The improving effect and mechanisms of Anshen Dingzhi Prescription on Alzheimer's disease-like behavior induced by D-galactose combined with AβO in mice / 药学学报

The purpose of this study was to explore the improving effect of Anshen Dingzhi Prescription (ADP) on Alzheimer's disease (AD)-like behavior in mice and its mechanisms. The main chemical components of ADP were identified by ultra performance liquid chromatography-time-of-flight mass spectrometry (UPLC-Q-TOF-MS). The AD-like mouse model was induced by D-galactose (D-gal) combined with Aβ1-42 oligomer (AβO). The effect of ADP on AD-like behavior in mice was assessed using various behavioral experiments; pathomorphological changes in mouse hippocampal tissue were observed by Nissl staining and transmission electron microscopy; ELISA was used in the assessment of oxidative stress factors and inflammation-related factor levels; Western blot was performed to detect the expression of Aβ, Tau and glial fibrillary acidic protein (GFAP) proteins. The active components of ADP were screened according to TCMSP and HERB database, and the action targets of active components were predicted by Swiss Target Prediction platform. In addition, the targets of AD were predicted through DisGeNET database. Further, GO and KEGG enrichment analysis of common targets was carried out by Metascape database. Combined with the results of GO and KEGG analysis, in vivo experiments were carried out to explore the potential mechanism of ADP improving AD-like behavior in mice from the PI3K/Akt, calcium signal pathway and synaptic function. Finally, the core components of ADP were molecularly docked to the validated targets using Autodock Vina. Animal experiments were approved by the Animal Ethics Committee of Anhui University of Chinese Medicine (approval number: AHUCM-mouse-2021080). The results showed that the five chemical components, including ginsenoside Rg1, ginsenoside Rb1, tenuifolin, poricoic acid B and α-asarone were found in the ADP. ADP significantly improved the anxiety-like behavior and memory impairment, protected hippocampal neurons, decreased the levels of oxidative stress and inflammation, and inhibited the expression of Aβ and p-Tau induced by D-galactose combined with AβO in mice. The results of network pharmacology suggested that PI3K/Akt, calcium signal pathway and cell components related to postsynaptic membrane might be the key factors for ADP to improve AD. Animal experiments revealed that ADP up-regulated N-methyl-D-aspartate receptor 2A (GluN2A), postsynaptic density protein 95 (PSD95), calpain-1, phosphorylated protein kinase B (p-Akt), phosphorylated cAMP response element binding protein (p-CREB), brain-derived neurotrophic factor (BDNF) expression and inhibited p-GluN2B and calpain-2 expression in the hippocampus of AD-like mice. The molecular docking results demonstrated that the core components of ADP, such as panaxacol, dehydroeburicoic acid, deoxyharringtonine, etc. had a high binding ability with the validated targets GRIN2A, GRIN2B, PSD95, etc. In summary, our results indicate ADP improves AD-like pathological and behavioral changes induced by D-galactose combined with AβO in mice, and the mechanism might be related to the NMDAR/calpain axis and Akt/CREB/BDNF pathway.

Epidemiological characteristics of varicella in Songjiang District， Shanghai from 2013 to 2021 / 上海预防医学

ObjectiveTo evaluate the effectiveness of the varicella vaccine immunization strategy in Shanghai， and to provide evidence for enhancing prevention and control measures by analyzing the incidence and trends of varicella in Songjiang District， Shanghai from 2013 to 2021. MethodsA descriptive analysis was conducted on 12 417 varicella cases reported in Songjiang District between 2013 and 2021. The epidemiological distribution of varicella cases was described， and the incidence rates were compared among different demographic variables， including registered residence， gender， age， and occupation. ResultsA total of 12 417 varicella cases were reported in Songjiang District from 2013 to 2021，with an average annual incidence of 77.03/105. The incidence of varicella showed an increasing trend from 2013 to 2017 （χ2trend=19.39， P<0.001）， followed by a subsequent decrease from 2017 to 2021（χ2trend=758.62， P<0.001）. Varicella cases demonstrated significant seasonal variation， with peak incidences occurring in April to May and November to January of the following year. The incidence rate among local residents was higher than that among non-local residents （χ2=2 935.58， P<0.001）. Most （38.59%） of the cases were students aged between 5 and 9 years old， accounting for 23.45% of the total cases. However， the age distribution of cases varied over the years （χ2=615.57， P<0.001）， and the incidence among children aged 5 to 9 years showed a declining trend since 2017. ConclusionThe overall incidence of varicella in Songjiang District exhibites a declining trend in recent years. Although varicella primarily affects children， there have notable changes in the age distribution. Adjustment of the immunization strategy for varicella vaccines in Shanghai effectively reduces the proportion of school-age subjects.

Influence of sleep fragmentation in infancy and toddler period on emotional and behavioral problem at the age of 6 years: a birth cohort study / 中华儿科杂志

Objective: To investigate the influence of sleep fragmentation in infancy and toddler period on emotional and behavioral problems at the age of 6 years. Methods: Using a prospective cohort design, 262 children were extracted from mother-child birth cohort recruited from May 2012 to July 2013 in Renji Hospital, School of Medicine, Shanghai Jiao Tong University. Children's sleep and physical activities were assessed using actigraphy at 6, 12, 18, 24, and 36 months of age, from which the sleep fragmentation index (FI) at each follow-up point was calculated. Children's emotional and behavioral problems at 6 years of age were assessed using the strengths and difficulties questionnaire. Group-based trajectory model was applied to determine sleep FI in infancy and toddler period trajectory groups with Bayesian information criteria being used to determine the best fitting model. Children's emotional and behavioral problems between groups were examined with independent t test and linear regression models, etc. Results: A total of 177 children, with 91 boys and 86 girls, were included in the final analysis and were divided into 2 groups: high FI group (n=30) and low FI group (n=147). Compared with children in the low FI group, those in the high FI group presents with higher total difficulties score and higher hyperactivity or inattention score ((11.0±4.9) vs. (8.9±4.1), (4.9±2.7) vs. (3.7±2.3) scores, t=2.17, 2.23, both P<0.05, respectively), with the differences remaining significant after adjusting for covariates (t=2.08, 2.09, both P<0.05 respectively). Conclusion: High sleep fragmentation in infancy and toddler period is associated with more emotional and behavioral problems, especially hyperactivity or inattention problems, at 6 years of age.

Effect of inactivated SARS-CoV-2 vaccine on the clinical outcomes of patients infected with the Omicron variant in Guangdong Province / 中华预防医学杂志

Objective: To evaluate the effect of inactivated SARS-CoV-2 vaccine on the clinical outcomes of patients infected with the Omicron variant. Methods: A total of 1 403 Omicron-infected patients admitted to 20 designated hospitals in Guangdong Province from January 1 to May 31, 2022, were selected as subjects in this study. A case-control study was conducted to collect the demographic data, underlying disease, vaccination status, last exposure date, gene sequencing of infected strains and clinical outcomes from the China Disease Prevention and Control Information System and Guangdong telemedicine platform. Pneumonia (common, severe and critical) and non-pneumonia (asymptomatic and mild) were selected as the case group and control group. The effect of inactivated SARS-CoV-2 vaccine on the clinical outcomes of patients infected with the Omicron variant was analyzed. Results: The median age [M (Q1, Q3)] of the subjects was 36 (27-47) years old, with males accounting for 52.25% (733 cases). The main outcome of the infection was non-pneumonia, accounting for 92.09% (1 292 cases), and the duration [M (Q1, Q3)] of the disease was 18 (14-22) days. There were 134 (9.55%), 39 (2.78%), 403 (28.72%), 437 (31.15%) and 390 (27.80%) cases with no or partial vaccination, within 90 days of primary vaccination, over 90 days of primary vaccination, within 90 days of booster vaccination and over 90 days of booster vaccination, respectively. Multivariate logistic regression analysis showed that after adjusting for gender, age, underlying disease, and location of the report, compared with those with no or partial vaccination, the risk of developing pneumonia was lower in those with over 90 days of primary vaccination, within 90 days of booster vaccination and over 90 days of booster vaccination [OR (95%CI) values were 0.52 (0.28-0.98), 0.39 (0.21-0.73) and 0.40 (0.21-0.77), respectively]. Cox proportional hazard regression model analysis showed that after adjusting for gender, age, underlying disease and location of the report, the duration of the disease was shorter in those who received booster vaccinated for more than 90 days compared with that in those who had no or partial vaccination [HR (95%CI): 1.26 (1.03-1.55)]. Conclusion: The inactivated SARS-CoV-2 vaccine affects the clinical outcomes of patients infected with the Omicron variant.

New research advances in the prospective cohort study of gestational diabetes mellitus / 中华预防医学杂志

Gestational diabetes mellitus (GDM) is associated with an increased risk of suffering diverse adverse pregnancy outcomes, threating maternal and child health seriously, with an increasing incidence rate year by year. However, the exact cause of GDM is still unknown. Prospective cohort studies obtain data through follow-up, which is helpful to clarify the causal relationship, so as to draw more accurate and reliable conclusions. In recent years, numerous prospective cohort studies on the GDM have emerged. This article elaborates along the occurrence and development process of GDM, in order to provide useful reference for the establishment of relevant high-quality prospective cohort studies in China.

Nomogram-Based Prediction of Risk of Cervical Lymph Node Metastasis in Differentiated Thyroid Carcinoma / 中国医学科学院学报

Objective To establish a nomogram for predicting the risk of cervical lymph node metastasis in differentiated thyroid carcinoma (DTC). Methods The patients with complete clinical data of DTC and cervical lymph node ultrasound and diagnosed based on pathological evidence from January 2019 to December 2021 were assigned into a training group (n=444) and a validation group (n=125).Lasso regression was performed to screen the data with differences between groups,and multivariate Logistic regression to establish a prediction model with the factors screened out by Lasso regression.C-index and calibration chart were employed to evaluate the prediction performance of the established model. Results The predictive factors for establishing the model were lymph node short diameter≥0.5 cm,long-to-short-axis ratio<2,disappearance of lymph node hilum,cystic transformation,hyperechogenicity,calcification,and abnormal blood flow (all P<0.001).The established model demonstrated a good discriminative ability,with the C index of 0.938 (95%CI=0.926-0.961) in the training group. Conclusion The nomogram established based on the ultrasound image features of cervical lymph nodes in DTC can accurately predict the risk of cervical lymph node metastasis in DTC.

Corynoxine B targets at HMGB1/2 to enhance autophagy for α-synuclein clearance in fly and rodent models of Parkinson's disease

Parkinson's disease (PD) is the most common neurodegenerative movement disease. It is featured by abnormal alpha-synuclein (α-syn) aggregation in dopaminergic neurons in the substantia nigra. Macroautophagy (autophagy) is an evolutionarily conserved cellular process for degradation of cellular contents, including protein aggregates, to maintain cellular homeostasis. Corynoxine B (Cory B), a natural alkaloid isolated from Uncaria rhynchophylla (Miq.) Jacks., has been reported to promote the clearance of α-syn in cell models by inducing autophagy. However, the molecular mechanism by which Cory B induces autophagy is not known, and the α-syn-lowering activity of Cory B has not been verified in animal models. Here, we report that Cory B enhanced the activity of Beclin 1/VPS34 complex and increased autophagy by promoting the interaction between Beclin 1 and HMGB1/2. Depletion of HMGB1/2 impaired Cory B-induced autophagy. We showed for the first time that, similar to HMGB1, HMGB2 is also required for autophagy and depletion of HMGB2 decreased autophagy levels and phosphatidylinositol 3-kinase III activity both under basal and stimulated conditions. By applying cellular thermal shift assay, surface plasmon resonance, and molecular docking, we confirmed that Cory B directly binds to HMGB1/2 near the C106 site. Furthermore, in vivo studies with a wild-type α-syn transgenic drosophila model of PD and an A53T α-syn transgenic mouse model of PD, Cory B enhanced autophagy, promoted α-syn clearance and improved behavioral abnormalities. Taken together, the results of this study reveal that Cory B enhances phosphatidylinositol 3-kinase III activity/autophagy by binding to HMGB1/2 and that this enhancement is neuroprotective against PD.

Clinical characteristics of anomalous aortic origin of a coronary artery in children / 中华儿科杂志

Objective: To analyze the clinical characteristics, diagnosis and treatment of anomalous aortic origin of a coronary artery (AAOCA) in children. Methods: There were 17 children diagnosed with AAOCA from January 2013 to January 2022 in Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine.Their clinical manifestations, laboratory and imaging data, treatment and prognosis were retrospectively analyzed. Results: These 17 children included 14 males and 3 females, with the age of (8.7±3.5) years. There were 4 anomalous left coronary artery (ALCA) and 13 anomalous right coronary artery (ARCA). Seven children presented with chest pain or chest pain after exercise, three patients presented with cardiac syncope, one complained chest tightness and weakness, and the other six patients had no specific symptoms. Cardiac syncope and chest tightness occurred in patients with ALCA. Fourteen children had the dangerous anatomical basis of myocardial ischemia caused by coronary artery compression or stenosis on imaging. Seven children had coronary artery repair, of whom two were ALCA and five were ARCA. One patient had received heart transplantation because of heart failure. The incidence of adverse cardiovascular events and poor prognosis in ALCA group was higher than that in ARCA group (4/4 vs. 0/13, P<0.05). They were followed up in the outpatient department regularly for 6 (6, 12) months; except for the one who lost visit, the rest of the patients had a good prognosis. Conclusions: Cardiogenic syncope or cardiac insufficiency usually occurs in ALCA, and adverse cardiovascular events and poor prognosis are more common in ALCA than in ARCA. Early surgical treatment should be considered for children with ALCA and ARCA accompanied by myocardial ischemia.

Effect of postoperative adjuvant chemotherapy on prognosis of patients with intrahepatic cholangiocarcinoma:a multicenter retrospective study / 中华外科杂志

Objectives: To examine the influence of adjuvant chemotherapy after radical resection on the survival of patients with intrahepatic cholangiocarcinoma(ICC) and to identify patients who may benefit from it. Methods: The clinical and pathological data of 654 patients with ICC diagnosed by postoperative pathology from December 2011 to December 2017 at 13 hospitals in China were collected retrospectively. According to the inclusion and exclusion criteria,455 patients were included in this study,including 69 patients (15.2%) who received adjuvant chemotherapy and 386 patients (84.8%) who did not receive adjuvant chemotherapy. There were 278 males and 177 females,with age of 59 (16) years (M(IQR))(range:23 to 88 years). Propensity score matching (PSM) method was used to balance the difference between adjuvant chemotherapy group and non-adjuvant chemotherapy group. Kaplan-Meier method was used to plot the survival curve,the Log-rank test was used to compare the difference of overall survival(OS) and recurrence free survival(RFS)between the two groups. Univariate analysis was used to determine prognostic factors for OS. Multivariate Cox proportional hazards models were then performed for prognostic factors with P<0.10 to identify potential independent risk factors. The study population were stratified by included study variables and the AJCC staging system,and a subgroup analysis was performed using the Kaplan-Meier method to explore the potential benefit subgroup population of adjuvant chemotherapy. Results: After 1∶1 PSM matching,69 patients were obtained in each group. There was no significant difference in baseline data between the two groups (all P>0.05). After PSM,Cox multivariate analysis showed that lymph node metastasis (HR=3.06,95%CI:1.52 to 6.16,P=0.039),width of resection margin (HR=0.56,95%CI:0.32 to 0.99,P=0.044) and adjuvant chemotherapy (HR=0.51,95%CI:0.29 to 0.91,P=0.022) were independent prognostic factors for OS. Kaplan-Meier analysis showed that the median OS time of adjuvant chemotherapy group was significantly longer than that of non-adjuvant chemotherapy group (P<0.05). There was no significant difference in RFS time between the adjuvant chemotherapy group and the non-adjuvant chemotherapy group (P>0.05). Subgroup analysis showed that,the OS of female patients,without HBV infection,carcinoembryonic antigen<9.6 μg/L,CA19-9≥200 U/ml,intraoperative bleeding<400 ml,tumor diameter>5 cm,microvascular invasion negative,without lymph node metastasis,and AJCC stage Ⅲ patients could benefit from adjuvant chemotherapy (all P<0.05). Conclusion: Adjuvant chemotherapy can prolong the OS of patients with ICC after radical resection,and patients with tumor diameter>5 cm,without lymph node metastasis,AJCC stage Ⅲ,and microvascular invasion negative are more likely to benefit from adjuvant chemotherapy.

Research progress on the relationship between persistent organic pollutants and gestational diabetes / 中华预防医学杂志

Gestational diabetes mellitus(GDM)is one of the common complications during pregnancy. It is associated with many adverse pregnancy outcomes, threatening maternal and child health seriously. The exact pathogenesis of GDM remains unclear. Long term exposure to persistent organic pollutants (POPs) is considered to be one of the risk factors for GDM. More and more studies are concerned about the relationship between them. Based on the literature published at home and abroad, this article summarizes the correlation and possibly related mechanism of POPs and GDM, and explores the correlation between pops and GDM, so as to provide a new idea for the prevention of gestational diabetes.

Epidemiological characteristics of measles in Baoshan District of Shanghai in 2005‒2021 / 上海预防医学

ObjectiveTo determine the epidemiological characteristics and distributions of measles in Baoshan District， Shanghai. MethodsThis study used the measles surveillance information and reporting system to collect reported cases of measles in Baoshan District in 2005‒2021 and then conducted descriptive epidemiological methods to determine the temporality using the concentration method. ResultsIn 2005‒2021， a total of 525 measles cases were reported in Baoshan District with an average annual reported incidence rate of 1.75/105， showing an overall fluctuating downward trend and obvious seasonality. The cases concentrated in 30‒39 years of age （31.24%）， 20‒29 years （28.57%）， and under 5 years （16.57%）. Majority of them were workers （18.10%）， preschool children （16.19%）， and unemployed persons （12.76%）. The incidence was significantly higher in the central region than in the other two regions for workers， preschool children， and unemployed persons （χ2=54.515， P<0.001）. Spatially， the incidence was significantly higher in the north-central sub-districts than in the south （χ2=88.103， P<0.001）. Moreover， 33.14% of measles cases did not receive measles-containing vaccine （MCV）， while 53.90% of the cases remained unknown. Additionally， uptake rate of MCV in non-local residents was significantly lower than in local residents （χ2=14.422， P<0.001）. ConclusionThe measles incidence remains remarkably low in Baoshan District of Shanghai. Young and middle-aged populations in the north-central region are susceptible to measles. It is recommended to further strengthen measles surveillance， maintain high coverage of MCV among school-age children combined with catch-up immunization for at-risk populations， and improve health education.

Management practice of Investigator-Initiated Trials in the new period / 中华医学科研管理杂志

Objective:In the context of China′s increasing standardized management requirements of clinical research, this article aims to explore the management methods of investigator-initiated trials in the new period, to provide possible reference for other medical institutions dedicated to clinical research.Methods:According to the requirements set forth by the＂Administrative Measures for Investigator-Initiated Trials in Medical and Health Institutions (Trial)", combined with the hospital management practice, experiences regarding the research management system construction and implementation, management system construction and its implementation effects are summarized and analyzed.Results:By exploring and summarizing the connotation of high-quality clinical research under the New Policy, tailored clinical research management system in our hospital was developed and implemented. And the hospital′s clinical research capability and level have been greatly improved, which enhancing the hospital academic influence, as well as its competence for serving the development of national and regional clinical research.Conclusions:Along with the rapid progress of clinical research, hospitals need to assure the compliance of national laws and regulations, and develop appropriate and applicable institutional management measures to empower the conduct of high quality clinical research.

Monitoring of adverse reaction of Haemophilus influenzae type b vaccine in Songjiang District， Shanghai / 上海预防医学

ObjectiveTo determine the reporting rate of adverse reaction of Haemophilus influenzae type b （Hib） containing vaccine in Songjiang District from 2016 to 2020， so as to provide evidence for the inclusion of Hib vaccine in children's immunization planning and safety monitoring. MethodsThe adverse reaction data of Hib vaccination were collected through the Chinese Disease Prevention and Control Information System and presented by descriptive methods. ResultsFrom 2016 to 2020， the reporting rate of adverse reaction of various Hib-containing vaccines in Songjiang District was determined to be 747.76/105 doses， among which the rates of general reaction and abnormal reaction were 734.31/105 doses and 13.45/105 doses， respectively. The reporting rate of general reaction was significantly higher than that of abnormal reaction （χ2=1 400.18，P<0.001）. Moreover， the reporting rate of adverse reaction did not differ significantly by sex or registered residence， whereas it differed significantly by age groups （χ2=366.07，P<0.001）. Children ≥12 months old had the highest reporting rate， which was caused by higher rate of general reaction （χ2=360.48，P<0.001） compared with other age groups； in contrast， there was no difference in the reporting rate of abnormal reactions across age groups. The reporting rate of adverse reaction differed significantly across four Hib-containing vaccines （χ2=508.51，P<0.001）， among which the reporting rate of pentavalent vaccine was the highest， followed by tetravalent vaccine， and Hib vaccine and meningococcal HI vaccine. This difference was mainly caused by general reaction （χ2=499.19，P<0.001）. The reporting rate of booster Hib-containing vaccines was significantly higher than that of basic immunization （χ2=462.85，P<0.001）. Furthermore， the reporting rate differed between DTaP-Hib vaccine and DTaP-IPV-Hib vaccine by injection sites（χ2=13.63，P=0.001；χ2=78.48， P<0.001）； the reporting rate on the thigh was lower than that on the hip or upper arm. Among the 1 501 reported adverse reactions， 97.21% of the general reactions and 85.19% of the abnormal reactions occurred within 72 hours following immunization. Principal clinical diagnosis was fever， redness and nodules （n=1 454）， accounting for 96.87% of the total reported adverse event following immunization（AEFI）， followed by allergic rash. ConclusionThe four types of Hib-containing vaccines have high safety. Health care practitioners at points of vaccination should improve the pre-examination， standardized operation and full notification in strict accordance with the requirements. It also warrants strengthening the AEFI monitoring， investigation and response， so as to effectively reduce the incidence and severity of adverse reactions.

Progress on clinical drug trials of esophageal squamous cell carcinoma in China from 2012 to 2021 / 中国胸心血管外科临床杂志

@#Objective     To summarize the progress and trend on clinical drug trials of esophageal squamous cell carcinoma in China. Methods     Based on the clinical drug trial registration and information disclosure platform and the drug data query system of the National Medical Products Administration, the characteristics of clinical trials, investigational drugs and listed drugs of esophageal squamous cell carcinoma in China from 2012 to 2021 were analyzed. Results     From 2012 to 2021, a total of 49 clinical drug trials of esophageal squamous cell carcinoma were registered in China, accounting for 1.6% of all clinical trials of anticancer drugs. Among them, there were 39 (79.6%) trials initiated by domestic pharmaceutical enterprises, 6 (12.2%) for adjuvant and neoadjuvant treatment, and 9 (18.4%) for local treatment. There were differences in the treatment line distribution between global and domestic enterprise-initiated trials (P=0.032). The above trials covered 29 investigational drugs, including 23 (79.3%) targeted drugs, most of which targeted programmed death-1, programmed death-ligand 1 and epidermal growth factor receptor. From 2012 to 2021, there were 2 drugs for esophageal squamous cell carcinoma listed in China, both of which were approved for the first-line and second-line treatment. Conclusion     Great achievements have been made in the clinical development of esophageal squamous cell carcinoma drugs in China. It is suggested that domestic enterprises increase the investment of esophageal squamous cell carcinoma, pay attention to adjuvant and local treatment, explore novel targets and drug categories, and focus on the details of pivotal trials.

Progress on clinical trials of common gastrointestinal cancer drugs in China from 2012 to 2021 / 中华肿瘤杂志

Objective: Systematically summarize the research progress of clinical trials of gastric cancer oncology drugs and the overview of marketed drugs in China from 2012 to 2021, providing data and decision-making evidence for relevant departments. Methods: Based on the registration database of the drug clinical trial registration and information disclosure platform of Food and Drug Administration of China and the data query system of domestic and imported drugs, the information on gastric cancer drug clinical trials, investigational drugs and marketed drugs from January 1, 2012 to December 31, 2021 was analyzed, and the differences between Chinese and foreign enterprises in terms of trial scope, trial phase, treatment lines and drug type, effect and mechanism studies were compared. Results: A total of 114 drug clinical trials related to gastric tumor were registered in China from 2012 to 2021, accounting for 3.7% (114/3 041) of all anticancer drug clinical trials in the same period, the registration number showed a significant growth rate after 2016 and reached its peak with 32 trials in 2020. Among them, 85 (74.6%, 85/114) trials were initiated by Chinese pharmaceutical enterprise. Compared with foreign pharmaceutical enterprise, Chinese pharmaceutical enterprise had higher rates of phase I trials (35.3% vs 6.9%, P=0.001), but the rate of international multicenter trials (11.9% vs 67.9%, P<0.001) was relatively low. There were 76 different drugs involved in relevant clinical trials, of which 65 (85.5%) were targeted drugs. For targeted drugs, HER2 is the most common one (14 types), followed by PD-1 and multi-target VEGER. In the past ten years, 3 of 4 marketed drugs for gastric cancer treatment were domestic and included in the national medical insurance directory. Conclusions: From 2012 to 2021, China has made some progress in drug research and development for gastric carcinoma. However, compared with the serious disease burden, it is still insufficient. Targeted strengthening of research and development of investment in many aspects of gastric cancer drugs, such as new target discovery, matured target excavating, combination drug development and early line therapy promotion, is the key work in the future, especially for domestic companies.

A follow up study depressive and anxiety symptoms of children in Wuhan City, Hubei Province / 中国学校卫生

Objective@#To investigate the progression of depressive and anxiety symptoms of children, especially whose parents were frontline workers in the combat of the coronavirus disease 2019 (COVID-19), and to provide evidence for children s mental health promotion.@*Methods@#In June and December 2020, two surveys were conducted among the children in a primary school in Qiaokou District, Wuhan. The questionnaire included demographic information, student learning conditions, and depressive/anxiety symptoms.@*Results@#A total of 963 children completed both surveys. The detection rate of depressive and anxiety symptoms at follow up was significantly higher than that at the baseline survey (depressive symptoms: OR=1.45, 95%CI =1.16-1.83; anxiety symptoms: OR=1.79, 95%CI =1.41-2.28, P <0.01). There was no statistically significant change in depressive/anxiety symptoms among children whose parents were frontline workers compared with those whose parents were not( P >0.05). Girls, lower learning efficiency, and less interaction with teachers in class were risk factors for depressive or anxiety symptoms of children( P < 0.05 ).@*Conclusion@#Mental health status of children requires continuous attention. Moreover, timely psychological protection should be given to prevent the occurrence of psychological problems and the further deterioration of psychological problems.

Effects of learning and lifestyle behaviors during home confinement on depressive and anxiety symptoms among primary school students / 中国学校卫生

Objective@#To examine the changes of depressive and anxiety symptoms in school aged children during home confinement and to identify possible influence of learning and lifestyle behaviors on mental health changes.@*Methods@#The population of this study were obtained from the "Tongji Mental Health Cohort". Two primary schools in Wuhan were selected through cluster sampling and students in grade 2-5 were surveyed. This study was divided into two stages. In the first stage (T1=during home learning), a total of 2 588 valid questionnaires were collected. In the second phase (T2=during school learning), 2 424 children were followed up successfully. Combining the results of the depression and anxiety symptoms of the two surveys of children respectively to classify the children s psychological outcomes. Association between home learning and lifestyle behaviors with the change of psychological symptoms in school aged children were estimated by disordered multi classification Logistic regression.@*Results@#The prevalence of depressive and anxiety symptoms were 28.9% and 21.0% in school aged children at T1, 35.6% and 30.6% at T2, respectively. The aggravation and persistence of depressive and anxiety symptoms in children were partly related to their home learning and lifestyle behaviors. Concentration in class（ OR=0.63，95%CI =0.45-0.89）, frequent interaction with teachers ( OR =0.74, 95% CI = 0.57- 0.95 ), participation in physical exercise at home ( OR =0.60, 95% CI =0.41-0.87) was negatively associated with depressive symptoms in children. Time spent on playing video games ( OR =1.15, 95% CI =1.06-1.24) and fear of infection with coronavirus disease 2019 ( OR =1.83, 95% CI =1.39-2.42) were positively associated with anxiety in children. Boys（ OR=0.70， 0.63 ） were more likely to suffer from depression and anxiety symptoms than girls.@*Conclusion@#The prevalence of depressive and anxiety symptoms among school aged children increased when they went back to school after home confinement, suggesting more attention are needed for mental health intervention among school aged children.

Correlation of endoscopy findings with symptoms in patients undergoing gastroscopy: a prospective study / 中华消化内镜杂志

Objective:To investigate the correlation of endoscopy findings with symptoms in patients undergoing gastroscopy.Methods:Patients who underwent gastroscopy for the first time in Renji Hospital of Shanghai Jiao Tong University School of Medicine from January to December 2017 were included in the questionnaire survey. The participants were asked to report their main symptoms of the digestive tract in details, and gastroscopy was completed within 2 weeks. Final gastroscopic diagnosis was made based on both gastroscopy and pathology, then patients were divided into the major-lesion (peptic ulcer and malignancy) group and the non-major-lesion (chronic gastritis, reflux esophagitis and others) group. The correlation of gastrointestinal symptoms with gastroscopic findings was analyzed. The risk for major gastroscopic lesions (peptic ulcer and malignant tumors) was assessed by multivariate Logistic regression analysis.Results:A total of 5 885 patients completed the questionnaire, 5 496 (93.4%) of whom completed gastroscopy. The detection rates of peptic ulcer were 12.3% (373/3 028), 12.6% (52/412), 17.9% (49/273), 9.5% (64/675) and 9.2% (102/1 108) in patients with dyspepsia, reflux, alarm, other symptoms and no symptoms, respectively, the detection rates of malignant tumors were 1.2% (36/3 028), 0.7% (3/412), 7.7% (21/273), 0.7% (5/675) and 0.4% (4/1 108), respectively in these patients. The most common symptoms was dyspepsia, accounted for 58.3% (373/640) and 52.2% (36/69) patients with peptic ulcer and malignant tumors, respectively. Alarm symptoms were found in 30.4% (21/69) patients with malignant tumors, and 15.9% (102/640) peptic ulcer patients and 5.8% (4/69) malignant tumor patients had no gastrointestinal symptoms. Compared to asymptomatic individuals, patients with dyspepsia ( P<0.001, OR=1.52, 95% CI: 1.21-1.92) and those with warning symptoms ( P<0.001, OR=2.87, 95% CI: 2.02-4.08) had significantly increased risk for major lesions (peptic ulcer and malignant tumors) detected by gastroscopy. Conclusion:Although dyspepsia and alarm symptoms are positively associated with upper gastrointestinal malignancy and peptic ulcer, they are of limited predictive value for upper gastrointestinal diseases.

c-MYC-mediated TRIB3/P62+ aggresomes accumulation triggers paraptosis upon the combination of everolimus and ginsenoside Rh2

The mammalian target of rapamycin (mTOR) pathway is abnormally activated in lung cancer. However, the anti-lung cancer effect of mTOR inhibitors as monotherapy is modest. Here, we identified that ginsenoside Rh2, an active component of Panax ginseng C. A. Mey., enhanced the anti-cancer effect of the mTOR inhibitor everolimus both in vitro and in vivo. Moreover, ginsenoside Rh2 alleviated the hepatic fat accumulation caused by everolimus in xenograft nude mice models. The combination of everolimus and ginsenoside Rh2 (labeled Eve-Rh2) induced caspase-independent cell death and cytoplasmic vacuolation in lung cancer cells, indicating that Eve-Rh2 prevented tumor progression by triggering paraptosis. Eve-Rh2 up-regulated the expression of c-MYC in cancer cells as well as tumor tissues. The increased c-MYC mediated the accumulation of tribbles homolog 3 (TRIB3)/P62+ aggresomes and consequently triggered paraptosis, bypassing the classical c-MYC/MAX pathway. Our study offers a potential effective and safe strategy for the treatment of lung cancer. Moreover, we have identified a new mechanism of TRIB3/P62+ aggresomes-triggered paraptosis and revealed a unique function of c-MYC.

Prevalence of chronic diseases among bus drivers in Hefei， Anhui / 上海预防医学

ObjectiveTo analyze the effect of working conditions on the occurrence and development of chronic diseases in bus drivers in Hefei. MethodsA total of 380 bus drivers were selected by convenient sampling method. Their basic information， working intensity， working environment， working habits， living habits and physical health were investigated. ResultsThe three most common occupational-related diseases were： 1） anxiety and depression caused by work environment such as noise and traffic jam （70.79%， 269/380）； 2） dry eyes， eye fatigue， blurred vision and so on （65.53%， 249/380）； 3） cervical and lumbar pain （63.16%， 240/380）. Gastrointestinal dysfunction （irritable bowel syndrome related symptoms） occurred in 42.37% （161/380） of the drivers and 45.53% （173/380） had suffered from hemorrhoids or anal fissure. Drivers with long-term suffocation were more likely to suffer from urinary tract infection （χ 2=22.330， P<0.001）. The rate of subjective eye discomfort was higher in the drivers with long working hours （χ 2=11.682， P<0.01）， and the rate of leg swelling was higher in the drivers with frequent driving without rest （χ 2=16.642， P<0.05）. There was a significant difference in the rate of anxiety and depression between the divers with different sleep duration （χ 2=17.379，P<0.001）. Results of multiple logistic regression analysis showed that the incidence of anxiety and depression was higher in drivers with longer working hours. In comparison with the group of over 6 working hours， the rate increased to 4.080 times in the group of over 8 working hours， 2.583 times in the group of over 10 working hours， and 2.484 times in the group of over 12 working hours， respectively. Occasional and frequent non-stop working drivers were 4.302 and 4.828 times， respectively， more likely to be anxious or depressed. Logistic regression analysis also showed that the incidence of gastrointestinal dysfunction （irritable bowel syndrome related symptoms） in drivers with anxiety and depression was 3.792 times higher than that in drivers without anxiety and depression （OR=3.792， 95% CI 2.384 to 6.029， P<0.001）. ConclusionSome working environment， excessive working intensity， poor living and working habits， and mental problems are closely related to the occurrence and development of chronic diseases in bus drivers.