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Improving the digital citizenship of secondary vocational students is critical for cultivating vocational talents in education. It is an inevitable requirement for modernizing vocational education. Focusing on social media competence, this study explores possible ways to improve the digital citizenship of secondary vocational students. A total of 469 secondary vocational students in Wuhan city, Hubei province, were investigated using questionnaires. The data analysis shows that the four dimensions of social media competence (technical use, content interpretation, content generation, and anticipatory reflection) significantly predict digital citizenship. On this basis, we propose four paths for improving the digital citizenship of secondary vocational students: creating a suitable environment for secondary vocational students to apply their skills in information technology; enhancing the ability of secondary vocational students to discriminate about information on the Internet; improving students' interpersonal communication ability when dealing with technical support; building an early warning system for secondary vocational students' behavioral perception.

The rapid integration of social media into personal, professional, and educational settings has catalyzed the need to assess social media competence. This study provides the rationale for developing an instrument to conduct such an assessment, and the research illustrates evidence of validity and reliability in assessing social media competence in the field of higher education. The instrument includes 28 items and 4 dimensions: technical usability, content interpretation, content generation, and anticipatory reflection. Data were collected from a sample of 622 college students. Exploratory and confirmatory factor analyses were conducted, and this study finds that the instrument shows no signs of deficiency in its validity or reliability when measuring social media competence. Accordingly, the instrument could be used to evaluate and improve levels of social media competence in higher education.

Based on an extensive literature review, in this study we proposed a model of influencing factors that affect teachers' intention to adopt mobile devices in teaching. An online survey questionnaire was developed to investigate K-12 teachers' intention to adopt mobile devices in teaching and the influencing factors of that intention. Partial least squares (PLS) was employed to validate the proposed model and hypotheses using data collected from 132 primary and secondary school teachers. Results showed that teachers' attitude and technology beliefs, and their self-efficacy regarding mobile-based teaching had significant positive impacts on their intention to adopt mobile devices in teaching. Meanwhile, teachers' mobile device skills and mobile-based pedagogical knowledge strongly influenced their self-efficacy of mobile device-based teaching. Finally, the subject culture clash had a significant negative influence on teachers' attitudes, technology beliefs, and self-efficacy toward mobile-based teaching. Based on these findings, we put forward a number of suggestions to promote teaching using mobile devices.

The Internet, new media and social change have created issues requiring digital citizenship education, particularly within the socio-cultural context of Chinese education. Recent digital citizenship standards for education developed by organizations such as the International Society for Technology in Education (ISTE) highlight the importance of this issue. Researchers have explored digital citizenship with some mediated behavioral determinants; however, the critical influence of interpersonal communication competence (ICC) has not yet been explored. To expand understanding of the components needed for improving the appropriateness of digital citizenship among future role models of society, this study investigates the relationship between ICC skills and digital citizenship with a sample of 905 pre-service teachers. The results showed that 10 ICC skills were positively predictive of digital citizenship. Environmental control and immediacy were found to be the strongest predictors of digital citizenship among the skills examined. These results theoretically emphasize the importance of ICC skills in mediated behavior and provide practical direction for improving pre-service teachers' digital citizenship, which can positively enable the behavior instructors display and convey to their future students.

Neuromyelitis optica spectrum disorders (NMOSDs) are most common in anti-aquaporin 4 (AQP4) antibody positive NMOSDs, which are characterized by recurrent episodes of optic neuritis and myelitis, etc., and severely reduce the quality of life. In recent years, new insights into the diagnostic techniques, diagonstic markers, and immunotherapy of anti-AQP4 antibody positive NMOSDs have continued to emerge, and here we focus on synthesizing new advances in the diagnostic techniques and diagonstic markers of anti-AQP4 antibody positive NMOSDs and the most recent recommendations for its treatment, in hopes of summarizing to promote the understanding and application of new diagnostic and therapeutic techniques for anti-AQP4 antibody positive NMOSDs in China, and to explore more possible clinical diagnostic and therapeutic approaches. [ABSTRACT FROM AUTHOR]

Objective To preliminarily summarize the epidemiological and clinical characteristics of functional movement disorder (FMD) based on movement disorders clinic in China. Methods and Results A total of 593 patients with movement disorders newly diagnosed in movement disorders clinic of 22 clinical medical centers from August to September in 2023 were included, including 37 patients (6.24%) with FMD and 556 patients (93.76%) with organic movement disorder. Comparison of the epidemiological characteristics of the 2 groups, the proportions of corona virus disease (COVID-19) infection (χ² = 4.217, P = 0.040) and psychopsychological symptoms (χ² = 18.694, P = 0.000) in the FMD group were higher than those in the organic movement disorder group, while age (t = 3.757, P = 0.000), age of onset (t = 3.720, P = 0.000) and proportion of hypertension (χ² = 4.736, P = 0.030) were lower than those in the organic movement disorder group. Comparison of the clinical characteristics of the 2 groups, the FMD group had higher proportions of tremor (χ² = 3.955, P = 0.047) and myoclonus (Fisher's exact probability: P = 0.011) than the organic movement disorder group, and the proportions of parkinsonism (χ² = 8.491, P = 0.004) and gait disorder (χ² = 5.028, P = 0.025) were lower than those in the organic movement disorder group. Conclusions The age and age of onset, as well as the proportions of COVID-19 infection, hypertension, psychopsychological symptoms, tremor, myoclonus, parkinsonism and gait disorder with FMD were different from those with organic movement disorder in China. [ABSTRACT FROM AUTHOR]

The global emergence of new media and social change have drawn attention to the topic of digital citizenship. Previous literature has examined individuals' digital citizenship with some determinants of technology use. However, individuals' level of social media competence (SMC) has not yet been examined in relation to digital citizenship. To increase knowledge of the ingredients that may be important for education programs to improve individuals' digital citizenship, this study examined SMC and digital citizenship among 772 college students. The results identified that five of the six social media competencies examined were predictors of individuals' digital citizenship. These findings provided empirical evidence of a relationship between SMC and digital citizenship, which should be considered by researchers and practitioners when formalizing educational programs, developing curricula, and designing pedagogy for improving individuals' digital citizenship. [ABSTRACT FROM AUTHOR]

The Internet, new media and social change have created issues requiring digital citizenship education, particularly within the socio-cultural context of Chinese education. Recent digital citizenship standards for education developed by organizations such as the International Society for Technology in Education (ISTE) highlight the importance of this issue. Researchers have explored digital citizenship with some mediated behavioral determinants; however, the critical influence of interpersonal communication competence (ICC) has not yet been explored. To expand understanding of the components needed for improving the appropriateness of digital citizenship among future role models of society, this study investigates the relationship between ICC skills and digital citizenship with a sample of 905 pre-service teachers. The results showed that 10 ICC skills were positively predictive of digital citizenship. Environmental control and immediacy were found to be the strongest predictors of digital citizenship among the skills examined. These results theoretically emphasize the importance of ICC skills in mediated behavior and provide practical direction for improving pre-service teachers' digital citizenship, which can positively enable the behavior instructors display and convey to their future students. [ABSTRACT FROM AUTHOR]

[Display omitted] • Ore deposits in the Gejiu superlarge tin polymetallic district, China, were studied. • The mineralization of chalcopyrite was simulated using the finite-element method. • The hydrothermal flow is one of the key factors affecting the mineralization. • The pore fluid flow is driven by the temperature gradient. • Favorable metallogenic areas are located at intersections between structural units. The Gejiu superlarge tin polymetallic mining area in Yunnan hosts the largest tin-copper polymetallic ore field worldwide. The output of tin and copper provides power for the development of the country. Therefore, the study of mineralization is very important. But the geological structure is diverse, and the mineralization of different geological structures is different. In this study, the geological characteristics, tectonics, mineralogy, and geochemistry of these typical magmatic hydrothermal deposits were analyzed, various geological structures are studied, and the finite-element method was used to simulate the mineralization of chalcopyrite in the study area. Finally, the results are validated against the instance area. The numerical results show that the hydrothermal flow is the main factor controlling the mineralization. The pore fluid flow is driven by the temperature gradient. Favorable metallogenic areas are located in faults, between horizontal strata, and at intersections of faults. In the future, by simulating the metallogenic region and studying the metallogenic structure, the locations of ore bodies can be predicted. Our research confirms the results of the coupled model in the field of emerging computational geoscience and provides insights into the mineralization process. [ABSTRACT FROM AUTHOR]

Background: Cisplatin-based adjuvant chemotherapy is the standard of care for patients with resected stage II-IIIA non-small-cell lung cancer (NSCLC). RADIANT and SELECT trial data suggest patients with EGFR-mutant stage IB-IIIA resected NSCLC could benefit from adjuvant EGFR tyrosine kinase inhibitor treatment. We aimed to compare the efficacy of adjuvant gefitinib versus vinorelbine plus cisplatin in patients with completely resected EGFR-mutant stage II-IIIA (N1-N2) NSCLC.Methods: We did a randomised, open-label, phase 3 trial at 27 centres in China. We enrolled patients aged 18-75 years with completely resected (R0), stage II-IIIA (N1-N2), EGFR-mutant (exon 19 deletion or exon 21 Leu858Arg) NSCLC. Patients were stratified by N stage and EGFR mutation status and randomised (1:1) by Pocock and Simon minimisation with a random element to either gefitinib (250 mg once daily) for 24 months or intravenous vinorelbine (25 mg/m2 on days 1 and 8) plus intravenous cisplatin (75 mg/m2 on day 1) every 3 weeks for four cycles. The primary endpoint was disease-free survival in the intention-to-treat population, which comprised all randomised patients; the safety population included all randomised patients who received at least one dose of study medication. Enrolment to the study is closed but survival follow-up is ongoing. The study is registered with ClinicalTrials.gov, number NCT01405079.Findings: Between Sept 19, 2011, and April 24, 2014, 483 patients were screened and 222 patients were randomised, 111 to gefitinib and 111 to vinorelbine plus cisplatin. Median follow-up was 36·5 months (IQR 23·8-44·8). Median disease-free survival was significantly longer with gefitinib (28·7 months [95% CI 24·9-32·5]) than with vinorelbine plus cisplatin (18·0 months [13·6-22·3]; hazard ratio [HR] 0·60, 95% CI 0·42-0·87; p=0·0054). In the safety population, the most commonly reported grade 3 or worse adverse events in the gefitinib group (n=106) were raised alanine aminotransferase and asparate aminotransferase (two [2%] patients with each event vs none with vinorelbine plus cisplatin). In the vinorelbine plus cisplatin group (n=87), the most frequently reported grade 3 or worse adverse events were neutropenia (30 [34%] patients vs none with gefitinib), leucopenia (14 [16%] vs none), and vomiting (eight [9%] vs none). Serious adverse events were reported for seven (7%) patients who received gefitinib and 20 (23%) patients who received vinorelbine plus cisplatin. No interstitial lung disease was noted with gefitinib. No deaths were treatment related.Interpretation: Adjuvant gefitinib led to significantly longer disease-free survival compared with that for vinorelbine plus cisplatin in patients with completely resected stage II-IIIA (N1-N2) EGFR-mutant NSCLC. Based on the superior disease-free survival, reduced toxicity, and improved quality of life, adjuvant gefitinib could be a potential treatment option compared with adjuvant chemotherapy in these patients. However, the duration of benefit with gefitinib after 24 months might be limited and overall survival data are not yet mature.Funding: Guangdong Provincial Key Laboratory of Lung Cancer Translational Medicine; National Health and Family Planning Commission of People's Republic of China; Guangzhou Science and Technology Bureau; AstraZeneca China. [ABSTRACT FROM AUTHOR]

Objective: To examine the epidemiology of sleep problems and insomnia among the community older individuals in Hebei Province, China, and to investigate the potential sociodemographic and clinical correlates and medication use.Methods: This cross-sectional study was conducted with community adults, aged 60 years or older, who resided in four major cities in Hebei province. Basic sociodemographic and clinical data were collected and analyzed. A total of 3176 older adults (1292 men, 70.2 ± 6.8 years; 1884 women, 68.8 ± 6.7 years) were interviewed. All of the participants were interviewed with a standardized questionnaire and underwent insomnia screening.Results: The prevalence of insomnia was 37.75%. The most common type of sleep disturbance was difficulty maintaining sleep, followed by difficulty initiating sleep and early morning awakening. Never smoking, experiencing the loss of a parent, a history of coronary heart disease, and depression symptoms were independent risk factors for insomnia in men. Occasional drinking was an independent protective factor against insomnia in men. Older age, depression symptoms, a history of cerebral hemorrhage, hyperlipidemia, living without a spouse, and having mild cognitive impairment were independent risk factors for insomnia in women. Only 11.1% of the sample with insomnia were taking sleeping medications regularly.Conclusion: Insomnia is highly prevalent among the community older population in Hebei Province. The percentage of individuals regularly taking sleeping medication is low among those with insomnia. Individuals with complaints of insomnia frequently have poor physical and mental health and may need more medical attention. Comprehensive measures that involve psychosocial and personal behaviors should be implemented to alleviate insomnia in older individuals. [ABSTRACT FROM AUTHOR]

• Approximately 8.6% sampled Chinese children have a blood lead level (BLL) > 50 µg/L. • Rural children are more vulnerable compared to urban children (29.2 vs 26.5 μg/dL). • Rural IQ points loss is four times that of urban areas (144 million vs. 36 million points). • Coal and biomass fuel combustion is contributing to BLLs, especially for rural areas. • The guideline of children's BLLs should be strengthened. Despite the global abundance of studies on children's lead (Pb) exposure, the magnitude of Pb exposure among children across China remains unclear, especially for rural areas. In 2000, Pb was removed from petrol, marking a change in the sources of Pb exposure in China. To better understand children's Pb exposure and inform potential approaches to exposure reduction, we conducted a national blood Pb survey of 31,373 children (0–84 months old) from May 2013 to March 2015, using a multi-stage and multi-strata sampling method. Blood lead levels (BLLs) were tested using graphite furnace atomic absorption spectrometry with a detection limit of 1 µg/L. The results show that Chinese children had a contemporary geometric mean (GM) BLL of 26.7 μg/L, with 8.6% of BLLs exceeding 50 µg/L. Boys had higher BLLs (GM 27.2 μg/L) compared to girls (GM: 25.9 μg/L) (p < 0.001). Children at the age of 0–36 months had a lower PbB (GM 25.7 μg/L) level compared with those aged 36–84 months (GM 27.9 μg/L) (p < 0.001). When taking into account sociodemographic factors, a multivariate logistic regression analysis shows that the odds ratios (OR) of having a BLL of 27 µg/dL (i.e., median BLL of this study) or higher were 1.88 (95% CI: 1.76, 2.02) and 1.35 (95% CI: 1.22, 1.49) for homes using coal and biomass fuels, respectively, compared to those using gas or electricity. Meanwhile, children in homes close to roads were more likely to have BLLs exceeding 27 µg/dL (OR: 1.11, 95% CI: 1.03, 1.20). In China, rural children had higher BLLs compared to urban children. As a result of pediatric exposure to Pb, there were approximately 144 million and 36 million IQ points lost for rural children and urban children, respectively, revealing a disparity of Pb exposure between rural and urban areas in China. Cleaner domestic fuels and improved cooking/heating equipment will reduce contemporary Pb exposure in rural areas. In addition, the association between contemporary BLLs and distance away from roads further suggests that resuspension of legacy soil/dust Pb should not be neglected in future remediation programs and household interventions. As a large scale survey, this study provides evidence for revising the reference value of BLL, improving the guideline for clinical and public health management, and implementing interventions to prevent adverse health outcomes associated with low-level Pb exposure in children. [ABSTRACT FROM AUTHOR]

Porcine orthoreoviruses belong to the family Reoviridae and cause mainly mild enteritis in piglets. We present here the complete genome sequence of a novel porcine orthoreovirus strain (GD-1) isolated from a piglet in southern China. Our data will facilitate future investigations of the molecular characteristics and epidemiology of porcine orthoreoviruses. [ABSTRACT FROM AUTHOR]

Competing Interests: Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare. This work was supported by the National Natural Science Foundation of China (42077398).

Evidence has shown that risks of cognitive impairment differ between genders. This cross-sectional study sought to determine the prevalence of mild cognitive impairment (MCI) in Chinese community-dwelling women aged above 60 years and identify risks of MCI by multivariate logistic regression analysis. Totally, 1760 Chinese community-dwelling women entered the study. Cognitive function was assessed with Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). MCI was diagnosed by Petersen's criteria. Sociodemographic information, past medical conditions, and age at menopause were screened. The primary study outcome was prevalence of MCI. MCI was diagnosed in 378 (21.5%) women. Older age was a significant risk of MCI (OR 1.621, 95%CI 1.386-1.894; P < 0.001). Low education was associated a 4-fold increase in the risk of MCI (OR 4.036, 95%CI 3.168-5.142). Furthermore, current depression was associated with 2.6-fold increase in the risk of MCI (OR 2.618, 95%CI 1.499-4.587, P = 0.001). Moreover, frequent physical exercise and more leisure and social time activities were associated with significantly reduced risks of MCI, while poor financial status was associated with a significantly increased risk of MCI. Slightly more than 20% of Chinese women aged above 60 years had MCI, and independent risks included older age, low education status, and current depression, highlighting the importance of screening for and removing or minimizing risks of MCI in this specific population., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

In response to coronavirus disease 2019 (COVID-19), the Shanghai Burn Clinical Quality Control Center organized experts to formulate and implement a set of rapid, simple, and effective prevention and control measures, and there have not been any cases of health care professionals or inpatients in burn units suspected or confirmed with COVID-19. This article elaborates on the specific measures in burn units in response to the epidemic, including the implementation of standardized procedures, remote consultations, strengthened follow-up, exchange of experience, and popular science, among others. We share experience from Shanghai to benefit related disciplines in other countries and regions., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Wuhan was the first epicentre of COVID-19 in the world, accounting for 80% of cases in China during the first wave. We aimed to assess household transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and risk factors associated with infectivity and susceptibility to infection in Wuhan., Methods: This retrospective cohort study included the households of all laboratory-confirmed or clinically confirmed COVID-19 cases and laboratory-confirmed asymptomatic SARS-CoV-2 infections identified by the Wuhan Center for Disease Control and Prevention between Dec 2, 2019, and April 18, 2020. We defined households as groups of family members and close relatives who did not necessarily live at the same address and considered households that shared common contacts as epidemiologically linked. We used a statistical transmission model to estimate household secondary attack rates and to quantify risk factors associated with infectivity and susceptibility to infection, accounting for individual-level exposure history. We assessed how intervention policies affected the household reproductive number, defined as the mean number of household contacts a case can infect., Findings: 27 101 households with 29 578 primary cases and 57 581 household contacts were identified. The secondary attack rate estimated with the transmission model was 15·6% (95% CI 15·2-16·0), assuming a mean incubation period of 5 days and a maximum infectious period of 22 days. Individuals aged 60 years or older were at a higher risk of infection with SARS-CoV-2 than all other age groups. Infants aged 0-1 years were significantly more likely to be infected than children aged 2-5 years (odds ratio [OR] 2·20, 95% CI 1·40-3·44) and children aged 6-12 years (1·53, 1·01-2·34). Given the same exposure time, children and adolescents younger than 20 years of age were more likely to infect others than were adults aged 60 years or older (1·58, 1·28-1·95). Asymptomatic individuals were much less likely to infect others than were symptomatic cases (0·21, 0·14-0·31). Symptomatic cases were more likely to infect others before symptom onset than after (1·42, 1·30-1·55). After mass isolation of cases, quarantine of household contacts, and restriction of movement policies were implemented, household reproductive numbers declined by 52% among primary cases (from 0·25 [95% CI 0·24-0·26] to 0·12 [0·10-0·13]) and by 63% among secondary cases (from 0·17 [0·16-0·18] to 0·063 [0·057-0·070])., Interpretation: Within households, children and adolescents were less susceptible to SARS-CoV-2 infection but were more infectious than older individuals. Presymptomatic cases were more infectious and individuals with asymptomatic infection less infectious than symptomatic cases. These findings have implications for devising interventions for blocking household transmission of SARS-CoV-2, such as timely vaccination of eligible children once resources become available., Funding: National Natural Science Foundation of China, Fundamental Research Funds for the Central Universities, US National Institutes of Health, and US National Science Foundation., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Purpose: ADJUVANT-CTONG1104 (ClinicalTrials.gov identifier: NCT01405079), a randomized phase III trial, showed that adjuvant gefitinib treatment significantly improved disease-free survival (DFS) versus vinorelbine plus cisplatin (VP) in patients with epidermal growth factor receptor ( EGFR ) mutation-positive resected stage II-IIIA (N1-N2) non-small-cell lung cancer (NSCLC). Here, we report the final overall survival (OS) results., Methods: From September 2011 to April 2014, 222 patients from 27 sites were randomly assigned 1:1 to adjuvant gefitinib (n = 111) or VP (n = 111). Patients with resected stage II-IIIA (N1-N2) NSCLC and EGFR -activating mutation were enrolled, receiving gefitinib for 24 months or VP every 3 weeks for four cycles. The primary end point was DFS (intention-to-treat [ITT] population). Secondary end points included OS, 3-, 5-year (y) DFS rates, and 5-year OS rate. Post hoc analysis was conducted for subsequent therapy data., Results: Median follow-up was 80.0 months. Median OS (ITT) was 75.5 and 62.8 months with gefitinib and VP, respectively (hazard ratio [HR], 0.92; 95% CI, 0.62 to 1.36; P = .674); respective 5-year OS rates were 53.2% and 51.2% ( P = .784). Subsequent therapy was administered upon progression in 68.4% and 73.6% of patients receiving gefitinib and VP, respectively. Subsequent targeted therapy contributed most to OS (HR, 0.23; 95% CI, 0.14 to 0.38) compared with no subsequent therapy. Updated 3y DFS rates were 39.6% and 32. 5% with gefitinib and VP ( P = .316) and 5y DFS rates were 22. 6% and 23.2% ( P = .928), respectively., Conclusion: Adjuvant therapy with gefitinib in patients with early-stage NSCLC and EGFR mutation demonstrated improved DFS over standard of care chemotherapy. Although this DFS advantage did not translate to a significant OS difference, OS with adjuvant gefitinib was one of the longest observed in this patient group compared with historic data.

The progression of lung adenocarcinoma through lymph node metastasis has been well established; however, the process of segmental lymph node (LSN) metastasis in cT1N0M0 lung adenocarcinoma remains unclear. We aimed to elucidate the markers of lymph node metastasis to different segments in early-stage lung adenocarcinoma and identify new indications for segmentectomy. A total of 200 patients were enrolled in this study. These patients were diagnosed with cT1N0M0 lung adenocarcinoma after positron emission tomography/computed tomography and received lobectomy and lymph node dissection surgeries. Lymph nodes retrieved from each station were sorted. The metastatic status of the isolated (i) LSNs and several characteristics were analyzed. Patients with ground-glass nodules (GGNs) ( P =0.025), AIS/MIA/lepidic adenocarcinoma ( P =0.038), nodules with a maximum diameter ≤1 cm ( P =0.017), maximum standardized uptake value (SUV max ) < 2.5 ( P =0.029), serum carcinoembryonic antigen (CEA) levels ≤4.5 ng/ml ( P =0.036), and no N1 lymph nodes metastasis ( P =0.036) had significantly lower iLSN metastasis rates than those without these characteristics. Pure GGNs, CEA levels ≤4.5 ng/ml, SUV max  < 2.5, tumors with a maximum diameter of ≤1 cm, or those confirmed to be adenocarcinoma in situ , minimally invasive adenocarcinoma, or invasive lepidic-predominant adenocarcinoma by frozen section may indicate segmentectomy. However, segmentectomy is not suitable for patients with metastasis to the N1 lymph nodes., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Guanghao Sun et al.)

Background: Experimental studies have demonstrated that cadmium exposure induces alterations on immune function, but epidemiological evidence is lacking., Objective: To examine the associations between prenatal and postnatal cadmium exposure and cellular immune responses among pre-school children., Methods: Pre-school aged children (n = 407) were followed from a prospective birth cohort study in Wuhan, China. Maternal urinary and children's plasma cadmium concentrations were measured as biomarkers of prenatal and postnatal cadmium exposure, respectively. Children's cellular immune responses were assessed by peripheral blood T lymphocyte subsets and plasma cytokines. Multivariable adjusted models were applied to estimate the associations of prenatal and postnatal cadmium exposure with T lymphocyte subsets and cytokines, and the effect modification by child gender were also examined., Results: Maternal urinary cadmium was associated with reduced absolute counts of CD3 + CD4 + cells (-12.45%; 95% CI: -23.74%, 0.40% for the highest vs. lowest quartile; p for trend = 0.045). Inverse associations of maternal urinary cadmium with %CD3 + CD4 + cells and CD4 + /CD8 + ratio were only observed among females (both p-interaction < 0.050); whereas an inverse association with absolute counts of CD3 + CD8 + cells was only observed among males (p-interaction = 0.057). Positive associations of maternal urinary cadmium with %CD3 + CD4 + cells, interleukin-4 (IL-4), and IL-6 were only observed among females, although there were no significant interactions. We observed no clear associations of children's plasma cadmium with T lymphocyte subsets and cytokines., Conclusion: Prenatal but not postnatal cadmium exposure was associated with sex-specific alterations on children's cellular immune responses., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This work focuses on the application of nanoindentation measurements and the finite element method for analyzing the mechanical properties of the rostrum of the outstanding driller Cyrtotrachelus buqueti Guer. Nanoindentation tests were carried out to measure the Young's modulus and hardness of the rostrum, with the results for the "dry" samples being 13.886 ± 0.75 and 0.368 ± 0.0445 GPa, respectively. The values for the "fresh" samples showed no clear difference from those of the "dry" ones. Moreover, field observation was conducted to determine the motion behaviors of the rostrum on the weevil. Micro-computed tomography technology was employed to obtain structural information about the rostrum, using 9 µm slices. A real three-dimensional model of the rostrum was created using the MIMICS application. Finally, the mechanical properties of the rostrum were determined by finite element analysis. It was concluded that the rostrum provides an ideal biological template for the design of biocomposite materials and lightweight tube-shaped structures. The properties determined in this study can potentially be applied in different fields, such as in the design of automotive hybrid transmission shafts, helicopter tail drive shafts, robotic arms, and other sandwich structures in aerospace engineering.

Introduction: Adjuvant gefitinib therapy prolonged disease-free survival in patients with resected early-stage EGFR-mutation positive NSCLC in the ADJUVANT study (CTONG 1104). However, treatment failure patterns after gefitinib therapy are less well characterized., Methods: Overall, 222 stage N1-N2, EGFR-mutant NSCLC patients received gefitinib or vinorelbine plus cisplatin (VP) treatment. Tumor recurrences or metastases occurring during follow-up were defined as treatment failure; sites and data of first treatment failure were recorded. A post hoc analysis of treatment failure patterns which was estimated by Kaplan-Meier and hazard rate curves in modified intention-to-treat patients was conducted., Results: There were 114 recurrences and 10 deaths before recurrence across 124 progression events. Spatial distribution analysis showed that the first metastasis site was most frequently the central nervous system in the gefitinib group (29 of 106 [27.4%]), extracranial metastases were most frequent in the VP group (32 of 87 [36.8%]). Temporal distribution analysis showed lower tumor recurrence with gefitinib than with VP 0 to 21 months post-surgery. However, recurrence with gefitinib showed a constant rate of increase 12 months post-surgery. The first peak of extracranial metastasis appeared during 9 to 15 months with VP and 24 to 30 months with gefitinib. The highest peak for central nervous system metastases post-surgery occurred after 12 to 18 months with VP and 24 to 36 months with gefitinib., Conclusions: Adjuvant gefitinib showed advantages over VP chemotherapy in treatment failure patterns especially in extracranial metastasis. Adjuvant tyrosine kinas inhibitors may be considered as a treatment option in resected stage N1-N2 EGFR-mutant NSCLC but longer duration should be explored., (Copyright © 2018 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)

Purpose: To identify risk factors for intestinal metaplasia in a southeastern Chinese population., Methods: Subjects who underwent upper GI endoscopy and endoscopic biopsy in the First Affiliated Hospital of Nanjing Medical University from 2008 to 2013 were included into this study. Various demographic, geographic, clinical and pathological data were analyzed separately to identify risk factors for intestinal metaplasia., Results: The incidence of intestinal metaplasia differed significantly in 17 municipal areas ranging from 16.79 to 38.56% and was positively correlated with the age range of 40-70 years, male gender, gastric ulcer, bile reflux, Helicobacter pylori infection, atrophic gastritis, dysplasia, gastric cancer, degree of chronic and acute inflammation, and gross domestic product per capita (P < 0.01). Multivariate linear regression analysis indicated that only gross domestic product per capita revealed a significant difference in the incidence of intestinal metaplasia among all factors mentioned., Conclusion: This study confirms age, male gender, gastric ulcer, bile reflux, H. pylori infection, severe degree of chronic and acute inflammation to be the risk factors for intestinal metaplasia. We speculate that the gross domestic product per capita of different areas may be a potential independent risk factor impacting the incidence of intestinal metaplasia.

SIRT6 has been demonstrated to exert protective effects on endothelial cells and is closely associated with lipid metabolism, glucose metabolism, and obesity, indicating an important role in the pathogenesis and progression of coronary artery disease (CAD). Nonetheless, the biological significance of SIRT6 variants on CAD is far to be elucidated. Here we aimed to investigate the influence of SIRT6 polymorphisms on individual susceptibility and severity of CAD. Multivariate logistic regression analysis exhibited no significant association between these five polymorphisms and CAD risk in the genotype and allele frequencies. However, we found that the rs352493 polymorphism in SIRT6 exhibited a significant effect on the severity of CAD; C allele (χ(2) = 7.793, adjusted P = 0.013) and the combined CC/CT genotypes (χ(2) = 5.609, adjusted P = 0.031) presented the greater CAD severity. In addition, A allele (χ(2) = 5.208, adjusted P = 0.046) and AA (χ(2) = 4.842, adjusted P = 0.054) of rs3760908 were also associated with greater CAD severity in Chinese subjects. Our data provided the first evidence that SIRT6 tagSNPs rs352493 and rs3760908 play significant roles in the severity of CAD in Chinese Han subjects, which might be useful predictors of the severity of CAD.

Introduction: Oesophageal cancer is the eighth most common cause of cancer worldwide. In 2009 in China, the incidence and death rate of oesophageal cancer was 22.14 per 100 000 person-years and 16.77 per 100 000 person-years, respectively, the highest in the world. Minimally invasive oesophagectomy (MIO) was introduced into clinical practice with the aim of reducing the morbidity rate. The mechanisms of MIO may lie in minimising the reaction to surgical injury and inflammation. There are some randomised trials regarding minimally invasive versus open oesophagectomy, with 100-850 subjects enrolled. To date, no large randomised controlled trial comparing minimally invasive versus open oesophagectomy has been reported in China, where squamous cell carcinoma predominated over adenocarcinoma of the oesophagus., Methods and Analysis: This is a 3 year multicentre, prospective, randomised, open and parallel controlled trial, which aims to compare the effectiveness of minimally invasive thoraco-laparoscopic oesophagectomy to open three-stage transthoracic oesophagectomy for resectable oesophageal cancer. Group A patients receive MIO which involves thoracoscopic oesophagectomy and laparoscopic gastric mobilisation with cervical anastomosis. Group B patients receive the open three-stage transthoracic oesophagectomy which involves a right thoracotomy and laparotomy with cervical anastomosis. Primary endpoints include respiratory complications within 30 days after operation. The secondary endpoints include other postoperative complications, influences on pulmonary function, intraoperative data including blood loss, operative time, the number and location of lymph nodes dissected, and mortality in hospital, the length of hospital stay, total expenses in hospital, mortality within 30 days, survival rate after 2 years, postoperative pain, and health-related quality of life (HRQoL). Three hundred and twenty-four patients in each group will be needed and a total of 648 patients will finally be enrolled into the study., Ethics and Dissemination: The study protocol has been approved by the Institutional Ethics Committees of all participating institutions. The findings of this trial will be disseminated to patients and through peer-reviewed publications and international presentations., Trial Registration Number: NCT02355249., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

SIRT1 exerts protective effects against endothelial cells dysfunction, inflammation and atherosclerosis, indicating an important role on myocardial infarction (MI) pathogenesis. Nonetheless, the effects of SIRT1 variants on MI risk remain poorly understood. Here we aimed to investigate the influence of SIRT1 polymorphisms on individual susceptibility to MI. Genotyping of three tagSNPs (rs7069102, rs3818292 and rs4746720) in SIRT1 gene was performed in a Chinese Han population, consisting of 287 MI cases and 654 control subjects. In a logistic regression analysis, we found that G allele of rs7069102 had increased MI risk with odds ratio (OR) of 1.57 [95% confidence interval (CI) = 1.15-2.16, Bonferroni corrected P (Pc) = 0.015] after adjustment for conventional risk factors compared to C allele. Similarly, the combined CG/GG genotypes was associated with the increased MI risk (OR = 1.64, 95% CI = 1.14-2.35, Pc = 0.021) compared to the CC genotype. Further stratified analysis revealed a more significant association with MI risk among younger subjects (≤ 55 years old). Consistent with these results, the haplotype rs7069102G-rs3818292A-rs4746720T containing the rs7069102 G allele was also associated with the increased MI risk (OR = 1.41, 95% CI = 1.09-1.84, Pc = 0.040). However, we did not detect any association of rs3818292 and rs4746720 with MI risk. Our study provides the first evidence that the tagSNP rs7069102 and haplotype rs7069102G-rs3818292A-rs4746720T in SIRT1 gene confer susceptibility to MI in the Chinese Han population.

Background: Di-(2-ethylhexyl) phthalate (DEHP) is a common plasticizer used in industrial and diverse consumer products. Animal studies indicate DEHP caused developmental, reproductive, and hepatic toxicities. However, human studies of the potential effects of DEHP are limited., Methods: The exposed site with a history of over 20 years of waste plastic recycling was located in Hunan Province, China. The reference site without known DEHP pollution source was about 50 km far away from the exposed site. In this study, 181 workers working in plastic waste recycling and 160 gender-age matched farmers were recruited. DEHP concentrations in water and cultivated soil samples, serum thyroid-stimulating hormone, malondialdehyde (MDA), superoxide dismutase (SOD), urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), and micronuclei frequency in human capillary blood lymphocytes were analyzed., Results: Mean levels of DEHP were greater in environment at the recycling site than at reference site (industry wastewater for the exposed: 42.43 μg/l; well water: 14.20 vs. 0.79 μg/l, pond water: 135.68 vs. 0.37 μg/l, cultivated soil: 13.07 vs. 0.81 mg/kg, p < 0.05 for all). The workers had higher median levels of MDA (3.80 vs. 3.14 nmol/ml) and urinary 8-OHdG (340.37 vs. 268.18 μmol/mol creatinine) and decreased SOD activities (112.15 vs. 123.82 U/ml) than the reference group (p < 0.01 for all). Multivariate analysis revealed that the history of working in waste plastic recycling was an independent risk factor for the increased urinary 8-OHdG levels in the male workers (p < 0.01)., Conclusions: The occupational DEHP exposure might contribute to oxidative deoxyribonucleic acid damage in the male workers.