[Deepening the Action on Salt Reduction in China-suggestions on strategy and implementation plan]

Excessive sodium/salt intake is the leading dietary risk factor for the loss of healthy life in the Chinese population. The "Healthy China 2030" Action Plan set the goal of reducing salt intake by 20% by 2030. However, salt intake in China is still at a very high level in the world, with adults reaching 11 g/d, more than twice the recommended limit of 5 g/d. The current policies and action plans of China have targeted catering workers, children, adolescents, and home chefs in salt, oil, and sugar reduction actions. However, there are still obvious deficiencies in the coordinated promotion and implementation. This study, therefore, proposed a set of comprehensive strategies (named CHRPS that is composed of communication and education, salt reduction in home cooking, salt reduction in restaurants, reducing salt content in pre-packaged food, and surveillance and evaluation) and key implementation points for further deepening the salt reduction action in China. These strategies were developed based on the main sources of dietary sodium for Chinese residents, the status of"knowledge, attitude and practice"in salt reduction, evidence of effective intervention measures, existing policies and requirements, and the salt reduction strategies of the World Health Organization and experience from some other countries. As a scientific reference, the CHRPS strategies will help the government and relevant organizations quickly implement salt reduction work and facilitate the earlier realization of China's salt reduction goal.

[Opportunities and challenges of schistosomiasis control during the construction of the Chengdu-Chongqing economic circle]

Chengdu-Chongqing economic circle is centered on Chengdu City and Chongqing Municipality, with aims to build the "fourth growth pole" of China's economy. During this circle, elimination of schistosomiasis had been achieved in 82.5% of the endemic counties (districts) of Sichuan Province, and schistosomiasis is not historically endemic in Chongqing Municipality; however, there is still a risk of schistosmiasis transmission in Sichuan Province and Chongqing Municipality because the natural and social factors affecting schistosomiasis transmission have not been completely eliminated in these areas. Based on the endemic situation of schistosomiasis in Sichuan Province and Chongqing Municipality, we analyzed the opportunities and challenges of schistosomiasis control during the construction of Chengdu-Chongqing economic circle, and proposed the corresponding suggestions, so as to provide insights into the sustainable development of schistosomiasis control in the context of the Chengdu-Chongqing economic circle construction.

[Surgical treatment of primary liver cancer:a report of 10 966 cases]

Objective: To summarize the experience of surgical treatment of primary liver cancer. Methods: The clinical data of 10 966 surgically managed cases with primary liver cancer, from January 1986 to December 2019 at Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University, were retrospectively analyzed. The life table method was used to calculate the survival rate and postoperative recurrence rate. Log-rank test was used to compare the survival process of different groups, and the Cox regression model was used for multivariate analysis. In addition, 2 884 cases of hepatocellular carcinoma(HCC) with more detailed follow-up data from 2009 to 2019 were selected for survival analysis. Among 2 549 patients treated with hepatectomy, there were 2 107 males and 442 females, with an age of (56.6±11.1) years (range: 20 to 86 years). Among 335 patients treated with liver transplantation, there were 292 males and 43 females, with an age of (51.0±9.7) years (range: 21 to 73 years). The outcomes of hepatectomy versus liver transplantation, anatomic versus non-anatomic hepatectomy were compared, respectively. Results: Of the 10 966 patients with primary liver cancer, 10 331 patients underwent hepatectomy and 635 patients underwent liver transplantation. Patients with liver resection were categorized into three groups: 1986－1995(712 cases), 1996－2008(3 988 cases), 2009‒2019(5 631 cases). The 5-year overall survival rate was 32.9% in the first group(1986－1995). The 5-year overall survival rate of resected primary liver cancer was 51.7% in the third group(2009-2019), among which the 5-year overal survival rates of hepatocellular carcinoma, intrahepatic cholangiocarcinoma and mixed liver cancer were 57.4%, 26.6% and 50.6%, respectively. Further analysis was performed on 2 549 HCC patients with primary hepatectomy. The 1-, 3-, 5-, and 10-year overall survival rates were 88.1%, 71.9%, 60.0%, and 41.0%, respectively, and the perioperative mortality rate was 1.0%. Two hundred and forty-seven HCC patients underwent primary liver transplantation, with 1-, 3-, 5-, and 10-year overall survival rates of 84.0%, 64.8%, 61.9%, and 57.6%, respectively. Eighty-eight HCC patients underwent salvage liver transplantation, with the 1-, 3-, 5-, and 10-year overall survival rates of 86.8%, 65.2%, 52.5%, and 52.5%, respectively. There was no significant difference in survival rates between the two groups with liver transplantation (P>0.05). Comparing the overall survival rates and recurrence rates of primary hepatectomy (2 549 cases) with primary liver transplantation (247 cases), the 1-, 3-, 5-, and 10-year overall survival rates in patients within Milan criteria treated with hepatectomy and transplantation were 96.3%, 87.1%, 76.9%, 54.7%, and 95.4%, 79.4%, 77.4%, 71.7%, respectively (P=0.754). The 1-, 3-, 5-year recurrence rates were 16.3%, 35.9%, 47.6% and 8.1%, 11.7%, 13.9%, respectively(P<0.01). The 1-, 3-, 5-, 10-year overall survival rates in patients with no large vessels invasion beyond the Milan criteria treated with liver resection and transplantation were 87.2%, 65.9%, 53.0%, 33.0% and 87.6%, 71.8%, 71.8%, 69.3%, respectively(P=0.003); the 1-, 3-, 5-year recurrence rate were 39.2%, 57.8%, 69.7% and 29.7%, 36.7%, 36.7%, respectively (P<0.01). The 1-, 3-, 5-, and 10-year overall survival rates in patients with large vessels invasion treated with liver resection and transplantation were 62.1%, 36.1%, 22.2%, 15.0% and 62.9%, 31.8%,19.9%, 0, respectively (P=0.387); the 1-, 3-, 5-year recurrence rates were 61.5%, 74.7%, 80.8% and 59.7%, 82.9%, 87.2%, respectively(P=0.909). Independent prognostic factors for both overall survival and recurrence-free survival rates of HCC patients treated with liver resection included gender, neoadjuvant therapy, symptoms, AST, intraoperative or postoperative blood transfusion, tumor number, tumor size, cirrhosis, macrovascular invasion, microvascular invasion, and pathological differentiation. Propensity score matching analysis of 443 pairs further showed that there was no significant difference in overall survival rate between anatomical liver resection and non-anatomical liver resection(P=0.895), but the recurrence rate of non-anatomical liver resection was higher than that of anatomical liver resection(P=0.035). Conclusions: In the past decade, the overall survival rate of HCC undergoing surgical treatment is significantly higher than before. For HCC patients with good liver function reservation, surgical resection can be performed first, and salvage liver transplantation can be performed after recurrence. The effect of salvage liver transplantation is comparable to that of primary liver transplantation. As for the choice of liver resection approaches, non-anatomical resection can reserve more liver tissue and can be selected as long as the negative margin is guaranteed.

[Longitudinal surveillance of schistosomiasis in hilly regions of Sichuan Province from 2015 to 2019]

OBJECTIVE

To investigate the changes in the endemic situation of schistosomiasis in national surveillance sites of Sichuan Province, so as to provide the scientific evidence for formulating the schistosomiasis elimination strategy.

METHODS

From 2015 to 2019, 63 national schistosomiasis surveillance sites were assigned in Sichuan Province, in which Schistosoma japonicum infections were monitored in humans, livestock, wild feces and snails. The monitoring data were descriptively analyzed.

RESULTS

A total of 94 119 person-time local residents were serologically screened for S. japonicum infections in 63 national surveillance sites of Sichuan Province from 2015 to 2019, with sero-prevalence rates ranging from 1.28% to 3.11%, and the sero-positives were predominantly detected in local residents at ages of over 50 years and in farmers. A total of 94 119 person-time mobile populations were serologically screened for S. japonicum infections in the national surveillance sites during the 5-year period, with sero-prevalence of 1.10% to 1.59%. There were no egg-positives identified in either local residents or mobile populations. Among the 6 126 herd-time livestock detected, no egg-positives were identified, and no S. japonicum infection was detected in the 205 wild feces. Snail survey was performed covering an area of 8 484.08 hm², and 724.80 hm² snail habitats were identified, including 2.43 hm² emerging snail habitats and 63.00 hm² re-emerging snail habitats. The mean occurrence of frames with snails was 6.87% to 19.63%, and the mean density of living snails was 0.18 to 0.62 snails/0.1 m² in the national surveillance sites of Sichuan Province from 2015 to 2019; however, no S. japonicum infection was detected in snails.

CONCLUSIONS

The endemic situation of schistosomiasis has reduced to the lowest level in Sichuan Province; however, there is a rise in snail habitats, and there is still a risk of schistosomiasis resurgence. Further improvements of the surveillance system for schistosomiasis are required to achieve the goal of schistosomiasis elimination in Sichuan Province as soon as possible.

Direct regeneration of cathode materials from spent lithium iron phosphate batteries using a solid phase sintering method

A direct regeneration of cathode materials from spent LiFePO₄ batteries using a solid phase sintering method has been proposed in this article.

First result from the Alpha Magnetic Spectrometer on the International Space Station: precision measurement of the positron fraction in primary cosmic rays of 0.5-350 GeV

A precision measurement by the Alpha Magnetic Spectrometer on the International Space Station of the positron fraction in primary cosmic rays in the energy range from 0.5 to 350 GeV based on 6.8 × 10(6) positron and electron events is presented. The very accurate data show that the positron fraction is steadily increasing from 10 to ∼ 250  GeV, but, from 20 to 250 GeV, the slope decreases by an order of magnitude. The positron fraction spectrum shows no fine structure, and the positron to electron ratio shows no observable anisotropy. Together, these features show the existence of new physical phenomena.

The Sino-MONICA-Beijing Study: report on results between 1984 and 1986

The Beijing Heart Lung and Blood Vessel Medical Center has participated in the World Health Organisation MONICA project since 1981. Our study, named Sino-MONICA-Beijing, has been carried out in Beijing and covers a population approximately of 700,000. After a 2-year pilot study, the project started formally January 1, 1984. This paper presents the organization and methodology of the study, with emphasis on the monitoring system and on how events were found. The main results of the cardiovascular disease (CVD) event monitoring are as follows: average annual mortality from all causes, for the 3-year period of 1984-86 was 319/100,000 for men and 238/100,000 for women aged 25-64; from CVD 119/100,000 for men and 101/100,000 for women; from ischemic heart disease 29/100,000 for men and 14/100,000 for women; and from cerebrovascular disease 59/100,000 for men and 52/100,000 for women. Preliminary experience has shown that Sino-MONICA-Beijing is a well-standardized project of long-term surveillance of CVD in the communities of Beijing.

Artemin is oncogenic for human mammary carcinoma cells

We report that artemin, a member of the glial cell line-derived neurotrophic factor family of ligands, is oncogenic for human mammary carcinoma. Artemin is expressed in numerous human mammary carcinoma cell lines. Forced expression of artemin in mammary carcinoma cells results in increased anchorage-independent growth, increased colony formation in soft agar and in three-dimensional Matrigel, and also promotes a scattered cell phenotype with enhanced migration and invasion. Moreover, forced expression of artemin increases tumor size in xenograft models and leads to highly proliferative, poorly differentiated and invasive tumors. Expression data in Oncomine indicate that high artemin expression is significantly associated with residual disease after chemotherapy, metastasis, relapse and death. Artemin protein is detectable in 65% of mammary carcinoma and its expression correlates to decreased overall survival in the cohort of patients. Depletion of endogenous artemin with small interfering RNA, or antibody inhibition of artemin, decreases the oncogenicity and invasiveness of mammary carcinoma cells. Artemin is therefore oncogenic for human mammary carcinoma, and targeted therapeutic approaches to inhibit artemin function in mammary carcinoma warrant consideration.

Characterization of a high voltage flat panel display unit using nanotube-based emitters

Details are given of an experimental investigation carried out to study the field electron emission characteristics of a field emission flat panel display unit using a carbon nanotube-epoxy composite as electron emission material. These include: (i) dependence of direct emission current-voltage characteristic on vacuum gap spacing, (ii) the variation of the proportion of emission current passing through an aperture hole of a gate electrode with changing structural parameters of the device, and (iii) the uniformity and display characteristics of a typical display unit. Our findings indicate that it is very likely for one to produce a near-market prototype high voltage field emission flat panel display, if more sophisticated fabrication and assembly technique is adapted.

[Gene therapy of hypertension]

Hypertension is a disease caused by multiple genes. The traditional treatments have many defects. A gene therapy has been proposed where antisense oligonucleotide (AS ODN) is developed to specifically block the expression of hypertension candidate genes. It is of long-term effect, high efficiency and non toxicity. Preliminary results are encouraging, but much work needs to be done before gene therapy could be applied to humans.

Rapid intravenous administration of amino acids prevents biliary sludge induced by total parenteral nutrition in humans

The aim of this study was to evaluate whether daily rapid intravenous administration of amino acids (IVAA) prevented the formation of biliary sludge in humans receiving long-term total parenteral nutrition (TPN). Thirty adult patients receiving TPN for more than 28 consecutive days were studied. They were randomized to receive either saline solution (placebo) intravenously (15 patients) or 6.9% branched chain amino acid (BCAA)-enriched amino acid (15 synthetic amino acids; Freamine HBC) solution given by administration rapid intravenous (15 patients). The groups were similar with respect to age, sex, diagnosis, liver function test results, amylase levels, TPN time, and time of study. All patients underwent weekly ultrasound studies. Volume and emptying studies of the gallbladder in response to the study drug were performed after 1 week. As a result, none of the patients receiving rapid IVAA had sludge, whereas 11 of the 15 patients receiving placebo had sludge (P < 0.01). Results of emptying studies showed significant contraction of the gallbladder in those in the rapid IVAA group, but not in the placebo group. Consequently, the data suggest that rapid IVAA given daily prevents TPN-induced stasis and sludge in the gallbladder. We conclude that rapid IVAA should be used as routine prophylaxis against biliary sludge and formation of gallstones in patients receiving long-term TPN.

[Epidemiological studies on the relationship between psychosocial factors and cardiovascular disease]

Psychosocial factors contribute significantly to the pathogenesis and expressions of cardiovascular disease(CVD). Recent studies have demonstrated that 5 specific psychosocial entities are most relevant: (1) depression, (2) anxiety; (3) personality factors and character traits; (4) social isolation, and (5) chronic life stress. Epidemiological studies consistently demonstrate a significant prospective relationship between the occurrence of major depression and the cardiac events. Increasing evidence now links anxiety disorders to the development of CVD events in general populations. Although type A behavior is continuously found to be positively related with increased risk of CVD, a series of studies have reported no correlation between type A behavior and CVD risk. However, hostility, a major attribute of the type A behavior pattern, is considered to be more pathogenic. Social isolation characterized mainly by a relatively small social network has been shown to be associated with increase in the incidence of CVD over time. Finally, chronic life stress, particularly the work-related stress, proved to be closely related to CVD risk. The pathophysiological mechanisms of psychosocial factors on the pathogenesis of CVD are: (1) excessive sympathetic nervous system activation, (2) triggering of myocardial ischemia; (3) promotion of arrhythmogenesis, (4) stimulation of platelet function, and (5) deterioration of endothelial function.

[Repair of cardiac defects by minimal incision without aortic cross-clamp]

From July 1998 to June 1999, seventy two patients underwent repair of congenital heart defects by a partial sternal split and a limited skin incision(4-8 cm) under cardiopulmonary bypass without aortic cross-clamp at our institution. The average age of these patients was 4 years and 5 months(range: 7 months to 12 years), and the average weight was 15.6 kg(range: 7 kg to 30 kg). Fifty six patients had simple ventricular septal defects, sixteen suffered from atrial septal defects. The average bypass time was (21 +/- 20) min (range: 8-58 min). All patients recovered rapidly from the operation in an uneventful postoperative course. Our experience demonstrates that this technique is feasible and can be performed easily in young children with simple cardiac defects, and has excellent cosmetic results.

[Experimental safety study using rats and mice irradiated with the complex field cure instrument]

The complex field cure instrument is a new medical instrument. The complex field is composed of several sorts of physical quantum fields. Mice and rats are continuously irradiated by the complex field for 20 days to 90 days. The result shows that WBC, Hb and PLT value of the animals irradiated with the instrument are more than the control group, and their biochemical index is normal. The internal organs of the experimental animals show no toxicity. The visceval coefficient (liver, spleen) of the experimental animals is more than the control group. The marrow micronucleas test is negative. The chromosome test show no distortion. All of the results have proved that the instrument produces no toxicity side effect. Application of the instrument is safe and reliable and it may increase immune function of the body.

[Study on the relationship between lung cancer at preclinic stage and psycho-social factor. A case-control study]

A case-control study of primary lung cancer patients including 309 case (male 193, female 116) and 1,231 controls (male 768, female 463) was carried out in the monitored population for SINO-MONICA Project (WHO) during 1990-1993. This was a population based case-control study involved 0.75 million population in order to detect the relationship between lung cancer at preclinic stage and 6 psychosocial factors. There were 3 factors positively associated with lung cancer. They were 1) burst of "emotion and could not be controlled" (OR 1.82 P < 0.01), 2) "poor working circumstances" including poor relationship with colleagues (OR 1.37 P < 0.05) and superiors (OR 1.55 P < 0.01) and 3) the "depressive feeling for a long time" (OR 4.14 P < 0.01), when we considered "long standing depressive feeling" as a risk factor for lung cancer and calculated by an exposure rate of 8.8%, the population attributable risk percent (PAR%) would be 21.6% (male 18.7%, female 26.4%). Our findings suggested that the relationship between lung cancer at preclinic stage and psycho-social factor did exist.

Improved algorithm for electromagnetic scattering of plane waves and shaped beams by multilayered spheres

An efficient numerical procedure for computing the scattering coefficients of a multilayered sphere is discussed. The stability of the numerical scheme allows us to extend the feasible range of computations, both in size parameter and in number of layers for a given size, by several orders of magnitude with respect to previously published algorithms. Exemplifying results, such as scattering diagrams and cross-sectional curves, including the case of Gaussian beam illumination, are provided. Particular attention is paid to scattering at the rainbow angle for which approaches based on geometrical optics might fail to provide accurate enough results.

[Epidemiological characteristics of stroke in 16 provinces of China]

Epidemiological survey was conducted, according to diagnostic standard from WHO-MONICA project, on stroke events in 16 provinces of China. There were significant differences in geographical distribution of morbidity and mortality of stroke events. The morbidity and mortality were higher in northern China than in southern China (P < 0.001). The differences of morbidity varied from 11 to 14 times. The morbidity and mortality were higher in man than in woman (P < 0.01 or P < 0.05) and were higher in rural areas than in cities. The geographical differences in the morbidity and mortality for stroke may be related to many factors, and may be in parallel with the hypertension prevalence rate, which was higher in northern China than in Southern China. The age of patients with stroke was younger in northern China than in southern China (P < 0.01). The frequency of cerebral hemorrhage was higher in southern China than in northern China.

Stroke in China (Sino-MONICA-Beijing study) 1984-1986

We present here the results of the Sino-MONICA-Beijing stroke study based on 700,000 Beijing residents in 1984-1986. To compare incidence rates for stroke with other communities and countries, we adopted the criteria of the WHO Collaborative Study of 17 centers which used the same definition and methodology as was used in this study. Over the 3-year period of the study, 2,593 stroke events were registered in the 25- to 74-year age-group. The incidence rate for all strokes was 189.5/100,000 and the incidence rate for first strokes was 133.6/100,000. Men had a significantly higher incidence rate than women (all strokes 219.7/100,000 for male vs. 160.5/100,000 for female, OR = 1.32, 99% limits 1.19-1.46; first strokes 151.6/100,000 for male vs. 116.4/100,000 for female, OR = 1.25, 99% limits 1.11-1.42). In comparison with other studies, age-adjusted incidence rate of stroke in Beijing was higher than in other countries, especially for hemorrhagic stroke. The proportion of hemorrhagic stroke related to other types of stroke was also higher in Beijing. Further analysis of the cases confirmed by computerized tomography also supported this finding. Unlike the incidence rates, the 4-week case fatality rate for women, 39.5%, was higher than for men, 32.8%. This finding was confirmed by a multiple logistic analysis controlling for age (p less than 0.001) and for previous stroke (p less than 0.001). The adjusted sex difference is also significant (OR = 1.37, p less than 0.001). In addition, results showed that men had a higher hospitalization rate than women. More women than men were treated at home, possibly indicating better medical care for men.

[Clinical and ultrastructural studies on 8 cases of methamidophos toxicologic myopathy]

Clinically, there was pain or numbness in the lower limbs at first; then followed by muscular weakness and symmetrical wasting of the small muscles of the hands and lower limbs. Electromyography showed myogenic changes in all the 8 cases and biopsies indicated atrophy of muscle fibers. The most prominent ultrastructural change was presence of abnormal accumulation of myofibers with regeneration and necrosis. There was decrease of mitochondria and glycogen even disappearance of M--line or Z--line. The pathogenesis is considered due to cell--mediated--immunity and direct toxic effect.

Cardiovascular community control programs in Beijing

Cardiovascular community control program in Beijing started in 1969. In the past 20 years, eleven such programs had been established, covering a total population of 750,000. For those programs that have been operating for over 5-10 years, a marked drop in the mortality and morbidity rates of hypertension, stroke and acute myocardial infarction has been observed. It is proposed that this type of community control program should be further expanded in the next ten years so as to materialize the WHO goal of "Health for all by 2000".