Causal associations between serum amino acid levels and osteoarthritis: a Mendelian randomization study.

OBJECTIVE: The association between serum amino acid (AA) levels and osteoarthritis (OA) risk remains unclear. METHOD: We performed a two-sample Mendelian randomization (MR) analysis to analyze the causal effects of serum AA levels on the OA risk by using summary-level genome-wide association study (GWAS) data. Inverse variance weighted (IVW) and Wald ratio were used as the main analysis. We also applied MR-Egger, Weighted median and Robust Adjusted Profile Score (MR.RAPS) methods. Heterogeneity and horizontally pleiotropic outliers were checked. The causal effects of AAs on early-onset all OA were explored. We also performed multivariable MR (MVMR) and conducted the bidirectional MR. RESULTS: The results suggested that genetically predicted alanine (Ala), tyrosine (Tyr) and isoleucine (Ile) levels were significantly associated with OA risk [e.g., association between Ala and hip/knee OA risk: OR = 0.82, 95% confidence interval (CI) = 0.75-0.90, P = 1.54E-05]. The study yielded little evidence of associations between genetically predicted AA levels with early-onset all OA risk. When adjusting the body mass index (BMI) in the MVMR model, suggestive causal effects of Ala and Tyr were also identified, while the effects of Ile substantially attenuated with OA risk. No significant associations between OA and AA levels were observed after testing for bidirectionality. CONCLUSIONS: Some AAs, such as Ala, Tyr and Ile likely affects the OA risk especially at hip or knee joints. The findings highlight the important role that serum AAs might play in the development of OA and provided new treatment approaches to OA.

[Clinical observation of 8 cases with central nervous system anaerobic infection diagnosed by metagenomic next-generation sequencing of cerebrospinal fluid].

The current study summarized the clinical characteristics of 8 patients with central nervous system anaerobic infections who visited the Second Hospital of Hebei Medical University from June 2019 to June 2021. Among the 8 patients, 7 cases had headache and fever as the first symptoms, and 1 case had left-sided limb weakness as the first symptom. Four patients had a previous history of diabetes (1 patient had a history of tooth extraction before the onset of the disease), 1 patient had a previous history of sinusitis, 1 patient had a history of tooth extraction before the onset of the disease, and 2 patients had chronic extensive periodontitis or periapical periodontitis. Five cases showed abnormal intracranial and/or meningeal enhancement on cranial magnetic resonance imaging (MRI), and 1 case showed swelling of the whole brain tissue on cranial computed tomography (CT). After treatment, symptoms of 4 cases were improved, symptoms of 1 case were aggravated, and 3 cases died. Anaerobic infections can occur in various parts of the body:the central nervous system, oral cavity, head and neck, chest, abdomen, pelvis, skin and soft tissues. It is generally believed that anaerobic bacteria rarely cause central nervous system infection, therefore, anaerobic culture of cerebrospinal fluid is usually not performed. Moreover, anaerobic culture is affected by many factors, and thus it is difficult to obtain positive results. Metagenomic next-generation sequencing can identify multiple pathogens (viral, bacterial, fungal, or parasitic) from samples based on DNA and/or RNA sequences and has advantages in diagnosing anaerobic infections of the central nervous system. Prompt empirical antimicrobial therapy is essential for the prognosis of the patients.

[Cerebrospinal fluid TP53 gene mutation in patients with lung cancer associated meningitis and its clinical implications].

Objective: To observe the role of cerebrospinal fluid (CSF) TP53 gene mutation in lung cancer associated meningitis. Methods: A retrospective analysis was performed on 35 patients diagnosed with lung cancer associated meningitis at the Second Hospital of Hebei Medical University from December 2015 to December 2018.All patients underwent the next-generation sequencing of CSF, and TP53 gene was found to be mutant or wild type, including 23 patients with TP53 mutant type and 12 patients with TP53 wild type. The clinical characteristics, CSF leukocyte, protein, glucose, chloride, Karnofsky performance (KPS) and overall survival were observed. Results: Headache, nausea and vomiting were the main clinical manifestations in both groups.There were no significant differences in CSF pressure, leukocyte, biochemical indicators and KPS between the two groups. The average time from diagnosis of lung cancer to diagnosis of lung cancer associated meningitis in the TP53 mutant group was significantly shorter than that in the TP53 wild type group (5.79 months vs 25.5 months).The median survival time of patients in the TP53 mutant group from lung cancer diagnosis to the observation endpoint was 19.77 months, while it was 88.73 months in the TP53 wild type group, and the difference was statistically significant (P=0.043). Conclusions: Mutation in the tumor suppressor gene TP53 can be detected in the CSF of patients with lung cancer associated meningitis. Patients with such mutation have earlier meningeal metastasis and shorter median survival time.

[Analysis on the monitoring results of occupational health of workers who leaving their posts from small-sized coal mines].

Objective: To explore the health status of the workers who were leaving their posts from small-scaled coal mines, and to provide evidence for coal workers' pneumoconiosis prevention and safeguard measures. Methods: In 2017, 1008 workers from the coal mine in a town were monitored for occupational health, and the effects of working type, age were analyzed and evaluated. Results: The health monitoring of the mine workers in this town showed high rate of the abnormal detection of respiratory system and cardiovascular system, the incidence rate of pneumoconiosis was up to 34.82%. The incidence of pneumoconiosis in different types of work was not the same (P<0.05) , and the incidence of tunneling workers' pneumoconiosis was the highest. Pneumoconiosis detection rate increased with age (P<0.05) . The difference of pneumoconiosis detection rate among workers of different ages was statistically significant (P<0.05) , among which the pneumoconiosis detection rate was the highest in the group of 40 years old. Conclusion: The pneumoconiosis is serious in small coal mines in this town. It should strengthen the prevention of diseases such as respiratory system and cardiovascular system of coal mine workers, and pay attention to their health management and prolong the life of patients with pneumoconiosis.

[Cephalic artery peak velocity variation during passive leg raising can predict fluid responsiveness in mechanically ventilated severe sepsis patients with spontaneous breathing].

Objective: To explore whether cephalic artery peak velocity variation during passive leg raising (ΔVpeak(CA)-PLR) could effectively predict fluid responsiveness in mechanically ventilated severe sepsis patients with spontaneous breathing. Methods: Total of 38 patients on mechanical ventilation with spontaneous breathing admitted to the Fourth Departments of Intensive Care Unit (ICU) of Fujian Provincial Hospital from January to December in 2017 were enrolled.The patients were diagnosed with severe sepsis or sepsis shock.The peak velocity in cephalic artery (Vpeak(CA)) during PLR was measured by bedside portable ultrasonic, and then ΔVpeak(CA)-PLR was calculated.All patients received volume expansion (VE) test and the changes of stroke volume during VE test (ΔSV-VE) were measured.Patients were classified as responsive group or non-responsive group according to the ΔSV-VE increased ≥15% or not after VE test.Furthermore, the sensitivity and specificity of ΔVpeak(CA)-PLR for predicting fluid responsiveness were evaluated by receiver operating characteristic (ROC) curve.The comparisons between groups were performed with Student's unpaired two-tailed t test, and Pearson's test was used for the correlation analysis. Results: Among the patients, 22 cases responded to VE test and the rest 16 cases did not.There were no significantly differences in age, gender, body mass index, infection site, sepsis-related organ failure assessment score, acute physiology and chronic health evaluation Ⅱ score, ventilator parameters and dose of vasoactive agent between the two groups.The ΔVpeak(CA)-PLR in responsive group was markedly higher than that in non-responsive group (15.7%±4.2% vs 6.9%±4.3%, t=6.240, P<0.05), and the ΔVpeak(CA)-PLR in the responsive group was positively related to the ΔSV-VE (r=0.723, P<0.05). Furthermore, the area of ΔVpeak(CA)-PLR under ROC curve was 0.912.The sensitivity and specificity of ΔVpeak(CA)-PLR≥12.2% to predict fluid responsiveness in the patients with sepsis were 81.8% and 87.5%, respectively. Conclusion: ΔVpeak(CA)-PLR measured by bedside portable ultrasonic can predict the fluid responsiveness in mechanically ventilated severe sepsis patients with spontaneous breathing, and it can be used to guide further fluid resuscitation.

[Intervention effect assessment of response to heatwave in communities of four cities, China].

Objective: To evaluate the intervention effects of response to heatwave in communities of four cities, China. Methods: Baseline survey on heatwave and climate change related knowledge, attitude and practice (KAP) was conducted in the pilot communities in Harbin, Nanjing, Shenzhen and Chongqing, using face-to-face questionnaire interview in November, 2011 to November, 2013. Finally, 1 604 residents were interviewed. Intervention measures were implemented in summers of 2013 and 2014, including delivering early warning information of heatwave health risk and launching health education and promotion. The second survey was conducted in same communities using the same questionnaire and sampling method as baseline survey in November, 2014, and 1 640 residents were interviewed. The Chi-square test was used to compare the demographic characteristics and KAP of community residents between before and after intervention, and the factors that affected the intervention effect were selected by logistic multiple stepwise regression model. Results: The age of the residents interviewed before and after intervention was (46.4 ± 15.5) years and (45.0 ± 15.9) years, respectively. Overall, the residents' awareness rates of heatwave before and after intervention were 70.5% (1 131/1 604) and 82.9% (1 359/1 640) (χ2=69.40, P<0.001). The rate of residents who had wished to receive early warning information increased 6.3% (χ2=41.11, P<0.001), which reached 94.6% (1 551/1 604) after intervention from 88.3% (1 416/1 604) in baseline survey. Both heatwave health risk early warning and health education had big impacts to residents. There were 92.7% (1 105 residents) among the 1 192 residents who had received the early warning information arrange work and rest time according to the early warning information and 93.0% (1 231 residents) among the 1 323 residents who knew about health education activities being conducted in community thought that the community health education activities had made active role in protecting health from heatwaves. After a series of intervention, male had a effect on attitude about hot wave than female in Nanjing and Chongqing, OR (95%CI) were 1.48(1.02-2.16) and 1.45 (1.18-2.05) , respectively; compared with subjects below primary school education, people with college degree or above had higer KAP in all cities (ORs range from 1.18 to 2.05), P<0.05; regular physical exercise (ORs range from 1.39 to 2.70) also had profound impacts on KAP in all cities (P<0.05). Conclusion: s Early warning and health education were effective measures to enhance residents' response capacity to climate change.

Combination of LINE-1 hypomethylation and RASSF1A promoter hypermethylation in serum DNA is a non-invasion prognostic biomarker for early recurrence of hepatocellular carcinoma after curative resection.

Hepatocarcinogenesis, a multistep process, involves not only genetic mutations but also epigenetic alterations. Widespread of global DNA hypomethylation is accompanied with specific regional hypermethylation especially at tumor suppressor genes' promoters. The aim of this study is to determine the efficacy of combined DNA methylation analysis of a global DNA methylation marker - LINE-1 and a tumor suppressor gene highly associated with the malignancy of HCC- RASSF1A in serum as a novel prognostic marker for diagnosis of early recurrence after curative resection.LINE-1 was hypomethylated in 66.7% (70/105) and RASSF1A promoter was hypermethylated in 73.3% (77/105) of HCC serum DNA samples by methylation specific PCR, but in none of the healthy controls: LINE-1 hypometylation (0/50) and RASSF1A hypermethylation (0/50). A significant association was found between LINE-1 hypomethylation and clinical pathologic features including HBsAg positivity (p=0.009), tumor size (p=0.001) and AFP levels (p<0.001). Besides, significant correlation was detected between RASSF1A promoter hypermethylation and lymph nodes metastasis (p=0.045).The results of Kaplan-Meier estimates of survival suggested that LINE-1 hypomethylation was highly associated with poor survival of patients (disease-free survival p=0.002, overall survival p=0.0123). More importantly, co-evaluation of LINE-1 hypomethylation and RASSF1A promoter hypermethylation was found to be significantly correlated to early recurrence and poor prognosis (disease-free survival p=0.0001, overall survival p=0.05) in patients after curative resection.In conclusion, our study showed that the combined examination of LINE-1 hypomethylation and RASSF1A promoter hypermethylation was effective in predicting early recurrence of HCC after curative resection. Patients with dual positivity of LINE-1 hypomethylation and RASSF1A promoter hypermethylation should be supplied with more intensive care and close follow-up after they undergo tumor resection.

The prognostic value of combination of CD90 and OCT4 for hepatocellular carcinoma after curative resection.

CD90 has been identified as a candidate marker of cancer stem cells (CSCs) for HCC, whereas it also has been considered as a marker for tumor-associated fibroblasts (CAFs). OCT4, as a key transcription factor required to maintain pluripotency of human embryonic stem cell and cancer cells, has been characterized to be involved in malignant transformation and tumorigenesis of various cancers. This study aimed to examine expression patterns of CD90 in HCC and investigate whether combination of both CD90 and OCT4 could provide a more powerful predictor for prognosis of HCC than either one alone.CD90 and OCT4 were examined by immunohistochemistry. The relationship between CD90/OCT4 expression and clinicopathologic characteristics was analyzed. The correlation between CD90/OCT4 expression and overall survival and disease-free survival was determined with Kaplan-Meier analysis.CD90 was found mainly expressed in tumor-associated CAFs and OCT4 was mainly expressed in tumor cells. The expression of CD90 and OCT4 in HCC was significantly higher than in adjacent non-tumor and normal liver tissues. CD90 expression was correlated with pathological grade, satellite lesion, PVTT and recurrence. OCT4 expression was correlated with pathological grade, tumor size and recurrence. Data demonstrated no correlation between CD90 and OCT4. High expression of CD90 or OCT4 predicts a poor prognosis. Furthermore, combination of both CD90 and OCT4 provides a more sensitive predictor for prognosis of HCC than either marker alone.CD90 and OCT4 are both independent and reliable biomarker for predicting prognosis of HCC patients after hepatic resection. Our results indicated the accuracy of prediction can be enhanced by their combination.

Association between CYP19A1, GSTM1, GSTT1, and GSTP1 genetic polymorphisms and the development of endometriosis in a Chinese population.

Endometriosis is a common, complicated, and highly heterogeneous endocrine disease. Many genetic factors could affect the development of endometriosis. We performed a case-control study to evaluate the association between polymorphisms in CYP19A1 rs2899470, GSTM1, GSTT1, and GSTP1 rs1695 and the development of endometriosis in a Chinese population. Between March 2014 and October 2015, 262 endometriosis patients and 275 control subjects were recruited from the Inner Mongolia Medical University. Genotyping was conducted using polymerase chain reaction-coupled with restriction fragment length polymorphism. Individuals carrying the TT genotype of CYP19A1 rs2899470 expressed a higher risk of endometriosis than those carrying the GG genotype, and the adjusted ORs (95%CI) was 2.33 (1.27-4.33). Moreover, those with the TG + TT genotype were correlated with an elevated risk of endometriosis, compared to those with the GG genotype (OR = 1.48, 95%CI = 1.03-2.13). However, GSTM1, GSTT1, and GSTP1 rs1695 polymorphisms did not affect the pathogenesis of endometriosis. In conclusion, our results suggested that CYP19A1 rs2899470 polymorphism is associated with risk for endometriosis in the Chinese population.

ICE1 demethylation drives the range expansion of a plant invader through cold tolerance divergence.

Cold tolerance adaption is a crucial determinant for the establishment and expansion of invasive alien plants into new cold environments; however, its evolutionary mechanism is poorly understood. Crofton weed (Ageratina adenophora), a highly invasive alien plant, is continuously spreading across subtropical areas in China, north-eastward from the first colonized south-western tropical regions, through cold tolerance evolution. Close relations between the cold tolerance levels of 34 populations, represented by 147 accessions, and the latitude, extreme lowest temperature, coldest month average temperature, and invasion period have provided direct insight into its cold tolerance divergence. A comparative study of the CBF pathway, associated with the cold tolerance enhancement of cold-susceptible CBF1-transgenic plant, among four geographically distinct crofton weed populations revealed that the CBF pathway plays a key role in the observed cold tolerance divergence. Four epialleles of the cold response regulator ICE1 ranged from 66 to 50 methylated cytosines, representing a 4.4% to 3.3% methylation rate and significantly corresponding to the lowest to highest cold tolerance levels among these different populations. The significant negative relation between the transcription levels of the primary CBF pathway members, except for CBF2, and the methylation levels among the four populations firstly demonstrates that the demethylation-upregulated transcription level of CBF pathway is responsible for this evolution. These facts, combined with the cold tolerance variation and methylation found among three native and two other introduced populations, indicate that the ICE1-demethylated upregulation of cold tolerance may be the underlying evolutionary mechanism allowing crofton weed to expand northward in China.

[Research on Yaowang Temple based on local chronicles of Henan].

By looking up the local chronicles of the China Digital Chronicles Database and the China Chronicles Database, it was found that there are 450 kinds of local chronicles in Henan, of which 45 contain Yaowang Temple.According to these 45 kinds of local Chronicles, it can be seen that a total of 35 Yaowang temples were built in 25 counties (cities) of Henan, mostly distributed in the west, north and south of Henan, especially in the west. Among them, eight Yaowang temples recorded the construction time, from the Ming Dynasty to the Republic of China, but most of them were built in the Qing Dynasty. There are records of the builders of the 8 Yaowang Temples, most of whom were local government officials. Qi Bo, Hua Tuo, Bian Que, Sun Simiao and Wei Cizang were recorded as Yaowang in three places, and Sun Simiao was enshrined in two of them. The architectural pattern of Yaowang Temple varies greatly from three courtyards to natural caves. Local chronicles contain all kinds of legends and stories about the Yaowang, which is a concrete embodiment of the belief in Yaowang. The belief in Yaowang not only carries people's thirst for health, but also prays for good weather.

[Prevalence of frailty and related factors in middle-aged and elderly people in island and mountainous areas of Taizhou, Zhejiang Province].

Objective: To compare the prevalence of frailty and related factors in middle-aged and elderly people aged ≥45 years in island and mountainous areas of Taizhou, Zhejiang Province. Methods: Based on cross-sectional design, stratified cluster sampling and quota sampling methods were adopted. One administrative district was randomly selected from each of six coastal and three inland administrative districts in Taizhou during July to August, representing two different geographical terrains. In the island area (Jiaojiang District), all residents aged ≥45 years were included by cluster sampling. In the mountainous area (Xianju County), participants were selected through quota sampling, with same gender and age distributions. Data about their demographic characteristics, lifestyle and health-related factors were collected through questionnaire surveys and laboratory examinations. The prevalence of frailty was assessed using the Fried frailty phenotype scale. Hierarchical analysis and multivariate logistic regression analysis were used to compare the influencing factors of frailty. Results: A total of 1 011 local residents were studied, in whom island and mountainous residents accounted for 48.1% (486/1 011) and 51.9% (525/1 011) respectively; men and women accounted for 45.9% (464/1 011) and 54.1% (547/1 011) respectively. Middle-aged (45-49 years), younger elderly (60-74 years), and older elderly (≥75 years) residents accounted for 38.6% (390/1 011), 44.6% (451/1 011), and 16.8% (170/1 011) respectively. The overall prevalence rate of frailty was 3.6% (36/1 011), the prevalence rate was 3.7% (17/464) in men and 3.5% (19/547) in women. The prevalence rates in age groups 45-59,60-74 years and ≥75 years were 0.3% (1/390), 2.2% (10/451), and 14.7% (25/170), respectively. The prevalence rates of frailty and pre-frailty in island area were 6.0% (29/486) and 39.1% (190/486), respectively, which was higher than those in mountainous area (1.3%, 7/525) and (30.9%, 162/525). After adjusting for potential confounding factors, the risk for frailty in island residents was significantly higher than that in mountainous residents (aOR=1.55,95%CI: 1.07-2.25,P=0.019). In island area, older age (60-74 years:aOR=2.52,95%CI: 1.56-4.13; ≥75 years:aOR=11.65,95%CI:5.38-26.70), being women (aOR=1.94,95%CI: 1.20-3.17), suffering from depression (aOR=1.09,95%CI:1.02-1.17) were associated with frailty symptoms. In mountainous area, older age was also associated with an increased risk of frailty symptoms, but the OR value was lower than those in island area (60-74 years: aOR=1.74,95%CI:1.04-2.94;≥75 years: aOR=4.78,95%CI:2.45-9.50). Polydrug use (aOR=2.08,95%CI: 1.14-3.80) and suffering from depression (aOR=1.10,95%CI: 1.02-1.18) had significant positive association with frailty symptoms. Higher education level had significant negative association with frailty symptoms (junior high school: aOR=0.40,95%CI: 0.21-0.75; senior high school and technical secondary school: aOR=0.29,95%CI: 0.15-0.53; college or above:aOR=0.22,95%CI: 0.11-0.42). Conclusions: The prevalence of frailty in middle-aged and elderly community residents was significantly higher in island area than in mountainous area in Taizhou. The frailty-related factors varied with area. The elderly people (≥75 years) and women in island area had higher risk for frailty. Older age and suffering from depression were the independent risk factors for frailty. It is necessary to pay attention to the health risk factors and special environment in island area, and take comprehensive intervention measures to delay the process of debilitation and improve the quality of life of middle-aged and elderly people.

[Improvement of China's legal system for public health emergency management from the perspective of lifecycle management].

A crucial lesson gained through the pandemic preparedness and response to COVID-19 is that all measures for epidemic control must be law-based. The legal system is related not only to public health emergency management per se but also to all aspects of the institutional supporting system throughout the lifecycle. Based on the lifecycle emergency management model, this article analyses the problems of the current legal system and the potential solutions. It is suggested that the lifecycle emergency management model shall be followed to establish a more comprehensive public health legal system and to gather the intelligence and consensus of experts with different expertise, including epidemiologists, sociologists, economists, jurist and others, which will collaboratively promote the science-based legislation in the field of epidemic preparedness and response for the establishment of a comprehensive legal system for public health emergency management and with Chinese characteristics.

Role of five-fold twin boundary on the enhanced mechanical properties of fcc Fe nanowires.

The role of 5-fold twin boundary on the structural and mechanical properties of fcc Fe nanowire under tension is explored by classical molecular dynamics. Twin-stabilized fcc nanowire with various diameters (6-24 nm) are examined by tension tests at several temperatures ranging from 0.01 to 1100 K. Significant increase in the Young's modulus of the smaller nanowires is revealed to originate from the central area of quinquefoliolate-like stress-distribution over the 5-fold twin, rather than from the surface tension that is often considered as the main source of such size-effects found in nanostructures. Because of the excess compressive stress caused by crossing twin-boundaries, the atoms in the center behave stiffer than those in bulk and even expand laterally under axial tension, providing locally negative Poisson's ratio. The yield strength of nanowire is also enhanced by the twin boundary that suppresses dislocation nucleation within a fcc twin-domain; therefore, the plasticity of nanowire is initiated by strain-induced fcc→bcc phase transformation that destroys the twin structure. After the yield, the nucleated bcc phase immediately spreads to the entire area, and forms a multigrain structure to realize ductile deformation followed by necking. As temperature elevated close to the critical temperature between bcc and fcc phases, the increased stability of fcc phase competes with the phase transformation under tension, and hence dislocation nucleations in fcc phase are observed exclusively at the highest temperature in our study.

[Wan's gynecology and obstetrics (Wan Shi Nv Ke) collected by the library of China Academy of Chinese Medical Sciences].

Wan's gynecology and obstetrics (Wan Shi Nv Ke), collected by the library of China Academy of Chinese Medical Sciences, was examined with the field method. It was found some issues existed both in the recording and description of Wan's gynecology and obstetrics (Wan Shi Nv Ke) collected by the library of China Academy of Chinese Medical Sciences in the electronic catalogue of ancient books and in the General catalogue of ancient books of traditional Chinese Medicine (Zhong Guo Zhong Yi Gu Ji Zong Mu), in terms of the same version with different registration, wrong publication time, some contents missed in publication, and the version actually not collected.

[Progress of schistosomiasis control in People's Republic of China in 2021].

This report presented the endemic status of schistosomiasis and analyzed the data collected from the national schistosomiasis prevention and control system and national schistosomiasis surveillance sites in the People's Republic of China at a national level in 2021. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis in China, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to consolidate the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan, Hubei, Anhui, Jiangxi and Hunan provinces maintained the criteria of transmission control by the end of 2021. A total of 451 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2021, with 27 571 endemic villages covering 73 250 600 people at risk of infections. Among the 451 endemic counties (cities, districts), 75.17% (339/451), 22.17% (100/451) and 2.66% (12/451) achieved the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. By the end of 2021, 29 037 cases with advanced schistosomiasis were documented in China. In 2021, 4 405 056 individuals received serological tests and 72 937 were sero-positive. A total of 220 629 individuals received stool examinations and 3 were positive. In 2021, snail survey was performed in 19 291 endemic villages in China and Oncomelania snails were found in 7 026 villages, accounting for 36.42% of all surveyed villages, with 12 villages identified with emerging snail habitats. Snail survey was performed at an area of 686 574.46 hm2 and 191 159.91 hm2 snail habitats were found, including 1 063.08 hm2 emerging snail habitats and 5 113.87 hm2 reemerging snail habitats. In 2021, 525 878 bovines were raised in the schistosomiasis endemic areas of China, and 115 437 received serological examinations, with 231 positives detected. Among the 128 719 bovines received stool examinations, no positives were identified. In 2021, there were 19 927 schistosomiasis patients receiving praziquantel chemotherapy, and 729 113 person-time individuals and 256 913 herd-time bovines were given expanded chemotherapy. In 2021, snail control with chemicals was performed in 117 372.74 hm2 snail habitats, and the actual area of chemical treatment was 65 640.50 hm2, while environmental improvements were performed in snail habitats covering an area of 1 244.25 hm2. Data from the national schistosomiasis surveillance sites of China showed that the mean prevalence of Schistosoma japonicum infections were both zero in humans and bovines in 2021, and no S. japonicum infection was detected in snails. The results demonstrate that the overall endemic status of schistosomiasis remained at a low level in China in 2021; however, the progress towards schistosomiasis elimination was slowed and the areas of snail habitats rebounded mildly. Strengthening researches on snail diffusion and control, and improving schistosomiasis surveillance and forecast are recommended to prevent reemerging schistosomiasis.

Fenton-biological treatment of reverse osmosis membrane concentrate from a metal plating wastewater recycle system.

Although reverse osmosis (RO) has been widely used in the recycling of metal plating wastewater, organic compounds and heavy metals in the RO concentrate are difficult to remove by conventional treatment. A combination process including Fenton oxidation and a biological aerated filter was used to treat RO concentrate containing complex Cu and Ni from metal plating. During the Fenton treatment, Cu and Ni ions were released due to degradation of organic compounds and then removed by pH adjustment and coagulation. The concentrate was further treated using by a biological aerated filter. Optimum conditions were as follows: initial pH of influent of 4.0; dosage of H2O2 of 5.0 mmol l(-1); ratio of n(Fe2+)/n(H2O2) of 0.8; precipitation pH of Cu and Ni ions of 8.0; and a hydraulic retention time of the biological aerated filter of 2.5 h. The results showed that concentrations of effluent COD, Cu and Ni ions were less than 40 mg l(-1), 0.5 mg l(-1) and 0.3 mg l(-1), respectively; this means the treated effluent meets the emission standards for pollutants from electroplating set by China's Environmental Protection Agency.

[A longitudinal analysis on dynamic change of platelet count in HIV-infected patients with access to antiretroviral therapy in Dehong Dai and Jingpo Autonomous Prefecture].

Objective: To explore the dynamic change of platelet count and related factors in HIV-infected patients with access to antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture of Yunnan province. Methods: A longitudinal analysis was used to analyze the dynamic change of platelet count in HIV-infected patients with access to ART. Linear mixed model (LMM) was used to analyze factors associated with the dynamic change of platelet count. Stratified analysis and sensitivity analysis were also conducted. Results: A total of 761 HIV-infected patients were recruited and 608 cases had at least one follow-up record (80.0%,608/761). 374, 555 and 233 cases were investigated in follow-up visits at month 6, 12 and 24, respectively. The mean platelet count and the proportion of higher platelet count (>300×109/L) were significantly higher in women than in men at both baseline survey and each follow-up visit (P<0.05). Among patients with no obvious liver fibrosis, the mean platelet count was significantly higher in women than in men at baseline survey and each follow-up visit; while in the patients with liver fibrosis, the mean baseline platelet count was still significantly higher in women than in men, but the difference had no significance at follow-up visits. Results of LMM revealed that follow-up platelet count was positively correlated with gender (ß=5.90, 95%CI: 1.09-10.70, P=0.016), baseline platelet count (ß=0.82, 95%CI: 0.79-0.86, P<0.001) and time (ß=1.76, 95%CI: 1.52-2.01, P<0.001). Sensitivity analysis among 220 cases who had both 12- and 24-month follow-up visits further confirmed that follow-up platelets count was still positively associated with gender (ß=10.50, 95%CI: 2.24-18.74, P=0.013), baseline platelet count (ß=0.71, 95%CI: 0.65-0.77, P<0.001) and time (ß=1.60, 95%CI: 1.20-1.99, P<0.001) but negatively associated with age (ß=-0.42, 95%CI: -0.78--0.06, P=0.021). Conclusions: The platelet count of HIV-infected patients gradually increased after ART. The mean platelet count was consistently higher in women than in men. Attention should be paid to the gender specific difference in platelet count in HIV-infected patients and timely intervention should be given to reduce the morbidity and mortality of platelet-related diseases.

[Analysis on prediction power of HIV infection risk assessment tool in men who have sex with men in Guizhou province].

Objective: To evaluate the prediction power of HIV infection risk assessment tool and the applicability in MSM in Guizhou province. Methods: MSM were recruited through snowball sampling method. Questionnaire surveys were conducted among the MSM using HIV infection risk assessment tool, and combined with HIV serologic test results, the risk prediction power of HIV infection risk assessment tool was evaluated. Results: A total of 3 379 MSM were recruited from January 2018 to December 2019 in Guizhou. The HIV infection rate was 3.3%(111/3 379). The mean risk scores of HIV positive and HIV negative MSM were (12.15±3.08) and (12.07±3.07), respectively. The difference in risk score was significant between MSM with different HIV status (t=8.69, P<0.001). According to the principle of decision tree, individual risk scores were divided into following three categories: ≤11.96, 11.97-14.80 and >14.80, the HIV infection rate was 0.8%, 4.3% and 8.6% respectively, suggesting that the higher the individual risk score was, the higher the HIV infection rate was (trend χ2=88.18, P<0.001). Multivariate logistic regression analysis showed that the higher the individual risk score was, the higher the risk of HIV infection was. Compared to the total score ≤11.96, the aOR values at total scores of 11.97-14.80 and >14.80 were 6.34 (95%CI: 3.38-11.88) and 14.07(95%CI: 7.44-26.61), respectively. The risk of HIV infection in Miao ethnic group was higher than that in Han ethnic group (aOR=1.83, 95%CI:1.04-3.21), and the risk of HIV infection in those with education level of primary school and below was higher than that in undergraduates or those with education level of junior college and above (aOR=2.50, 95%CI:1.06-5.88), and the risk of HIV infection was higher in those who had bisexual behaviors than in those who had homosexual behaviors (aOR=1.95, 95%CI:1.19-3.19). The risk of HIV infection was higher in those who had never received HIV testing (aOR=1.53, 95%CI:1.01-2.33). The area under the receiver operating characteristic (ROC) curve and area under ROC (AUC) for HIV infection prediction was 0.751 (95%CI:0.710-0.792, P<0.001). The maximum Youden's index was individual risk score of 12.56, and the sensitivity of the risk assessment tool was 0.838, and its specificity was 0.412. Conclusions: The results of HIV infection risk assessment tool in Guizhou indicated that in MSM the higher the individual risk score, the higher the risk of HIV infection is. The tool can be used to evaluate the risk of HIV infection in MSM, but the specificity should be improved.

[Risk analysis of immunological failure of antiretroviral therapy in HIV/AIDS patients in Taizhou prefecture, 2006-2019].

Objective: To analyze the immunological failure of antiretroviral therapy (ART), its association with baseline anemia and related factors in HIV/AIDS patients in Taizhou prefecture, during 2006-2019. Methods: A retrospective cohort study was conducted among HIV/AIDS patients under ART. Cox regression model was used to analyze predictors of immunological failure and logistic regression model was used to analyze factors of baseline anemia. Results: A total of 2 904 HIV/AIDS patients were enrolled with a median time of 28 (P(25)-P(75):12-53) months follow-up of ART, in which 177 cases (6.1%) were identified as immunological failure with a failure rate of 2.17 per 100 person-years. The cumulative incidence rates of immunological failure in the first, third, fifth, and tenth years were 5.49%, 6.94%, 7.30% and 8.82%, respectively. Results of multivariate logistic regression analysis showed that for the risk of baseline anemia, ≥66 years old group had 4.17 times higher risk than 18-25 years old group (95%CI: 1.68-10.33), males had 0.67 times higher risk than females (95%CI: 0.50-0.89), and CD(4)(+)T cell counts (CD(4))<200 cells/µl group had 4.35 times higher risk than CD(4)≥350 cells/µl group (95%CI: 2.81-6.72), baseline white blood cells<4.0×10(9) cells/L group had 1.73 times higher risk than 4.0×10(9) cells/L-9.9×10(9) cells/L group (95%CI: 1.31-2.29), baseline platelet counts <100×10(9) cells/L and >300×10(9) cells/L groups had 2.02 times and 4.45 times higher risk than 100×10(9) cells/L-299×10(9) cells/L group (95%CI: 1.36-3.01, 95%CI: 3.05-6.50), respectively. WHO classified stage Ⅲ/Ⅳ group had 2.15 times higher risk than WHO classified stageⅠ/Ⅱ group (95%CI: 1.61-2.87), while heterosexual transmission group had 2.03 times higher risk than homosexual transmission group (95%CI: 1.42-2.92). Results of multivariate cox proportional risk regression showed that for the risk of immunological failure, baseline anemia group had 1.77 times higher risk than no anemia group (95%CI: 1.20-2.60), WHO classified stage Ⅲ/Ⅳ group had 1.66 times higher risk than WHO classified stage Ⅰ/Ⅱ group (95%CI: 1.10-2.48), and withdrawal of follow up and death groups had 3.18 times and 4.61 times higher risks than treatment group (95%CI: 1.96-5.19, 95%CI: 2.98-7.13), respectively. Conclusions: The immunological effect of ART among HIV/AIDS patients in Taizhou prefecture was affected by multiple factors, including anemia, clinical stage and follow-up status. Enhancing surveillance of baseline anemia and timely correction of anemia in elder group can help improve treatment outcome of HIV/AIDS patients.