Fever clinic construction and management targeted to prevention and control of healthcare-associated respiratory viral infections in Jiangsu, China: A cross-sectional observational study.

To analyze the post-COVID-19 construction and management of fever clinics targeted to prevention and control of healthcare-associated respiratory viral infections in medical institutions at all levels in China, and to provide a basis for promoting their standardized construction, we conducted this survey on the construction of fever clinics in 429 medical institutions of Jiangsu Province from July to December 2020. Contents of the questionnaire included the general situation of medical institutions, the construction status and future construction plans of fever clinics. We find the construction rate of fever clinic in medical institutions of Jiangsu province was 75.3%. All construction indicators, quality management systems and processes fail to fully meet the requirements of documents and standards. Jiangsu province actively promotes the construction of fever clinic layout, but there is still a gap with the construction standard. As a result, it is necessary to further promote standardized construction of fever clinic, and necessary financial input should be increased to expand all constructions of fever clinic in primary medical institutions.

[Retrospective analysis and comparison of total internal disability preservation technique and standardized reconstruction technique].

OBJECTIVE: To investigate the efficacy and clinical results of total internal protection technique in anterior cruciate ligament reconstruction. METHODS: A total of 56 patients undergoing anterior cruciate ligament reconstruction treated from January 2018 to December 2019 were selected. According to the different surgical methods, they were divided into total internal reconstruction group and standard bone tunnel group. There were 21 patients in the total internal reconstruction group, including 15 males and 6 females, aged from 20 to 48 with an average of (35.6±6.7) years old, and 35 patients in the standard tibial tunnel group, including 26 males and 9 females, aged 22 to 51 years old with an average of (33.7±9.6) years old. Preoperative examination of Lachman test was positive, magnetic resonance indicated anterior cruciate ligament rupture. There were no significant differences between the two groups in age, sex, body mass index, time from injury to ACL reconstruction, combined meniscus injury and operation method, operation time, ligament diameter, ligament length and other general information. Postoperative evaluation included operation duration, length and diameter of transplanted tendon after braid. International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner score and perioperative complications 2 years after surgery. RESULTS: Both groups were followed up, ranging from 24 to 30 months with an average of (26.9±3.4) months. Postoperative incision healing was good, and no failure or joint infection occurred at the last follow-up. There was no statistically significant difference between the two groups in IKDC score, Lysholm score and Tegner score before, 1 year and 2 years after surgery. However, IKDC score, Lysholm score and Tegner score at 1 year and 2 years after surgery. CONCLUSION: The same postoperative function and stability of knee joint can be obtained by both the residual whole technique and the standardized reconstruction technique. In the residual whole group, only the semitendinosus muscle is taken, and the femoral thin muscle is retained, with greater tibial bone mass preserved, which is safe and effective in clinical practice.

Biomechanical improvement of anterior talofibular ligament by augmentation repair of ligament advance reinforcement system: a cadaver study.

BACKGROUND: Ankle sprain are one of the most frequent sports injuries. Some individuals will develop chronic lateral ankle instability (CLAI) after ankle sprain and suffer from recurrent ankle sprain. Current surgical treatment of CAI with anterior talofibular ligament (ATFL) rupture fails to restore the stability of the native ATFL. Ligament Advance Reinforcement System (LARS) augmentation repair of ATFL was developed to improve its primary stability after repaired. METHODS: This study was performed to evaluate whether LARS augmentation repair of ATFL had similar stability as the modified Broström repair and the intact ATFL to maintain ankle construct stability. Standardized surgical techniques were performed on eighteen fresh frozen cadaver ankle specimens. The intact ATFL group has just undergone an ATFL exploratory surgery. The modified Broström procedure is based on anatomical repair of the ATFL with a 2.9 mm suture anchor, and the LARS procedure is an augmentation procedure of the ATFL using LARS ligaments based on the modified Broström procedure. A dynamic tensile test machine was used to assess load-to-failure testing in the three groups. The ultimate failure load and stiffness were calculated and reported from the load-displacement curve. A one-way analysis of variance was used to detect significant differences (p < 0.05) between the LARS augmentation repair, the modified Broström repair and the intact ATFL, followed by least significant difference (LSD) post-hoc tests. RESULTS: The LARS augmentation repair group showed an increased in ultimate failure to load and stiffness compared to the other two groups. There were no significant differences in ultimate failure to load and stiffness between the modified Broström and the intact ATFL, the LARS ligament for ATFL augmentation allows for improved primary stability after repair and reduced stress on the repaired ATFL, which facilitates healing of the remnant ligament. CONCLUSIONS: The LARS augmentation repair of ATFL represents a stable technique that may allow for the ankle stability to be restored in patients with CAI after surgery.

Global-scale no-tillage impacts on soil aggregates and associated carbon and nitrogen concentrations in croplands: A meta-analysis.

No-tillage treatment, including no-tillage with straw retention (NTS) and without (NT), has been widely used as an efficient and sustainable alternative to conventional tillage with straw retention (CTS) and without (CT) and greatly affects soil physical quality and organic matter dynamics in cropland ecosystems. Although some studies have reported the effects of NTS on soil aggregate stability and soil organic carbon (SOC) concentration, the underlying mechanisms of how soil aggregates, aggregate-associated SOC and total nitrogen (TN) respond to no-tillage remain unclear. Through a global meta-analysis of 91 studies in cropland ecosystems, we evaluated the effects of no-tillage on soil aggregates and their associated SOC and TN concentrations. On average, no-tillage treatment significantly decreased the proportions of microaggregates (MA) by 21.4 % (95 % CI, -25.5 to -17.3 %) and silt+clay size particles (SIC) by 24.1 (95 % CI, -30.9 to -17.0 %), and increased the proportions of large macroaggregate (LA) by 49.5 % (95 % CI, 36.7-63.0 %) and small macroaggregate (SA) by 6.1 % (95 % CI, 2.0-10.9 %) compared to those in conventional tillage. The SOC concentrations for all three aggregate sizes increased significantly with no tillage: for LA by 28.2 % (95 % CI, 18.8-39.5 %), SA by 18.0 % (95 % CI, 12.8-23.3 %), and MA by 9.1 % (95 % CI, 2.6-16.8 %). TN also increased significantly for all sizes with no tillage, with LA by 13.6 % (95 % CI, 8.6-17.6 %), SA by 11.0 % (95 % CI, 5.0-17.0 %), MA by 11.7 % (95 % CI, 7.0-16.4 %), and SIC by 7.6 % (95 % CI, 2.4-13.8 %). The magnitude of the no-tillage treatment effect on soil aggregation, aggregate-associated SOC and TN varied with the environmental and experimental conditions. The positive effect on the proportions of LA occurred with initial soil organic matter (SOM) content >10 g kg-1, whereas SOM <10 g kg-1 did not change significantly. Additionally, the effect size of NTS compared with CTS was lower than that of NT compared with CT. These findings suggest that NTS may promote physically protective SOC accumulation through the formation of macroaggregates by reducing disturbance destruction and increasing plant-derived binding agents. The findings highlight that no-tillage may enhance the formation of soil aggregates and the associated SOC and TN concentrations in global cropland ecosystems.

Rational Design by Structural Biology of Industrializable, Long-Acting Antihyperglycemic GLP-1 Receptor Agonists.

Glucagon-like peptide-1 (GLP-1) is easily degraded by dipeptidyl peptidase-4 (DPP-4) in the human body, limiting its therapeutic effect on type II diabetes. Therefore, improving GLP-1 receptor agonist (GLP-1RA) stability is a major obstacle for drug development. We analyzed human GLP-1, DPP-4, and GLP-1 receptor structures and designed three GLP-1RAs, which were introduced into fusion protein fragments and changed in the overall conformation. This modification effectively prevented GLP-1RAs from entering the DPP-4 active center without affecting GLP-1RAs' ability to bind to GLP-1R, the new GLP-1RA hypoglycemic effect lasting for >24 h. Through molecular modeling, molecular dynamics calculation, and simulation, possible tertiary structure models of GLP-1RAs were obtained; molecular docking with DPP-4 and GLP-1R showed access to the fusion protein. The overall conformational change of GLP-1RAs prevented DPP-4 binding, without affecting GLP-1RAs' affinity to GLP-1R. This study provides important drug design ideas for GLP-1RA development and a new example for application of structural biology-based protein design in drug development.

Timosaponin B-II alleviates osteoarthritis-related inflammation and extracellular matrix degradation through inhibition of mitogen-activated protein kinases and nuclear factor-κB pathways in vitro.

Osteoarthritis (OA), an inflammatory response in chondrocytes, leads to extracellular matrix (ECM) degradation and cartilage destruction. Timosaponin B-II (TB-II) is the main bioactive component of Rhizoma Anemarrhenae with reported antioxidant and anti-inflammatory effects. This study investigated the anti-OA function and mechanism of TB-II on IL-1ß-stimulated SW1353 cells and primary rat chondrocytes. We firstly screened the concentration of TB-II in SW1353 cells and primary rat chondrocytes using CCK-8 assay. Thereafter, SW1353 cells and chondrocytes were, respectively, pretreated with TB-II (20 and 40 µg/mL) and TB-II (10 and 30 µg/mL) for 24 h and then stimulated with interleukin 1ß (IL-1ß, 10 ng/mL) for another 24 hours. Results showed that TB-II suppressed the production of reactive oxygen species, the protein levels of inducible nitric oxide synthase and cyclooxygenase-2 in IL-1ß-stimulated SW1353 cells and chondrocytes. IL-1ß-induced high secretion levels of nitric oxide and prostaglandin 2, TNF-α, IL-6 and MCP-1 were down-regulated by TB-II treatment, indicating an anti-inflammatory effect of TB-II on OA in vitro condition. Moreover, TB-II weakened the mRNA and protein expression of (matrix metalloproteinase) MMPs including MMP-1, MMP-3, and MMP-13, indicating the protection of TB-II against ECM degradation. Mechanically, TB-II suppressed MAPKs and NF-κB pathways under IL-1ß stimulation evidenced by the down-regulated protein expression of p-ERK, p-p38, p-JNK, p-p65 and the reduced translocation of p65 subunit to the nucleus. The present study demonstrated that TB-II might become a novel therapeutic agent for OA treatment through repressing IL-1ß-stimulated inflammation, oxidative stress and ECM degradation via suppressing the MAPKs and NF-κB pathways.

Cost-effectiveness analysis of a community-based colorectal cancer screening program in Shanghai, China.

OBJECTIVE: This study investigated the cost-effectiveness of a community-based colorectal cancer-screening program (C-CRCSP) in Shanghai, China, among the residents in the urban, suburban and rural areas. METHODS: A Markov model was constructed to evaluate the cost-effectiveness of a 25-year annual C-CRCSP including 100 000 populations. Cost-effectiveness was determined by the incremental cost-effectiveness ratio (ICER); referring to either life-years gained, or quality-adjusted life-years (QALYs) gained. The threshold was gross domestic product per capita. Univariate and multivariate sensitivity analyses were performed to investigate the influence of compliance, prevalence, technological performance, medical cost and annual cost discount rate (3.5%) on ICER. A probabilistic sensitivity analysis evaluated the probability of the cost-effectiveness of C-CRCSP at different maximum acceptable ceiling ratios. RESULTS: Compared with no screening, the C-CRCSP resulted in total gains of 7840 QALYs and 2210 life-years (LY), at a total cost of CNY 58.54 million; that is, the ICER were CNY 7460/QALYs and CNY 26650/LY. Stratifying by residency, the cumulative gains in QALYs and LY were estimated to be the lowest in the urban populations compared with the rural and suburban populations. The cost for the urban population was 3-fold and 6-fold that of the suburban and rural populations. The ICER for QALYs ranged from 2180 (rural) to 16 840 (urban). CONCLUSION: The cost-effectiveness of a C-CRCSP in Shanghai was most favorable for the rural population, while the urban population benefits less in terms of QALYs. ICER could be enhanced by measures that increase compliance.

Clinicopathological features of superficial CD34-positive fibroblastic tumor.

BACKGROUND: Superficial CD34-positive fibroblastoma (SCPFT) is a newly discovered mesenchymal tumor characterized by high polymorphism, low mitotic rate, and diffuse CD34-positive reactions. AIM: To further determine the clinicopathological features of SCPFT. METHODS: We retrospectively analyzed the clinicopathological data, immunohistochemistry results, and differential diagnoses of four patients with SCPFT and performed a literature review. Relevant fusion genes were also detected. RESULTS: The tumors were all located in the lower extremities and presented as slow-growing painless masses located in the dermis and subcutaneous tissue. Microscopically, the tumors were composed of spindle-shaped to epithelioid cells with scattered abnormal and pleomorphic nuclei on a fibrous or fibromyxoid background. Necrosis was not found in the tumor tissues, and mitotic figures were rare. Immunohistochemically, the tumor cells were strongly positive for vimentin and CD34, and CKpan showed focal positivity in two tumors. All four patients were followed (13-57 mo, mean 35 mo), and one patient experienced local recurrence. CONCLUSION: SCPFT is a newly discovered borderline mesenchymal tumor that can locally recur or even metastasize. Familiarity with its clinicopathological features will help avoid confusion with skin mesenchymal tumors with similar features.

Low-temperature processed tantalum/niobium co-doped TiO2electron transport layer for high-performance planar perovskite solar cells.

A low-temperature preparation process is significantly important for scalable and flexible devices. However, the serious interface defects between the normally used titanium dioxide (TiO2) electron transport layer (ETL) obtained via a low-temperature method and perovskite suppress the further improvement of perovskite solar cells (PSCs). Here, we develop a facile low-temperature chemical bath method to prepare a TiO2ETL with tantalum (Ta) and niobium (Nb) co-doping. Systematic investigations indicate that Ta/Nb co-doping could increase the conduction band level of TiO2and could decrease the trap-state density, boosting electron injection efficiency and reducing the charge recombination between the perovskite/ETL interface. A superior power conversion efficiency of 19.44% can be achieved by a planar PSC with a Ta/Nb co-doped TiO2ETL, which is much higher than that of pristine TiO2(17.60%). Our achievements in this work provide new insights on low-temperature fabrication of low-cost and highly efficient PSCs.

Assessing and mapping cultural ecosystem services supply, demand and flow of farmlands in the Hangzhou metropolitan area, China.

Despite research on monitoring and mapping cultural ecosystem services (CESs) increasing exponentially in recent years, our knowledge of the CESs of farmlands is still inadequate, particularly in megacities. Analyzing the CESs of farmlands is a daunting challenge partly due to the lack of appropriate frameworks, and partly because of paucity of information on farmland. In this paper, the maximum entropy (Maxent) model along with agricultural big data were combined to measure and map CESs supply with respect to aesthetics and recreation, within farmlands in the Hangzhou metropolitan area of China between 2010 and 2016. We also quantified the characteristics of CESs based on demand and flow to enhance the understanding of the CESs of farmlands. The results indicated that the Maxent model was robust in mapping CESs supply. Moreover, the farmlands with high aesthetic supply were closely related to natural attributes and mainly distributed in rural areas. In contrast, the farmlands with high recreational supply were highly dependent on human factors which led to the rapid growth of such farmlands near the city center compared to aesthetic farmlands. Farmlands located along water bodies provided high integrated supply, while high demand was characteristic of strongly urbanized areas, and flow patterns of farmlands were greatly affected by popular scenic spots. The growth of CESs supply, demand and flow within farmlands might be closely related to the increase of agritourism, improved infrastructures, increasing income and leisure time of beneficiaries. This study highlighted the importance of the CESs of farmlands in the Hangzhou metropolitan area, although more research is needed to demonstrate the utility of the CESs of farmlands in urban environments.

Avian influenza viruses (AIVs) H9N2 are in the course of reassorting into novel AIVs.

In 2013, two episodes of influenza emerged in China and caused worldwide concern. A new H7N9 avian influenza virus (AIV) first appeared in China on February 19, 2013. By August 31, 2013, the virus had spread to ten provinces and two metropolitan cities. Of 134 patients with H7N9 influenza, 45 died. From then on, epidemics emerged sporadically in China and resulted in several victims. On November 30, 2013, a 73-year-old woman presented with an influenza-like illness. She developed multiple organ failure and died 9 d after the onset of disease. A novel reassortant AIV, H10N8, was isolated from a tracheal aspirate specimen that was obtained from the patient 7 d after onset. This case was the first human case of influenza A subtype H10N8. On 4 February, 2014, another death due to H10N8 avian influenza was reported in Jiangxi Province, China.

Microbial community structures and functions of wastewater treatment systems in plateau and cold regions.

Wastewater treatment plants (WWTPs) in plateau regions have unique microbial community structures. In this study, Illumina high-throughput sequencing technology was applied to investigate microbial communities of plateau WWTPs. The research showed that microbial diversities and richness were negatively associated with the altitude and positively to the water temperature to a certain extent. The dominant phyla of plateau and control WWTPs were similar, which mainly included Proteobacteria, Bacteroidetes, Chloroflexi and Firmicutes. In plateau WWTPs, the LEfSe analysis found 4 biomarkers which can catabolize aromatic compounds, indicating the microorganisms that can degrade refractory organics might survive better in plateau WWTPs. The analysis of functional genera and enzymes showed that there was no significant difference in abundances of organic degrading bacteria, but the nitrogen removal bacteria were less abundant and phosphorus removal bacteria were more abundant in plateau WWTPs.

'Outbreak Gold Standard' selection to provide optimized threshold for infectious diseases early-alert based on China Infectious Disease Automated-alert and Response System.

The China Infectious Disease Automated-alert and Response System (CIDARS) was successfully implemented and became operational nationwide in 2008. The CIDARS plays an important role in and has been integrated into the routine outbreak monitoring efforts of the Center for Disease Control (CDC) at all levels in China. In the CIDARS, thresholds are determined using the "Mean+2SD? in the early stage which have limitations. This study compared the performance of optimized thresholds defined using the "Mean +2SD? method to the performance of 5 novel algorithms to select optimal "Outbreak Gold Standard (OGS)? and corresponding thresholds for outbreak detection. Data for infectious disease were organized by calendar week and year. The "Mean+2SD?, C1, C2, moving average (MA), seasonal model (SM), and cumulative sum (CUSUM) algorithms were applied. Outbreak signals for the predicted value (Px) were calculated using a percentile-based moving window. When the outbreak signals generated by an algorithm were in line with a Px generated outbreak signal for each week, this Px was then defined as the optimized threshold for that algorithm. In this study, six infectious diseases were selected and classified into TYPE A (chickenpox and mumps), TYPE B (influenza and rubella) and TYPE C [hand foot and mouth disease (HFMD) and scarlet fever]. Optimized thresholds for chickenpox (P55), mumps (P50), influenza (P40, P55, and P75), rubella (P45 and P75), HFMD (P65 and P70), and scarlet fever (P75 and P80) were identified. The C1, C2, CUSUM, SM, and MA algorithms were appropriate for TYPE A. All 6 algorithms were appropriate for TYPE B. C1 and CUSUM algorithms were appropriate for TYPE C. It is critical to incorporate more flexible algorithms as OGS into the CIDRAS and to identify the proper OGS and corresponding recommended optimized threshold by different infectious disease types.

'Outbreak Gold Standard'Selection to Provide Optimized Threshold for Infectious Diseases Early-alert Based on China Infectious Disease Automated-alert and Response System / 华中科技大学学报（医学）（英德文版）

The China Infectious Disease Automated-alert and Response System (CIDARS) was successfully implemented and became operational nationwide in 2008.The CIDARS plays an important role in and has been integrated into the routine outbreak monitoring efforts of the Center for Disease Control (CDC) at all levels in China.In the CIDARS,thresholds are determined using the'Mean+2SD'in the early stage which have limitations.This study compared the performance of optimized thresholds defined using the'Mean +2SD'method to the performance of 5 novel algorithms to select optimal 'Outbreak Gold Standard (OGS)'and corresponding thresholds for outbreak detection.Data for infectious disease were organized by calendar week and year.The'Mean+2SD',C1,C2,moving average (MA),seasonal model (SM),and cumulative sum (CUSUM) algorithms were applied.Outbreak signals for the predicted value (Px) were calculated using a percentile-based moving window.When the outbreak signals generated by an algorithm were in line with a Px generated outbreak signal for each week,this Px was then defined as the optimized threshold for that algorithm.In this study,six infectious diseases were selected and classified into TYPE A (chickenpox and mumps),TYPE B (influenza and rubella) and TYPE C [hand foot and mouth disease (HFMD) and scarlet fever].Optimized thresholds for chickenpox (P55),mumps (P50),influenza (P40,P55,and P75),rubella (P45 and P75),HFMD (P65 and P70),and scarlet fever (P75 and Ps0) were identified.The C1,C2,CUSUM,SM,and MA algorithms were appropriate for TYPE A.All 6 algorithms were appropriate for TYPE B.C1 and CUSUM algorithms were appropriate for TYPE C.It is critical to incorporate more flexible algorithms as OGS into the CIDRAS and to identify the proper OGS and corresponding recommended optimized threshold by different infectious disease types.

The Effect of Salt-Processed Psoralea corylifolia on Generative Organ Targeting.

Psoralen and isopsoralen are two isomers and main effective components within Psoralea corylifolia. In order to investigate the salt-processing effect on tissue distribution characters of psoralen and isopsoralen, a sensitive and accurate ultrahigh pressure liquid chromatographic tandem mass spectrometric (UHPLC-MS/MS) method has been developed and validated for simultaneous determination of the 2 components in rats' tissues after administration of the extracts that came from either crude or salt-processed Psoralea corylifolia L. Data displayed that both areas under the curve (AUC) of psoralen and isopsoralen from salt-processed scurfpea fruit group were significantly increased compared with that of the crude herb group, especially in heart (p < 0.05), ovary, and testes (p < 0.001). Though the RE and RCmax of psoralen and isopsoralen in all of the investigated organs were over 1.0, generative organs kept the maximum value. The experiment manifested that salt-processing of scurfpea fruit can increase the distribution of psoralen and isopsoralen to generative organs, heart and spleen, and the distribution of psoralen and isopsoralen to generative organs is significantly higher compared to heart and spleen (p < 0.01). Results indicate that salt-processing of scurfpea fruit can significantly increase the distribution of psoralen and isopsoralen to generative organs.

Evaluation of the influence of salt processing on pharmacokinetics of psoralen and isopsoralen in Psoralea corylifolia L.

A sensitive, specific and rapid ultra-high-pressure liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method has been developed to investigate pharmacokinetic properties of psoralen and isopsoralen, two compounds isolated from raw/salt-processed fruit of Psoralea corylifolia L. UHPLC-MS/MS was used with positive ion electrospray. The mobile phase was composed of acetonitrile and 0.1% formic acid aqueous solution and a gradient elution program at flow rate of 0.3 mL/min was applied. Multiple reaction monitoring mode was used for the quantification of psoralen, isopsoralen ([M + H](+) m/z 187.0 → m/z 131.0) and scoparone (m/z 207.0 → m/z 151.1). Scoparone served as an internal standard. The method was fully validated for its sensitivity, selectivity, stability, matrix effect and extraction recovery. The obtained results showed that salt-processed Buguzhi significantly promoted the absorption of psoralen and isopsoralen, and increased the bioavailability of these compounds.

Positive skeletal effect of two ingredients of Psoralea corylifolia L. on estrogen deficiency-induced osteoporosis and the possible mechanisms of action.

Estrogen replacement therapy (ERT) is utilized as a major regime for treatment of postmenopausal osteoporosis at present. However, long-term supplement of estrogen may cause uterine hyperplasia and hypertension leading to a high risk of endometrial cancer and breast cancer. Psoralea corylifolia L. has long been used as tonic and food additives in many countries. Previous studies had found two ingredients in P. corylifolia L.: bavachin and bakuchiol exhibited osteoblastic activity. The present study was designed to investigate the protective effect of bakuchiol and bavachin on ovariectomy-induced bone loss and explore the possible mechanism. In vivo, bakuchiol and bavachin could prevented estrogen deficiency-induced bone loss in ovariectomized rats without uterotrophic activity. In vitro studies suggested that bakuchiol and bavachin induced primary human osteoblast differentiation by up-regulating the Wnt signalling pathway. This study suggests that such a bone-protective role makes them a promising and safe estrogen supplement for the ERT.

Modifiable Lifestyle Factors and Triple-negative Breast Cancer Survival: A Population-based Prospective Study.

BACKGROUND: Very little is known about the effect of modifiable lifestyle factors on outcomes of triple-negative breast cancer. We examined this association in a population-based prospective cohort study of patients with triple-negative breast cancer. METHODS: A total of 518 women with confirmed triple-negative breast cancer, recruited by the Shanghai Breast Cancer Survival Study, completed 6-, 18-, 36-, and 60-month postdiagnosis surveys. We applied Cox proportional hazard models to evaluate the associations. RESULTS: The mean age at diagnosis was 53.4 (standard deviation = 10.6) years old. After a median follow-up of 9.1 years (range: 0.6-11.8), 128 deaths and 112 recurrences were documented. Exercise during the first 60 months postdiagnosis was inversely associated with total mortality and recurrence/disease-specific mortality with adjusted hazard ratios (HRs) of 0.67 (95% confidence interval [CI] = 0.46, 0.96) and 0.58 (95% CI = 0.39, 0.86), respectively. Women with higher exercise-metabolic equivalent scores (≥7.6 metabolic equivalent-hours/week) and longer duration of exercise (≥2.5 hours/week) had lower risk of total and recurrence/disease-specific mortality than did nonexercisers. Compared with nontea drinkers, survival was better among women who were regular tea drinkers during the first 60 months for all cause (HR = 0.57, 95% CI = 0.34, 0.93) and recurrence/disease-specific mortality (HR = 0.54, 95% CI = 0.31, 0.96). There was no dose-response pattern for tea consumption. No interactions were observed for body mass index, menopausal status, and comorbidity. CONCLUSIONS: These findings show that postdiagnosis exercise and tea intake were associated with improved survival among women with triple-negative breast cancer.

[Distribution of univalvia molluscs in area with natural decline of Oncomelania hupensis snails in Eastern Dongting Lake area].

OBJECTIVE: To understand the distribution of univalvia molluscs in Eastern Dongting lake area where the Oncomelania hupensis is extinct, so as to explore the causes of extinction and to provide the evidence for formulating schistosomiasis control strategy. METHODS: The univalvia molluscs of the Qianliang Lake district, Jianxin District and Junshan Park were investigated in August of 2013. All the collected snails were classified and identified. The data were analyzed by using the method of Shapiro-Wilk normality test and non-parametric test. The ecological biodiversity differences from each district were compared by the biodiversity indexes. RESULTS: The univalvia molluscs collected were from 6 species in 3 families in Gastropoda class, namely Oncomelania hupensis Gredler in Pomatiopsidae family, Parafossarulus striatulus, Alocinma longicornis, Parafossarulus sineasis, Bithynia fuchsisana in Bithyniidae family, and one genus provisioy nally named Radix in Lymaneidae family. In Junshan Park, a total of 4553 snails were collected, among which 1264 were Oncomelania snails. In Jianxin District, 336 univalvia molluscs were collected, and no Oncomelania snails were found. In Qianliang Lake district, there were only 7 Alocinma longicornis snails, 2 Parafossarulus sinensis snails and 1 Parafossarulus striatulus snail collected. There were significant differences among the distributions of the samples from the three districts (chi2 = 166.225, P < 0.01) .The Simpson's diversity indexes in Qianliang Lake area, Jianxin Dis- trict and Junshan Park were 0.4028, 0.7186 and 0.6788, respectively, and the Shannon-Wiener indexes of the 3 areas were 0.7215, 1.4313 and 1.1999, respectively. CONCLUSIONS: With the extinction of Oncomelania snails, the species and quantities of other snails become rare in Qianliang Lake area. Whether their causes are relevant is worth further studying.

[Natural growth and decline of Oncomelania hupensis snails in marshland of Qianliang Lake District in Eastern Dongting Lake area, China].

OBJECTIVE: To understand the change trend of Oncomelania hupensis snails in the bottomland areas of Qian Liang Lake district in Eastern Dongting Lake area so as to provide the evidence for formulating a schistosomiasis control strategy. METHODS: The monitoring data of snails of Qianliang Lake district from 1988 to 2011 were collected retrospectively and analyzed by using the method of the trend Chi-square test. The correlations among the snail density indicators were analyzed. RESULTS: 1988 to 2011, the area of snails surveyed did not change and was 433.2 hm(2). The monitoring data showed that the change trend of the density of living snails and the schistosome infection rates of snails were not obvious (P > 0.05), but the mortality of snails showed a falling trend (P < 0.05); There were positive correlations between the average density of infected snails and the mortality of snails (r = 0.640, P < 0.05) , the infection rate of snails (r = 0.639, P < 0.05) , and the average density of living snails (r = 0.646, P < 0.05) , respectively. There was no correlation among other snail indicators. In 1999, only 7 snails were found, of them, only one snail was alive. The alive snails were not found after 2000. CONCLUSION: In the bottomland areas of Qianliang Lake district, the change trend of the density of alive snails were not obvious from 1988 to 1998, but the number of snails underwent a sharp drop in 1999 and snails have been not found till now.