Monotropein Induced Apoptosis and Suppressed Cell Cycle Progression in Colorectal Cancer Cells / 中国结合医学杂志

OBJECTIVE@#To determine whether monotropein has an anticancer effect and explore its potential mechanisms against colorectal cancer (CRC) through network pharmacology and molecular docking combined with experimental verification.@*METHODS@#Network pharmacology and molecular docking were used to predict potential targets of monotropein against CRC. Cell counting kit assay, plate monoclonal assay and microscopic observation were used to investigate the antiproliferative effects of monotropein on CRC cells HCT116, HT29 and LoVo. Flow cytometry and scratch assay were used to analyze apoptosis and cell cycle, as well as cell migration, respectively in HCT116, HT29, and LoVo cells. Western blotting was used to detect the expression of proteins related to apoptosis, cell cycle, and cell migration, and the expression of proteins key to the Akt pathway.@*RESULTS@#The Gene Ontology and Reactome enrichment analyses indicated that the anticancer potential of monotropein against CRC might be involved in multiple cancer-related signaling pathways. Among these pathways, RAC-beta serine/threonine-protein kinase (Akt1, Akt2), cyclin-dependent kinase 6 (CDK6), matrix metalloproteinase-9 (MMP9), epidermal growth factor receptor (EGFR), cell division control protein 42 homolog (CDC42) were shown as the potential anticancer targets of monotropein against CRC. Molecular docking suggested that monotropein may interact with the 6 targets (Akt1, Akt2, CDK6, MMP9, EGFR, CDC42). Subsequently, cell activity of HCT116, HT29 and LoVo cell lines were significantly suppressed by monotropein (P<0.05). Furthermore, our research revealed that monotropein induced cell apoptosis by inhibiting Bcl-2 and increasing Bax, induced G1-S cycle arrest in colorectal cancer by decreasing the expressions of CyclinD1, CDK4 and CDK6, inhibited cell migration by suppressing the expressions of CDC42 and MMP9 (P<0.05), and might play an anticancer role through Akt signaling pathway.@*CONCLUSION@#Monotropein exerts its antitumor effects primarily by arresting the cell cycle, causing cell apoptosis, and inhibiting cell migration. This indicates a high potential for developing novel medication for treating CRC.

Application of PBL-based scenario simulation teaching in the standardized residency training in the department of critical care medicine / 中华医学教育探索杂志

Objective:To explore the role and effect of problem-based learning (PBL)-based scenario simulation teaching in the standardized residency training in the department of critical care medicine.Methods:A total of 48 residents who received standardized residency training in the Department of Critical Care Medicine of the First Affiliated Hospital of Soochow University from March 2019 to December 2019 were randomly divided into the experimental group and the control group, with 24 ones in each group. The experimental group used PBL-based scenario simulation teaching, while the control group adopted the traditional teaching. After the end of the teaching, the exam scores of the two groups were observed and compared. Then the questionnaire was used to analyze the differences of the results. SPSS 17.0 was used for t-test. Results:The scores of theoretical assessment (85.50±5.15) and skill assessment (82.38±5.64) in the experimental group were higher than those in the control group[(77.04±8.69) and (70.92±5.65)], and the differences were statistically significant ( P < 0.05). The experimental group was higher than the control group in improving learning interest and efficiency, improving clinical work ability, strengthening clinical thinking ability, improving teamwork ability, and improving doctor-patient communication ability, and the difference was statistically significant ( P < 0.05). Conclusion:The PBL-based scenario simulation teaching has more advantages over the traditional teaching and is worthy of promotion.

Lack of association between the VEGFA gene polymorphisms and preterm birth in Korean women

Preterm birth (PTB), a pregnancy-related disease, is defined as a birth before 37 weeks of gestation. It is a major cause of maternal mortality and morbidity worldwide, and its incidence rate is steadily increasing. Various genetic factors can contribute to the etiology of PTB. Vascular endothelial growth factor A (VEGFA) gene is an important angiogenic gene and its polymorphisms have been reported to be associated with PTB development. Therefore, we conducted a case-control study to evaluate the association between VEGFA rs699947, rs2010963, and rs3025039 polymorphisms and PTB in Korean women. A total of 271 subjects (116 patients with PTB and 155 women at ≥38 weeks of gestation) were analyzed in this study. The genotyping of VEGFA gene polymorphisms was performed using polymerase chain reaction– restriction fragment length polymorphism. No significant association between the patients with PTB and the control groups was confirmed. In the combination analysis, we found a significant association between PTB and VEGFA rs699947 CC-rs2010963 GG-rs3025039 CC combination (odds ratio, 3.77; 95% confidence interval, 1.091 to 13.032; p = 0.031). The VEGFA rs699947, rs2010963, and rs3025039 polymorphisms might have no genetic association with the pathogenesis of PTB in Korean women. However, the combination analysis indicates the possibility that VEGFA acts in PTB pathophysiology. Therefore, larger sample sets and replication studies are required to further elucidate our findings.

Predictive value of pulse infusion index in the short-term prognosis of patients with sepsis-induced acute kidney injury / 中华危重病急救医学

OBJECTIVE@#To investigate the predictive value of pulse infusion index (PPI) in the short-term prognosis of patients with sepsis-induced acute kidney injury (AKI).@*METHODS@#A retrospective cohort study was conducted. The clinical data of patients with sepsis-induced AKI admitted to intensive care unit (ICU) of the First Affiliated Hospital of Soochow University from July 2021 to December 2022 were enrolled. The basic information of the patients were collect, including age, gender, site of infection, underlying disease, mean arterial pressure (MAP) and heart rate (HR) at admission, as well as the use of mechanical ventilation and vasoactive drugs, and norepinephrine (NE) dosage. Laboratory indicators, sequential organ failure assessment (SOFA) score and PPI within 24 hours of admission were also recorded, and the patient's prognosis during ICU hospitalization was also recorded. The differences in clinical data between the patients of two groups with different prognosis were compared. Spearman correlation method was used to analyze the correlation between PPI and SOFA score. Binary multivariate Logistic regression analysis was used to screen independent risk factors for death during ICU hospitalization in sepsis patients with AKI. Receiver operator characteristic curve (ROC curve) was plotted to evaluate the predictive value of PPI for the short-term prognosis of patients with sepsis-induced AKI.@*RESULTS@#A total of 102 patients with sepsis-induced AKI were enrolled, of which 70 patients in the survival group and 32 patients in the death group, with ICU mortality of 31.4. Compared with the survival group, SOFA score, HR, procalcitonin (PCT), serum creatinine (SCr), and NE dosage in the death group were significantly increased [SOFA score: 11.22±2.48 vs. 8.56±2.01, HR (bpm): 103.80±12.47 vs. 97.41±9.73, PCT (μg/L): 9.22 (5.24, 17.84) vs. 6.19 (3.86, 7.71), SCr (μmol/L): 163.2 (104.7, 307.9) vs. 125.5 (89.3, 221.0), Lac (mmol/L): 2.81 (1.95, 4.22) vs. 2.13 (1.74, 2.89), NE usage (μg×kg-1×min-1): 0.7 (0.4, 1.1) vs. 0.5 (0.2, 0.6), all P < 0.05], while PPI was significantly lower than that in survival group [0.83 (0.42, 1.55) vs. 1.70 (1.14, 2.20), P < 0.01]. Spearman correlation analysis showed that based on SOFA score, PPI was closely related to the severity of patients with sepsis-induced AKI (r = -0.328, P < 0.05). Binary multivariate Logistic regression analysis showed that PPI [odds ratio (OR) = 0.590, 95% confidence interval (95%CI) was 0.361-0.966, P = 0.002], SOFA score (OR = 1.406, 95%CI was 1.280-1.545, P < 0.001), PCT (OR = 2.061, 95%CI was 1.267-3.350, P = 0.006) were independent risk factors of the short-term prognosis of patients with sepsis-induced AKI. ROC curve analysis showed that the area under the ROC curve (AUC) of PPI for death during ICU hospitalization in patients with sepsis-induced AKI was 0.779 (95%CI was 0.686-0.855, P < 0.001), which superior to PCT (AUC = 0.677, 95%CI was 0.577-0.766, P = 0.004), and similar to SOFA score (AUC = 0.794, 95%CI was 0.703-0.868, P < 0.001). When the cut-off value of PPI was 0.72, the sensitivity was 50.0%, and the specificity was 97.1%.@*CONCLUSIONS@#PPI has a good predictive value for the short-term prognosis of patients with sepsis-induced AKI during ICU hospitalization.

Prevalence and frequencies of human papilloma virus types in adenocarcinoma in situ of the uterine cervix / 中华病理学杂志

Objective: To examine the prevalence and frequencies of human papillomavirus (HPV) genotypes in cervical adenocarcinoma in situ (AIS). Methods: The cases of cervical AIS with concurrent tests of cytology and HPV typing from January 2007 to February 2020 in the Obstetrics and Gynecology Hospital of Fudan University were collected and analyzed. Results: A total of 478 cases of cervical AIS were obtained. The average age of the patients was 39.4 years (range, 19-81 years). The largest age group was 30-39 years (44.8%), followed by 40-49 years (34.7%). Among the 478 patients, 355 underwent high-risk HPV (hrHPV) testing and had a hrHPV-positive rate of 93.8%. Of the 355 patients, 277 also underwent HPV typing and were mostly positive for either or both HPV16 and HPV18 (93.1%), with 55.6% positive for HPV18 and 48.7% positive for HPV16. Among the 478 cases, 266 cases (55.6%) were diagnosed with both AIS and squamous intraepithelial lesion (SIL), while 212 cases (44.4%) were diagnosed with only AIS. Patients infected with HPV16 in the AIS and SIL group significantly outnumbered those in the AIS alone group (P<0.05). Moreover, the rate of positive cytology was 55.9% (167/299 cases), while that of negative cytology was 44.1% (132/299). Among the 109 patients with negative cytology results and co-tested hrHPV, there were 101 HPV-positive cases (92.7%), of which 88 cases were subject to HPV typing and showed an HPV16/18 positive rate of 94.3% (83/88 cases). Conclusions: The combination of HPV typing and cytological screening can maximize the detection rate of cervical AIS, and should continue to be utilized, ideally on a larger scale, in the future.

Prediction of trends for fine-scale spread of Oncomelania hupensis in Shanghai Municipality based on supervised machine learning models / 中国血吸虫病防治杂志

OBJECTIVE@#To predict the trends for fine-scale spread of Oncomelania hupensis based on supervised machine learning models in Shanghai Municipality, so as to provide insights into precision O. hupensis snail control.@*METHODS@#Based on 2016 O. hupensis snail survey data in Shanghai Municipality and climatic, geographical, vegetation and socioeconomic data relating to O. hupensis snail distribution, seven supervised machine learning models were created to predict the risk of snail spread in Shanghai, including decision tree, random forest, generalized boosted model, support vector machine, naive Bayes, k-nearest neighbor and C5.0. The performance of seven models for predicting snail spread was evaluated with the area under the receiver operating characteristic curve (AUC), F1-score and accuracy, and optimal models were selected to identify the environmental variables affecting snail spread and predict the areas at risk of snail spread in Shanghai Municipality.@*RESULTS@#Seven supervised machine learning models were successfully created to predict the risk of snail spread in Shanghai Municipality, and random forest (AUC = 0.901, F1-score = 0.840, ACC = 0.797) and generalized boosted model (AUC= 0.889, F1-score = 0.869, ACC = 0.835) showed higher predictive performance than other models. Random forest analysis showed that the three most important climatic variables contributing to snail spread in Shanghai included aridity (11.87%), ≥ 0 °C annual accumulated temperature (10.19%), moisture index (10.18%) and average annual precipitation (9.86%), the two most important vegetation variables included the vegetation index of the first quarter (8.30%) and vegetation index of the second quarter (7.69%). Snails were more likely to spread at aridity of < 0.87, ≥ 0 °C annual accumulated temperature of 5 550 to 5 675 °C, moisture index of > 39% and average annual precipitation of > 1 180 mm, and with the vegetation index of the first quarter of > 0.4 and the vegetation index of the first quarter of > 0.6. According to the water resource developments and township administrative maps, the areas at risk of snail spread were mainly predicted in 10 townships/subdistricts, covering the Xipian, Dongpian and Tainan sections of southern Shanghai.@*CONCLUSIONS@#Supervised machine learning models are effective to predict the risk of fine-scale O. hupensis snail spread and identify the environmental determinants relating to snail spread. The areas at risk of O. hupensis snail spread are mainly located in southwestern Songjiang District, northwestern Jinshan District and southeastern Qingpu District of Shanghai Municipality.

Effect of Micro-fertilizer Containing Rare Earth on Growth，Yield and Quality of Angelica sinensis / 中国实验方剂学杂志

ObjectiveTo investigate the effects of micro-fertilizer containing rare earth of different types and concentrations on the growth，yield and quality of Angelica sinensis. MethodOn the basis of the single-factor randomized block design， the growth and index components of Angelica sinensis were determined with rare earth-containing nitrate and chloride micro-fertilizers of different concentrations as foliar fertilizers. ResultSpraying 0.8 g·mL-1 rare earth-containing chloride micro-fertilizer could increase the economic yield of A. sinensis， with the fresh yield per mu （1 mu≈667 m2） reaching 855.4 kg and the dry yield per mu 350.7 kg，which increased by 15.16% and 28.70% respectively compared with that in the control group CK1. Spraying 1.2 g·mL-1 rare earth-containing nitrate micro-fertilizer could promote the growth and development of A. sinensis and significantly increase the content of index components， with the plant height reaching 93.05 cm，the stem diameter 15.60 mm，the root diameter 16.10 mm，the main root length 36.5 cm，and the number of leaves 11.25 pieces per plant， which increased by 32.76%，31.98%，41.98%，53.36%，and 45.16%， respectively， compared with those in the control group CK2. Besides， the content of ferulic acid，volatile oil，ligustilide， and extract was 0.96%，0.41%，0.30% and 48.76%，respectively，which increased by 12.94%，17.14%，11.11%， and 12.07%，respectively，compared with that in the control group CK2. ConclusionSpraying 0.8 g·mL-1 rare earth-containing chloride micro-fertilizer and 1.2 g·mL-1 rare earth-containing nitrate micro-fertilizer can promote the growth and development of A. sinensis，improve the medicinal properties，and increase yield and quality. Rare earth-containing micro-fertilizers can be applied in the standardization of A. sinensis cultivation， which can change the production status of A. sinensis that depends on chemical fertilizers and single fertilization， and promote the green， organic and ecological cultivation of A. sinensis.

Effect of Notch1 on extracellular matrix deposition in the renal tubulointerstitium of diabetes / 生理学报

The aim of the present study was to observe the effects of Notch1 and autophagy on extracellular matrix deposition in renal tubulointerstitium of diabetes and to explore the mechanism. The mice were randomly divided into normal control group (db/m mice) and diabetes group (db/db mice). After 12 weeks of feeding, the mice were sacrificed and the corresponding biochemical indexes were measured. Rat renal tubular epithelial cells NRK52E were cultured under normal glucose (NG) and high glucose (HG) respectively, and the expression of Notch1 and LC3 proteins were detected by Western blotting. Autophagosomes in NRK52E cells with overexpressed and knockdown Notch1 under NG and HG conditions were observed by confocal microscope, and the expression changes of Notch1, Collagen-I and III protein were detected by immunofluorescence. The results showed that the Notch1 and Collagen-III expressions were increased (P < 0.01) and the LC3 expression was decreased (P < 0.05) in db/db mice compared with db/m mice. In vitro, the Notch1 was increased (P < 0.01) and the LC3 expression was decreased significantly (P < 0.01) in NRK52E cells of HG group compared with NG group. There was no significant change of Notch1 and LC3 expression between the mannitol (MA) group and the NG group. Autophagy was decreased and extracellular matrix deposition was aggravated when Notch1 was overexpressed. In contrast, autophagy was increased and extracellular matrix deposition was relieved by knockdown of Notch1 under HG conditions. In conclusion, Notch1 protein expression was increased and autophagy was reduced in renal tissue of diabetes and renal tubular epithelial cells under HG. The extracellular matrix deposition in the renal tubulointerstitium was relieved by regulating autophagy after the knockdown of Notch1.

Value of bedside echocardiography in predicting persistent patency of the ductus arteriosus during the early postnatal period in very low birth weight infants / 中国当代儿科杂志

OBJECTIVES@#To study the value of bedside echocardiography in predicting persistent patency of the ductus arteriosus during the early postnatal period in very low birth weight (VLBW) infants.@*METHODS@#A retrospective analysis was performed for 51 VLBW infants who were admitted from March 2020 to June 2021, with an age of ≤3 days and a length of hospital stay of ≥14 days. According to the diameter of patent ductus arteriosus (PDA) on days 14 and 28 after birth, the infants were divided into three groups: large PDA group (PDA diameter ≥2 mm), small PDA group (PDA diameter <2 mm), and PDA closure group (PDA diameter =0 mm). The echocardiographic parameters measured at 72 hours after birth were compared among the three groups. The receiver operating characteristic (ROC) curve was used to evaluate the value of the echocardiographic parameters in predicting persistent patency of the ductus arteriosus (PDA≥2 mm) at the ages of 14 and 28 days.@*RESULTS@#On day 14 after birth, there were 17 infants in the large PDA group, 11 in the small PDA group, and 23 in the PDA closure group. On day 28 after birth, there were 14 infants in the large PDA group, 9 in the small PDA group, and 26 in the PDA closure group. There were significant differences in gestational age, birth weight, rate of pulmonary surfactant use, and incidence rate of hypotension among the three groups (P<0.05). PDA diameter, end-diastolic velocity of the left pulmonary artery, left ventricular output, and left ventricular output/superior vena cava flow ratio measured at 72 hours after birth were associated with persistent patency of the ductus arteriosus at the ages of 14 and 28 days (P<0.05), and the ratio of the left atrium to aorta diameter was associated with persistent patency of the ductus arteriosus at the age of 28 days (P<0.05). The ROC curve analysis showed that the area under the curve that the PDA diameter measured at 72 hours after birth predicting the persistent patency of the ductus arteriosus at the ages of 14 and 28 days was the largest (0.841 and 0.927 respectively), followed by end-diastolic velocity of the left pulmonary artery, with the area under the curve of 0.793 and 0.833 respectively.@*CONCLUSIONS@#The indicators obtained by beside echocardiography at 72 hours after birth, especially PDA diameter and end-diastolic velocity of the left pulmonary artery, can predict persistent patency of the ductus arteriosus at the ages of 14 and 28 days in VLBW infants, which provides a basis for the implementation of early targeted treatment strategy for PDA.

Risk factors of perivalvular leakage after transcatheter aortic valve replacement with Venus-A valve / 中华心血管病杂志

Objective: To investigate the risk factors of moderate or severe perivalvular leakage (PVL) after transcatheter aortic valve replacement (TAVR) with Veneus-A valve. Methods: This study was a single-center case-control study. The clinical data of patients with severe aortic stenosis, who underwent TAVR in the Department of Cardiology of Second Affiliated Hospital of Army Medical University from October 2017 to January 2021, were analyzed. According to the circumferential extent of prosthetic valve paravalvular regurgitation measured by transthoracic echocardiography before discharge (patients who died in hospital were referred to transesophageal echocardiography results after valve implanted), the patients were divided into moderate or severe PVL group and mild or non-PVL group. The clinical features, CT scan and analysis results of aortic root were compared between the two groups. Multivariate logistic regression analysis was used to identify the independent risk factors of postoperative moderate or severe PVL, and receiver operating characteristic (ROC) curve was used to explore the predictive value of related factors. Results: Eighty-two patients (mean age: (70.9±6.5) years, 46 males) were included in the analysis, there were 16 patients in the moderate or severe PVL group and 66 patients in the mild or non-PVL group. The proportion of male gender, depth of valve implantation, size of valve annulus and left ventricular outflow tract (LVOT), and coverage index of LVOT were significantly higher in moderate or severe PVL group than those in mild or non-PVL group (Pall<0.05). As there was a strong collinearity among the valve annular short diameter, LVOT short diameter and LVOT coverage index (partial correlation coefficient R 0.251-0.779, P<0.05), these parameters were not entered in regression model. Multivariate logistic regression analysis showed that valve implantation depth(OR=1.239,95%CI 1.036-1.442,P=0.023), aortic angulation(OR=1.128, 95%CI 1.044-1.312,P=0.038)and LVOT tract coverage index (OR=1.123, 95%CI1.003-1.315, P=0.032) were independent risk factors for moderate or severe PVL after TAVR. The ROC curve showed that the valve implantation depth could predict the occurrence of moderate or severe PVL after TAVR (area under ROC curve (AUC)=0.697, 95%CI 0.554-0.851, P=0.039). Conclusion: Among patients with severe aortic stenosis who undergo TAVR with Venus-A valve, the implantation depth, aortic angulation and LVOT coverage index are independent risk factors of moderate/severe PVL after TAVR, among which valve implantation depth could be used to predict the occurrence of moderate/severe PVL after TAVR.

Characteristics and outcomes following transcatheter aortic valve replacement in China: a report from China aortic valve transcatheter replacement registry (CARRY) / 中华医学杂志(英文版)

BACKGROUND@#The past decade has witnessed an ever-increasing momentum of transcatheter aortic valve replacement (TAVR) and a subsequent paradigm shift in the contemporary management of severe aortic stenosis (AS). We conducted a multi-centric TAVR registry based on Chinese patients (the China Aortic valve tRanscatheter Replacement registrY [CARRY]) to delineate the clinical characteristics and outcomes of Chinese patients who underwent TAVR and compare the results between different valve types in different Chinese regions.@*METHODS@#CARRY is an all-comer registry of aortic valve disease patients undergoing TAVR across China and was designed as an observational study that retrospectively included all TAVR patients at each participating site. Seven hospitals in China participated in the CARRY, and 1204 patients from April 2012 to November 2020 were included. Categorical variables were compared using the chi-squared test, and continuous variables were analyzed using a t test or analysis of variance (ANOVA) test. The Kaplan-Meier curve was used to estimate the risk of adverse events during follow-up.@*RESULTS@#The mean age of the patients was 73.8 ± 6.5 years and 57.2% were male. The median Society of Thoracic Surgeon-Predicted Risk of Mortality score was 6.0 (3.7-8.9). Regarding the aortic valve, the proportion of bicuspid aortic valve (BAV) was 48.5%. During the hospital stay, the stroke rate was 0.7%, and the incidence of high-degree atrioventricular block indicating permanent pacemaker implantation was 11.0%. The in-hospital all-cause mortality rate was 2.2%. After 1 year, the overall mortality rate was 4.5%. Compared to patients with tricuspid aortic valve (TAV), those with BAV had similar in-hospital complication rates, but a lower incidence of in-hospital mortality (1.4% vs. 3.3%) and 1 year mortality (2.3% vs. 5.8%).@*CONCLUSIONS@#TAVR candidates in China were younger, higher proportion of BAV, and had lower rates of post-procedural complications and mortality than other international all-comer registries. Given the use of early generation valves in the majority of the population, patients with BAV had similar rates of complications, but lower mortality than those with TAV. These findings further propel the extension of TAVR in low-risk patients.@*TRIAL REGISTRATION@#https://www.chictr.org.cn/ (No. ChiCTR2000038526).

Prevalence of Clonorchis sinensis infections in freshwater fish in mainland China: A meta-analysis / 中国血吸虫病防治杂志

Objective To understand the real prevalence of Clonorchis sinensis infections in the freshwater fish in mainland China, so as to provide insights into clonorchiasis control and detection of freshwater fish. Methods All literatures reporting the prevalence of C. sinensis infections in the freshwater fish, the second intermediate host of the parasite, were jointly retrieved in Chinese and English electronic databases from January 1, 2010 to December 31, 2020, including Wanfang Data, CNKI, PubMed, Web of Science, Embase and Cochrane Library. All studies were screened based on inclusion and exclusion criteria, and the quality of all enrolled literatures was evaluated. The pooled prevalence of C. sinensis infections in freshwater fish and its 95% confidence interval (CI) were estimated using the software Stata version 15.0, and subgroup analyses were performed to investigate the region-, season- and sample source-specific pooled prevalence of C. sinensis infections in freshwater fish. In addition, the sensitivity and publication bias of all included studies were analyzed. Results A total of 40 eligible literatures were included in this study, including 37 Chinese literatures and 3 English literatures, and there were 10 high-quality literatures, 27 moderate-quality literatures and 3 low-quality literatures. A total of 53 species containing 37 959 freshwater fish were reported in these 40 studies, and 73.58% (39/53) of freshwater fish species were identified with C. sinensis infections. Meta-analysis showed 23.5% [95% CI: (0.19, 0.28)] pooled prevalence of C. sinensis infections in freshwater fish in mainland China, and subgroup analyses higher prevalence of C. sinensis infections in freshwater fish in northeastern China [35.7%, 95% CI: (0.22, 0.50)] than in central [25.9%, 95% CI: (0.04, 0.48)] and southern China [20.6%, 95% CI: (0.09, 0.32)], higher prevalence of C. sinensis infections in freshwater fish sampled in spring [44.1%, 95% CI: (0.35, 0.53)] than in autumn [6.7%, 95% CI: (0.05, 0.08)] and summer [3.3%, 95% CI: (−0.01, 0.07)], and higher prevalence of C. sinensis infections in freshwater fish sampled from natural water [25.2%, 95% CI: (0.17, 0.33)] than from retail trades [22.2%, 95% CI: (0.17, 0.28)] and breeding chain [12.3%, 95% CI: (0.03, 0.22)]. However, all included studies had a publication bias with a low sensitivity. Conclusions The prevalence of C. sinensis infections is high in freshwater fish in mainland China, and there are still challenges for clonorchiasis control. Reinforcement of health education, diagnostics development and food safety supervision is recommended in future clonorchiasis control programs.

Expert consensus on the strategy and measures to interrupt the transmission of schistosomiasis in China / 中国血吸虫病防治杂志

Since 2015 when the transmission of schistosomiasis was controlled in China, the country has been moving towards elimination of schistosomiasis, with the surveillance-response as the main interventions for schistosomiasis control. During the period of the 13th Five-Year Plan, the transmission of schistosomiasis had been interrupted in four provinces of Sichuan, Jiangsu, Yunnan and Hubei and the prevalence of schistosomiasis has been at the historically lowest level in China. As a consequence, the goal set in The 13th Five-Year National Schistosomiasis Control Program in China is almost achieved. However, there are multiple challenges during the stage moving towards elimination of schistosomiasis in China, including the widespread distribution of intermediate host snails and complicated snail habitats, many types of sources of Schistosoma japonicum infections and difficulty in management of bovines and sheep, unmet requirements for the current schistosomiasis control program with the currently available tools, and vulnerable control achievements. During the 14th Five-Year period, it is crucial to consolidate the schistosomiasis control achievements and gradually solve the above difficulties, and critical to provide the basis for achieving the ultimate goal of elimination of schistosomiasis in China. Based on the past experiences from the national schistosomiasis control program and the challenges for schistosomiasis elimination in China, an expert consensus has been reached pertaining to the objectives, control strategy and measures for The 14th Five-Year National Schistosomiasis Control Program in China, so as to provide insights in to the development of The 14th Five-Year National Schistosomiasis Control Program in China.

Factors Related to Smoking Recurrence within Six-months Smoking Cessation among Employees in Enterprises with Smaller than 300 Workers

Purpose@#The purpose of this study is to identify factors associated with smoking relapse within six months after quit attempts among workers in small and medium-sized enterprises in South Korea. @*Methods@#The analysis was conducted for a total of 194 people who attempted to quit smoking by applying for a smoking cessation support service at the Regional Tobacco Control Center. The data used in the study were extracted from the Smoking Cessation Service Integrated Information System. Kaplan-Meier estimator and Cox proportional hazards regression model were used to identify variables associated with smoking relapse within six months’ time period. @*Results@#Smoking relapse rate within six months was 66.0%, and variables associated with relapse included the cases such as carbon monoxide (CO) at the time of registration (HR: 2.15, 95% CI: 1.10~4.22 for CO ≥20 ppm or more vs.CO ＜10 ppm), the average number of cigarettes smoked per day (HR: 1.04, 95% CI: 1.00~1.07), and the number of counseling(HR: 0.60, 95% CI: 0.54~0.67). @*Conclusion@#Smoking characteristics and counseling showed one of the strongest correlations with relapse within six months. This implies that it is necessary to understand the smoking characteristics and patterns of workers and to provide continuous smoking cessation counseling tailored to individual characteristics for effective smoking relapse prevention.

Impact of the Preoperative Neutrophil to Lymphocyte Ratio on Patients with Head and Neck Cancer / 대한이비인후과학회지

Background and Objectives@#To investigate the prognostic value of the neutrophil to lymphocyte ratio (NLR) in patients with head and neck squamous cell cancer (HNSCC).Subjects and Method Clinical data from 259 patients with HNSCC were collected retrospectively. NLR was adopted as potential prognostic biomarkers. @*Results@#NLR was associated with cancer recurrence (p=0.002 and p＜0.001, respectively). Patients with a NLR ＞2.15 had significantly decreased 5-year disease specific survival (DSS) based on the Kaplan-Meier survival curves (p＜0.001 and p=0.029, respectively). The Multivariate Cox regression analysis confirmed a significant association between 5-year DSS and the NLR (using 2.15 as the cut-off; hazard ratio, 1.852; 95% confidence interval, 1.237-2.771; p= 0.003). @*Conclusion@#A NLR cut-off value ≥2.15 was associated with adverse outcomes in patients with HNSCC.

Analysis on Metabolites of Major Components of Shaoyao Gancaotang in Urine and Feces of Normal and Polycystic Ovary Syndrome Rats / 中国实验方剂学杂志

Objective::To analyze and identify the metabolites of major components of Shaoyao Gancaotang in urine and feces of normal and polycystic ovary syndrome (PCOS) rats, and to explore the effect of PCOS on the metabolism of Shaoyao Gancaotang. Method::Female SD rats were randomly divided into normal group and PCOS group. PCOS rat model was prepared by administration of letrozole solution for 21 days, and the estrous cycle of rats was observed. UHPLC-QTRAP-MS/MS technique and LightSight 2.3 software were used to analyze and identify the metabolites of major components of Shaoyao Gancaotang in urine and feces of normal and PCOS rats. The mobile phase was water-methanol for gradient elution, the flow rate was 0.3 mL·min-1, electrospray ion source was employed under negative ion mode. Result::Phase Ⅰ and phase Ⅱ reactions mainly occurred in drug metabolism. A total of 27 metabolites were detected in urine of normal rats, and 34 metabolites were detected in urine of PCOS rats. A total of 29 metabolites were detected in feces of normal rats, and 27 metabolites were detected in feces of PCOS rats. Conclusion::The metabolites in the urine of PCOS rats are more diverse than those of normal rats, and the disease status of PCOS may affect the in vivo metabolic pathway of active ingredients in Shaoyao Gancaotang.

Spinal transcription factor GATA4 mediated adenosine A1 receptor activation contributes to electroacupuncture analgesia in neuropathic pain rats / 针刺研究

OBJECTIVE: To investigate the effect of electroacupuncture (EA) on pain behaviors and expression of spinal transcription factor GATA-binding Protein 4 (GATA4) and adenosine A1 receptor in neuropathic pain rats, so as to explore its mechanism underlying pain relief. METHODS: The present study includes 2 parts. In the first part, 18 SD rats were randomly divided into control, adenovirus short-hairpin interference RNA for GATA4 (AV-shGATA4 RNA) and adenovirus empty vector (AV-control short-hairpin RNA, AV-shCTRL) groups, with 6 rats in each group. The expression of GATA4 protein in the lumbar spinal cord (L4-L6) was detected to evaluate the transfection efficiency of AV-shGATA4 RNA (silencing GATA4 expression). In the second part, thirty SD rats were randomly divided into 5 groups, namely sham operation, CCI model, EA, EA+AV-shGATA4 RNA, and EA+AV-shCTRL groups, with 6 rats in each group. The neuropathic pain model was established by chronic constriction injury (CCI) of the right sciatic nerve. On the 7th day following modeling, EA was applied to the right "Zusanli"(ST36) and "Taichong"(LR3) (1 mA，2 Hz /100 Hz) for 30 min. Rats of the EA+AV-shGATA4 RNA and EA+AV-shCTRL groups received intrathecal injection of AV-shGATA4 RNA and AV-shCTRL(1×1011 PFU/mL，10 μL)at the spinal L4-L6 segments, separately, 48 h before EA intervention. The mechanical pain threshold and thermal pain threshold of the affected limb were detected before molding, 7 days following molding and 60 min after EA. The expressions of adenosine A1 receptor and GATA4 protein in the spinal cord (L4-L6) were detected by Western blot. RESULTS: Outcomes of the first part showed that compared with the control group, no significant changes were found in the mechanical and thermal pain thresholds in both AV-shCTRL and AV-shGATA4 RNA groups and in the expression of spinal GATA4 protein of the AV-shCTRL group (P＞0.05). The expression of spinal GATA4 protein of the AV-shGATA4 RNA group was significantly lower than that of the AV-shCTRL group (P 0.05). On the 7th day following modeling, the mechanical and thermal pain thresholds were significantly lowered in compa-rison with their own pre-modeling of each group and with the sham operation group (P0.05), suggesting a critical involvement of GATA4 in EA analgesia. The expression levels of adenosine A1 receptor and GATA4 protein were significantly increased in the model group than in the sham operation group (P0.05), suggesting that the effects of EA in up-regulating the expression of A1 receptor and GATA4 were eliminated after silencing GATA4 protein. CONCLUSION: EA of ST36 and LR3 can relieve pain by increasing the expression of adenosine A1 receptor of the lumbar spinal cord in neuropathic pain rats, which is probably mediated by GATA4 protein.

Evaluation of the measures in early warning and disposal of snail environment in a forest land in Songjiang District, Shanghai / 上海预防医学

Objective To evaluate the methods in early warning of schistosomiasis and elimination of snails in an ecological public forest in Yexie Town of Songjiang District, and provide the basis for monitoring and controlling snails in forest land in the future. Methods The monitoring data of snails, schistosomiasis and snail elimination in the public forest were collected to evaluate the effect of controlling snails. Results The area with existence of snails was found to be 10.47 hm2, and it was decreased by 98.28% after three times of snail elimination.A total of 1 904 serological tests was performed (test rate of 88.76%) with the positive rate of 0.16%.Pathogenic test result was negative in 3 subjects examined.Serological samples of 11 dogs and 1 sheep were all negative for the test.None of the 1 480 live snails tested was found to be positive in infection.The awareness rate of schistosomiasis control knowledge and behavior formation in 275 students were 98.2% and 95.3%, respectively. Conclusion The snails in the public forest in Yexie Town have been effectively controlled, but there are still scattered living snails.The measures in eliminating and monitoring of snails should be continued and strengthened.

Clinical features of neonatal enterovirus infection / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of neonatal enterovirus infection, especially severe enterovirus infection.@*METHODS@#A retrospective analysis was performed for the clinical data of 244 neonates with enterovirus infection. According to the severity of infection, they were divided into a common infection group with 231 neonates and a severe infection group with 13 neonates. Clinical features were compared between the two groups.@*RESULTS@#Of the 244 neonates, 207 (84.8%) developed the disease in May to October, with the highest number of patients in June to July. Compared with the common infection group, the severe infection group had a significantly lower gestational age at birth and a significantly higher proportion of preterm infants (P<0.05). Compared with the common infection group, the severe infection group had a significantly earlier onset time (P<0.05) and significantly higher incidence rates of skin petechiae and ecchymosis, respiratory symptoms, sepsis-like manifestations (poor appetite, crying less, and less movement), concomitant diseases (such as pneumonia, myocarditis, necrotic hepatitis, and coagulation disorder), thrombocytopenia, prolonged prothrombin time, elevated creatine kinase-MB, and elevated alanine aminotransferase (P<0.05). The severe infection group had a significantly higher mortality rate than the common infection group (P<0.05).@*CONCLUSIONS@#There are significant differences in onset time, common clinical manifestations, and concomitant diseases between the neonates with common and severe enterovirus infection. In the enterovirus epidemic season, if the neonates have rashes and/or sepsis-like manifestations such as poor appetite and less movement, especially if the laboratory tests suggest liver damage and coagulation dysfunction, it is necessary to pay particular attention to the possibility of severe enterovirus infection.

Effect of acupoint stimulation on the quality of recovery in patients with radical thyroidectomy under the concept of enhanced recovery after surgery: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of acupoint stimulation on the quality of recovery in patients with radical thyroidectomy under the concept of enhanced recovery after surgery (ERAS).@*METHODS@#A total of 62 patients with radical thyroidectomy were randomized into an observation group and a control group, 31 cases in each one. In both of the two groups, general anesthesia with tracheal intubation was applied, the same anesthesia induction and maintenance medication were given. In the observation group, auricular point pressing with magnetic beads was adopted at bilateral shenmen (TF) and transcutaneous electrical acupoint stimulation (dilatational wave, 2 Hz/100 Hz in frequency, 6 to 12 mA) was performed at bilateral Hegu (LI 4) and Neiguan (PC 6) from 30 min before anesthesia induction to the end of the anesthesia. In the control group, medical adhesive plaster was pasted at bilateral shenmen (TF) and the electrodes were plastered at bilateral Hegu (LI 4) and Neiguan (PC 6) with no corresponding stimulation. In both of the two groups, visual analogue scale for anxiety (VAS-A) score was observed to evaluate the anxiety severity before anesthesia induction; the total intraoperative dosages of sufentanil, remifentanil and propofol were recorded; the numerical rating scale (NRS) score was used to assess the pain severity of instant time (T0) and 30 min (T1) of entering post-anesthesia recovery room (PACU), motor and static mode at 2 h (T2), 6 h (T3), 12 h (T4), 24 h (T5) after surgery; time of first anal exhaust, time of getting out of bed after surgery, total hospitalization time and the incidences of postoperative nausea and vomiting were observed; the quality of recovery was assessed by the 40-item quality of recovery score (QoR-40).@*RESULTS@#The VAS-A score and the total intraoperative dosage of remifentanil in the observation group were reduced compared with the control group (0.05). The time of first anal exhaust and getting out of bed after surgery in the observation group were advanced than those in the control group (0.05). Compared with the control group, the QoR-40 score was increased in the observation group (<0.05).@*CONCLUSION@#Acupoint stimulation can improve the preoperative anxiety in patients with radical thyroidectomy, reduce the intraoperative anesthetic dosage and postoperative pain, advance the time of anal exhaust and getting out of bed, improve the quality of postoperative recovery and enhance the recovery process.