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The aim of this study was to explore the relationship between serum uric acid (SUA) and the triglyceride-glucose (TyG) index, which is a more effective indicator of insulin resistance. The study participants included 1700 children and adolescents with short stature who were recruited at the Affiliated Hospital of Jining Medical University in China between March 2013 and April 2021. A positive association between SUA levels and the TyG index was detected by univariate analysis (p < 0.001). Furthermore, a nonlinear relationship was detected between SUA and the TyG index, whose point was 6.55 mg/dL. There was a positive association between SUA and the TyG index when the SUA level was greater than 6.55 mg/dL (β 0.17, 95% CI: 0.07, 0.27; P < 0.001). However, we did not observe a significant relationship between SUA and the TyG index when the SUA level was less than 6.55 mg/dL (β 0.02, 95% CI: − 0.01, 0.05; P = 0.091). In addition, a stratified analysis was performed to appraise changes in this relationship for different sexes. The relationship between SUA and the TyG index in males and females is consistent with that in the general population, showing a nonlinear relationship. However, the inflection points of SUA level were significantly higher in males than in females, and the inflection points were approximately 6.72 and 5.88 mg/dL, respectively. This study revealed a nonlinear relationship between SUA and the TyG index in children with short stature. The nonlinear relationship remained in gender stratification analysis, but the inflection point of SUA level was higher in men. Further studies are needed to establish a causal relationship between SUA levels and the TyG index in children with short stature. [ABSTRACT FROM AUTHOR]

The high-strain dynamic test method possesses the attributes of speed, efficiency, and environmentally-friendly, low-carbon characteristics. To study the reliability of the high-strain dynamic test method in detecting the bearing capacity of pile foundation in permafrost regions, 4 test piles, each with a length of 15 m and a diameter of 1.0 m, were poured based on the actual bridge construction project in the permafrost region of Daxing'an Mountains in China. Based on the temperature data between the piles and soil, the refreezing state of the pile foundation was comprehensively judged. Subsequently, the static method was employed to assess the friction resistance values and single pile bearing capacity of each soil layer on the pile side under different freezing states before and after the pile foundation refreezing. Building upon these findings, the restrictive parameters for soil elastic limit q (i) , soil resistance R U (i) and other parameters in the pile-soil model of high-strain dynamic test method are clarified. The test and analysis results indicate that under the condition that the ground temperature of frozen soil is about − 1.9 °C, the pile-soil refreezing takes about 120 days, and the pile-soil refreezing is a slow process; In CAPWAPC calculation program, after the values of soil parameters were constrained by the results of static-load test, the calculated curve is in satisfactory agreement with the measured curve, and the parameters of the pile-soil model are reliable, which can be used for the rapid detection of the ultimate bearing capacity of piles in permafrost regions; In the process of pile-soil refreezing, the change of temperature field affects the freezing strength between pile and soil, the process of pile-soil refreezing is positively correlated with the increase of pile foundation bearing capacity. [ABSTRACT FROM AUTHOR]

Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder. An increasing number of researchers have found extra motor features in ALS, which are also called ALS-plus syndromes. Besides, a great majority of ALS patients also have cognitive impairment. However, clinical surveys of the frequency and genetic background of ALS-plus syndromes are rare, especially in China. Methods: We investigated a large cohort of 1015 patients with ALS, classifying them into six groups according to different extramotor symptoms and documenting their clinical manifestations. Meanwhile, based on their cognitive function, we divided these patients into two groups and compared demographic characteristics. Genetic screening for rare damage variants (RDVs) was also performed on 847 patients. Results: As a result, 16.75% of patients were identified with ALS-plus syndrome, and 49.5% of patients suffered cognitive impairment. ALS-plus group had lower ALSFRS-R scores, longer diagnostic delay time, and longer survival times, compared to ALS pure group. RDVs occurred less frequently in ALS-plus patients than in ALS-pure patients (P = 0.042) but showed no difference between ALS-cognitive impairment patients and ALS-cognitive normal patients. Besides, ALS-cognitive impairment group tends to harbour more ALS-plus symptoms than ALS-cognitive normal group (P = 0.001). Conclusion: In summary, ALS-plus patients in China are not rare and show multiple differences from ALS-pure patients in clinical and genetic features. Besides, ALS-cognitive impairment group tends to harbour more ALS-plus syndrome than ALS-cognitive normal group. Our observations correspond with the theory that ALS involves several diseases with different mechanisms and provide clinical validation. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to assess the level of moral courage among nurses in China, and to explore related influential factors, to help nursing managers take measures to improve nurses' moral courage. Design: A cross‐sectional study. Methods: The data adopted a convenient sampling method. From September to December 2021, 583 nurses from five hospitals in Fujian Province completed the Chinese version of the Nurses' Moral Courage Scale (NMCS). Data were analysed using descriptive statistics, chi‐square test, T‐test, Pearson correlation analysis and multiple regression analysis. Results: The Chinese nurses perceived themselves, on average, as morally courageous. The mean NMCS score was 3.64 ± 0.692. The six factors showed statistically significant correlations (p < 0.05) with moral courage. Regression analysis showed that the main factors influencing nurses' moral courage were active learning of ethics knowledge and nursing was a career goal. Conclusion: This study provides the self‐evaluation level and related influencing factors of Chinese nurses' moral courage. There is no doubt that nurses still need strong moral courage to face unknown ethical problems and challenges in the future. Nursing managers should pay attention to the cultivation of nurses' moral courage, using various forms of educational activities to help nurses alleviate moral problems and improve their moral courage, to maintain patients' access to high‐quality nursing. [ABSTRACT FROM AUTHOR]

Background: Moral courage is a recognized virtue. In the context of the COVID-19 pandemic, the master's students of nursing (MSNs) in China have shown tenacious moral courage. Objective: This study elaborates on the moral courage of Chinese MSNs through their experiences of volunteering during the pandemic. Research Design: Descriptive qualitative, interview-based. Participants and Research Context: Participants were nursing postgraduate students who participated in the prevention and control of the COVID-19 pandemic selected by purposeful sampling. The sample size was determined by data saturation, which was reached with 10 participants. Data were analyzed using a deductive method of content analysis. Because of the isolation policy, telephone interviews were adopted. Ethical considerations: After obtaining the approval of the ethical institution of the author's school (No. 138, 30 August 2021), verbal consent was obtained before the interview with the participants. All data were processed anonymously and confidentially. In addition, we recruited participants through MSNs' counselors, and obtained their phone numbers with their permission. Results: Data analysis resulted in 15 subcategories that were subsequently grouped into 3 major categories including proceed without hesitation, the outcome of practicing moral courage, and develop and maintain moral courage. Conclusion: This qualitative study is based on the special background of the COVID-19 pandemic, and the MSNs in China have shown tenacious moral courage in the work of epidemic prevention and control. Five factors led them to take action without hesitation, and six possible outcomes followed. Lastly, this study provides some suggestions for nurses and nursing students to enhance their moral courage. To better develop and support moral courage in the future, it is necessary to use different methods and multidisciplinary approaches to study moral courage. [ABSTRACT FROM AUTHOR]

Background: The updated estimates of hepatitis C virus (HCV) seroprevalence are critical for developing strategies to manage or eliminate HCV infection. Methods: A comprehensive study on HCV seroprevalence was conducted among 365,210 patients at Jinan Central Hospital, China, from 2008 to 2020. The patients were tested for anti-HCV, HCV core antigen, hepatitis B surface antigen, syphilis antibody, human immunodeficiency virus antigen + antibody, antihepatitis A virus IgM, and antihepatitis E virus IgM. Results: HCV seroprevalence was 0.79% and was related to age. HCV seropositivity was lower in children (aged < 18 years) than in adults (aged ≥ 18 years) (0.15% vs. 0.81%). High HCV prevalence was reported in adults aged ≥ 41 years, and HCV seropositivity in those aged 41–80 years accounted for 74.56% of all seropositive individuals. Notably, the rate of HCV–HIV coinfection was 0. HCV seroprevalence was considerably higher in patients at the Kidney Disease Unit and Dialysis Department than in those at other departments (inpatient or outpatient). Conclusions: HCV seroprevalence was lower in Jinan region but higher in patients at the Kidney Disease Unit and Dialysis Department, especially in those undergoing hemodialysis. [ABSTRACT FROM AUTHOR]

The physician assistant/associate (PA) profession originated in the United States; PAs play an active role in alleviating the shortage of health and medical resources and improving the quality of medical care. This position has been introduced in and developed by many countries. Based on extensive literature research, this article summarizes the three main features of PAs, namely, that there is professional education for training PAs, the PA is an independent and exclusive professional type and PAs assist doctors in completing medical work. With reference to the innovative concept of the PA profession, this article summarized the existing "assistant" position in China that is similar to the PA position, compared it with the three features of PAs, revealed the shortcomings of the existing "assistant" position in China, provided a reference for the development of relevant careers in China, and provided solutions for solving the problems of medical and health resources in China. [ABSTRACT FROM AUTHOR]

Oxytropis plants are widely distributed in the grasslands in northern China. Some Oxytropis species have been reported to contain the mycotoxin swainsonine, an alkaloid which causes poisoning in livestock, referred to as locoism. Previous studies showed that endophytic fungi (Alternaria oxytropis) symbiotically associate with these Oxytropis species to produce swainsonine. However, the influence of variation within the Oxytropis genus on the fixation or loss of symbiosis and toxicity is poorly understood, as is the influence of environmental factors. Here we used a collection of 17 common Oxytropis species sampled in northern China to assess genetic diversity using genotyping by sequencing which was compared with the levels of the endophyte and swainsonine. Results showed that nine Oxytropis species have detectable A. oxytropis colonisation, and seven Oxytropis species contain sufficient swainsonine to be considered poisonous, whereas the rest may be non-toxic. Species variation rather than the genetic lineage was associated with the fixation or loss of endophyte and swainsonine production, which appears to have resulted from genetic drift. Genotype × Environment (G × E) effects were also found to influence endophyte and swainsonine levels amongst species of the Oxytropis genus. Our study will provide a better understanding about the evolutionary basis of A. oxytropis symbiosis and swainsonine biosynthesis in locoweeds. [ABSTRACT FROM AUTHOR]

Background: The unprecedented coronavirus disease 2019 (COVID-19) pandemic has caused millions of infections worldwide and represents a significant challenge facing modern health care systems. This study was conducted to investigate the impact of lockdown measures in a tertiary Children's Hospital in southwest China, which might be used to predict long-term effects related to health-seeking behavior of parents/caregivers. Methods: This study included newborns enrolled over a span of 86 weeks between January 4, 2019, and August 27, 2020. We designated two time periods for analysis purposes: a stable pre-COVID period(55 weeks between January 4, 2019, and January 23, 2020) and a COVID-impacted period (31 weeks between January 24, 2020, and August 27, 2020). An interrupted time-series analysis was employed to compare changes and trends in hospital admissions and disease spectra before and after the period of nonpharmaceutical interventions (NPIs). Furthermore, this study was conducted to evaluate whether the health-seeking behavior of parents/caregivers was influenced by pandemic factors. Results: Overall, 16,640 infants were admitted to the neonatology department during the pre-COVID period (n = 12,082) and the COVID-impacted period (n = 4,558). The per week neonatal admissions consistently decreased following the first days of NPIs (January 24, 2020). The average weekly admission rates of 220/week pre-COVID period and 147/week COVID-impacted period. There was an evident decrease in the volume of admissions for all disease spectra after the intervention, whereas the decrease of patients complaining about pathological jaundice-related conditions was statistically significant (p<0.05). In the COVID-impacted period, the percentage of patients who suffered from respiratory system diseases, neonatal encephalopathy, and infectious diseases decreased, while the percentage of pathological jaundice-related conditions and gastrointestinal system diseases increased. The neonatal mortality rates (NMRs) increased by 8.7% during the COVID-impacted period compared with the pre-COVID period. Conclusions: In summary, there was a significant decline in neonatal admissions in a tertiary care hospital during the COVID-19 Pandemic and the associated NPIs. Additionally, this situation had a remarkable impact on disease spectra and health-seeking behavior of parents/caregivers. We, therefore, advise continuing follow-ups and monitoring the main health indicators in vulnerable populations affected by this Pandemic over time. [ABSTRACT FROM AUTHOR]

Objective. To identify the aetiology of growth and development diseases and assess the long-term effectiveness of recombinant human growth hormone (rhGH) therapy in a real-life clinical setting and provide better guidance in clinical strategy and decision making. Methods. This retrospective study included 1145 children and adolescents with short stature admitted to the Department of Endocrinology, Affiliated Hospital of Jining Medical University, from January 2013 to December 2019, of whom 484 received rhGH treatment. The related anthropometrics and laboratory examinations were assessed in all participants. Results. A total of 1145 children and adolescents with short stature aged 10.5 ± 3.3 years, including 740 boys and 405 girls, were analysed in this study. The number of children and adolescents with short stature gradually increased per year from 2013 to 2019. The mean pretreatment height standard deviation score (SDS) and insulin-like growth factor-1 SDS were − 2.93 ± 1.05 and -1.01 (-1.83--0.16), respectively. The majority of the children (658, 57.47%) were prepubescent. In total, 484 subjects aged 10.6 ± 3.2 years received rhGH and were followed up, and among them, 292 children were treated for more than one year. As the treatment time increased, the children's height SDS gradually increased, and most of them attained a height SDS within the normal range. The mean height SDS in children who were treated for more than one year was − 3.0 ± 1.0 at baseline and gradually increased to − 0.8 ± 0.3 by year 6. The results were consistent across subgroups of different aetiologies of short stature. Conclusions. Increasing attention has been given to the height of children during the period of 2013–2019 in eastern China. The present findings indicate that children with short stature need to be referred to a specialist centre to diagnose the cause of growth failure and that short children receiving rhGH therapy show a significant increase in height over time. [ABSTRACT FROM AUTHOR]

Background: The growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis is critical for the regulation of children's growth and development. Serum IGF-1 concentrations are usually low in individuals with idiopathic short stature (ISS) despite normal endogenous GH levels, and the associated underlying factors are unknown. This study aimed to explore the relationship between IGF-1 and hemoglobin (Hb) in children with ISS. Methods: A cross-sectional analysis was performed including 178 children and adolescents with ISS who were enrolled from March 2013 to February 2019. The related clinical and biochemical parameters were evaluated for each patient. Univariate analysis, smooth curve fitting and multivariate piecewise linear regression were performed. Result: The mean levels of IGF-1 standard deviation scores (SDS) and Hb were − 0.99 (− 1.60 - -0.09) and 131.81 ± 9.36 g/L, respectively. Univariate analysis displayed a significant positive association between Hb and IGF-1 SDS (P < 0.001). After adjusting for potential confounding factors, the positive relationship between Hb and IGF-1 SDS remained (P = 0.001). Furthermore, there was an inflection point for Hb in the curve. In a multivariate piecewise linear regression model, IGF-1 SDS was significantly positively associated with Hb when Hb concentrations were lower than 145 g/L (B 0.05; 95% CI 0.02, 0.07; P < 0.001). However, IGF-1 SDS decreased with increasing Hb levels when Hb concentrations were greater than 145 g/L (B -0.15; 95% CI -0.23, − 0.06; P = 0.001). Conclusion: This study demonstrated that Hb is associated with IGF-1 in Chinese children and adolescents with ISS. The levels of IGF-1 increased with the elevation of Hb, but when the concentration of Hb exceeded a certain range, with the increase of Hb, IGF-1 decreased instead. [ABSTRACT FROM AUTHOR]

Condyloma acuminatum (CA) is a benign epithelium hyperplasia mainly caused by human papillomavirus (HPV), which is now the second most common viral sexually transmitted infection (STI) in China. In total, 90% of CA patients are caused by the low-risk HPV 6 and 11. Aside from low-risk HPV infection there are likely other factors within the local microenvironment that contribute to CA and there has been related research before. In this study, 62 vaginal specimens were analyzed using 16S rRNA gene sequencing. The diversity of the vaginal microbiota was higher and the composition was different with LR-HPV infection. While the relative abundance of dominant Firmicutes was lower, Actinobacteria, Proteobacteria, and Fusobacteria phyla were significantly higher; at the genus level Gardnerella, Bifidobacterium, Sneathia, Hydrogenophilus, Burkholderia, and Atopobium were higher. This study firstly confirmed a more accurate and comprehensive understanding of the relationship between low-risk HPV infection and vaginal microbiota, in order to provide a theoretical basis for further research on the occurrence and development of CA. [ABSTRACT FROM AUTHOR]

Objective. This study aimed to examine the relationship between serum alanine aminotransferase (ALT) and growth hormone (GH) in children and adolescents with short stature. Methods. In this retrospective cohort study, 670 Chinese children and adolescents with short stature were included, and 253 of them received recombinant human GH (rhGH) therapy. Anthropometric and biochemical indicators were measured. GH peak levels were assessed after provocation tests with L-dopa and insulin. The subjects were divided into 3 groups according to the GH peak level. The association between the GH peak and ALT was analyzed. The change of ALT during rhGH therapy was assessed by a generalized additive mixed model. Results. Serum ALT and incidence of ALT elevation were both decreased across the GH tertiles (P = 0.002, 0.012, respectively). A univariate analysis showed that the GH peak was negatively associated with ALT (β: -0.12; 95%CI: -0.22, -0.02; P = 0.023). Furthermore, multiple linear stepwise regression analysis demonstrated that the GH peak was independently related to ALT after adjusting for other confounding variables (β: -0.12; 95%CI: -0.24, -0.00; P = 0.042). Besides, mean values of the change in ALT from baseline displayed that, during the early stages of rhGH treatment, serum ALT level indicated a temporary upward trend, but it subsequently gradually decreased (β: -0.16; 95%CI: -0.23, -0.09; P < 0.001). Conclusions. GH secretion level was strongly negatively correlated with ALT in short children and adolescents. And rhGH therapy could reduce ALT level over time. [ABSTRACT FROM AUTHOR]

• First study to evaluate urban landscape planning and human-wildlife conflict in China. • Raccoon dog distribution positively associated with anthropogenic factors. • Species had great expansion potential but ignored in urban landscape planning. Rapid urbanization has caused drastic changes in urban ecosystems, resulting in various urgent management needs from mitigating biodiversity loss to preventing human-wildlife conflicts. Using species distribution modeling to understand urban species' distributional patterns and predict their future changes is thus important to support decision-making. Raccoon dog (Nyctereutes procyonoides) that previously inhabited Shanghai had been extirpated from the metropolitan area but recently returned to and expanded in almost all districts, causing hundreds of human-raccoon dog conflicts. In this study, we initiated a citizen science project, identified factors associated with raccoon dog habitat selection, and predicted its current suitable habitat as well as potential future ranges under different city development scenarios. By constructing an ensemble modeling using data from camera trap surveys, interviews and rescuing records, we found that raccoon dog distribution was positively associated with several anthropogenic factors including nighttime light, human population, and percentage area of buildings. We predicted a 156,024 ha suitable habitat for raccoon dogs throughout Shanghai, among which only 5,811 ha (3.72 %) was currently occupied. Our results indicated considerable potential of raccoon dogs' future expansion, which had been consistently ignored in previous management plans. To alleviate the increasing human-raccoon dog conflicts, we found strategies to slow down raccoon dog movement effective tools, and suggest adaptive management to provide fast response and flexible solutions. This is the first study to investigate human-wildlife conflict in China's urban environment, and our approach has substantial implications for Shanghai as well as other regions where urban species are undergoing rapid expansion. [ABSTRACT FROM AUTHOR]

Improving eco-efficiency in arid areas is the crucial to resolve the dual constraints of scarce water resources and the fragile carrying capacity of the ecological environment on agricultural production. This study investigated the eco-efficiency of seed maize production in Zhangye City, the largest seed maize producer in the arid northwestern region of China. The environmental impacts were assessed through a life cycle assessment and incorporated into a data envelopment analysis model, together with economic factors to evaluate ecological efficiency. A Tobit regression model was applied to identify the key elements affecting eco-efficiency and determine suggestions for further improvements. The results showed that the environmental acidification index of Zhangye was 1.2079–1.3978 times larger than the world per capita level, with the primary cause being the application of nitrogen fertilizer. Water consumption was lower than the world average level. The comprehensive environmental index was lower than the 2000 world per capita level but higher than that of other Chinese regions. A production eco-efficiency evaluation showed that 14.68% of households achieved relatively efficient production. Water was the most influential element. Each additional 100 units of water reduce eco-efficiency by 0.34%. A comparative study of small, medium and large farms was carried out to examine the effect of farm size. Small farms were the most eco-efficient, followed by medium-sized farms, with large farms having the lowest eco-efficiency. The results highlighted that certain targeted policy interventions may be inefficient, including interventions focusing on expansion of the production scale, and that restrictions on fertilizer use and improving water-saving facilities can improve eco-efficiency performance. Image 1 • Environmental impacts of NW China oasis are lower than 2000 world values per capita • 14.68% of oasis households achieved relatively eco-efficient production in NW China • Fertilizer and water are the main factors affecting eco-efficiency in NW China • Eco-efficiency is highest for small farms followed by medium-sized then large farms • Controlling fertilizer, water & farm size helps improve eco-efficiency in NW China [ABSTRACT FROM AUTHOR]

Establishing adequate nature reserves and managing them effectively requires an enormous amount of resources, and is particularly challenging when species and communities are believed to have diverse needs. Decision-makers need to understand how wildlife survives in human-disturbed habitat and how they can coexist with anthropogenic activities. Forest livestock grazing is one of the main sources of income for many local communities in Yunnan Province, China, but its association with endangered green peafowl (Pavo muticus) is largely unknown. We linked our field survey data with satellite imagery and conducted occupancy modeling and diel activity analysis to examine the spatio-temporal response of green peafowl to free-ranging livestock in Yubaiding Nature Reserve. Although it is widely believed that many grazing practices should be prohibited in green peafowl habitat, we found that green peafowl occurrence probability was positively associated with moderate cattle and goat abundance. Our temporal analysis also showed that green peafowl did not avoid livestock grazing or individual people. In contrast to green peafowl tolerance to ordinary human activities, we found significant negative associations between green peafowl and major infrastructure. Our findings show that limits on grazing intensity are a possible management strategy for conserving green peafowl habitat instead of an outright grazing ban. Our study will contribute immediately to green peafowl conservation planning in China. Our study also has implications for the conservation plans for other species in other locations, because our findings convey that conservation targets can promote the synergy between species conservation and human activity. [ABSTRACT FROM AUTHOR]

In this paper, three commonly used PET and PBT copolymers films as inner gauge materials of laminated steel were screened and identified, and then 6 kinds of cyclic PET and PBT oligomers that could be obtained as commercially available standards were selected from the screening results for research. An ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) technique for simultaneous detection of cyclic PET and PBT oligomers in laminated steel cans was first developed. Four different laminated steel metal cans were selected to carry out the migration tests at 40 °C for 10 days in three food simulants of 10% ethanol, 50% ethanol and isooctane. Then commercially acquired cyclic PET dimer to pentamer, cyclic PBT dimer and trimer were used as external standards, and the six oligomers in the migration solutions were quantitatively analyzed by UPLC-QTOF-MS technology. The results showed that all oligomers could be separated well with good linear relationship and high limit of detection. The recoveries of cyclic PET and PBT oligomers ranged from 80.00% to 105.18%, which indicated that UPLC-QTOF-MS was an effective method for simultaneous determination of cyclic PET and PBT oligomers in laminated steel cans. Among the six oligomers tested, cyclic PET trimers and cyclic PET tetramers had the most migration. In addition, the total content of the six oligomers for every can was all the largest in isooctane simulant, meanwhile the content of oligomers in 50% ethanol simulant was far greater than that in 10% ethanol simulant. Moreover, the influence on the amount of oligomers migration by comparing the sterilization and non-sterilization process was studied to find that high sterilization temperature produced more migration and the test methods prescribed by the EU and China standard regulations may cause an underestimate of the amount of oligomer migration. • Three laminated - films used for laminated steel cans were screened and identified. • Simultaneous detection technique of cyclic PET and PBT oligomers migrated from laminated steel cans was well established. • Food simulants played a key role in the migration of oligomers. • Suggest simulated sterilization before migration tests on laminated steel cans. [ABSTRACT FROM AUTHOR]

Introduction: Recently, chloride channel CLIC-like 1 (CLCC1) was reported to be a novel ALS-related gene. We aimed to screen CLCC1 variants in our ALS cohort and further explore the genotype-phenotype correlation of CLCC1-related ALS., Methods: We screened rare damaging variants in CLCC1 from our cohorts of 1005 ALS patients and 1224 healthy controls with whole-exome sequencing in Central South China. Fisher's exact test was conducted for association analysis at the entire gene level and single variant level., Results: In total, four heterozygous missense variants in CLCC1 were identified from four unrelated sporadic ALS patients and predicted to be putative pathogenic by in silico tools and protein model prediction, accounting for 0.40% of all patients (4/1005). The four variants were c.A275C (p.Q92P), c.G1139A (p.R380K), c.C1244T (p.T415M), and c.G1328A (p.R443Q), respectively, which had not been reported in ALS patients previously. Three of four variants were located in exon 10. Patients harboring CLCC1 variants seemed to share a group of similar clinical features, including earlier age at onset, rapid progression, spinal onset, and vulnerable cognitive status. Statistically, we did not find CLCC1 to be associated with the risk of ALS at the entire gene level or single variant level., Conclusion: Our findings further expanded the genetic and clinical spectrum of CLCC1-related ALS and provided more genetic evidence for anion channel involvement in the pathogenesis of ALS, but further investigations are needed to verify our findings., (© 2023 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.)

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant is undergoing continuous evolution and convergent mutation. These new subvariants are raising concerns that they may evade neutralizing monoclonal antibodies (mAbs). We investigated the serum neutralization efficacy of Evusheld (cilgavimab and tixagevimab) against SARS-CoV-2 Omicron BA.2, BA.2.75, BA.2.76, BA.5, BF.7, BQ.1.1, and XBB.1.5. A total of 90 serum samples from healthy individuals were collected in Shanghai. Anti-RBD antibodies were measured and symptoms of infection with COVID-19 were compared among those individuals. The neutralizing activity of serum against Omicron variants was analyzed by pseudovirus neutralization assays in 22 samples. Evusheld retained neutralizing activity against BA.2, BA.2.75, and BA.5, albeit with somewhat reduced titers. However, the neutralizing activity of Evusheld against BA.2.76, BF.7, BQ.1.1, and XBB.1.5 significantly decreased, with XBB.1.5 showing the greatest escape activity among the subvariants. We also observed that Evusheld recipients displayed elevated antibody levels in their serum, which efficiently neutralized the original variant, and exhibited different characteristics of infection than those who did not receive Evusheld. The mAb has partial neutralization activity against Omicron sublineages. However, the increasing doses of mAb and a larger size of population should be further investigated., (© 2023 Wiley Periodicals LLC.)

Antibiotics and antibiotic resistance genes (ARGs) in the aquatic environment have raised great concerns, as the deleterious effects of residual antibiotics and the emergence of ARGs are challenges to aquaculture. This study analyzed feed, water, sediment and prawns' tissues from six culture ponds (integrated culture: rice-prawn pond; monoculture: prawn pond) in Tianjin, Northeast China. Eighteen types of antibiotics were detected in all ponds, which conferring to four classes of antibiotics including sulfonamides, tetracyclines, fluoroquinolones, macrolides. The mean log bioaccumulation factor (BAF) values for five antibiotics were analyzed in the hepatopancreas, muscle, and plasma, and we found the maximum Log BAF (1.45) for enrofloxacin in prawn plasma. Correlation analysis of antibiotic concentrations between the plasma and the other two tissues indicated that enrofloxacin, norfloxacin, and erythromycin levels in the hepatopancreas and muscle can be predicted by their plasma concentrations. We also conducted a hazard quotient analysis and found that the risk to human health of eating antibiotic-exposed prawns from the two types of aquaculture method was relatively low. Compared with monoculture, rice-prawn co-culture could significantly decrease the abundance of ARGs; additionally, significant correlations were detected among ARGs, antibiotics, and non-antibiotic environmental factors (e.g., total nitrogen, total ammonia nitrogen, and chemical oxygen demand) in prawn. The present study indicated that the rice-prawn co-culture system is more effective than monoculture for mitigating the bioaccumulation of antibiotics and the occurrence of ARGs in prawn., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Ethnopharmacological Relevance: The dried bark of Ailanthus altissima (Mill.) Swingle (BAA), commonly designated as "Chunpi" in Chinese, is extensively used as a common traditional medicine in China, Korea, and India. It has been used to treat multiple ailments, including asthma, epilepsy, spermatorrhea, bleeding, and ophthalmic diseases, for thousands of years., Aim of the Review: To present a comprehensive and constructive review on the phytochemistry, pharmacology, pharmacokinetics, traditional uses, quality control, and toxicology of BAA; to aid the assessment of the therapeutic potential of BAA; to guide researchers working on the development of novel therapeutic agents., Materials and Methods: Information related to BAA (from 1960 to 2020) was retrieved from a wide variety of electronic databases, such as PubMed, Web of Science, China Knowledge Resource Integrated Database, ScienceDirect, SciFinder, and Google Scholar. Additional information and materials were acquired from Chinese Medicine Monographs, the 2020 edition of the Chinese Pharmacopoeia, and several web sources, such as the official website of The Plant List and Flora of China. Additionally, perspectives for future investigations and applications of BAA were extensively explored., Results: Approximately 221 chemical compounds, including alkaloids, quassinoids, phenylpropanoids, triterpenoids, volatile oils, and other compounds, have been isolated and characterized from BAA; among these, the quassinoid ailanthone is the most typical. The crude extracts and active compounds of BAA have been reported to exert a wide range of pharmacological activities, such as antitumor, anti-inflammatory, antiviral, herbicidal, and insecticidal activities. Although BAA is safe when administered at a conventional dose, at higher doses, it exhibits toxicity due to the presence of quassinoids. Thus, more studies are required to evaluate the efficacy and safety of BAA., Conclusion: Modern pharmacological studies have revealed that BAA, as a valuable medicinal resource, possesses the potential to treat a wide variety of ailments, especially, cancer and gastrointestinal inflammation. These studies present a wide range of perspectives for the development of new drugs related to BAA. However, only a few traditional uses are associated with the reported pharmacological activities of BAA and have been confirmed by preclinical and clinical studies. Moreover, the pharmacokinetics, toxicology, and quality control of BAA should be considered indispensable research topics., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Family caregivers need to be supported in caring for patients at the end of life, but practical tools to assess their support needs have been missing in China. So this study aimed to culturally adapt and validate the Carer Support Needs Assessment Tool (CSNAT)., Methods: Cross-cultural adaptation of the original CSNAT for a Chinese setting was performed according to Brislin's translation guidelines. A pilot study was conducted with 15 Chinese family caregivers of cancer patients receiving hospice home care and 5 medical staff. A cross-sectional survey of 205 family caregivers was conducted from December 2018 to May 2019 at a home-based hospice care institute in Shenzhen, China. The validation procedure comprised the establishment of (1) content validity by a group of six experts; (2) face validity by 15 family caregivers; (3) criterion validity by calculating Spearman's correlations between the CSNAT and caregiving burden, caregiving preparedness and quality of life scales; (4) internal consistency using Cronbach's alpha., Results: The CSNAT demonstrated good face validity and good content validity. CSNAT scores showed clear positive correlations with caregiving burden and negative correlations with preparedness for caregiving and quality of life. Internal consistency was high (Cronbach's alpha = 0.899), although such reliability testing is not recommended for this tool., Conclusions: The Chinese version of the CSNAT is a valid tool that is appropriate for identifying needs of family caregivers of cancer patients in home-based hospice care.

The purpose of this study was to investigate the relationship between systolic blood pressure (SBP) and uric acid (UA) in patients with idiopathic short stature (ISS). The present study was a cross-sectional study. A total of 210 Chinese children and adolescents with ISS were included, and their anthropometrics and biochemical parameters were measured. Growth hormone peak levels were assessed after provocation tests with L-dopa and insulin. The univariate analysis results showed a significant positive association between UA and SBP levels (P < 0.001). Furthermore, a non-linear relationship was detected between UA and SBP. In multivariate piecewise linear regression, the inflection point of UA was 4.13 mg/dl (95% CI 3.28, 6.65; P = 0.03), the levels of SBP increased with the increase in UA when the UA level was >4.13 mg/dl (β 2.63, 95% CI: 0.94, 4.31; P = 0.002). However, we did not observe a significant relationship between UA and SBP when the UA level was <4.13 mg/dl (β -2.72, 95% CI -6.89, 1.45; P = 0.202). Our study found a nonlinear relationship between UA and SBP in Chinese children and adolescents with ISS and showed that SBP levels were associated positively with the rise of UA levels when the UA levels reached the inflection point.

Several large prospective studies show an association between serum uric acid (SUA) and cancer, however there is a lack of evidence in China. We aimed to investigate the effects of SUA levels on cancer incidence and mortality in China. This study included 20,577 adult hypertensive patients with valid SUA measurements who participated in the China Stroke Primary Prevention Trial where subjects were randomly assigned to receive a double-blind treatment of either 10 mg enalapril (n = 10,286) or 10.8 mg enalapril-folic acid (n = 10,291). Subjects were prospectively followed for a median of 4.5 years. Cox proportional hazards models were used to calculate hazards ratios (HR) of cancer risk associated with SUA. A total of 232 participants developed cancer. SUA was independently associated with increased cancer risk in the enalapril group [HR: 1.12, (95% CI: 1.03-1.22)]. Compared to the lowest tertile, combined subjects with SUA levels from the upper two tertiles had a higher risk of cancer in the enalapril group [T2 + T3: HR: 1.58, (95% CI: 1.02-2.47)]. In cancer site-specific analyses, a positive association of SUA levels with digestive cancer and all fatal cancer was also observed [HR: 1.18, (95% CI: 1.09-1.27); HR: 1.15, (95% CI: 1.03-1.28), respectively] in the enalapril group. Interestingly, SUA levels were not associated with the risk of cancer or related mortality in the enalapril folic acid group. Our results suggest that elevated SUA is independently and positively associated with the risk of total cancer incidence, digestive cancer incidence and cancer mortality among hypertensive Chinese., (© 2017 UICC.)

Background: A few studies on the depth from the skin to the cervical epidural space (DSES) have been reported from the United States, South Korea, Japan, and Taiwan. There are no published reports from mainland China., Objectives: The goal of this study was to collect standard data on Chinese adults from mainland China in a large medical center with a wide geographical range of patients., Study Design: A prospective study., Setting: Department of Anesthesiology, Pain Medicine, and Critical Care Medicine, Aviation General Hospital of China Medical University., Methods: The survey included 410 patients. Measurements were made of DSES, the dural sac, and the spinal cord by automatic measuring ruler on transverse and sagittal images of the cervical spine at the C5-6, C6-7, C7-T1, T1-2, and T2-3 intervertebral space obtained by magnetic resonance imaging (MRI). We also obtained the width of the epidural space by measuring the distance from the (LF) to the dural sac., Results: DSES at C5-6, C6-7, C7-T1, T1-2, and T2-3, respectively, was 4.69 ± 0.84 cm, 5.14 ± 0.98 cm, 5.56 ± 1.03 cm, 5.81 ± 0.94 cm, and 5.76 ± 0.86 cm on T2W (weighted) MRIs obtained in the sagittal plane (mean ± SD). The distance at C5-6, C6-7, and C7-T1 in transverse images was 4.67 ± 0.86 cm, 5.18 ± 1.02 cm, and 5.55 ± 0.97 cm, respectively. All measured distances from the skin to the epidural space were significantly greater in men than in women. Multivariate regression analysis revealed significant partial correlation between DSES and (BMI)., Limitation: Limitations include the absence of healthy individuals as well as the influence of the difference in neck positioning during the MRI examination vs. active epidural puncture., Conclusion: DSES varied with the cervical intervertebral level in those patients studied from the population of mainland China. The greatest DSES was noted at C7-T1 in men and T1-2 in women, and the least was at C5-6 in both men and women. DSES had a significant relationship with neck circumference and BMI in both genders. We suggest that the DSES be measured with MRI before performing epidural puncture. The lower cervical and upper thoracic intervertebral spaces appear to provide a greater margin of safety for epidural puncture.

Background: Since 2003, the number of pilot areas of the New Rural Cooperative Medical System (NRCMS) has increased in rural China. And the major efforts have been concentrated on the enrollment of prospective members. In this study, we examined the satisfaction of the rural residents with the NRCMS as well as factors affecting their attitudes towards the NRCMS., Methods: The data for this study were collected from a survey involving twenty counties in Liaoning Province. Interviews and focus groups were conducted between 10th January and 20th August 2008. A total of 2,780 people aged 18-72 were randomly selected and interviewed. Data were evaluated by nonparametric tests and ordinal regression models., Results: 71.6% of the study subjects were satisfied with the NRCMS. Single factor analysis showed that attitudes towards the NRCMS were influenced by gender, age, marital status, and self-rated health status. In the ordinal regression analysis, gender, age, and self-rated health status affect satisfaction (P < 0.05)., Conclusions: We found that a considerable proportion of farmers were satisfied with the NRCMS. Gender, age, and self-rated health status had significant effects on farmers' attitudes towards the NRCMS. The Chinese Central Government attempted to adopt active measures in the future to continuously improve the NRCMS, including initiating educational programs, building new medical facilities and increasing financial investment.