[Analysis of efficacy and prognosis of allogeneic hematopoietic stem cell transplantation for the treatment of combined immunodeficiency]

Objective: To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation for the treatment of combined immunodeficiency (CID) and explore prognostic risk factors. Methods: In this retrospective cohort study, clinical characteristics, laboratory tests and prognosis of 73 CID children who underwent allogeneic hematopoietic stem cell transplantation from February 2014 to April 2022 in the Children's Hospital of Fudan University were analyzed. Based on the subtypes of diseases, all patients were divided into severe combined immunodeficiency disease (SCID) group and other CID group. Based on the types of donors, all patients were divided into matched sibling donor group, matched unrelated donor group, unrelated cord blood group, and haploidentical donor group. Kaplan-Meier method and Log-Rank test were used to analyze the survival data. Cox regression was used to analyze prognostic factors. Results: Among the 73 patients, there were 61 (84%) males and 12 (16%) females. Fifty-five (75%) patients were SCID, and 18 (25%) patients were other CID. Donor source included 2 (3%) matched sibling donors (MSD), 3 (4%) matched unrelated donors (MUD), 64 (88%) unrelated cord blood (UCB), and 4 (5%) haploidentical donors. The age at transplant was 10.7 (5.9, 27.5) months, and the follow-up time was 36.2 (2.5, 62.9) months. The 3-year overall survival rate of 73 patients with CID was (67±6) %. No significant difference was found in the 3-year overall survival rates between patients with SCID (55 cases) and other CID (18 cases) ((64±7) % vs. (78±10) %, χ2=1.31, P=0.252). And no significant difference was found in the 3-year overall survival rates among patients who received MSD or MUD (5 cases), UCB (64 cases), and haploidentical donor (4 cases) transplant (100% vs. (66±6)% vs. (50±25) %, χ2=2.30, P=0.317). Cox regression analysis showed that the medical history of sepsis (HR=2.55, 95%CI 1.05-6.20, P=0.039) and hypoalbuminemia at transplant (HR=2.96, 95%CI 1.14-7.68, P=0.026) were independent risk factors for the prognosis of allogeneic hematopoietic stem cell transplantation in pediatric patients with CID. Conclusions: Allogeneic hematopoietic stem cell transplantation is an effective treatment for CID. The medical history of sepsis and hypoalbuminemia at transplant were risk factors for prognosis. Enhancing infection prevention and nutritional intervention before transplant can improve patient prognosis.

China's application of the One Health approach in addressing public health threats at the human-animal-environment interface: Advances and challenges

Background

Due to emerging issues such as global climate change and zoonotic disease pandemics, the One Health approach has gained more attention since the turn of the 21st century. Although One Health thinking has deep roots and early applications in Chinese history, significant gaps exist in China's real-world implementation at the complex interface of the human-animal-environment.

Methods

We abstracted the data from the global One Health index study and analysed China's performance in selected fields based on Structure-Process-Outcome model. By comparing China to the Belt & Road and G20 countries, the advances and gaps in China's One Health performance were determined and analysed.

Findings

For the selected scientific fields, China generally performs better in ensuring food security and controlling antimicrobial resistance and worse in addressing climate change. Based on the SPO model, the "structure" indicators have the highest proportion (80.00%) of high ranking and the "outcome" indicators have the highest proportion (20.00%) of low ranking. When compared with Belt and Road countries, China scores above the median in almost all indicators (16 out of 18) under the selected scientific fields. When compared with G20 countries, China ranks highest in food security (scores 72.56 and ranks 6th), and lowest in climate change (48.74, 11th).

Conclusion

Our results indicate that while China has made significant efforts to enhance the application of the One Health approach in national policies, it still faces challenges in translating policies into practical measures. It is recommended that a holistic One Health action framework be established for China in accordance with diverse social and cultural contexts, with a particular emphasis on overcoming data barriers and mobilizing stakeholders both domestically and globally. Implementation mechanisms, with clarified stakeholder responsibilities and incentives, should be improved along with top-level design.

Fe3O4nanoparticles anchored on carbon nanotubes as high-performance anodes for asymmetric supercapacitors

Fe3O4/CNT composites are synthesized with ethylene glycol as solvent by a one-step solvothermal method and used as anode materials for asymmetric supercapacitors (ASC). An appropriate amount of water in ethylene glycol can accelerate the formation of Fe3O4and reduce the average size of Fe3O4to around 20 nm. However, spherical Fe3O4particles larger than 100 nm will form in pure ethylene glycol for long reaction time. The Fe3O4/CNT composite with small Fe3O4nanoparticles exhibits a high specific surface area, promoted electron transfer ability, as well as a high utilization rate of active materials. The optimized electrode shows a high specific capacity of 689 C g-1at 1 A g-1, and remains 443 C g-1at 10 A g-1. The inferior long-term cycling stability is due to the phase transition of Fe3O4and a reductive effect to form metallic Fe. An ASC using Fe3O4/CNT and NiCoO2/C composites as anode and cathode, respectively, delivers a high energy density of 58.1 Wh kg-1at a power density of 1007 W kg-1in a voltage window of 1.67 V and has a capacity retention of 63% after 5000 cycles. The self-discharge behavior of the ASC is also investigated.

Effects of different light-emitting diode light on hatch performance, embryo development, eye structure, and plasma melatonin in layer incubation

Light intensity, wavelength, and photoperiod have a combined effect on chicken incubation. This study was conducted to evaluate the effect of 12-h light, 12-h dark (12L:12D) photoperiod of white light (380-780 nm, WL), blue light (455/447.5-462.5 nm, BL), and green light (525/515-535 nm, GL) in chicken perceived light intensity during layer incubation on hatching performance, embryo development, eye structure, and melatonin concentration. Three batches of eggs from Jinghong No. 1 layer breeder were used in this experiment. Light stimulation had no effect on hatchability, and no consistent effect on embryo weight and newly hatched chick weight. However, the average hatching time of white light group and green light group was 7.3 h and 5.5 h later than that of the control group. Therefore, the holding period of chicks was significantly shortened (P = 0.001) in these 2 light groups. Light stimulation had a significant effect on the thickness of retinal layers (P < 0.05), retinal layers of white light group was thicker than that of the other 3 groups. Melatonin levels of chicks hatched in the green light and blue light were significantly higher than that of chicks hatched in the white light and darkness (P < 0.05). It indicated that the monochrome green and blue light promoted the expression of melatonin in chicken embryos. No significant diurnal rhythms were found at the level of plasma melatonin in 4 groups on d 21 using cosine analysis. It was concluded that green light has a positive effect on embryo development and melatonin secretion, while white light probably has positive effect on eye development. Furthermore, both green and white light stimulation resulted in late hatch for layer egg incubation. The obtained results are important in determining the light protocol for chicken incubation.

[Detection of small airway dysfunction in bronchial asthma and its clinical application]

Bronchial asthma is a common chronic inflammatory airway disease. Small airway dysfunction (SAD) can be present in asthmatics with different phenotypes, clinical stages and varied severity, and has implication for drug efficacy and patient prognosis. Currently, there is no consensus on the criteria for SAD, and its inflammatory mechanism remains unclear. In this paper, we reviewed the research advances in the evaluation, prevalence, pathogenesis, clinical features and treatment of SAD in asthmatics to improve awareness of the disease.

[Constructing the Bayesian network models to explore the factors related to glomerular and tubular injury]

Objective: To construct Bayesian network (BN) models to explore the factors related to glomerular injury (GI) and tubular injury (TI). Methods: A cross-sectional study was carried out. From April to November 2019, Shanxi Provincial People's Hospital performed an opportunistic screening for chronic kidney disease in 10 counties of Shanxi Province. The general data and laboratory results of blood and urine samples were collected. Chi-square test and logistic regression were used to explore the related factors of GI and TI, which were included in the construction of BN models with max-min hill-climbing (MMHC) algorithm. Results: A total of 12 269 participants were included, there were 5 198 males and 7 071 females, with a median age of 58 (40-91) years. The prevalence of GI and TI was 12.7% (1 561/12 269) and 11.6% (1 425/12 269), respectively. The BN model consisted of 8 nodes and 10 edges for GI, and 11 nodes and 17 edges for TI, respectively. BN models showed that age and glycated hemoglobin were direct related factors for GI, while gender and fasting blood glucose were indirect related factors for GI. Age, gender, fasting blood glucose and glycosylated hemoglobin were direct related factors for TI. Additionally, the area under the receiver operating characteristic curve (AUC) was 0.761 (95%CI: 0.746-0.777) and 0.753 (95%CI: 0.736-0.769) for GI and TI BN models, respectively. Conclusions: BN models allow for identifying the complex network relationships among the factors related to GI and TI. Meanwhile, Bayesian risk reasoning can provide reference value for the clinical prevention of GI and TI.

Controllable reduction of NiCoO2@NiCo core-shell nanospheres on CNTs for high-performance electrochemical energy storage

The performances of energy storage devices are strongly dependent on the electrode materials. Owing to the high theoretical capacity, NiCoO₂ is a promising transition metal oxide for supercapacitors. Despite many efforts have been devoted, it still lacks of effective methods to overcome its shortcomings such as low conductivity and poor stability, in order to achieve its theoretical capacity. Herein, utilizing the thermal reducibility of trisodium citrate and its hydrolyzate, a series of NiCoO₂@NiCo/CNT ternary composites in which NiCoO₂@NiCo core-shell nanospheres deposited on CNT surface with adjustable metal contents are synthesized. Benefiting from the enhanced synergistic effect of both metallic core and CNTs, the optimized composite exhibits an extremely high specific capacitance (2660 F g^-1 at 1 A g^-1, the effective specific capacitance of the loaded metal oxide is 4199 F g^-1, close to the theoretical value), an excellent rate performance and stability, when the metal content is about 37%. After depolarized calculation, the energy storage mechanism of the composite is reasonably analyzed. By controlling the contents of hexamethylenetetramine, trisodium citrate and CNTs in the reactant, the roles of them are distinguished. This study reveals an efficient novel strategy for transition metal oxides to maximize the electrochemical performances.

The approaching pilot for One Health governance index

BACKGROUND

One Health approach advocates realizing the best health and harmonious symbiosis of human, animal and natural environment through cross-border, multi-sectoral and interdisciplinary cooperation. The good governance model is the leading factor for the performance of One Health governance. In order to tackle the complex problems in the One Health governance at the global level, the variation of One Health governance in different countries was analyzed by a set of indicators within the One Health system.

METHOD

The capacity of One Health governance was assessed after establishment of a set of indicators for the One Health governance index (OHGI) following the methodology of the global One Health index. The data to calculate OHGI was collected from various database sources, including the Food and Agriculture Organization, the World Health Organization, the World Organization for Animal Health, and official health-related institutions of various countries. Eight indicators (including 19 sub-indicators) were employed in the OHGI system to comprehensively evaluate the capacity of One Health governance in 146 countries of the world.

RESULTS

Among the 146 countries scored in the OHGI system, the average score was 34.11, with a median score of 31.49, ranged from 8.50 to 70.28. Most countries with higher OHGI scores come from Europe and Central Asia, East Asia and the Pacific and North America, while countries with the lower OHGI scores are almost from sub-Saharan Africa. Six countries scored more than 65 points, including Australia, Sweden, Germany, Netherlands, the United States of America and Finland, indicating that these countries are relatively mature in most aspects of One Health governance. However, there were some developing countries with OHGI scored lower than 15. Therefore, the gap between countries with higher OHGI scores and those with lower OHGI scores is more than 60.

CONCLUSIONS

Good governance on One Health is an important indicator to measure One Health's governance capacity. The political stability, the level of rule of law and economic conditions in different regions are significantly correlated with the One Health governance capacity. Actions need to be taken urgently to close the gap of One Health governance between different regions.

A new paradigm of sewage collection in rural areas

Rural sewage collection networks play extremely important roles in rural sewage treatment, and the lack of a suitable collection model makes this task difficult. Hence, there is an urgent need to develop a new method to collect and deal with rural sewage. This paper establishes a rural sewage optimal collection model (RSOCM) with critical distance (d) and sewage quota per unit area (q_s) as the constraint factors. The implementation of critical distance for rural sewage collection pipeline networks was demonstrated for 38 rural areas in the Huicheng District, Huizhou City, Guangdong Province of China. The average critical distances of 22 m, 38 m, 29 m, 29 m, 41 m, and 55 m were demonstrated for Sandong Town, Ma'an Town, Luzhou Town, Ruhu Town, Hengli Town, and Shuikou Subdistrict, respectively. The q_s is used to create the best possible pipe network layout, determine the appropriate treatment method, and reduce construction costs. This model can be widely applied to sewage collection in rural areas of China, where the overall sewage collection system can implement different regional strategies to maximize rural pollution control and protect the environment.

[Epidemiological characteristics and Spatial-temporal clustering of hand, foot and mouth disease in Shanxi province, 2009-2020]

Objective: To analyze the epidemiology and spatial-temporal distribution characteristics of hand, foot and mouth disease (HFMD) in Shanxi province. Methods: The data of HFMD in Shanxi province from 2009 to 2020 were collected from notifiable disease management information system of Chinese information system for disease control and prevention and analyzed by descriptive epidemiology, Joinpoint regression, spatial autocorrelation analysis and spatio- temporal scanning analysis. Results: A total of 293 477 HFMD cases were reported in Shanxi province from 2009 to 2020, with an average annual incidence of 67.64/100 000 (293 477/433 867 454), severe disease rate of 5.36/100 000 (2 326/433 867 454), severe disease ratio of 0.79%(2 326/293 477), mortality of 0.015/100 000 (66/433 867 454), and fatality rate of 22.49/100 000 (66/293 477). The reported incidence rate, severe disease rate, mortality rate and fatality rate of HFMD showed decreasing trends. The main high-risk groups were scattered children and kindergarten children aged 0-5. The incidence of HFMD had obvious seasonal variation, with two peaks every year: the main peak was during June-July, the secondary peak was during September-October and the peak period is from April to November. A total of 13 942 laboratory cases were confirmed, with a diagnosis rate of 4.75% (13 942/293 477), including 4 438 (35.11%, 4 438/293 477) Enterovirus A71 (EV-A71) positive cases, 4 609 (33.06%, 4 609/293 477) Coxsackievirus A16 (CV-A16) positive cases, and 4 895 (31.83%, 4 895/293 477) other enterovirus positive cases. There was a spatial positive correlation (Moran's I ranged from 0.12 to 0.58, all P<0.05) and the spatial clustering was obvious. High-risk regions were mainly distributed in Taiyuan in central Shanxi province, Linfen and Yuncheng in southern Shanxi province, and Changzhi in southeastern Shanxi province. Spatial-temporal scanning analysis revealed 1 the most likely cluster and 8 secondary likely clusters, of which the most likely cluster (RR=2.65, LLR=22 387.42, P<0.001) located in Taiyuan and Jinzhong city, Shanxi province, including 12 counties (districts), and accumulated from April 1, 2009 to November 30, 2018. Conclusions: There was obvious spatial-temporal clustering of HFMD in Shanxi province, and the epidemic situation was in decline. The key areas were the districts in urban areas and the counties adjacent to it. Meanwhile, the monitoring and classification of other enterovirus types of HFMD should be strengthened.

[The influence of meteorological factors on SARS-CoV-2 transmission: evidence from laboratory and epidemiological studies]

SARS-CoV-2 has infected more than 600 million people worldwide and caused more than 6 million deaths. The emerging novel variants have made the epidemic rebound in many places. Meteorological factors can affect the epidemic spread by changing virus activity, transmission dynamic parameters and host susceptibility. This paper systematically analyzed the currently available laboratory and epidemiological studies on the association between the meteorological factors and COVID-19 incidence, in order to provide scientific evidence for future epidemic control and prevention, as well as developing early warning system.

[Analysis of risk factors and prognosis of cytomegalovirus infection post umbilical cord blood stem cell transplantation in children with primary immunodeficiency diseases]

Objective: To investigate the risk factors and outcomes of cytomegalovirus (CMV) infection post umbilical cord blood stem cell transplantation (UCBT) in children with primary immunodeficiency diseases (PID). Methods: Clinical data of 143 PID children who received UCBT in the Children's Hospital of Fudan University from January 2015 to June 2020 were collected retrospectively. CMV-DNA in the plasma was surveilled once or twice a week within 100 days post-UCBT. According to the CMV-DNA test results, children were divided into the CMV-infected group and the CMV-uninfected group. The incidence and risk factors of CMV infection were analyzed. At 1-month post-UCBT, the absolute lymphocyte count, ratio of lymphocyte subsets and immunoglobulin levels were compared between those whose CMV infection developed 1-month later post-UCBT and those not. Mann-Whitney U test and chi-squared test were used for comparision between groups. Kaplan-Meier survival analysis was used to analyze the impact of CMV infection on survival. Results: Among 143 patients, there were 113 males and 30 females, with a age of 14 (8, 27) months at UCBT. Chronic granulomatosis disease (n=49), very-early-onset inflammatory bowel disease (n=43) and severe combined immunodefiency (n=29) were the three main kinds of PID. The rate of CMV infection was 21.7% (31/143), and the time of infection occurring was 44 (31, 49) days post-UCBT. The incidence of recurrent CMV infection was 4.2% (6/143) and refractory CMV infection was 4.9% (7/143).There was no significant difference in the first time CMV-DNA copy and peak CMV-DNA copy during treatment between the recurrent CMV infection group and the non-recurrent CMV infection group (32.8 (18.3, 63.1)×10⁶ vs. 22.5 (13.2, 31.9)×10⁶ copies/L, Z=-0.95, P=0.340;35.2 (20.2, 54.6)×10⁶ vs. 28.4 (24.1, 53.5)×10⁶copies/L, Z=-0.10, P=0.920), so were those between the refractory CMV infection group and non-refractory CMV infection group (21.8 (13.1, 32.2)×10⁶ vs. 25.9 (14.2, 12.2)×10⁶copies/L, Z=-1.04, P=0.299; 47.7 (27.9, 77.6)×10⁶ vs. 27.7 (19.7,51.8)×10⁶copies/L, Z=-1.49, P=0.137). The CMV-infected group accepted more reduced-intensity conditioning (RIC) regimen than the CMV-uninfected group (45.2% (14/31) vs. 25.0% (28/112), χ²=4.76, P<0.05). The rate of CMV-seropositive recipients and Ⅱ-Ⅳ acute graft versus host diseases (aGVHD) are significantly higher in the CMV-infected group than the CMV-uninfected group (100% (31/31) vs. 78.6% (88/112), 64.5% (20/31) vs. 26.8% (30/112), χ²=7.98,15.20, both P<0.05). The follow-up time was 31.6 (13.2, 45.9) months, CMV infection had no effect on overall survival (OS) rate (χ²=0.02, P=0.843). There was significant difference in the survival rate among three groups of refractory CMV infection, non-refractory CMV infection and the CMV-uninfected (4/7 vs.95.8% (23/24) vs. 86.6% (97/112), χ²=5.91, P=0.037), while there was no significant difference in the survival rate among three groups of recurrent CMV infection, non-recurrent CMV infection and the CMV-uninfected (5/6 vs. 88.0% (22/25) vs. 86.6% (97/112), χ²=0.43, P=0.896). Children who developed CMV infection after 30 days post-UCBT had lower absolute count and rate of CD4⁺ T cells and immunoglobulin G (IgG) level than those in the CMV-uninfected group (124.1 (81.5, 167.6) ×10⁶ vs. 175.5 (108.3, 257.2) ×10⁶/L, 0.240 (0.164, 0.404) vs. 0.376 (0.222, 0.469), 9.3 (6.2, 14.7) vs. 13.6 (10.7, 16.4) g/L, Z=-2.48, -2.12,-2.47, all P<0.05), but have higher rate of CD8⁺T cells than those in CMV-uninfected group (0.418 (0.281, 0.624) vs. 0.249 (0.154, 0.434), Z=-2.56, P=0.010). Conclusions: RIC regimen, grade Ⅱ-Ⅳ aGVHD and CMV-seropositive recipients are the main risk factors associated with CMV infection in PID patients post-UCBT. Survival rate of children with refractory CMV infection after UCBT is reduced. Immune reconstitution in children after UCBT should be regularly monitored, and frequency of CMV-DNA monitoring should be increased for children with delayed immune reconstitution.

[The feasibility study of objective evaluation of the severity of motion sickness by quantitative analysis of the facial skin color]

Objective: To explore the feasibility of applying quantitative analysis of the facial skin color to evaluate the severity of motion sickness objectively and to seek objective indicators that can reflect the severity of motion sickness. Methods: Motion sickness was induced in 51 male adult subjects recruited at the Air Force Medical University by Coriolis acceleration stimulation, and facial skin colorimetric values were acquired using a portable spectrophotometer at five time points: before stimulation and at 0 min, 10 min, 20 min and 30 min after the end of stimulation. The Graybiel rating scales were applied to assess the severity of motion sickness in subjects at each time point after stimulation, and the correlation between the magnitude of change in each colorimetric value and the maximum Graybiel's score was analyzed. The ROC curves were used to compare the evaluation performance of colorimetric value indicators which could reflect the severity of motion sickness. Results: Each colorimetric value in the CIE-L^*a^*b^* color system changed significantly after exposure to provocative motion stimuli, and the trend was consistent with the typical sign of pallor in motion sickness. The magnitudes of the increase in the colorimetric value CIE-L^*, the decrease in CIE-a^*, and the increase in CIE-b^* were all significantly and positively correlated with the maximum of Graybiel's scores (r=0.490 0, P=0.000 3; r=0.549 3, P<0.000 1; r=0.540 9, P<0.000 1). Comparing the performance of three colorimetric indicators to assess the severity of motion sickness, CIE-a^* had an area under the ROC curve of 0.875 0, a sensitivity of 85.71%, and a specificity of 87.50%, which was better than CIE-L^* and CIE-b^*. Conclusions: The CIE-L^*a^*b^* colorimeter values can be considered as objective indicators of the severity of motion sickness, among which the colorimetric indicator CIE-a^* has the most diagnostic significance, and the method of quantitative analysis of the facial skin color can provide a new reference for the objective evaluation of the severity of motion sickness.

Monitoring mild cognitive impairment of workers exposed to occupational aluminium based on quantitative susceptibility mapping

AIM

To investigate the diagnostic value of quantitative susceptibility mapping (QSM) in mild cognitive impairment (MCI) of aluminium (Al) workers.

MATERIALS AND METHODS

The basic data of 53 workers in an Al factory were collected and divided into the MCI group and normal control (NC) group by Montreal Cognitive Assessment (MoCA) scores. All participants were tested for plasma Al concentration and had magnetic resonance imaging (MRI). The QSM values of many areas of the brain were delineated and measured. Independent two-sample t-tests or non-parametric tests were used to compare the parameter values between the two groups. Spearman's correlation analysis was performed between QSM values, MoCA scores, and plasma Al concentration. The receiver operating characteristic curve and z test were performed to assess diagnostic efficacy and the best parameter.

RESULTS

There was no difference in age and educational level. Plasma Al concentration of the MCI group was higher than that of NC group (p=0.057). QSM values of the left hippocampus, left dentate nucleus, right substantia nigra, and left putamen in MCI group were higher than that of NC group (p<0.05), and the left hippocampus had the best diagnostic efficacy. QSM values correlated negatively with MoCA scores. No correlation was found between QSM values and plasma Al concentration (p>0.05).

CONCLUSION

QSM might be a neuroimaging marker for the diagnosis of MCI. The left hippocampus showed the best diagnostic efficacy. Plasma Al concentration of the MCI group was higher than that of the NC group. A correlation between QSM and plasma Al concentration was not found.

A novel multi-objective optimization framework for urban green-gray infrastructure implementation under impacts of climate change

Frequent urban flooding disasters can cause severe economic and property losses. Accordingly, the construction of sponge city has become critical to alleviating urban flooding. However, the functional and structural integration of Green Infrastructure (GI) and Gray Drainage Facility (GDF) is still a matter of concern. This study proposed a novel implementation framework for GI and GDF synchronization optimization (G-GSOIF) based on the SWMM and SUSTAIN models, and used data from Beilin District in Xi'an, China to verify the effects. The results show that the spatiotemporal integrated optimization design of GI and GDF proves to be effective in stormwater management. The total investment was reduced by 16.7% and economic benefit was increased by 15.4% based on disaster risk control, and the utilization rate of rainwater resources exceeded 40%. The Staged optimization model (SSOM) based on the SUSTAIN model established in the G-GSOIF was demonstrated to effectively cope with the impact of future climate change by adjusting and optimizing the design scheme dynamically in different simulation scenarios. Integrated LID (I-LID) measures are conducive for simulation of large catchment areas, and have the same implementation effect as distributed LID measures. The results of this study could support decision-making for urban stormwater management and sponge city construction.

Towards a global One Health index: a potential assessment tool for One Health performance

Background

A One Health approach has been increasingly mainstreamed by the international community, as it provides for holistic thinking in recognizing the close links and inter-dependence of the health of humans, animals and the environment. However, the dearth of real-world evidence has hampered application of a One Health approach in shaping policies and practice. This study proposes the development of a potential evaluation tool for One Health performance, in order to contribute to the scientific measurement of One Health approach and the identification of gaps where One Health capacity building is most urgently needed.

Methods

We describe five steps towards a global One Health index (GOHI), including (i) framework formulation; (ii) indicator selection; (iii) database building; (iv) weight determination; and (v) GOHI scores calculation. A cell-like framework for GOHI is proposed, which comprises an external drivers index (EDI), an intrinsic drivers index (IDI) and a core drivers index (CDI). We construct the indicator scheme for GOHI based on this framework after multiple rounds of panel discussions with our expert advisory committee. A fuzzy analytical hierarchy process is adopted to determine the weights for each of the indicators.

Results

The weighted indicator scheme of GOHI comprises three first-level indicators, 13 second-level indicators, and 57 third-level indicators. According to the pilot analysis based on the data from more than 200 countries/territories the GOHI scores overall are far from ideal (the highest score of 65.0 out of a maximum score of 100), and we found considerable variations among different countries/territories (31.8–65.0). The results from the pilot analysis are consistent with the results from a literature review, which suggests that a GOHI as a potential tool for the assessment of One Health performance might be feasible.

Conclusions

GOHI—subject to rigorous validation—would represent the world’s first evaluation tool that constructs the conceptual framework from a holistic perspective of One Health. Future application of GOHI might promote a common understanding of a strong One Health approach and provide reference for promoting effective measures to strengthen One Health capacity building. With further adaptations under various scenarios, GOHI, along with its technical protocols and databases, will be updated regularly to address current technical limitations, and capture new knowledge.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s40249-022-00979-9.

[Research advances on skin wounds suturing techniques and their clinical application]

Stitching skin wounds is one of the essential skills of a surgeon. Whether it is a traumatic wound or a surgical incision, choosing the most appropriate closure technique according to its characteristics is an important factor for good healing. Various skin wounds suturing techniques have been created and improved over the years, which have advantages of simple operation, precise alignment, reducing tension of the wound edges, and reducing scar formation, etc. Although these techniques provide more options for wound suture, they also put forward requirements for the judgment and operation ability of the operators. This article summarizes the advantages and disadvantages of the different skin wounds suturing techniques and their clinical application.

[Prospects of gene therapy for monogenic nephrolithiasis]

Monogenic nephrolithiasis is comparatively rare in clinical practice, but its yearly increasing incidence and impacts on physical and mental health are worth wide attention. At present, management of monogenic nephrolithiasis are still the medication and surgery. This article regards the research progress on primary hyperoxaluria as the breakthrough point to review the etiological therapy of monogenic nephrolithiasis. We aim to promote more studies on other monogenic nephrolithiasis, more methods and drugs for gene therapy, precise and individualized treatment of monogenic nephrolithiasis, and thus to promote the prevention and treatment of monogenic nephrolithiasis in China.

Towards the formulation of rural sewage discharge standards in China

In China, most rural areas lack specific sewage discharge standards. Even though China governments proposed a series of local standards, the most of the existing China's rural sewage discharge standards are still similar to urban discharge standards. This research analyses comprehensively the data of rural sewage discharge standards in the 31 provinces and cities in China in terms of grade and indicator, and forms a structural framework for the formulation and revised standards in rural areas of China. In the formulation, we use 2 components, end-use and environmental capacity, to reflect local characteristics of the grades and indicators, and also propose the methods of combining discharge standards with relevant water quality standards to save energy. And we also use the mathematical model to illustrate environmental capacity in different regions. The paper shows the great potential in guiding the design of discharge standards formulation and revision for rural wastewater treatment in China and other developing countries as well.

[Analysis of baseline characteristics and treatment status of hepatitis C in sentinel hospitals from 2017 to 2019]

Objective: To understand the hepatitis C diagnosis type, progression and treatment in medical institutions. Methods: Monitoring posts were set up in the secondary and tertiary-level hospitals in some parts of the country. Reported infectious diseases cases of hepatitis C in sentinel hospitals during the three consecutive years from 2017 to 2019 were investigated to understand their general demographic characteristics, diagnosis, liver fibrosis degree, and treatment. The diagnosis, treatment and related factors were analyzed by chi square test and trend. Results: A total of 16 241 cases of hepatitis C were investigated in three years. Among them, 7 538 cases were clinically diagnosed (46.41%) and 8703 cases (53.59%) were confirmed as hepatitis C. Among the confirmed cases, 60 cases (0.69%) were acute and 8643 cases (99.31%) were chronic. In the past three years, the proportion of cases diagnosed by liver diseases related departments decreased from 62.23% to 40.01%, while the proportion of medical and surgical cases of non-liver diseases increased from less than 30% to nearly 60%. The proportion of confirmed cases in secondary hospitals (26.27%) was significantly lower than that in tertiary hospitals (62.48%), and the difference was statistically significant (χ (2) = 1594.833, P < 0.001). There were also differences in the proportion of confirmed cases in different regions (P < 0.001). The cases with FIB-4 > 3.25 accounted for 35.78%, and the proportion was increased significantly with age (χ (2) trend = 1159.624, P < 0.001). The average proportion of antiviral treatment was less than 10%, and the proportion of antiviral treatment in secondary hospitals was very low (2.13%); however, the proportion of liver-protective monotherapy treatment was decreased from 30.40% in 2017 to 11.14% in 2019, and the difference was statistically significant (P < 0.001). Conclusion: The large-scale screening of hepatitis C by medical institutions is increasing year by year, but only about half of the cases can be diagnosed, and the diagnostic capacity of secondary hospitals is particularly unsatisfactory. Most of the confirmed cases are chronic hepatitis C, and more than one third of them have abnormal liver fibrosis indicators, and the proportion increases with age. The proportion of antiviral treatment for hepatitis C is lower in secondary than tertiary-level hospitals. Therefore, there is an urgent need to raise the attention of both parties (doctors and patients) to enhance diagnostic capabilities and expand the coverage of antiviral treatment for hepatitis C.

[Effect of pedicled thoracodorsal artery perforator flap on the repair of moderate to severe axillary scar contracture deformity]

Objective: To investigate the effect of pedicled thoracodorsal artery perforator (TDAP) flap on the repair of axillary moderate to severe scar contracture deformity. Methods: From January 2012 to January 2017, 29 patients with axillary moderate to severe scar contracture deformity were admitted to the the Second Xiangya Hospital of Central South University, including 18 females and 11 males, aged 14-42 years. There were 3 patients with cicatricial contracture deformity of bilateral axillas and 26 patients with cicatricial contracture deformity of unilateral axilla. After relevant preoperative examinations were completed and basic diseases were controlled, axillary scar was removed or released under the anesthesia of endotracheal intubation. The areas of wounds ranged from 7.5 cm×5.0 cm to 21.0 cm×8.5 cm after the operation. The pedicled TDAP flaps were used to repair the defects, which were thinned based on demand of the recipient sites before being transferred. The areas of flaps ranged from 9.0 cm×6.0 cm to 22.0 cm×10.0 cm. The donor sites were sutured directly. The status of thinned flaps, the survival of flaps after the operation and during follow-up, and the shoulder joint function during follow-up were observed. Results: Thirty-two pedicled TDAP flaps were harvested for repairing the defects. Among them, 14 flaps were transferred directly without thinning and the thickness of the flaps ranged from 9.0 mm to 15.0 mm, with average thickness of 13.6 mm.While the other 18 flaps were thinned, and the thickness of the thinned flaps ranged from 5.0 mm to 8.0 mm, with average thickness of 7.5 mm. The distal parts of 3 flaps in 3 patients showed small size of blackening or necrosis within 72 hours after the operation, and 2 of them were thinned and the other one was not. Finally, the 3 flaps were healed after hyperbaric oxygen therapy, dressing change, or other treatments. One flap occurred vein congestion 8 hours after the operation caused by pressure on the pedicle, and the color of the flap turned back to normal after the pressure was relieved. The rest of the flaps survived well. All the patients were followed up for 9 to 36 months, with an average of 18 months. All the flaps survived well, the color of the flaps was nearly the same as the recipient sites, and none of the flaps developed obvious contraction. The shoulder joint function of all patients was significantly improved compared with that before operation, with abduction angles of shoulder joints ranged from 90.0-145.0°, with an average of 130.0°. Conclusions: Pedicled TDAP flap is an relatively ideal choice for the repair of moderate to severe axillary scar contracture deformity, and better results will be achieved if the flaps are thinned to a appropriate thickness according to the condition of axillary defects.

Core-shell nanowires of NiCo2O4@α-Co(OH)2 on Ni foam with enhanced performances for supercapacitors

The composites of NiCo₂O₄ with unique structures are extensively explored as promising electrodes. In this work, core-shell structured nanowires anchored on nickel foam are synthesized by the hydrothermal synthesis of NiCo₂O₄ as core and subsequent electrodeposition of α-Co(OH)₂ as shell. The core-shell composites exhibit enhanced electrochemical performances ascribing to the synergistic reactions from both materials, showing higher specific capacitance than any single component. By changing the deposition time, the mass loading of α-Co(OH)₂ can be easily controlled. The electrochemical performances of the hybrid electrodes are diverse with the mass loading of Co(OH)₂. The optimized hybrid electrode with 3 mins electrodeposition exhibits the highest specific capacitance (1298 F g^-1 at 1 A g^-1) among all electrodes. The redox reaction is a main contributor to the total specific capacitance through electrochemical kinetics analysis. An asymmetric supercapacitor assembled by the optimized material as positive electrode and activated carbon as negative electrode can achieve a relatively high energy density of 39.7 Wh kg^-1 at a power density of 387.5 W kg^-1 (at 0.5 A g^-1) in a voltage of 1.55 V.

[Genomic analysis of a 2019-novel coronavirus (2019-nCoV) strain in the first COVID-19 patient found in Hangzhou]

Objective: To understand the viral genomic characteristics of a 2019-novel coronavirus (2019-nCoV) strain in the first COVID-19 patient found in Hangzhou, China. Methods: Viral RNA was extracted in throat swab and sputum sample of the patient and was performed real-time reverse transcription PCR detection and obtained viral genome by high-throughput sequencing method. Phylogenetic analysis was conducted using 29 2019-nCoV genomes and 30 β-coronavirus genomes deposited in NCBI GenBank. Fifteen genomes from Wuhan were grouped by mutation sites and others were identified by Wuhan's or specific mutation sites. Results: A 29 833 bp length genome of the first 2019-nCoV strain in Hangzhou was obtained, covering full length of the coding regions of coronavirus. Phylogenetic analysis showed that the genome was closest to the genome of a bat SARS-like coronavirus strain RaTG13 with an identity of 96.11% (28 666/29 826). Among the genes between two genomes, E genes were highly conserved (99.56%), while S genes had lowest identity (92.87%). The genome sequence similarities among 29 strains from China (Hangzhou, Wuhan, and Shenzhen), Japan, USA, and Finland, were all more than 99.9%; however, some single nucleotide polymorphisms were identified in some strains. Conclusion: The genome of Hangzhou 2019-nCoV strain was very close to the genomes of strains from other cities in China and overseas collected at early epidemic phase. The 2019-nCoV genome sequencing method used in this paper provides an useful tool for monitoring variation of viral genes.

[Cone-beam CT analysis on the treatment efficacy in the vertically impacted maxillary central incisors]

Objective: To analyze the treatment efficacy in the vertically impacted maxillary central incisors using cone-beam CT (CBCT) and explore the treatment timing and the influence of orthodontic traction on the root development and alveolar bone height in the mixed dentition. Methods: Twenty-two patients with vertically impacted maxillary central incisor who were admitted to the Department of Orthodontics, Stomatological Hospital affiliated to Nanjing Medical University from December 2012 to December 2017 were selected [12 males and 10 females, (9.2±0.9) years]. Based on the dental age, patients were classified as early treatment group (teeth ranging from a third to two thirds of root formation, n=12) and late treatment group (teeth with nearly or fully complete root formation, n=10). The contralateral maxillary central incisor was used as the control. Three-dimensional reconstruction of CBCT before treatment, after treatment and one year after treatment was carried out to measure root length, tooth surface area, tooth volume, labial and lingual apical alveolar bone thickness, the loss of labial alveolar bone height and intraosseous root ratio. The clinical crown length was measured in the mouth. The difference values of the measurement variables between the impacted teeth and the control teeth were calculated and analyzed(measurement values of impacted teeth were subtracted from control values). Results: The values of root length difference beween the impacted teeth and the control teeth in the early and late treatment group were (1.58±1.56) mm and (2.57±1.00) mm, respectively after the treatment and the values were significantly less than those corresponding values before treatment [(3.47±1.40) and (3.36±0.79) mm] (P<0.05). After the treatment, the values of the surface area and volume difference between the impacted teeth and the control teeth in the early treatment group [(0±34) mm(2) and (-10±44) mm(3)] were significantly less than those corresponding values before treatment [(38±31) mm(2) and (55±70) mm(3)] (P<0.05). The value differences of any measurement variables between the early and late treatment group were not significantly different after the treatment (P>0.05). The root length and intraosseous root ratio of the impacted teeth after the treatment in the early and late treatment group were significantly less than those of the control teeth after the treatment (P<0.05). The clinical crown length, the loss of labial alveolar bone height of the impacted teeth after the treatment were significantly larger than those of the control teeth after the treatment (P<0.05). Conclusions: Orthodontic traction promoted the root growth and development of the vertically impacted maxillary central incisors. However, the root length and alveolar bone height still cannot reach the normal level after treatment. Treatment timing had no effect on root development and alveolar bone height of vertically impacted maxillary central incisors in mixed dentition.

[Cost-effectiveness analysis of rabies immunization strategy based on dynamic-decision tree model]

Objective: To evaluate the cost-utility of different immunization strategies for rabies in China, and to provide a reference for determining the optimal immunization strategy. Methods: The system dynamics model was used to simulate the epidemic of canine rabies and a decision tree model was conducted to analysis different immune strategies. Relevant probabilities were obtained through literature search and on-site investigation. Sensitivity analysis was used to explore the important influenced factors. Results: At baseline, from a social perspective, 70% vaccination of dogs was the optimal strategy compared to current vaccination strategy (43% vaccination in dogs, human category-Ⅱ exposure vaccination/category-Ⅲ exposure vaccination combined with RIG). The total cost was 14 084 354 CNY, and the total utility value was 22 078 616.23 QALYs, and the incremental cost-utility ratio was-62 148 147 CNY/QALY; if human vaccination was considered, 55% vaccination of dogs combined with strategy one was the optimal strategy, its incremental cost-utility ratio was-444 620 557 CNY/QALY. The probability that an injured dog carries rabies virus was the most sensitive parameter. When it was greater than 0.005 03, strategy four was the optimal strategy. When it was less than 82/100 000, strategy one was the optimal strategy; when it was between 82/100 000 and 120/100 000, strategy two was the optimal strategy; when it was between 120/100 000 and 503/100 000, strategy two was the optimal strategy. Conclusion: It was conducive to increase the vaccination coverage of canine for the prevention and control of rabies.

Development of a water cycle management approach to Sponge City construction in Xi'an, China

In recent years, climate change, population growth, and inefficient use of water have exacerbated the water resources scarcity problems around the world. Hence, this paper establishes a new approach of Sponge City construction (SCC) based on water cycle management (WCM) for the sustainable exploitation of groundwater, recycled wastewater and rainwater in the Xi'an Siyuan University. The University is located in an isolated area that is far away from the city center so that no centralized water supply system could be utilized. To mitigate water scarcity problems in the University, 39% of the annual rainfall is harvested and stored from impervious surfaces and grasslands by using the Curve Number (CN) method. This stored water is reused for non-potable purposes: 40% for toilet flushing and 60% as miscellaneous water. According to findings, the available rainwater of500-700 m³/d accounts for 16-23% of the non-potable water from April to December. Moreover, the utilization rate of water resources increases from 204% to 227%. With the minimum volume of large-scale rainwater harvesting cistern of 52,760 m³, the environment could be adequately watered while improving the expansion and development conditions on the campus. Furthermore, water scarcity problems could be mitigated through optimization of the water resources utilization system. This study demonstrates that this new approach of SCC based on WCM could alleviate water resources scarcity problems in Xi'an Siyuan University effectively. It is hoped that this study will provide a model and example of the new approach for future applications.

Light-induced systemic signalling down-regulates photosynthetic performance of soybean leaves with different directional effects

When plants are exposed to a heterogeneous environment, photosynthesis of leaves is not only determined by their local condition, but also by certain signals from other parts of the same plant, termed systemic regulation. Our present study was conducted to investigate the effects of light-dependent systemic regulation on the photosynthetic performance of soybean (Glycine max L. Merr.) under heterogeneous light conditions. Soybean plants were treated with heterogeneous light. Then gas exchange characteristics were measured to evaluate the photosynthetic performance of leaves. Parameters related to photosynthetic pigments, chlorophyll fluorescence, Rubisco and photosynthates were examined to study the mechanisms of light-dependent systemic regulation on photosynthesis. Light-induced systemic signalling by illuminated leaves reduced the Pn of both upper and lower non-illuminated leaves on the same soybean plant. The decrease in gs and increase in Ci in these non-illuminated leaves indicated restriction of carbon assimilation, which was further verified by the decline in content and activity of Rubisco. However, the activation state of Rubisco decreased only in upper non-illuminated leaves. Quantum efficiency of PSII (ΦPSII) and ETR also decreased only in upper non-illuminated leaves. Moreover, the effects of light-induced systemic signalling on carbohydrate content were also detectable only in upper non-illuminated leaves. Light-induced systemic signalling by illuminated leaves restricts carbon assimilation and down-regulates photosynthetic performance of non-illuminated leaves within a soybean plant. However, effects of such systemic regulation differed when regulated in upward or downward direction.

[Prognostic value of total cholesterol content of erythrocyte membranes in patients with acute coronary syndrome]

Objective: Previous cross-sectional studies suggested that elevated levels of total cholesterol content of erythrocyte membrane (CEM) could significantly increase the risk of acute coronary syndrome (ACS). The purpose of the present study was to assess the predictive value of baseline CEM levels for the risk of clinical endpoint events in patients with ACS through prospective follow-up studies. Methods: This study is a prospective follow-up study, which consisted of 859 patients with first ACS (698 patients with unstable angina pectoris and 161 patients with acute myocardial infarction), diagnosed and hospitalized in the First and Second Affiliated Hospital of Anhui Medical University. The routine blood lipid levels and CEM were measured. Patients were divided into two groups according to the median of baseline CEM: CEM≤131.56 μg/mg group (n=430) and CEM>131.56 μg/mg group (n=429). Patients were followed up at 6 months interval. The clinical endpoints were nonfatal myocardial infarction, nonfatal stroke, all-cause mortality, all-cause mortality, heart failure requiring hospitalization, and coronary artery revascularization. Kaplan-Meier curve analysis and Cox proportional hazard model were used to analyze the impact of elevated CEM on the occurrence of clinical end-point events. HR values and 95%CI of each variable were obtained. Cox regression analysis of all-cause mortality was performed according to whether patients had risk factors for coronary heart disease (hypertension, diabetes, smoking and elevated LDL-C) and whether they were treated with PCI. Results: The follow-up time was 1 640 (1 380, 2 189) days. Cox analysis after adjustment showed that an elevated baseline of CEM (>131.56 μg/mg) was associated with an increased risk of all-cause mortality (HR=1.690, 95%CI 1.041-2.742, P=0.034), but had no significant predictive effect on the other clinical endpoints. Subgroup analysis showed that elevated baseline CEM levels in ACS patients with LDL-C>1.8 mmol/L (HR=1.687, 95%CI 1.026-2.774, P=0.039), receiving in-hospital PCI (HR=2.365, 95%CI 1.054-5.307, P=0.037), or male (HR=1.794, 95%CI 1.010-3.186, P=0.046) were associated with an increased risk of all-cause mortality. Conclusion: The results showed that elevated CEM levels can increase the risk of all-cause mortality in ACS patients.

Superconductivity in a unique type of copper oxide

The mechanism of superconductivity in cuprates remains one of the big challenges of condensed matter physics. High-T c cuprates crystallize into a layered perovskite structure featuring copper oxygen octahedral coordination. Due to the Jahn Teller effect in combination with the strong static Coulomb interaction, the octahedra in high-T c cuprates are elongated along the c axis, leading to a 3dx 2-y 2 orbital at the top of the band structure wherein the doped holes reside. This scenario gives rise to 2D characteristics in high-T c cuprates that favor d-wave pairing symmetry. Here, we report superconductivity in a cuprate Ba2CuO4-y , wherein the local octahedron is in a very exceptional compressed version. The Ba2CuO4-y compound was synthesized at high pressure at high temperatures and shows bulk superconductivity with critical temperature (T c ) above 70 K at ambient conditions. This superconducting transition temperature is more than 30 K higher than the T c for the isostructural counterparts based on classical La2CuO4 X-ray absorption measurements indicate the heavily doped nature of the Ba2CuO4-y superconductor. In compressed octahedron, the 3d3z 2-r 2 orbital will be lifted above the 3dx 2-y 2 orbital, leading to significant 3D nature in addition to the conventional 3dx 2-y 2 orbital. This work sheds important light on advancing our comprehensive understanding of the superconducting mechanism of high T c in cuprate materials.

[Genetic screening in early diagnosis of neonatal WAS gene-related disorders]

Objective: To explore the clinical value of genetic screening for early identification of WAS gene-related disorders in newborns. Methods: This was a retrospective study. Neonatal Genome Project from Children's Hospital of Fudan University collected 5 800 high-risk newborns in the neonatal intensive care unit to study the patients' genetic causes using high-throughput sequencing from January 2016 to December 2017. Eleven newborns (all were boys) with pathogenic or likely pathogenic variants in WAS gene were enrolled. Data of clinical characteristics,gene variants and genotype-phenotype correlation were collected and summarized. Results: Eleven patients included 5 cases with Wiskott-Aldrich syndrome (WAS) and 6 cases with X-linked thrombocytopenia (XLT).Two patients with WAS developed clinical manifestations in the early neonatal period,and 3 patients in 5-8 weeks after birth. Three neonates with XLT were hospitalized for other diseases in the first place.Their platelet count was found to be reduced after admission to hospital, and diagnosis was made after genetic testing. Eleven pathogenic or likely pathogenic variants in WAS gene were identified. Among them, 7 were first reported in this study, including 2 frame shift variants c.138delG and c.388_390del, 4 splicing variants c.1453+1G>A,c.734+1G>C,c.135G>A and c.1453+3G>C, and 1 missense variant c.1118C>T. The other 4 reported variants were c.777+1G>A,c.107_108delTT, c.436delC and c.1509_*3delAGTG. Conclusions: The clinical features of WAS gene-related disorders in neonatal period lack specificity. Genetic screening in newborns plays an important role in the early diagnosis of diseases and provides providing evidence for the early intervention.

Li(Cd,Mn)P: a new cadmium based diluted ferromagnetic semiconductor with independent spin & charge doping

We report a new diluted ferromagnetic semiconductor Li_1+y(Cd,Mn)P, wherein carrier is doped via excess Li while spin is doped by isovalence substitution of Mn²⁺ into Cd²⁺. The extended Cd 4d-orbitals lead to more itinerant characters of Li_1+y(Cd,Mn)P than that of analogous Li_1+y(Zn,Mn)P. A higher Curie temperature of 45 K than that for Li_1+y(Zn,Mn)P is obtained in Li_1+y(Cd,Mn)P polycrystalline samples by Arrott plot technique. The p-type carriers are determined by Hall effect measurements. The first principle calculations and X-ray diffraction measurements indicate that occupation of excess Li is at Cd sites rather than the interstitial site. Consequently holes are doped by excess Li substitution. More interestingly Li_1+y(Cd,Mn)P shows a very low coercive field (<100 Oe) and giant negative magnetoresistance (~80%) in ferromagnetic state that will benefit potential spintronics applications.

[Study on the general mental health status and influencing factors of Chinese Medical Team members]

Objective: To analyze the mental health status of the Chinese Medical Team (CMT) members and its influencing factors. Methods: A total of 1 015 members of the CMT were recruited and surveyed by using a self-administered questionnaire and 12-item General Health Questionnaire (GHQ-12) from May 10 to June 10, 2018. Multivariable logistic regression models were used to identify risk factors for mental health problems. Results: A total of 808 subjects completed the questionnaire and an estimated 25.9% of them were suspected to have mental health problems (GHQ-12≥3). Logistic model analysis indicated that family life (OR=1.928, 95%CI: 1.162-3.197), domestic work status (OR=2.069, 95%CI: 1.210-3.538), father's health status (OR=1.703, 95%CI: 1.060-2.736), disease symptoms (OR=2.087, 95%CI: 1.363-3.194), captain (OR=1.996, 95%CI: 1.128-3.532), cultural differences (OR=2.439, 95%CI: 1.621-3.671) were the risk factors for mental health. Age (OR=0.736, 95%CI: 0.571-0.949), leisure activities (OR=0.654, 95%CI: 0.490-0.872) were the protective factors. Drinking habits (OR=7.439, 95%CI: 1.290- 42.900), loneliness (OR=4.094, 95%CI: 2.438-6.875), and respect from the hospital (OR=0.783, 95%CI: 0.610-1.004) were relative to mental health problems. Conclusion: CMT members have certain mental health problems, especially young members and captains. Therefore, interventions should be implemented to improve the mental health of CMT members and to promote the development of foreign aid work.

Decreased expression of MS4A12 inhibits differentiation and predicts early stage survival in colon cancer

Lack of normal differentiation was considered as a common defect in cancer cells. MS4A12, a colon-specific gene, belongs to MS4A family that plays an important role in differentiation, proliferation and cell cycle regulation. The aim of the study was to investigate MS4A12 role in colon cancer cell differentiation and its prognostic value in colon cancer. We used sodium butyrate (BS) to set up differentiated model of colon cancer cell line LoVo. Cell differentiation was evaluated with ALP activity and E-cadherin. We used BS (4 mmol/L) inducing differentiation of LoVo cell and found after BS treated over 48h MS4A12 variant-1 (one of MS4A12 gene transcripts) as well as ALP and E-cadherin of LoVo cells were all increased significantly. When silence MS4A12 variant-1, the elevation of ALP and E-cadherin in BS-treated cells were all inhibited. Besides, after silence MS4A12 variant-1, the cells showed significant resistances to BS function of induction cell cycle arrest and apoptosis. Survival analysis used GEO datasets GSE39582 and GSE38832 that include 681 distinct colon cancer samples. Log-rank test and Cox's proportional hazards regression were applied to analyzing single and multiple prognostic variables, respectively. In early stage colon cancer, the patients with low MS4A12 expression had a poor survival (HR=1.72; p=0.036), while in advanced stage colon cancer MS412 had little prognostic value (HR=0.89; p=0.601). These results indicated MS4A12 might relate to colon cancer cell differentiation and supposed to be a risk classification marker for early stage colon cancer.

[Effects of CD34(+) selected stem cells for the treatment of poor graft function after allogeneic stem cell transplantation]

目的

观察输注纯化供者CD34⁺细胞治疗单倍型造血干细胞移植后移植物功能不良的疗效和安全性。

方法

对2014年1月至2018年3月期间接受供者纯化CD34⁺细胞治疗的12例单倍型造血干细胞移植后移植物功能不良患者进行回顾性分析。

结果

12例患者中男9例、女3例，中位年龄26（14~54）岁；急性淋巴细胞白血病4例，急性髓系白血病5例，慢性髓性白血病2例，慢性粒-单核细胞白血病1例。分选产物CD34⁺细胞纯度为92.0%（44.0%~97.0%），回收率为55.0%（45.0%~96.7%），回输CD34⁺细胞的中位数为1.9（0.9~4.4）×10⁶/kg，CD3⁺细胞中位数为0.6（0.3~2.0）×10⁴/kg。中性粒细胞恢复中位时间为18（14~39）d，血小板恢复中位时间为29（16~153）d，红细胞恢复中位时间为60（9~124）d。12例患者输注过程中未发生严重不良反应，10例获得完全缓解，1例患者获得部分缓解，1例患者无效，未发生重症感染和重度GVHD。

结论

回输供者纯化CD34⁺细胞是单倍型造血干细胞移植后植入功能不良的一种安全、有效治疗方法。

[Clinical features, treatment distribution and outcomes of Mooren's ulcer]

Objective: To investigate the clinical features, treatment distribution and transition of Mooren's ulcer, and to observe the clinical outcomes and recurrence. Methods: Retrospective series case study. Medical records of 125 patients (154 eyes) with Mooren's ulcer treated between January 1996 and December 2015 at our hospital were retrospectively reviewed. Seventy-eight males and 47 females were include, with age of (47.6±14.3) years (range: 23-82 years) and median disease course of 6 months (range: 1-240 months). Follow-up occurred between 4.5 and 122 months and the ratio of males to females was 1.66∶1. All patients were divided into two groups: group 1996-2005 and group 2006-2015. Chi-square test was used to analyze the difference of treatment distribution between the two groups and recurrence rate relative to different risk factors. Clinical features and treatment outcomes of Mooren's ulcers were observed simultaneously. Results: The lesion of the primary Mooren's ulcer involved nasal, temporal, superior, inferior and all limbus in 48, 41, 13, 23 and 29 eyes, respectively. The numbers of eyes treated with medical therapy, LKP and amniotic membrane grafting were 6, 61 and 1 in group 1996, with recurrence rate of 1/6, 24.59% and 0 respectively. The numbers in group 2006 were 27, 38 and 14 with recurrence rate of 7.41%, 34.21% and 2/14, respectively. The differences of eyes underwent three different therapies were statistical significance between two groups (χ(2)=29.315, P=0.000), but the differences of total recurrence rate were not (χ(2)=0.149, P=0.699). Thirty-four patients (34 eyes) suffered ulcer recurrence, among which 23 eyes (67.65%) had recurrence within 12 months after treatment and 31 eyes (91.12%) were saved. Finally, 150 of 154 eyes (97.40%) were saved and 129 eyes (83.77%) retained vision better than 0.05. Conclusions: Mooren's ulcers were prone to occur in males and in patients older than 35 years. The lesion more often involved interpalpebral limbus. Lamellar keratoplasty was the most frequently used surgical intervention for primary Mooren's ulcer with a recurrence rate of 28.28%. In recent 10 years, the percentage of patients treated with LKP decreased while percentage of medical treatment and amniotic membrane grafting went up obviously, and the total recurrence rate between two groups had no statitical differences. (Chin J Ophthalmol, 2019, 55:127-133).

Electron Mass Enhancement near a Nematic Quantum Critical Point in NaFe_{1-x}Co_{x}As

A magnetic order can be completely suppressed at zero temperature (T), by doping carriers or applying pressure, at a quantum critical point, around which physical properties change drastically. However, the situation is unclear for an electronic nematic order that breaks rotation symmetry. Here, we report nuclear magnetic resonance studies on NaFe_{1-x}Co_{x}As where magnetic and nematic transitions are well separated. The nuclear magnetic resonance spectrum is sensitive to inhomogeneous magnetic fields in the vortex state, which is related to London penetration depth λ_{L} that measures the electron mass m^{*}. We discovered two peaks in the doping dependence of λ_{L}^{2}(T∼0), one at x_{M}=0.027 where the spin-lattice relaxation rate shows quantum critical behavior, and another at x_{c}=0.032 around which the nematic transition temperature extrapolates to zero and the electrical resistivity shows a T-linear variation. Our results indicate that a nematic quantum critical point lies beneath the superconducting dome at x_{c} where m^{*} is enhanced. The impact of the nematic fluctuations on superconductivity is discussed.

[Clinicopathologic features and prognosis of adenoid cystic carcinoma of external auditory meatus]

Objective: To investigate clinicopathologic features and prognosis of adenoid cystic carcinoma (ACC) involving external auditory meatus. Methods: The clinical presentation and follow-up data of 63 patients with ACC of external auditory canal were collected from January 2006 to February 2017 at PLA General Hospital and Hainan Branch of PLA General Hospital. The clinicopathologic features and prognostic factors of external auditory canal ACC were analyzed. Results: (1) There were 28 males and 35 females and the average age of the first diagnosis was 48.9 years (22-81 years). The tumors showed cribriform pattern in 35 cases (15 cases of late stage), tubular pattern in 14 cases (8 cases of late stage), and solid pattern in 14 cases (9 cases of late stage). Cases with solid pattern was relatively more frequent than that of cribriform pattern and tubular pattern, but the difference was not statistically significant (P>0.05). (2) The average follow-up time was 62.4 months (2-228 months) in the 57 available cases. Among the 33 cases with recurrence, 18 cases had local recurrence and 15 cases had distant metastasis. The mean recurrence time was 40.6 months (2-204 months). Nine patients died of ACC: 2 cases in early stage (died at 48 and 102 months after the first treatment), 7 cases in late stage and 57 with (died at 9, 30, 32, 60, 72, 94 and 228 months). (3) Among the 37 patients with perineural invasion, there were 21 cases of cribriform pattern, 4 cases of tubular pattern and 12 cases of solid pattern; the number of cases in early stage and late stage were 15 and 22, respectively; and the differences were statistically significant (P<0.05). In addition, 31 cases had otalgia among the 37 patients with perineural invasion, where differences were not significant (P>0.05). (4) Thirty of 45 cases with tumor resection or partial resection of temporal bone had recurrence, whereas 3 of 12 cases of tumor combined with superficial lobectomy of parotid gland had recurrence. The difference was statistically significant (P<0.05). Postoperative adjuvant radiotherapy was given in 19 cases, including 7 cases of early stage (2 cases of recurrence), and 12 cases of late stage (8 cases of recurrence), among which there was no significant difference (P>0.05). Conclusions: ACC occurring in external auditory canal frequently recurs. Superficial parotid lobectomy at the first operation is necessary to prevent tumor recurrence. Postoperative adjuvant radiotherapy has certain curative effect on patients with early stage tumor, but it does not affect the recurrence rate. Patients at late stage are more prone to perineural invasion than those in early stage. In addition, cribriform and solid patterns are more common that tubular pattern, and there is no significant correlation between perineural invasion and otalgia.

Effects of high pressure on the ferromagnetism and in-plane electrical transport of (Ba0.904K0.096)(Zn0.805Mn0.195)2As2 single crystal

Pressure technique is an effective way to modify magnetic properties of diluted magnetic semiconductors (DMS). Based on single crystal, in-plane electrical transport properties of a new generation DMS (Ba_0.904K_0.096)(Zn_0.805Mn_0.195)₂As₂ have been measured with hydrostatic pressure up to 1.8 GPa. Magnetic properties of the single crystal sample are effectively tuned by pressure. Upon compression, the in-plane resistivity initially decreases but then increases when pressure is higher than 1.2 GPa. First principle calculations suggest that decrease of the resistivity is due to enhancement of density of state at Femi energy while increase of the resistivity under higher pressure is caused by distorted MnAs₄ tetrahedra. We reveal that the configuration of the MnAs₄ tetrahedra and strength of interlayer As-As bonding are of importance to ferromagnetic coupling of (Ba,K)(Zn,Mn)₂As₂.

[The relationship between smoking and hyperuricemia in Chinese residents]

Objective: To explore the relationship between smoking and hyperuricemia in Chinese residents. Methods: Based on data from the China Health and Nutrition Survey (CHNS), residents with blood samples provided in the 2009 round (including information of socio-demographic factors, lifestyle behaviors, medical history, and laboratory examinations etc.) were selected as the participants in the current analysis. Unconditional logistic regression models were utilized to compute the ORs and corresponding 95%CIs for assessing the relationship between smoking and hyperuricemia. Results: Among the 8 785 subjects, 1 435 had hyperuricemia with a prevalence rate of 16.3%, consisting of 886 men and 549 women with prevalence rates of 21.6% (886/4 110) and 11.7% (549/4 675) , respectively. Compared with never smokers, the adjusted OR (95%CI) for hyperuricemia was 0.83 (0.70-0.98) among current smokers, 0.77 (0.63-0.94) among current smokers with 20-39 years of smoking, and 0.79 (0.65-0.97) among current smokers with 11-20 cigarettes per day. When stratified by gender and compared with non-smoker, the adjusted OR (95%CI) for hyperuricemia among current smokers compared with never smokers was 0.83 (0.70-0.98) among men, while no significant association was found in female current smokers (OR=0.73, 95%CI: 0.42-1.26, P=0.260). Conclusion: In Chinese residents, there is an inverse association between smoking and hyperuricemia prevalence, and this association may be related to duration and intensity of smoking among current smokers. The findings need to be validated in large prospective cohort studies.

[The effect of ambient PM(10) on sperm quality in Wuhan]

Objective: To investigate the effect of exposure to particulate matter ≤10 μm in aerodynamic diameter (PM(10)) on sperm quality in different stages of sperm development. Methods: This cross-sectional study included 1 827 patients attending the reproductive medicine center in Renmin Hospital of Wuhan University during April 2013 to January 2015. Air pollution data from January 2013 to January 2015 was obtained from the database of Wuhan Municipal Environmental Protection Bureau. The generalized linear model was employed to assess the association between each exposure variables and sperm parameters for several exposure windows (0-9, 10-14, 15-69, 70-90, 0-90 days before sampling) . Results: The average levels of PM(10) was (116.2±71.6) μg/m(3) during the research period. Sperm volume was (75.4±49.1) ×10(6)/ml in sample population, (29.4±16.2) % in progressive motility and (51.8±21.6) % in total motility. Exposure to PM(10) was inversely associated with sperm concentration (β:-0.319; 95%CI:-0.529,-0.046) during 70-90 lag days. PM(10) exposure during the 0-90 lag days was significantly associated with progressive motility (β:-0.312; 95%CI:-0.527,-0.097) and total motility (β:-0.347; 95%CI:-0.636,-0.059) after adjusted for age, education level, BMI, smoking, abstinence time, temperature, humidity and season. Conclusion: Exposure to PM(10) was associated with statistically significant decrements in sperm concentration and motility, and the adverse impact on sperm concentration was significantly in early phases of spermatogenesis.

[Establishment and application of three-dimensional model of deep inferior epigastric artery perforator flap based on computed tomography angiography]

Objective: To explore the establishment and application of three-dimensional model of deep inferior epigastric artery perforator flap based on computed tomography angiography (CTA). Methods: Six patients with breast absence after modified radical mastectomy because of breast cancer, 5 patients with congenital absence of vagina, and 6 patients with Paget's disease of penis and scrotum were hospitalized in our unit from January 2012 to April 2017. The size of wounds after excision of the lesion or that of flaps needed for reconstruction ranged from 17 cm×5 cm to 25 cm×9 cm. Abdominal CTA was performed before the surgery, and data of CTA were sent to CT workstation to make three-dimensional model of deep inferior epigastric artery perforator flap according to shape and size of wound. The number, course, and location of deep inferior epigastric artery, vein, and their perforators, and the superficial inferior epigastric vein were observed in the above-mentioned three-dimensional model. The rectangular plane coordinate system with the umbilicus as the origin was established to locate and observe course and type of the largest deep inferior epigastric artery perforator in left and right side. Deep inferior epigastric artery perforator flaps were designed and deep inferior epigastric artery perforators etc. were marked according to three-dimensional models of the flaps before the surgery. The condition observed in three-dimensional model of the flap was compared with the clinical condition in the surgery of free transverse bilateral deep inferior epigastric artery perforator flap transplantation for breast reconstruction and longitudinal pedicled thinned unilateral deep inferior epigastric artery perforator flap transplantation for vagina reconstruction and wound repair of Paget's disease of penis or scrotum. The size of flap ranged from 17 cm×6 cm to 25 cm×10 cm. Results: Seventeen three-dimensional models of deep inferior epigastric artery perforator flaps were established, including 6 bilateral models and 11 unilateral models. Seventy-two reliable deep inferior epigastric artery perforators were observed in the three-dimensional model with 3.2±0.7 in the right and 3.1±0.8 in the left. The locations of the largest deep inferior epigastric artery perforators in the right and left were [(-3.2±1.4) cm, (-1.0±0.7) cm] and [(4.0±1.2) cm, (-1.2±1.1) cm] respectively. Fourteen largest deep inferior epigastric artery perforators coursed directly and nine coursed tortuously in the rectus muscle. Twenty-three superficial inferior epigastric veins were detected in the three-dimensional models of the flaps. The number, location, and course of deep inferior epigastric artery and vein and superficial inferior epigastric vein observed in the three-dimensional model of deep inferior epigastric artery perforator flap were in accordance with the condition observed in the surgery. Seventy reliable deep inferior epigastric artery perforators were detected in the surgery, and the other 2 perforators were unclear due to bleeding. Course of these perforators were in accordance with the condition observed in the three-dimensional model. Deep inferior epigastric artery perforator flaps of all patients survived well with no complication except that 1 patient suffered from delayed healing of wound in perineum. During follow-up of 1 to 12 months, all flaps survived with good shape and texture. Conclusions: The three-dimensional model of deep inferior epigastric artery perforator flap based on CTA can be established easily and can provide information of number, location, and course of deep inferior epigastric artery, vein, and their perforators, and superficial inferior epigastric vein to guide preoperative design and intraoperative dissection of the flap effectively.

[Clinical manifestations analysis of patients diagnosed with primary pulmonary mucosa-associated lymphoid tissue lymphoma]

Objective: To analyze the clinical features of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. Methods: A total of 14 cases diagnosed with primary pulmonary MALT lymphoma were collected from May 2007 to May 2017 in Zhongshan Hospital, Fudan University. The clinical features, pathological characteristics, diagnosis, treatment and prognosis were retrospectively analyzed. Results: All 14 cases were pathologically diagnosed with primary pulmonary MALT lymphoma. The biopsy tissues were obtained through the Video-assisted Thoracoscopic Surgery (VATS) (4 cases), percutaneous puncture (2 cases), and bronchoscopy (8 cases). Cell types of these tumors were centrocyte-like cells (10 cases), lymphocytoid cells (2 cases), and monocytoid B cells (2 cases). The B cell clonality was detected by IgH cloning test in 4 cases and 3 of them were demonstrated with monoclonal strips. MALT1 breakup gene was positive in 3 out of 6 examined cases using fluorescence in situ hybridization (FISH). As for the treatment, 8 patients underwent chemotherapy, 5 patients underwent surgical resection and 1 patient abandoned treatment. Twelve patients were followed up to 9 years. The tumor recurrence occurred in 2 patients and resulted their death. Conclusions: The clinical manifestations of primary pulmonary MALT lymphoma are lack of specificity. The pathology, immunohistochemistry, IgH cloning test and MALT1 breakup gene tested by FISH are the criteria for diagnosis.

Dietary choline and phospholipid supplementation enhanced docosahexaenoic acid enrichment in egg yolk of laying hens fed a 2% Schizochytrium powder-added diet

The aim of this study was to evaluate the effect of dietary phospholipid supplementation on laying hen performance, egg quality, and the fatty acid profile of egg yolks from hens fed a 2% Schizochytrium powder diet. Three-hundred-sixty 28-wk-old Hy-line W-36 laying hens were randomly allocated to one of the 5 dietary treatments, each treatment with 6 replicates of 12 birds each. All diets included 2% Schizochytrium powder (docosahexaenoic acid [DHA], 137.09 mg/g). The control group was not supplemented with any additional phospholipids, whereas the other 4 experimental diets were supplemented with 1,000 mg/kg choline (CHO), 1,000 mg/kg monoethanolamine (MEA), 1,000 mg/kg lysophosphatidylcholine (LPC), or 500 mg/kg LPC + 500 mg/kg MEA (LPC + MEA). The experimental diets were isocaloric (metabolizable energy, 11.15 MJ/kg) and isonitrogenous (crude protein, 16.60%). The feeding trial lasted 28 days. Laying hen performance and egg quality were not affected (P > 0.05) by the diets used. The monounsaturated fatty acid (MUFA) level was reduced in the LPC group at d 28 (P < 0.01), whereas the polyunsaturated fatty acid (PUFA) level was increased (P < 0.05). The omega-6 (n-6) PUFA level of the egg yolks in the LPC group had a trend to increase in comparison to the control (P = 0.07). The CHO and LPC groups had higher omega-3 (n-3) PUFA and DHA levels and lower n-6/n-3 ratios than the other groups at d 28 (P < 0.01). The DHA content in egg yolk reached a plateau after the laying hens consumed the experimental diets for 14 days, and higher yolk DHA contents were observed in the CHO and LPC groups as compared with the other groups at d 14. It was concluded that dietary choline supplementation for more than 14 d enhanced egg yolk enrichment with n-3 PUFA and DHA when laying hen diets were supplemented with 2% Schizochytrium powder. All the diets had no adverse effect on hen performance, egg quality, or egg components under the experimental condition.