission using the principle of least root mean square to fit the curve of the MHMRTDM to the reported data. We developed models with single or combined countermeasures to assess the effectiveness of interventions, which include vaccination, shortening the infectious period, and cutting transmission routes. The indicator, total attack rate (TAR), was adopted to assess the effectiveness., Results: From 2005 to 2018, 44 923 hepatitis E cases were reported in Jiangsu Province. The model fits the data well (R 2  = 0.655, P < 0.001). The incidence of the disease in Jiangsu Province and its cities peaks are around March; however, transmissibility of the disease peaks in December and January. The model showed that the most effective intervention was interrupting the pig-to-person route during the incidence trough of September, thereby reducing the TAR by 98.11%, followed by vaccination (reducing the TAR by 76.25% when the vaccination coefficient is 100%) and shortening the infectious period (reducing the TAR by 50.05% when the infectious period is shortened to 15 days)., Conclusions: HEV could be controlled by interrupting the pig-to-person route, shortening the infectious period, and vaccination. Among these interventions, the most effective was interrupting the pig-to-person route.

Tyrosine kinase inhibitors (TKIs) have improved the overall survival of patients with gastrointestinal stromal tumors (GISTs), but their side effects can impact dose intensity and, consequently, the clinical benefit. To date, no guideline or consensus has been published on the TKI-associated adverse reactions. Therefore, the Chinese Society of Surgeons for Gastrointestinal Stromal Tumor of the Chinese Medical Doctor Association organized an expert panel discussion involving representatives from gastrointestinal surgery, medical oncology, cardiology, dermatology, nephrology, endocrinology, and ophthalmology to consider the systemic clinical symptoms, molecular and cellular mechanisms, and treatment recommendations of GISTs. Here, we present the resultant evidence- and experience-based consensus to guide the management of TKI-associated side events in clinical practice., Competing Interests: Conflict-of-interest statement: All the authors report no conflicts of interest in this work.

Objective: To investigate the association between the prevalence of varicocele and benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) in elder man in China., Methods: A total of 831 BPH/LUTS outpatients who were 40 years or older were recruited. The patients' age, total prostatic volume (TPV), International Prostate Symptom Score, total prostate-specific antigen, nocturia, and body mass index were recorded. The presence and grade of varicocele were diagnosed by physical examination in combination with scrotal color Doppler., Results: The total prevalence of varicocele was 53.0%. The prevalence values of varicoceles in patients were 40-49, 50-59, 60-69, 70-79 years old, and 80 or above were 43.0%, 42.4%, 54.0%, 59.5%, and 64.0%, respectively. When comparing with varicocele grade, TPV (P  =  .002) was found to be significantly different. Nocturia frequencies increased significantly in patients with varicocele (P  <  .01). There were no difference in terms of International Prostate Symptom Score, total prostate-specific antigen, and body mass index between patients with no varicocele and with grades 1, 2, and 3 varicoceles (P  >  .05)., Conclusion: For elderly patients, the prevalence of varicocele shows an increasing trend with aging. Higher-grade varicoceles are associated with higher TPV and nocturia levels. Varicocele, which may be a factor that affects BPH/LUTS, cannot be overlooked., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background and Objective: Diagnostic modes may play an important role in treatments, but minimal information is available regarding their relationship in patients with lung cancer. This study may contribute to decision making in clinics and public health centers., Methods: The records of 505 hospitalized surgical patients with lung cancer at the Department of Thoracic Surgery, West China Hospital of Sichuan University from January 2013 to December 2013 were retrospectively reviewed. The patients were categorized into physical examination group (PEG, 131 patients) and symptomatic group (SG, 374 patients). Surgical approach, pathological stage, and diagnostic mode were analyzed., Results: Low-dose computed tomography (46.6%, 61/131) and computed radiography (51.1%, 67/131) were used as key diagnosis methods in 131 patients in PEG. The percentage of hospitalized surgical patients with lung cancer detected via physical examination in the city (35.4%, 80/229) was also significantly higher than in the township (18.1%, 50/276) (P<0.001). The ratio of stage I lung cancer detected via physical examination in the city (46.8%, 59/126) was significantly higher than that in the township (27.3%, 33/121) (P=0.001). The proportion of patients who underwent VATS lobectomy was significantly higher in PEG (73.3%, 96/131) than that in SG (44.4%, 166/374) (P<0.001), and the ratio of patients at stage I was significantly higher in PEG (70.2%, 92/131) than that in SG (41.4%, 155/374) (P<0.001)., Conclusions: The use of physical examination is more prevalent in cities than that in towns, and its combination with mini-invasive surgical treatment contributes to early diagnosis of patients with lung cancer.

Male infertility is a common and complex disease in urology and andrology, and for many years there has been no effective surgical treatment. With the emergence of microsurgery and assisted reproductive medicine (IVF/ICSI), rapid development has been achieved in the treatment of male infertility. The Center for Male Reproductive Medicine and Microsurgery at Weill Cornell Medical College of Cornell University has been playing an important leading role in developing microsurgical techniques for the management of male infertility. The development of microsurgical treatment of male infertility in China has experienced the 3 periods of emerging, making, and boosting ever since its systematic introduction from Weill Cornell Medical College 15 years ago. At present, many Chinese hospitals have adopted microsurgery in the management of male infertility, which has contributed to the initial establishment of a microsurgical treatment system for male infertility in China. However, some deficiencies do exist concerning microsurgical treatment of male infertility, as in normalized technical training programs for competent surgeons, unified criteria for evaluation of surgical outcomes, and detailed postoperative follow-up data. This article presents an overview on the 15-year development of microsurgical management of male infertility in China, points out the existing deficiencies, and offers some propositions for the promotion of its development.

Objective: To investigate the status of simulation education of anesthesiology in China., Methods: Five hundreds questionnaires were mailed to chairmen of department of anesthesiology in teaching hospitals in 29 provinces and autonomous regions in China. The retrieved questionnaires and data were processed and analyzed with statistics., Results: Sixty one questionnaires were retrieved, and retrieved rate is 12.2%. The result indicated that the theory and knowledge of anesthesiology was adopted for the training of medical students and residents in 2% teaching hospitals, theory and knowledge of anesthesiology combined with problem-based learning discussion in 52% teaching hospitals, theory and knowledge of anesthesiology combined with problem-based learning discussion and simulation training in 46% teaching hospitals. The order of simulation devices possessed was as follows: Basic Life Support (BLS) (79.6%), training model for clinical anesthesia techniques (53.1%) and Advances Life Support (ALS) (51.0%). There were only six teaching hospitals utilized Human Patient Simulator for anesthesia training. The result of evaluation of simulation education showed that 91.2% anesthesiologists recognized it as applicable, 90.1% anesthesiologists recognized it as medical ethic requirement and 86.0% anesthesiologists recognized it as partly close to clinical situation. The degree of cognition of anesthesiologists to simulation education was ordered as follows: manipulation correcting ability (92.6%), procedure controllability (87.0%), training adjustability (76.0%) and patients safety (68.5%)., Conclusion: The simulation education of anesthesiology in China is still in the preliminary period. The executive departments of education should enhance supports to the simulation education in both hard ware and in soft ware.

Objective: Standardization of and training in adult male circumcision can significantly reduce its complication rate. Currently no such program exists for its standardization and training, making it difficult to guarantee the quality of male circumcision services. We therefore established a standardized surgical protocol for adult male circumcision in China using the Shang Ring, and applied it to a clinical study examining the performance of the Shang Ring in adult male circumcision., Methods: A total of 328 adult men aged 18-58 (mean 27.8) years, 25 with phimosis and 303 with redundant prepuce, underwent circumcision with the Shang Ring, and evaluation of the operation time, pain scores (using the visual analog scale), postoperative complications, time for wound healing, and their satisfaction with the postoperative appearance., Results: The operation time was 4.7 +/- 1.3 minutes. The pain scores were 0. 2 +/- 0.6 during the surgery, 1.6 +/- 1.0 twenty hours postoperatively, 1.7 +/- 1.1 twenty hours prior to the ring removal, and 2.7 +/- 1.4 during the ring removal. Complications included infection in 2 (0.6%), bleeding in 2 (0.6%), and wound dehiscence in 2 (0.6%) of the patients. None of the patients with wound dehiscence required postoperative suturing and all were managed conservatively instead. Sixteen of the patients (4.9%) experienced penile edema. The time for complete wound healing after circumcision was 20.3 +/- 6.7 days. The rate of the patients'satisfaction was 99.7% (327/328)., Conclusion: The standard protocol of adult male circumcision with the Shang Ring has the advantages of short operation time, slight pain, low rate of complications, and high satisfaction and acceptance of the patients. Strict standardization of the surgical protocol can maximize its clinical advantages for adult male circumcision.

Although HIV is a significant problem in Africa, HIV infection rates are rising rapidly in other regions such as Asia and South America. International health organizations have recognized the need to develop effective strategies to check the worldwide transmission of HIV. Studies have demonstrated the significant reduction of HIV, HPV, HSV-2 and other STD infection rates with male circumcision (MC). Although numerous MC techniques are available, there are no standardized protocols and surgical training programs. Studies have shown that the standardization of MC techniques coupled with training programs can significantly reduce complication rates. High complication rates have been a primary obstacle to the implementation of MC services. We recommend the establishment of surgical standards and training protocols prior to the promotion of MC services in China.

Aim: To assess the psychometric properties of the Chinese Index of Premature Ejaculation (CIPE)., Methods: The sexual function of 167 patients with and 114 normal controls without premature ejaculation (PE) were evaluated with CIPE. All subjects were married and had regular sexual activity. The CIPE has 10 questions, focusing on libido, erectile function, ejaculatory latency, sexual satisfaction and difficulty in delaying ejaculation, self-confidence and depression. Each question was responded to on a 5 point Likert-type scale. The individual question score and the total scale score were analyzed between the two groups., Results: There were no significant differences between the age, duration of marriage and educational level (P> 0.05) of patients with and without PE and normal controls. The mean latency of patients with PE and normal controls were 1.6 +/- 1.2 and 10.2 +/- 9.5 minutes, respectively. Significant differences between patients with (26.7 +/- 4.6) PE and normal controls (41.9 +/- 4.0) were observed on the total score of CIPE (P< 0.01). Using binary logistic regression analysis, PE was significantly related to five questions of the original measure. They are the so-called the CIPE-5 and include: ejaculatory latency, sexual satisfaction of patients and sexual partner, difficulty in delaying ejaculation, anxiety and depression. Receiver Operating Characteristic (ROC) curve analysis of CIPE-5 questionnaire indicated that the sensitivity and specificity of CIPE were 97.60 % and 94.74 %, respectively. Employing the total score of CIPE-5, patients with PE could be divided into three groups: mild (>15 point) 19.8 %, moderate (10-14 point) 62.8 % and severe (< 9 point) 16.7 %., Conclusion: The CIPE-5 is a useful method for the evaluation of sexual function of patients with PE and can be used as a clinical endpoint for clinical trials studying the efficacy of pharmacological intervention.