[Epidemiological characteristics of imported malaria in Zhengzhou City from 2016 to 2020]

OBJECTIVE

To analyze the epidemiological characteristics of reported imported malaria cases in Zhengzhou City from 2016 to 2020, so as to provide insights into the management of imported malaria in the city.

METHODS

All data pertaining to cases with definitive diagnosis of malaria in Zhengzhou City from 2016 to 2020 were captured from the National Notifiable Disease Report System and the Information Management System for Parasitic Disease Control in China, including individual demographic data, and malaria onset, initial diagnosis and definitive diagnosis data. All data were descriptively analyzed. The duration from malaria onset to initial diagnosis, from initial diagnosis to definitive diagnosis and from onset to definitive diagnosis was compared among cases. In addition, the diagnoses of imported malaria cases in which definitive diagnosis was made were compared with the reexaminations by Zhengzhou Municipal Malaria Diagnosis Reference Laboratory.

RESULTS

A total of 302 cases with definitive diagnosis of malaria were reported in Zhengzhou City from 2016 to 2020, and all were imported cases, with Plasmodium falciparum malaria as the predominant type (230 cases, 76.2%). There were 293 malaria cases imported from Africa (293 cases, 97.0%), which mainly included Nigeria (48 cases, 15.9%), Angola (40 cases, 13.2%), and the Democratic Republic of the Congo (29 cases, 9.6%). There was no obvious seasonality found in the date of malaria onset and time of reporting malaria. The ratio of male to female malaria cases was 49.3:1, and there were 103 cases (34.1%) with the current residency address in Zhengzhou City, 193 cases (63.9%) with the current residency address in other cities of Henan Province and 6 cases (2.0%) in other provinces of China. There were 271 cases (89.7%) seeking initial diagnosis in medical institutions, and the diagnostic accuracy of malaria was 56.6% (171/302) at initial diagnosis institutions. A total of 122 cases (40.4%) sought medical care on the day of malaria onset, and 252 cases (86.4%) within 3 days; however, only 22 cases (7.3%) were definitively diagnosed on the day of onset, and 162 cases (53.6%) diagnosed within 3 days. There were no significant differences between malaria cases seeking initial diagnosis at medical institutions and disease control and prevention institutions in terms of the duration from malaria onset to initial diagnosis (Z = -1.663, P > 0.05), from initial diagnosis to definitive diagnosis (Z = -0.413, P > 0.05) or from malaria onset to definitive diagnosis (Z = -0.838, P > 0.05). The median duration (interquartile range) from initial diagnosis to definitive diagnosis of malaria was 3.00 (2.00), 3.00 (6.00), 2.00 (4.00) d and 1.00 (1.00) d among cases seeking medical care at township-level and lower, county-, city- and province-level medical institutions, and the median duration from initial diagnosis to definitive diagnosis of malaria was significantly longer among cases seeking medical care at township-level and lower medical institutions than at city (Z = -3.286, P < 0.008 33) and province-level medical institutions (Z = -9.119, P < 0.008 33), while the median duration from initial diagnosis to definitive diagnosis [1.00 (3.00) d vs. 2.00 (4.00) d; Z = -4.099, P < 0.016] and from malaria onset to definitive diagnosis [3.00 (4.00) d vs. 4.00 (5.00) d; Z = -2.868, P < 0.016] among malaria cases with the current residency address in Zhengzhou City was both shorter than in other cities of Henan Province. The diagnostic accuracy was 89.1% (269/302) among malaria cases in which definitive diagnosis was made, and the accuracy of malaria reexaminations was 94.0% (284/302) in Zhengzhou Municipal Malaria Diagnosis Reference Laboratory.

CONCLUSIONS

P. falciparum malaria was predominant among reported imported malaria cases in Zhengzhou City from 2016 to 2020, and these imported malaria cases were predominantly diagnosed at medical institutions; however, the diagnostic capability of malaria is poor in township-level and lower medical institutions. Strengthening the collaboration between medical institutions and disease control and prevention institutions and improving the diagnostic capability building at medical institutions are recommended to consolidate malaria elimination achivements.

[Application of 3D-printed navigation plate in pulsed radiofrequency therapy of dorsal root ganglion in thoracic postherpetic neuralgia]

Objective: To evaluate the accuracy, efficacy and safety of 3D-printed personalized navigation template in the treatment of thoracic postherpetic neuralgia (PHN) with dorsal root ganglion pulsed radiofrequency (DRG-PRF). Methods: A total of 63 patients with thoracic PHN from March 2019 to December 2020 in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were enrolled and randomly divided into study group (n=31) and control group (n=32) by random number table method. The study group received DRG-PRF treatment assisted by 3D-printed navigation template, while the control group received DRG-PRF treatment guided by conventional CT. The one-time success rate of puncture, the incidence of puncture times ≥3, the number of punctures, puncture time, visual analogue scale (VAS) score and surgical complications between the two groups were compared. Results: The one-time success rate of puncture in study group was 84.9% (79/93), which was higher than that of control group [30.2% (29/96)] (P<0.001). The incidence of puncture times ≥3, the number of punctures, puncture time in study group were 4.3% (4/93), 1 (1, 1) and 2.9 (2.8, 3.0) min, respectively, which were lower than that of the control group [21.9% (21/96), 2(1, 3), 9.0 (4.5, 12.9) min, respectively] (all P<0.01). No difference was found in VAS score at each time point before and after surgery between the two groups (all P>0.05). There was one case of pleura puncture in the control group, but no other complications such as straying into vertebral canal, hematoma, spinal cord injury, limb movement disorder, infection were found in the two groups. Conclusions: 3D-printed personalized navigation template is an effective method to guide DRG-PRF for the treatment of thoracic postherpetic neuralgia. It can significantly improve the surgical efficiency of DRG-PRF, but has no significant effect on the surgical efficacy.

[Prevalence of sharp instrument injuries among medical staff in a tertiary general hospital]

Objective: To investigate the current situation of sharp instrument injuries among medical workers in a tertiary general hospital in Fuzhou, so as to provide basis for formulating relevant policies. Methods: In June 2019, medical personnel working in a tertiary general hospital in Fuzhou, who may have sharp instrument injuries were selected as the research object. A total of 2720 questionnaires were received, including 2688 valid questionnaires, with an effective rate of 98.8%. The age, type of work, professional title, working years, operating habits, occurrence and reporting of sharp instrument injuries among medical staff from June 2018 to May 2019 were investigated. Results: The incidence of sharp instrument injury was 37.6% (1011/2688) . Among them, 20.6% (208/1011) had multiple sharp instrument injuries. The exposure rate of contaminated sharp instruments was 15.1% (405/2688) . With the increase of age, professional title and working years, the incidence of sharp instrument injury decreased year by year (χ(2)(trend)=12.393, 33.339, 15.160, P<0.05) . The first three causes of sharp instrument injury were breaking glass ampoules by hand (39.1%, 395/1011) , extracting liquid medicine (10.4%, 105/1011) and handling sharp instruments by hand (10.3%, 104/1011) . The main sharp instruments causing sharp injury were ampoules (43.2%, 437/1011) , syringe needles (20.3%, 205/1011) and suture needles (9.6%, 97/1011) . 874 (86.4%) medical staff had missed reports after sharp instrument injuries. Conclusion: The occurrence of sharp instrument injury in this hospital is still serious, and the protection of sharp instrument injury should be strengthened.

LncRNA NEAT1-miR-101-3p/miR-335-5p/miR-374a-3p/miR-628-5p-TRIM6 axis identified as the prognostic biomarker for lung adenocarcinoma via bioinformatics and meta-analysis

BACKGROUND

Overexpression of the tripartite motif containing 6 (TRIM6) is associated with dismal prognosis in cancer patients, but its exact roles in lung adenocarcinoma (LUAD) have not been reported.

METHODS

The roles of TRIM6 are identified by using The Cancer Genome Atlas (TCGA), TIMER2, Gene Expression Omnibus (GEO), etc., and the regulatory networks and related-prognostic biomarkers of TRIM6 are identified via the ENCORI and LNCAR databases in the LUAD progression.

RESULTS

TRIM6 expression level in LUAD tissues was significantly increased. TRIM6 over-expression level in LUAD patients was associated with smoking, clinical stage, histological type, lymph node metastasis, TP53 mutation and dismal prognosis, and related to prognosis-related age, race, sex, clinical stage and tumor purity of LUAD patients. TRIM6 overexpression was associated with the levels of CD8+ T cells, macrophages, neutrophils and myeloid dendritic cells, and correlated with the levels of LUAD immune cell markers CD8A, IRF5, CD163, VSIG4, MS4A4A, ITGAM, HLA-DPA1, NRP1, ITGAX, etc. TRIM6 might influence the progression of LUAD by regulating homologous recombination, oocyte meiosis, and ubiquitin-mediated proteolysis. LUAD patients with overexpression of miR-101-3p, miR-335-5p, miR-374a-3p, miR-628-5p, and NEAT1 had a poor prognosis.

CONCLUSIONS

NEAT1-miR-101-3p/335-5p/374a-3p/628-5p-TRIM6 network, which we constructed from our results, might be an important factor in the dismal prognosis of LUAD patients.

[Epidemiological characteristics of close contacts of COVID-19 cases and infection-related risk factors in Beijing]

Objective: To analyze the epidemiological characteristics of close contacts of COVID-19 cases and infection-related risk factors in Beijing and provide evidences for COVID-19 prevention and control. Methods: A total of 20 681 close contacts of COVID-19 cases, who had exposures during January 6, 2020 to February 15, 2021, were traced in Beijing. The information about their demographic characteristics, exposure history, and quarantine outcomes were collected and analyzed with descriptive statistics. The logistic regression analysis was used to identify the risk factors for COVID-19. Results: The infection rate SARS-CoV-2 in close contacts was 2.16% (447/20 681). The age M(P₂₅, P₇₅) was 35 (27, 49) years. The majority of the close contacts were aged 20-59 years, accounting for 81.77% (16 912/20 681). Centralized isolation was the major type of medical observation, accounting for 82.15% (16 989/20 681). Among the exposure types, working and studying in the same room (16.06%, 3 322/20 681), sharing same transport vehicle (12.88%, 2 664/20 681), performing diagnosis and treatment nursing (7.80%,1 612/20 681), and living together (7.23%,1 495/20 681), accounting for 43.96% (9 093/20 681). The index cases included staff (19.34%, 3 999/20 681), the unemployed (17.34%, 3 586/20 681), people engaged in business service (13.85%, 2 864/20 681), people engaged in food service (10.77%, 2 228/20 681), their close contacts accounted for 61.30% (12 677/20 681). Multivariate logistic regression analysis showed that compared with other types of exposure, the risk factors for infection were having meal together (OR=3.96, 95%CI: 2.30-6.83) and living together (OR=6.41, 95%CI:4.48-9.17); Compared with the other occupations, the index case being engaged in food service (OR=3.06, 95%CI:1.29-7.25) and teacher (OR=4.94, 95%CI:1.43-17.08) were risk factors for the infection. Conclusions: The main environmental exposure types of SARS-CoV-2 infection in close contacts were having meal together and living together. Contact with the index case being engaged in food service and teacher increased the risk for COVID-19. Comprehensive prevention and control measures such as centralized isolation and vaccination should be continued.

Evaluation of the roles and regulatory mechanisms of PD-1 target molecules in NSCLC progression

Background

Targeted programmed cell death protein 1 (PD-1) therapy could effectively improve the long-term prognosis of patients with non-small cell lung cancer (NSCLC). The role of PD-1 targets in the progression of NSCLC has not been fully revealed.

Methods

The differentially expressed genes (DEGs) in patients’ blood after NSCLC treatment with PD-1 blocker nivolumab in the GSE141479 dataset were analyzed by GEO2R and identified in the TCGA database. The mechanism of action involved in the PD-1 target molecules via the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). The protein-protein interaction (PPI) network shows the relationship between PD-1 target molecules. The factors affecting the prognosis of NSCLC patients were identified via the COX regression analysis and survival analysis to build the risk model and nomogram.

Results

There were 64 DEGs in patients’ blood after nivolumab treatment and 48 DEGs in NSCLC tissues. The PD-1 target molecules involved cell proliferation, DNA replication, cell cycle, lung cancer, and other cellular processes. The prognostic factors CCNA2, CHEK1, DLGAP5, E2F8, FOXM1, HIST1H2BH, HJURP, MKI67, PLK1, TPX2, and TYMS, and the independent factors HIST1H2BH and PLK1, influenced the prognosis of NSCLC patients. HIST1H2BH and PLK1 were overexpressed in LUAD and LUSC tissues. The elevated expression levels of HIST1H2BH and PLK1 were related to the overall survival (OS) and the progression-free survival of NSCLC patients. High-risk NSCLC patients had a poor prognosis and were an independent factor influencing the poor prognosis of NSCLC patients. The high-risk model group was enriched with signaling mechanisms such as cell cycle, DNA replication, and homologous recombination.

Conclusions

The risk model based on PD-1 target molecules was helpful to assess the prognosis of NSCLC patients. HIST1H2BH and PLK1 might become prognostic biomarkers of NSCLC patients.

Effective Model of Food Allergy in Mice Sensitized with Ovalbumin and Freud's Adjuvant

To better explore the pathophysiology of FA and its therapy, we aimed to establish a simple and practicable FA model with Freund's adjuvant and introduce an easy and reliable laboratory evaluation method for assessment of inflammation in intestinal segments at different anatomical locations. BALB/c mice were sensitized with ovalbumin combined with Freund's adjuvant. Complete Freund's adjuvant was chosen for the first sensitization and two weeks later incomplete Freund's adjuvant was used for a second sensitization. Two weeks later, the sensitized mice were challenged with 50 mg ovalbumin every other day. After the 6 challenge, all mice were assessed for systemic anaphylaxis, and then sacrificed for sample collection. All sensitized mice showed anaphylactic symptoms and markedly increased levels of serum ovalbumin-specific IgE and IgG1. The activity of mast cell protease-1 (mMCPT-1) was significantly increased in the serum and interstitial fluid of the duodenum, jejunum, ileum, and colon. A successful FA model was established, of which inflammation occurred in the duodenum, jejunum, ileum, and colon. This model provides a reliable and simple tool for analysis of the mechanism of FA and methods of immunotherapy. Moreover, combined detection of ovalbumin-specific antibody and local mMCPT-1 levels could potentially be used as the major indicator for assessment of food allergy.

[Surveillance of malaria vector Anopheles in Guizhou Province from 2005 to 2019]

OBJECTIVE

To understand the density, populations and habitats of malaria vector Anopheles in Guizhou Province from 2005 to 2019, so as to provide the evidence for formulating the countermeasures to tackle the risk of local transmission of imported malaria in the province.

METHODS

The malaria vector Anopheles density and populations were monitored using human bait trapping and light trapping techniques in Guizhou Province from 2005 to 2019, and all captured Anopheles was morphologically identified and counted. In addition, the distribution of Anopheles habitats was investigated.

RESULTS

During the period from 2005 through 2019, the malaria vector Anopheles density increased from early June in Guizhou Province, peaked on early July and then declined, which appeared a single peak. The greatest Anopheles density was seen on early August, 2018 [57.34 mosquitoes/(person-night)], and the lowest density was found on late October, 2009 [1.29 mosquitoes/(person-night)]. The annual mean Anopheles density slowly reduced from 17.91 mosquitoes/(person-night) in 2005 to 12.34 mosquitoes/(person-night) in 2012, with a 38.02% reduction (χ²_trend = 115.04, P < 0.01), while the annual mean Anopheles density showed a tendency towards a rise from 2017 to 2019 (χ²_trend = 420.00, P < 0.01). The malaria vector Anopheles was captured during the period between 19 : 00 and 7 : 00 of the next day in Guizhou Province from 2017 to 2019, with the overall density appearing a tendency towards a rise followed by a decline, and the Anopheles activity was highly frequent during the period between 19 : 00 and 21 : 00. The malaria vector Anopheles was monitored for 938 times using the light trapping method in Guizhou Province from 2005 to 2019, and a total of 52 781 Anopheles mosquitoes were captured, including 49 705 An. sinensis, 804 An. minimus, 238 An. anthropophagus, and 2 034 other Anopheles mosquitoes, with a significant difference seen in the Anopheles composition (χ² = 165.68, P < 0.01). From 2017 to 2019, a total of 24 557 Anopheles mosquitoes were captured in human housings, outdoors and livestock housings in Guizhou Province, with 67.65% captured in livestock housings and 12.01% in human housings, and there was a significant difference in the number of Anopheles mosquitoes captured from the three types of habitats (χ² = 55.04, P < 0.01). An. sinensis, An. minimus and An. anthropophagus were captured form all three types of habitats, in which 98.07% was An. sinensis, and 0.09% was An. anthropophagus.

CONCLUSIONS

The population structure of malaria vector Anopheles has changed in historically malaria-endemic areas of Guizhou Province, and An. sinensis has replaced An. minimus and An. anthropophagus to become the predominant malaria vector. The malaria vector Anopheles density has shown a tendency towards a rise in Guizhou Province during the recent years, and there have been a rise in the type and number of Anopheles mosquitoes, leading to a potential risk of local transmission of imported malaria. Long-term, persistent and extensive surveillance of malaria vectors is recommended in Guizhou Province.

[Association between parental education level and left ventricular hypertrophy in childhood]

Objective: To examine the relationship between parental education level and left ventricular hypertrophy (LVH) in children. Methods: The data comes from the baseline survey of the Huantai Childhood Cardiovascular Health Cohort Study (HCCH) conducted in Huantai County, Zibo City, Shandong Province. A convenient cluster sampling method was used to select a primary school in Huantai County, Zibo City, Shandong Province as a survey point. A cross-sectional survey was conducted from November 2017 to January 2018. A total of 1 316 children aged 6-11 years with complete data were included. LVH was defined as left ventricular mass index ≥ sex-and age-specific 90th percentile values of this population. Education levels of both parents were divided into junior high school or lower, high school, university or higher, respectively. Logistic regression models were used to analyze the association between parental education level and LVH in children. Results: The age of 1 316 participants was (8.9±1.5) years old. Among them, there were 703 boys (53.4%).After adjusting for gender, age, intake of vegetables and fruits, intake of carbonated drinks, physical activity, sleep time, screen time, overweight or obesity, and occasional hypertension, the logistic regression model results show that compared with those children whose parents' education level is junior high school or below, paternal or maternal education level of college or higher was associated with odds of LVH (father: OR=0.53, 95%CI: 0.33-0.87; mother: OR=0.52, 95%CI: 0.32-0.87; father/mother: OR=0.54,95%CI: 0.32-0.91). Conclusion: Parental education level is inversely associated with LVH in childhood. The probability of LVH in childhood decreases with the increase of parental education levels.

Measurement of the Cosmic Ray Helium Energy Spectrum from 70 GeV to 80 TeV with the DAMPE Space Mission

The measurement of the energy spectrum of cosmic ray helium nuclei from 70 GeV to 80 TeV using 4.5 years of data recorded by the Dark Matter Particle Explorer (DAMPE) is reported in this work. A hardening of the spectrum is observed at an energy of about 1.3 TeV, similar to previous observations. In addition, a spectral softening at about 34 TeV is revealed for the first time with large statistics and well controlled systematic uncertainties, with an overall significance of 4.3σ. The DAMPE spectral measurements of both cosmic protons and helium nuclei suggest a particle charge dependent softening energy, although with current uncertainties a dependence on the number of nucleons cannot be ruled out.

[Reference values and growth curves of weight/length, body mass index, and ponderal index of Chinese newborns of different gestational ages]

Objective: To establish the reference values and growth curves of weight/length, body mass index, and ponderal index for Chinese newborns with gestational ages of 24 to 42 weeks, in order to provide a reference for the assessment of body proportionality and nutritional status at birth. Methods: Cross-sectional study design was applied. From June 2015 to November 2018, a total of 24 375 singleton live birth newborns with gestational ages of 24 to 42 weeks from 13 cities including Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou, Kunming, Tianjin, Shenyang, Changsha, and Shenzhen were selected, excluding those impacting the establishment of the reference values. The generalized additive model for location, scale, and shape (GAMLSS) was employed to establish percentile (P₃, P₁₀, P₂₅, P₅₀, P₇₅, P₉₀, P₉₇) reference values and growth curves of weight/length, body mass index, and ponderal index for male and female newborns with gestational ages of 24 to 42 weeks. The established growth standards in this study were compared with the standards from the 1988 Chinese data, the INTERGROWTH project, and the USA reference values. Results: A total of 24 375 newborns with 12 264 preterm newborns (7 042 males and 5 222 females) and 12 111 full-term newborns (6 155 males and 5 956 females) were included in this study. The percentile reference values and growth curves of weight/length, body mass index, and ponderal index were obtained for male and female newborns with gestational ages of 24 to 42 weeks. Weight/length of males in all gestational ages at P₁₀, P₅₀ and P₉₀ was 0 to 0.2 kg/m higher than that of females, and body mass index of males in all gestational ages at the P₁₀, P₅₀ and P₉₀ was 0.1 to 0.3 kg/m² higher than that of females. The established growth curves of weight/length and body mass index at the upper percentile and ponderal index at both upper and lower percentiles were greatly different from those of the 1988 Chinese data, which, for example, reported the difference ranges at P₉₀ as -1.09 to 0.40 kg/m for weight/length, -1.19 to 0.92 kg/m² for body mass index, and -0.64 to 0.81 kg/m³ for ponderal index. The established weight/length curves were generally consistent with the reference values from the INTERGROWTH project with a difference of -0.17 to 0.20 kg/m at P₅₀, while being 0.02 to 0.40 kg/m lower at P₉₀ and 0.13 to 0.41 kg/m higher at P₁₀ than that of the INTERGROWTH reference values at gestational ages of ≤32 weeks. The established body mass index curves differed from that of the USA reference values with a difference of -0.47 to 0.17 kg/m² at P₅₀, while being 0.53 to 1.10 kg/m² lower at gestational ages of ≥37 weeks but 0.17 to 0.45 kg/m² higher at gestational ages of ≤28 weeks than that of the USA reference values at P₉₀. Conclusion: The establishment of the new standardized growth reference values of weight/length, body mass index, and ponderal index for Chinese newborns by different gestational ages are useful for clinical practice and scientific research.

Traditional uses, phytochemistry, and pharmacology of Toxicodendron vernicifluum (Stokes) F.A. Barkley - A review

ETHNOPHARMACOLOGICAL RELEVANCE

Toxicodendron vernicifluum (Stokes) F.A. Barkley (syn. Rhus verniciflua or vernicifera Stokes, Anacardiaceae) (RVS), the lacquer tree, also known as sumac, has been used in China, Japan and South Korea for thousands of years as a highly durable coating material and a traditional herbal medicine, which contains medicinal ingredients with anti-tumor, anti-inflammatory, antiviral, and anti-rheumatic activities.

AIM OF THIS REVIEW

This review intends to provide a comprehensive and critical appraisal of RVS, including its phytochemical data, botanical and pharmacological literature that support its therapeutic potential in treatment on human diseases, with emphasis on the isolation of natural occurring compounds and detailed pharmacological investigations.

MATERIALS AND METHODS

Specific information of RVS was collected by using the key words "Toxicodendron vernicifluum", "Rhus verniciflua Stokes", "Rhus vernicifera Stokes" and "Lacquer tree" through published scientific materials (including PubMed, ScienceDirect, Wiley, ACS, CNKI, Scifinder, Springer, Web of Science, Google Scholar, and Baidu Scholar) and other literature sources.

RESULTS

The major phytoconstituents, 175 of which are presented in this review, including flavonoids, urushiols, terpenes, phenolic acids and other types of compounds, of which flavonoids and urushiols are main components. The extracts and isolates purified from RVS showed a wide range of in vitro and in vivo pharmacological effects, such as anti-cancer, anti-oxidation, anti-inflammatory, antimicrobial, tyrosinase inhibition and so on.

CONCLUSION

The modern pharmacological research of RVS mainly focus on the pharmacological effects of crude extract or active constituents, of which the flavonoids are widely studied. However, there are few reports on the relationship between pharmacological effects and their structures. And at present, there is still a lack of researches that are of both effective and in-depth. Meanwhile, there is little research on quality control. Apart from the wood and lacquer, other botanical parts also need to be explored further. In addition to phenolic compounds, the study on other types of components in T. vernicifluum would start more sparks for the discovery of new bioactive principles.

[Research Status and Limitations of Sadomasochism]

Abstract

Sadomasochism is the sexual interest, psychosexual deviance or sexual crimes that are sexually aroused by suffering or causing others to suffer. This study summarizes the concept, assessment and diagnosis, categories and symptoms, psychological and biological mechanisms, judicial disposition and clinical intervention strategies of sadomasochism from the perspectives of clinical medicine, law, criminology and psychology, suggests that further research should take local people with sadomasochism preference and local patients as research objects, pay attention to different types of sadomasochists, conduct bottom-up research, explore the core elements and manifestations of sadomasochism, and accurately define and classify sadomasochism, construct an effective scale, a erectile measurement sexual stimulation system and a diagnostic criteria; discuss evaluation methods combined with crime scene data; discuss the validity of masochists' consent combined with diagnosis; establish targeted criminal correction programs and a treatment and rehabilitation system to provide reference for the improvement of medical, judicial and mental health services.

Efficacy of repetitive transcranial magnetic stimulation for post-stroke depression: a systematic review and meta-analysis of randomized clinical trials

We aimed to conduct a meta-analysis to evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in patients with post-stroke depression (PSD). Six relevant electronic databases (PubMed, CENTRAL, Embase, Web of Science, CINAHL, and PsycINFO) were searched. Randomized controlled trials (RCTs) that compared rTMS with control condition for PSD were included. The mean change in depression symptom scores was defined as the primary efficacy outcome. Secondary outcomes included the remission rate of depression, stroke recovery, and cognitive function recovery. In total, 7 RCTs with 351 participants were included. At post-treatment, rTMS was significantly more effective than the control condition, with a standardized mean difference (SMD) of -1.15 (95%CI: -1.62 to -0.69; P<0.001, I2=71%) and remission with an odds ratio (OR) of 3.46 (95%CI: 1.68 to 7.12; P<0.001; I2=11%). As for stroke recovery, rTMS was also better than the control condition (SMD=-0.67, 95%CI: -1.02 to -0.32; P<0.001). However, no significant difference was found for cognitive function recovery between the two groups (SMD=4.07, 95%CI: -1.41 to 9.55; P=0.15). To explore the potential moderators for the primary outcome, a series of subgroup and sensitivity analyses were performed. The results implied that rTMS may be more effective in Asian samples than in North American samples (P=0.03). In conclusion, from the current evidence in this study, rTMS could be an effective treatment for patients with PSD. Further clinical studies with larger sample sizes and clearer subgroup definitions are needed to confirm these outcomes.

Efficacy and safety of intraoperative radiotherapy in rectal cancer: A systematic review and meta-analysis

BACKGROUND

In recent years, intraoperative radiotherapy (IORT) has been increasingly used for the treatment of rectal cancer. However, the efficacy and safety of IORT for the treatment of rectal cancer are still controversial.

AIM

To evaluate the value of IORT for patients with rectal cancer.

METHODS

We searched PubMed, Embase, Cochrane Library, Web of Science databases, and conference abstracts and included randomized controlled trials and observational studies on IORT vs non-IORT for rectal cancer. Dichotomous variables were evaluated by odds ratio (OR) and 95% confidence interval (CI), hazard ratio (HR) and 95%CI was used as a summary statistic of survival outcomes. Statistical analyses were performed using Stata V.15.0 and Review Manager 5.3 software.

RESULTS

In this study, 3 randomized controlled studies and 12 observational studies were included with a total of 1460 patients, who are mainly residents of Europe, the United States, and Asia. Our results did not show significant differences in 5-year overall survival (HR = 0.80, 95%CI = 0.60-1.06; P = 0.126); 5-year disease-free survival (HR = 0.94, 95%CI = 0.73-1.22; P = 0.650); abscess (OR = 1.10, 95%CI = 0.67-1.80; P = 0.713), fistulae (OR = 0.79, 95%CI = 0.33-1.89; P = 0.600); wound complication (OR = 1.21, 95%CI = 0.62-2.36; P = 0.575); anastomotic leakage (OR = 1.09, 95%CI = 0.59-2.02; P = 0.775); and neurogenic bladder dysfunction (OR = 0.69, 95%CI = 0.31-1.55; P = 0.369). However, the meta-analysis of 5-year local control was significantly different (OR = 3.07, 95%CI = 1.66-5.66; P = 0.000).

CONCLUSION

The advantage of IORT is mainly reflected in 5-year local control, but it is not statistically significant for 5-year overall survival, 5-year disease-free survival, and complications.

[Design of huantai childhood cardiovascular health cohort study]

Cardiovascular disease (CVD) has been an important public health issue in China. Recently, the prevalence of obesity, elevated blood pressure, hyperglycemia, dyslipidemia, and unhealthy lifestyles was high in Chinese children and adolescents, which might increase the risk of short-term target organ damage and adult CVD. Therefore, we selected one primary school in Huantai County, Zibo City between November 2017 and January 2018 to establish the Huantai Childhood Cardiovascular Health Cohort Study. The aim of this project was to investigate the effects of childhood exposures on short-term target organ damage and adult CVD, and to provide evidence to curb the epidemic of CVD in China from the source. A total of 1 515 children aged 6-11 years old were included at the baseline. In this paper, we will introduce the overall design of the survey, including participants, methods, quality control, basic characteristics of the participants, study limitations, and future directions, which might provide some useful implications for similar researches in the future.

[Association between elevated blood pressure and high carotid intima-media thickness in children according to different blood pressure references]

Objective: To analyze the association between elevated blood pressure (BP) and carotid intima-media thickness (cIMT) in children according to four BP references. Methods: Study population came from"Huantai Childhood Cardiovascular Health Cohort Study"in Huantai County, Zibo City, Shandong Province. A convenient cluster sampling method was used to conduct a cross-sectional survey on 1 515 children from November 2017 to January 2018 in a primary school. A total of 1 431 children aged 6-11 years old with complete data were included in this study. Data on demographic characteristics, BP and cIMT were collected through questionnaire survey, physical examination and ultrasound examination. High cIMT was defined as the level of cIMT ≥ age-and sex-specific 90^th percentile of this study population. Based on the Chinese Guideline reference, the Health Industry reference, the International reference and the U.S. reference, all participants were divided into three subgroups: the normal BP, high normal BP and, elevated BP. The multivariate logistic regression models were used to examine the association between BP status and high cIMT in children. Results: The age of children was (8.9±1.5) years, and boys accounted for 53.4% (n=682). The multivariate logistic regression models showed that after adjusting for relevant confounding factors, the risk of high cIMT in elevated BP group was increased compared with the normal BP group according to the four references (all P values<0.05) Conclusion: Elevated BP according to the four BP references is associated with high cIMT in children.

[Association of abdominal obesity in childhood with high carotid intima-media thickness]

Objective: To examine the association of abdominal obesity assessed by waist circumference (WC) with carotid intima-media thickness (cIMT) in children. Methods: The study participants were from the "Huantai Childhood Cardiovascular Health Cohort Study" conducted in Huantai County, Zibo City, Shandong Province. A convenient cluster sampling method was used to select a primary school in Huantai County to conduct the baseline survey from November 2017 to January 2018. A total of 1 515 children aged 6-11 years old were included. The first follow-up survey was conducted from November to December 2019, and a total of 981 children aged 8-13 years old were finally included after exclusion of those with high cIMT at baseline. Questionnaire survey, physical examination and ultrasonic examination were used to collect general demographic characteristics, WC and cIMT information. According to the status of WC at baseline, the participants were divided into normal WC group and abdominal obesity group. Covariance analysis was used to compare the cIMT levels of children between normal WC group and abdominal obesity group. Multivariable logistic regression models were used to evaluate the association between baseline abdominal obesity and high cIMT during the follow-up. Results: The age of 981 children was (8.5±1.5) years at the baseline. The follow-up age was (10.5±1.5) years, and 520 boys accounted for 53.0%. The cIMT of children in the abdominal obesity group was 0.54 mm, which was higher than that in the normal WC group (0.51 mm) (P<0.001). Similarly, the prevalence of high cIMT in children with abdominal obesity (23.9%) was higher than that of normal WC group (3.9%) (P<0.001). After adjusting for potential covariates at the baseline and during the follow-up period, compared with the normal WC group, abdominal obesity was significantly associated with high cIMT (OR=5.78, 95%CI:3.43-9.74). Conclusion: The abdominal obesity in children could increase the risk of high cIMT.

[Clinical characteristics and ketogenic diet therapy of glucose transporter type 1 deficiency syndrome in children: a multicenter clinical study]

Objective: To explore the clinical characteristics of pediatric glucose transporter type 1 deficiency syndrome (GLUT1 DS), evaluate the efficacy and safety of ketogenic diet therapy (KDT). Methods: Clinical data of 19 children with GLUT1 DS admitted to Children's Hospital of Fudan University, Tianjin Children's Hospital, Shenzhen Children's Hospital, Children's Hospital of Nanjing Medical University and Jiangxi Provincial Children's Hospital between 2015 and 2019 were collected retrospectively. The first onset symptom, main clinical manifestations, cerebrospinal fluid features and genetic testing results of patients were summarized, the efficacy and safety of ketogenic diet treatment were analyzed. Results: Among the 19 cases, 13 were males and 6 females. The age of onset was 11.0 (1.5-45.0) months,the age of diagnosis was 54.0 (2.8-132.0) months. Epilepsy was the first onset symptom of 13 cases. Different forms of tonic-clonic seizures were the most common types of epilepsy (7 cases with generalized tonic-clonic seizures, 5 cases with focal tonic or clonic seizures, 4 cases with generalized tonic seizures). Antiepileptic drugs were effective in 4 cases. Paroxysmal motor dysfunction was present in 12 cases and ataxia was the most common one. All patients had different degrees of psychomotor retardation. Among 17 patients received cerebrospinal fluid examination, cerebrospinal fluid (CSF) glucose level was lower than 2.2 mmol/L and CSF glucose/glycemic index was<0.45 in 16 cases, only 1 case presented normal CSF glucose level (2.3 mmol/L) and normal CSF glucose/glycemic index(0.47). SLC2A1 gene mutations were found in 16 patients, missense, frameshift and nonsense mutations were the common types with 5 cases, 5 cases and 3 cases respectively. All 19 patients were treated with ketogenic diet, which was effective in 18 cases in seizure control, 11 cases in dyskinesia improvement and 18 cases in cognitive function improvement. No serious side effects were reported in any stage of KDT. Conclusions: The diagnosis of GLUT1 DS is often late. It is necessary to improve the early recognition of the disease and perform CSF glucose detection and genetic testing as early as possible. The KDT is an effective and safe treatment for GLUT1 DS, but a small number of patients have not response to diet therapy.

[Establishment of nutrition literacy core items for Chinese people]

Objective: To establish core items of nutrition literacy for general population in China. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts' consultation. Content validity test was used to determine the nutrition literacy item. Thirteen experts in the field of human nutrition, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of experts towards the items, active coefficient, and content validity were analyzed to generate the final list of nutrition literacy items. Results: 92.3% of questionnaires in two rounds were collected.The active coefficient of experts was satisfied and the authority coefficient was 0.96.In the content validity evaluation, the correlation I-CVI value of each item was above 0.83 and the κ value was above 0.74. The evaluation result was excellent.After the second round of expert consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of three scales (knowledge and concepts, lifestyles and dietary behaviors, and basic skills), ten subscales (basic nutrition philosophy, food classification and nutrition knowledge, healthy weight, eating behavior and culture, balanced diet, exercise health, food assessment, nutrition information acquisition and decision, nutrition safety, and weight management)with 25 items in total. Conclusions: The framework system and core items of nutrition literacy are established for Chinese people based on the content validity evaluation. The experts involved in the consultation process present a performance with good representativeness, enthusiasm and authority, and the content validity evaluation result is satisfied.

[Establishment of nutrition literacy core items for Chinese old people]

Objective: To establish the nutrition literacy core items for older people in China. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts consultation. Content validity test was used to determine the nutrition literacy items. Seven experts in the field of human nutrition, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of expertstowards the items, active coefficient, and content validitywere evaluated and analyzed to generate the final list of nutritionliteracy items. Results: A total of 85.7% (6/7) of questionnaires in two rounds were collected.The active coefficient of experts was satisfied and the authority coefficient was 0.96. In the content validity evaluation, the correlation I-CVI value of each item was above 0.90 and theκvalue was above 0.74. The evaluation result was excellent. After the second round of consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of three scales (knowledge and concepts, lifestyles and dietary behaviors, and basic skills), twelve subscales (reasonable nutrition, healthy weight, environment of dining, food classification, nutrition and disease, eat regularly, balanced diet, exercise health, information getting, household food measurement, reading nutrition label and calculating, and food safety)with 20 items in total. Conclusions: The framework system and core items of nutrition literacy are established for Chinese older people based on the content validity evaluation. The experts involved in the consultation process present a performance with good representativeness, enthusiasm and authority, and the content validity evaluation result is satisfied.

Development of a prognostic model based on an immunogenomic landscape analysis of colorectal cancer

Screening and therapeutic programs for colorectal cancer (CRC) are invasive or not effective and unable to meet patient needs. Major advances in immunogenomics may change this status but need more exploration. Differentially expressed genes and immune-related genes (IRGs) were identified by computational methods. A prognostic model was established and validated based on survival-related IRGs via stepwise multivariate Cox regression analysis. Nine IRGs were selected and identified as survival-related genes. A 7-gene prognostic model could offer a preliminary and valid determination of risk in CRC patients. The area under the curve of the receiver operating characteristic was 0.672. The 7-gene prognostic model might be used as a novel prognostic tool in CRC patients.

Effects of Acanthopanax senticosus supplementation on innate immunity and changes of related immune factors in healthy mice

Modern scientific research has shown that Acanthopanax senticosus (AS) can regulate the innate immunity of healthy animals, thus affecting the health of animals. However, there are few systematic reports on the changes of innate immune indices of healthy animals after consuming AS. The purpose of this project was to study the effect on healthy mice’s innate immunity and changes of related immune factors induced by feeding AS root powder supplementation. The results showed that the killing rate of natural cells increased in a dose-dependent manner in a certain time period. Compared to the control group, the treatment groups (T1, T2 and T3) improved significantly in the innate immune index (lysozyme, β-defensin-2 and duodenal secretory IgA (SIgA) to varying degrees) and induced corresponding changes of immune factors at certain time periods. The correlation between SIgA and IFN-γ in mouse serum was enhanced, and the higher the concentration of AS in the diet, the stronger the correlation was. However, there was no significant difference in growth performance among groups. It is proved that AS supplementation can enhance innate immunity and change several relevant immune factors and cells of healthy mice without affecting growth performance.