Macrophage ATG16L1 expression suppresses metabolic dysfunction-associated steatohepatitis progression by promoting lipophagy

Background/Aims@#Metabolic dysfunction-associated steatohepatitis (MASH) is an unmet clinical challenge due to the rapid increased occurrence but lacking approved drugs. Autophagy-related protein 16-like 1 (ATG16L1) plays an important role in the process of autophagy, which is indispensable for proper biogenesis of the autophagosome, but its role in modulating macrophage-related inflammation and metabolism during MASH has not been documented. Here, we aimed to elucidate the role of ATG16L1 in the progression of MASH. @*Methods@#Expression analysis was performed with liver samples from human and mice. MASH models were induced in myeloid-specific Atg16l1-deficient and myeloid-specific Atg16l1-overexpressed mice by high-fat and high-cholesterol diet or methionine- and choline-deficient diet to explore the function and mechanism of macrophage ATG16L1 in MASH. @*Results@#Macrophage-specific Atg16l1 knockout exacerbated MASH and inhibited energy expenditure, whereas macrophage-specific Atg16l1 transgenic overexpression attenuated MASH and promotes energy expenditure. Mechanistically, Atg16l1 knockout inhibited macrophage lipophagy, thereby suppressing macrophage β-oxidation and decreasing the production of 4-hydroxynonenal, which further inhibited stimulator of interferon genes(STING) carbonylation. STING palmitoylation was enhanced, STING trafficking from the endoplasmic reticulum to the Golgi was promoted, and downstream STING signaling was activated, promoting proinflammatory and profibrotic cytokines secretion, resulting in hepatic steatosis and hepatic stellate cells activation. Moreover, Atg16l1-deficiency enhanced macrophage phagosome ability but inhibited lysosome formation, engulfing mtDNA released by pyroptotic hepatocytes. Increased mtDNA promoted cGAS/STING signaling activation. Moreover, pharmacological promotion of ATG16L1 substantially blocked MASH progression. @*Conclusions@#ATG16L1 suppresses MASH progression by maintaining macrophage lipophagy, restraining liver inflammation, and may be a promising therapeutic target for MASH management.

Novel and Advanced Ultrasound Techniques for Thyroid Thermal Ablation

Thyroid radiofrequency ablation and microwave ablation are widely adopted minimally invasive treatments for diverse thyroid conditions worldwide. Fundamental skills such as the trans-isthmic approach and the moving shot technique are crucial for performing thyroid ablation, and advanced techniques, including hydrodissection and vascular ablation, improve safety and efficacy and reduce complications. Given the learning curve associated with ultrasound-guided therapeutic procedures, operators need training and experience. While training models exist, limited attention has been given to ultrasound maneuvers in ablation needle manipulation. This article introduces two essential maneuvers, the zigzag moving technique and the alienate maneuver, while also reviewing the latest ultrasound techniques in thyroid ablation, contributing valuable insights into this evolving field.

Effects of Huaiqihuang Granules on airway inflammation in bronchiolitis / 中国基层医药

Objective:To investigate the effects of Huaiqihuang Granule on airway inflammation and wheezing reattack in bronchiolitis. Methods:A total of 120 patients with bronchiolitis presenting airway inflammation and wheezing reattack who received treatment in Zaozhuang Municipal Hospital and Yicheng Hospital of Traditional Chinese Medicine between January 2018 and October 2019 were included in this study. These patients randomly underwent either conventional treatment (control group, n = 60) or conventional treatment + Huaiqihuang Granule treatment (experimental group, n = 60). They received pulmonary function examinations and laboratory tests for evaluating serum and urinary inflammatory factors at admission and 2 months after discharge. They were followed up by telephone 3 months and 1 year after onset. Results:The ratio of time to reach the peak tidal expiratory flow over total expiratory time (TPTEF/TE) and the volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE) were significantly higher in the experimental group compared with those in the control group ( t = 3.13, 3.60, all P < 0.01). The ratio of tidal peak flow to tidal expiratory flow when 25% of tidal volume remains in the lungs (PF/TEF25) and functional residual capacity/kg (FRCp/kg) significantly decreased in the experimental group compared with those in the control group ( t = 3.88, 3.74, all P < 0.01). Interleukin-4 level and the ratio of interleukin-4/γ-interferon levels were significantly lower in the experimental group than in the control group ( t = 5.70, 8.93, all P < 0.01). Gamma-interferon level was significantly higher in the experimental group than in the control group ( t = 3.85, P < 0.01). There was no significant difference in urinary leukotriene E4 level post-treatment between the two groups ( t = 1.18, P > 0.05). The number of patients who had a wheezing attack again within 3 months post-treatment and the number of patients who had ≥3 wheezing attacks were significantly lower in the experimental group compared with those in the control group ( χ2 = 5.18, 6.98, P < 0.01 or 0.05). Conclusion:Huaiqihuang granule can effectively regulate the balance of the Th 1/Th 2 ratio, inhibit airway inflammation in bronchiolitis, improve pulmonary function, and reduce the number of wheezing reattacks.

Research progress of EGFRvIII targeted immunotherapy in the treatment of glioblastoma / 药学学报

Glioblastoma (GBM) is the most common primary brain tumor, which is prone to recurrence and metastasis with poor prognosis. In recent years, immunotherapy has prolonged the survival of patients with GBM, providing a new option for the treatment of GBM. Target selection is very important for immunotherapy. Epidermal growth factor receptor variant III (EGFRvIII) is highly expressed on the surface of GBM cells in some patients, and EGFRvIII was not expressed in normal tissues. EGFRvIII are pivotal for the occurrence and progression of GBM, various targeted therapy including immunotherapy is promising to improve the efficacy of GBM. Currently, there are various approaches to target EGFRvIII, including humanized monoclonal antibodies, adoptive cell therapies and therapeutic vaccines. In this review, we focus on the preclinical and clinical findings of targeting EGFRvIII for GBM.

Epidemiological investigation on a visceral leishmaniasis case in Zhengzhou City of Henan Province / 中国血吸虫病防治杂志

Objective To perform an epidemiological investigation on a case with visceral leishmaniasis in Zhengzhou City, Henan Province, and to identify the source of infection, so as to illustrate the transmission chain and assess the risk of local leishmaniasis transmission. Methods The medical data were collected from a case with visceral leishmaniasis in Zhengzhou City, and the patient’s bone marrow smears were detected by microscopy. Serum anti-Leishmania antibody test and PCR assay were performed among high-risk residents and all dogs in the village where the patient lived. Sandflies were captured using light traps and artificial traps, and the captured female Phlebotomus chinensis was subjected to PCR assay. The internal transcribed spacer 1 (ITS1) gene was amplified with a nested PCR assay using the genomic DNA extracted from visceral leishmaniasis patients, positive dogs and sandflies, and the sequences were aligned with those download from NCBI. In addition, a phylogenetic tree was created based on the ITS1 gene. Results The visceral leishmaniasis patient had recurrent irregular fever, reduced complete blood counts, low hemoglobin, and a large number of Leishmania amastigotes in bone marrow smears, and was therefore diagnosed as visceral leishmaniasis. Both rk39 rapid diagnostic test and PCR assay tested negative among 324 residents living neighboring the patient’s residence, while 21.39% (43/201) dogs were positive for rk39 rapid diagnostic test and 13.93% (28/201) positive for PCR assay. There were 17 female Ph. chinensis tested positive for Leishmania (0.82%) by PCR assay, and the ITS gene sequences from visceral leishmaniasis patients, positive dogs and sandflies shared a 100% homology with L. infantum. The Leishmania species was therefore characterized as L. infantum. Conclusions L. infantum infection occurs in visceral leishmaniasis patients, dogs and sandflies in Zhengzhou City, indicating a complete transmission chain and a high transmission risk of visceral leishmaniasis by L. infantum. Intensified control measures are required to prevent local transmission of leishmaniasis in Zhengzhou City.

Application of mind mapping combined with scenario simulation teaching in probation teaching of abdominal trauma / 中华医学教育探索杂志

Objective:To explore the effect of mind mapping combined with scenario simulation teaching on probation teaching of abdominal trauma.Methods:The probation undergraduates from Batch 2017 five-year clinical medicine of Air Force Medical University were selected as research objects and randomly divided into experimental group ( n=98) and control group ( n=92). The experimental group was taught by mind mapping combined with scenario simulation teaching method, while the control group was taught by traditional teaching mode. After the end of the course, the effect of teaching was evaluated from two aspects: theoretical evaluation and teaching satisfaction evaluation. SPSS 19.0 was used for t test and chi-square test. Results:The results of theoretical test in the experimental group were significantly better than those of the control group [(84.03±8.99) vs. (78.53±8.97)], and the difference was statistically significant ( P<0.05). Compared with the control group, the experimental group had obvious advantages in learning interest, teamwork awareness and clear thinking, and achieved good teaching effect. Conclusion:Therefore, this teaching model helps to improve the teaching quality and provides some reference experience.

Susceptibility of Anopheles sinensis to insecticides in Puyang City, Henan Province / 中国血吸虫病防治杂志

Objective To investigate the susceptibility of Anopheles sinensis to malathion, deltamethrin and lambda-cyhalothrin in Puyang City, Henan Province, so as to provide the scientific basis for local malaria vector control. Methods An. sinensis was captured from Puyang County, Puyang City of Henan Province in September 2018 and July 2020, and the susceptibility of field captured An. sinensis to malathion, deltamethrin and lambda-cyhalothrin was tested using the filter-paper bioassay recommended by WHO. The insecticide resistance level was assessed based on the WHO criteria. Results In 2018 and 2010, the half knock-down times (KT50) of malathion were 91.08 min and 40.95 min for An. sinensis, with knock-down rates of 37.50% and 60.87% 60 min post-exposure to malathion and 24-hour mortality rates of 90.91% and 100%, respectively, and the insecticide resistance levels were moderately resistant (M) and susceptible (S). The KT50 of deltamethrin were 415.56 min and 341.19 min for An. sinensis in 2018 and 2020, with knock-down rates of 22.92% and 16.98% 60 min post-exposure to malathion and 24-hour mortality rates of 22.92% and 16.98%, and the insecticide resistance levels were all resistant (R). The KT50 of lambda-cyhalothrin were 164.22 min and 236.22 min for An. sinensis in 2018 and 2020, with knock-down rates of 30.39% and 38.30% 60 min postexposure to malathion and 24 h mortality rates of 19.60% and 21.28%, respectively, and the insecticide resistance levels were all R. Conclusion An. sinensis is relatively susceptible to malathion but has developed high-level resistance to deltamethrin and lambda-cyhalothrin in Puyang City, Henan Province..

Effect of Huanglian Wendantang on Classical Pathway of Skeletal Muscle Pyroptosis in IGT Rats / 中国实验方剂学杂志

Objective:To explore the effects of Huanglian Wendantang （HLWDT） on pyroptosis of skeletal muscle in rats with impaired glucose tolerance （IGT） and to explain the mechanism based on NOD-like receptor protein 3 （NLRP3）/cysteine aspartate-specific protease-1 （Caspase-1）/gasdermin D （GSDMD）/interleukin-1<italic>β </italic>（IL-1<italic>β</italic>）/IL-18 signaling pathway. Method:The SD male rats were fed with 45% high-fat diet for 20 weeks to induce the IGT model. After modeling， the rats were randomly divided into a blank group， a model group， a positive control group （metformin hydrochloride， 0.05 g·kg^-1d^-1）， and an HLWDT （7.8 g·kg^-1d^-1） group based on the body weight of rats. The blank group and the model group were fed with the same volume of distilled water. The dose for each group was set as 10 mL·kg^-1d^-1. After four weeks of continuous gavage， blood was collected and serum was separated. The skeletal muscles of rats were stored in liquid nitrogen. Subsequently， serum IL-1<italic>β</italic> and IL-18 were detected by the enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein expression levels of NLRP3， Caspase-1， and GSDMD were detected by real-time quantitative PCR （Real-time PCR） and Western blot， respectively. The expression of GSDMD， IL-1<italic>β</italic>， and IL-18 proteins in skeletal muscle tissues was detected by immunofluorescence. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of skeletal muscles. Result:Compared with the blank group， the model group showed increased IL-1<italic>β</italic> and IL-18 in serum， and NLRP3， Caspase-1， and GSDMD gene and protein expression in skeletal muscle tissues （<italic>P</italic><0.01）. Immunofluorescence assay showed that GSDMD， IL-18， and IL-1<italic>β </italic>protein expression in skeletal muscle tissues of the model group was significantly elevated （<italic>P</italic><0.01）. HE staining showed obvious pathological changes in skeletal muscles. Compared with the model group， the HLWDT group and the positive control group could decrease IL-1<italic>β</italic> and IL-18 in serum and NLRP3， Caspase-1， and GSDMD gene and protein expression in skeletal muscle tissues （<italic>P</italic><0.01）. In addition， immunofluorescence assay revealed that HLWDT could reduce protein expression levels of GSDMD， IL-1<italic>β</italic>， and IL-18 in skeletal muscles of IGT rats （<italic>P</italic><0.01）. The results of HE staining showed that HLWDT could improve the pathological changes of skeletal muscles in IGT rats<bold>.</bold> Conclusion:HLWDT can inhibit skeletal muscle pyroptosis of IGT rats， and the mechanism may be closely related to NLRP3/Caspase-1/GSDMD/IL-18/IL-1<italic>β</italic> signaling pathway.

Effect of acupuncture on pain and cerebral hemodynamics in patients with migraine: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the therapeutic effect between acupuncture combined with medication and simple medication on migraine and cerebral hemodynamics.@*METHODS@#A total of 120 patients with migraine were randomized into an acupuncture plus medication group (60 cases, 3 cases dropped off) and a medication group (60 cases, 6 cases dropped off). In the medication group, flunarizine hydrochloride capsule was given orally before sleep, 10 mg a day. On the basis of the treatment in the medication group, acupuncture was applied at Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5), Fengchi (GB 20) and etc. in the acupuncture plus medication group, 30 min each time, once a day. Treatment for 4 weeks was required in both groups. Before and after treatment, the visual analogue scale (VAS) score, indexes of cerebral hemodynamic [blood flow velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), vertebral artery (VA) and basilar artery (BA)] and total TCM syndrome score were observed, and the clinical therapeutic effect and the incidence of the adverse events were evaluated in both groups.@*RESULTS@#Compared before treatment, the VAS scores, the blood flow velocity of ACA, MCA, PCA, VA, BA and the total TCM syndrome scores were decreased in both groups (@*CONCLUSION@#Acupuncture combined with flunarizine hydrochloride capsule can effectively relieve the pain in patients with migraine, reduce the cerebral blood flow velocity, the efficacy is superior to simple flunarizine hydrochloride capsule.

Clinical characteristics and etiological analysis of early-onset and late-onset neonatal sepsis / 中华临床感染病杂志

Objective:To analyze the clinical characteristics, etiology and outcome of early-onset neonatal sepsis (EONS) and late-onset neonatal sepsis (LONS).Methods:The clinical data of 265 neonates with NS admitted in the neonatal ward of the the Affiliated Hospital of Qingdao University from January 2014 to September 2020 were enrolled, including 76 cases of EONS and 189 cases of LONS. The general information, clinical manifestation, laboratory findings, pathogen distribution, treatment and outcome of the two groups were analyzed with SPSS25.0 statistical software.Results:The rates of meconium-stained amniotic fluid, prenatal maternal fever, abnormal white blood cell (WBC) count and neutrophil count in EONS group were significantly higher than those in LONS group ( P<0.05 or <0.01). However, the rates of indwelling central venous catheters, mechanical ventilation, fever, abdominal distension, abnormal platelet count and serum prealbumin level in LONS group were significantly higher than those in EONS group ( P<0.05 or <0.01). Staphylococcus epidermidis(135/265)and Staphylococcus aureus (22/265) were the most common gram-positive bacteria and Escherichia coli (13/265) was the most common gram-negative bacteria in NS. The proportion of gram-positive bacteria was the highest in both EONS group (85.5%) and LONS group (84.7%), which was mainly Staphylococcus epidermidis of coagulase negative staphylococci. The proportion of Listeria monocytogenes and Streptococcus infections in EONS group was significantly higher than that in LONS group ( P<0.05 or <0.01). The proportion of Staphylococcus aureus infection in LONS group was significantly higher than that in EONS group ( P<0.01). There was no significant difference in case fatality rate between EONS group and LONS group (6.6% vs 2.6%, P>0.05). Conclusions:Perinatal amniotic fluid pollution and prenatal maternal fever are risk factors for the occurrence of EONS, while indwelling central venous catheter and mechanical ventilation are risk factors for the occurrence of LONS. Abnormal platelet count and abnormal serum prealbumin are more common in the LONS group. The bacteria detected in EONS and LONS are mainly Staphylococcus epidermidis. Clinical diagnosis and treatment of EONS and LONS should be managed differently.

Effect of moxibustion at Shenque (CV 8) on myocardial remodeling and function in exercise-induced fatigue rats / 针灸推拿医学（英文版）

Objective: To explore the effect of moxibustion at Shenque (CV 8) on myocardial structure and function in exercise-induced fatigue rats. Methods: A 12-week treadmill running training was performed to create an exercise-induced fatigue rat model. Sixty eligible male specific-pathogen-free grade Sprague-Dawley rats were randomly divided into a blank group, a control group, a model group, a non-meridian non-acupoint group, a Zusanli (ST 36) group and a Shenque (CV 8) group, with 10 rats in each group. Rats in the blank group did not receive treadmill running training or moxibustion. Rats in the control group did not receive treadmill running training but received mild moxibustion at Shenque (CV 8). Rats in the model group received treadmill running training but no moxibustion. Rats in the non-meridian non-acupoint group, the Zusanli (ST 36) group and the Shenque (CV 8) group received moxibustion at the non-meridian non-acupoint points, Zusanli (ST 36) or Shenque (CV 8) immediately after each treadmill running training, 15 min each time, once a day for 5 consecutive days a week at a 2-day interval, 60 times of moxibustion in total. Left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVESd), left ventricular diastolic volume (LVDv), left ventricular systolic volume (LVSv), ejection fraction (EF), stroke volume (SV), early diastolic peak flow velocity of mitral valve (E) and late diastolic peak flow velocity of mitral valve (A) of each group before and after the last treadmill running training were measured. Blood was collected 6 h after the last treadmill running training, and serum C-reactive protein (CRP), myoglobin (Mb), creatine kinase-myocardial band (CK-MB), cardiac troponin I (cTnI) and cardiac troponin T (cTnT) levels were detected. Finally, the heart was separated, the heart mass (HM) was measured, the cTnT level of the myocardial tissue was detected, the ultrastructural changes of the left ventricular myocardium were observed by transmission electron microscope, the left ventricular fraction shortening (LVFS), E/A and heart mass index (HMI) were calculated. Results: Compared with the same group before treatment, the rat cardiac LVEDd, LVESd, LVDv, LVSv, SV, E and A were significantly increased (all P<0.01), and the rat LVFS, E/A and EF were significantly decreased (all P<0.01) in the model group and the non-meridian non-acupoint group after treatment; the rat cardiac SV, LVDv, LVSv, E and A were all increased (all P<0.01), while E/A and EF were decreased (all P<0.01) in the Zusanli (ST 36) group after treatment; the rat cardiac LVDv, E and A were significantly increased (P<0.01 or P<0.05), and E/A was significantly decreased (P<0.01) in the Shenque (CV 8) group after treatment. After treatment, compared with the blank group, the rat cardiac LVEDd, LVESd, SV, LVDv, LVSv, E, A, the serum CRP, Mb, CK-MB, cTnI, cTnT and HMI, and the myocardial cTnT were increased (all P<0.01), and the LVFS, E/A and EF were all reduced (all P<0.01) in the model group; compared with the model group and the non-meridian non-acupoint group, rats in the Zusanli (ST 36) group and the Shenque (CV 8) group showed decreased LVEDd, LVESd, SV, LVDv, LVSv, E, A, serum CRP, Mb, CK-MB, cTnI, cTnT and HMI, and myocardial cTnT (P<0.01 or P<0.05), along with increased LVFS, E/A and EF (all P<0.01); compared with the Zusanli (ST 36) group, Mb and A of the Shenque (CV 8) group were decreased (both P<0.01), while both E/A and EF were increased (P<0.01, P<0.05). Transmission electron microscopy examination showed that myofibrils in the blank group and the control group were neatly arranged with clear light and dark bands; the model group and the non-meridian non-acupoint group showed different degrees of myofibril disintegration and breakage, increased and aggregated mitochondria of different sizes, and increased electron density. The myofibrils in the Shenque (CV 8) group and Zusanli (ST 36) group were arranged neatly with clear light and dark bands, and compensatory hyperplasia of mitochondria. Conclusion: Moxibustion at Shenque (CV 8) and Zusanli (ST 36) both can effectively improve the occurrence of myocardial remodeling in exercise-induced fatigue rats, and the effect of moxibustion at Shenque (CV 8) is better in improving cardiac function.

Mechanism of Huanglian Wendan Decoction in improving impaired glucose tolerance based on skeletal muscle NLRP3/caspase-1/IL-1β, IL-18 pathway / 中国中药杂志

This study investigated the mechanism of improving impaired glucose tolerance(IGT) of rats by Huanglian Wendan Decoction from the perspective of the skeletal muscle Nod-like receptor protein 3(NLRP3)/cysteinyl aspartate specific proteinase-1(caspase-1)/interleukin-1β(IL-1β), interleukin-18(IL-18) pathway. Healthy male SD rats were fed with the diet containing 45% fat for 20 weeks, accompanied by a high-temperature and high-humidity environment and an inactive lifestyle, for the establishment of the IGT rat model. The rats were divided into the blank control group, model control group, metformin hydrochloride group(positive drug group, 0.05 g·kg~(-1)·d~(-1)) and Huanglian Wendan Decoction group(7.8 g·kg~(-1)·d~(-1)). After continuous intragastric administration for 4 weeks, the obesity and glycemic indexes of all the rats were measured. The fasting serum insulin(FINS) level was determined by ELISA, with the insulin sensitivity index(ISI) and insulin resistance index(IRI) calculated. The mRNA and protein expression le-vels of nuclear factor kappaB(NF-κB), NLRP3, caspase-1, IL-1β and IL-18 in skeletal muscle tissue were detected by real-time polymerase chain reaction(PCR), Western blot and immunofluorescence. Compared with the blank control group, the model control group witnessed significantly increased mRNA and protein expression of NF-κB, NLRP3, caspase-1, IL-1β and IL-18. As revealed by the comparison with the model control group, Huanglian Wendan Decoction could effectively regulate the obesity status, reduce body weight, correct the abnormal levels of 2-hour plasma glucose(2 hPG), insulin resistance index(IRI), insulin sensitivity index(ISI), and lower the mRNA and protein expression of NF-κB, NLRP3, caspase-1, IL-1β and IL-18 in the skeletal muscle tissue of IGT rats. Combined with previous studies, the above results showed that the occurrence and development of IGT was closely related to inflammatory response and the classic pyroptosis pathway in skeletal muscle, such as NLRP3/caspase-1/IL-1β, IL-18. It is inferred that the mechanism of Huanglian Wendan Decoction was to alleviate insulin resistance(IR) and then reverse the course of IGT lies in the regulation of the abnormal insulin receptor signaling pathway based on the NLRP3 inflammasome pathway.

Exosomes in bladder cancer: novel biomarkers and targets / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Exosomes are nanometer-sized vesicles that contain various types of biologically active components, including proteins, nucleic acids, carbohydrates, and lipids, which vary with the type and physiological state of the cell. In recent years, several studies have showed that exosomes can provide new non-invasive diagnostic and prognostic biomarkers in patients affected by cancers, including bladder cancer (BC), and the lipid bilayer membrane structure makes exosomes as promising delivery vehicles for therapeutic applications. Exosomes have the characteristics of high abundance, high stability, tissue specificity, and wide distribution in body fluids, and are secreted as various types by cells in different states, thereby possessing great potential as biomarkers for BC. Herein, we briefly summarize the functions and roles of exosomes in the occurrence and development of BC and the current progress of research on exosomes in BC, while focusing on potential clinical applications of the diagnosis, treatment, and prognosis of BC.

Unmet Needs and Services of Rehabilitation for Adults with Disabilities / 中国康复理论与实践

Objective:To explore the status of disability, characteristics of unmet needs and services of rehabilitation and their related factors for adults with disabilities (AWDs). Methods:A total of 2 315 498 AWDs were sampled from the provincial level administration data (2019). Multiple response analysis was used to analysis the disability status of AWDs, characteristics of unmet needs and received services of rehabilitation, and related factors were explored with Logistic regression. Results:The distribution of disabilities for AWDs from high to low were physical disabilities (62.2%), visual disabilities (9.9%), intellectual disabilities (8.4%), mental disorders (7.3%), hearing disabilities (6.9%), multiple disabilities (2.8%) and speech disabilities (2.5%). The reporting rate of unmet needs of rehabilitation for AWDs from high to low were assistive devices (49.0%), medicine (33.3%), nursing care (27.7%), functional training (20.2%) and surgery (1.9%). The reporting rate of received service for AWDs from high to low were assistive devices (44.1%), nursing care (26.6%), medicine (25.9%), functional training (22.2%) and surgery (1.3%). The logistic regression model shown that types and severities of disabilities had significant effects on unmet needs and received services of rehabilitation for AWDs (P < 0.001). Conclusion:The reporting of unmet needs for AWDs had been influenced by their functioning and disability. There were gaps between unmet needs and received services. It proposed to develop precise and individualized reporting of unmet needs and service programs for AWDs.

Unmet Needs and Services of Rehabilitation for People with Physical Disabilities Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To explore the characteristics of unmet needs and services of rehabilitation for people with physical disabilities (PWPs). Methods:A total of 1 512 438 PWPs administration data of unmet needs and services of rehabilitation at provincial level were sampled and analyzed the characteristics of needs and services of rehabilitation, and the related factors of needs and services. Results:The reported unmet needs of PWPs from high to low were assistive devices assistive devices (55.9%), nursing care (27.0%), medicine (26.3%), functional training (23.9%) and surgery (2.3%). Received service of rehabilitation. The services of rehabilitation for PWPs arranged as assistive devices (48.2%), nursing caring (26.4%), functional training (24.3%), medicine (19.5%) and surgery (1.4%). The logistic regression model showed that age and severity of disabilities had significant effect on the reported unmet needs of rehabilitation and received services for PWPs (P < 0.001). Conclusion:PWPs reported unmet needs mainly in the fields of assistive devices, nursing care, medicine and rehabilitation training. They received primary services included assistive devices, nursing care and rehabilitation training and therapies. The services development will emphasize the accessibility and coverage. According to ICF model, it proposed to take measures to implement individualized and precise rehabilitation services to improve the quality of services.

Unmet Needs and Services of Rehabilitation for People with Visual Disability Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To analyze the characteristics of needs and development of rehabilitation services for people with visual disability (PVD). Methods:A total of 241 865 PVDs administration data of unmet needs and services of rehabilitation at provincial level were sampled and analyzed the characteristics of needs and services of rehabilitation, and the related factors of needs and services. Results:There were 50 882 (21.0%) PVDs reported their needs of rehabilitation, from high to low were assistive devices (56.5%), medicine (29.0%), nursing care (24.6%), functional training (15.5%), and surgery (4.2%). There were 43 492 (18.0%) PVDs reported their received services of rehabilitation, from high to low were assistive devices (55.0%), medicine (21.6 %), nursing care (20.8%), functional training (20.7%) and surgery (2.3%). The logistic regression model showed that severities of disabilities related with the reported unmet needs and received services (P < 0.001). Conclusion:PVDs reported unmet needs mainly in the fields of assistive devices, medicine, and nursing care. There is match structure of unmet needs and received services. It is important to provide accessible information environment. Information and communication technology (ICT) are proposed to assistive technology services for PVDs to enhance their capacity of information acquisition and to promote their participations.

Unmet Needs and Services Development of Rehabilitation for People with Hearing Disability Using Logistic Regression Analysis / 中国康复理论与实践

Objective:To explore the characteristics of unmet needs and services of rehabilitation for people with hearing disability (PHD). Methods:A total of 219 473 PHDs administration data of unmet needs and services of rehabilitation at provincial level were sampled (2019) and analyzed the characteristics of needs and services of rehabilitation with multiple response analysis, and the related factors of needs and services with Logistic regression. Results:There were 47 657 (21.7%) PHDs reported their unmet needs of rehabilitation, from high to low were assistive devices (65.5%), medicine (22.7%), nursing care (19.1%), functional training (16.2%) and surgery (2.2%). There were 34 684 (18.8%) PHDs reported their received services, from high to low were assistive devices (59.8%), medicine (22.5%), functional training (19.7%), nursing care (19.4%) and surgery (1.8%). The logistic regression model showed that age, types of household registration and severities of disabilities related with the reported unmet needs and received services (P < 0.001). Conclusion:PHDs mainly reported unmet needs in the fields of assistive devices, medicine, and rehabilitation training. The reported unmet needs for PHDs had matched the received services structurally. It proposed to use modern science and technology to develop services delivery and to improve accessibility and quality of rehabilitation services.

Hematological and genotypic features of 100 patients with hemoglobin E disorders from Yunnan Province / 中华医学遗传学杂志

Objective@#To explore hematological and genotypic characteristics of patients with hemoglobin E (Hb E) disorders from Yunnan Province.@*Methods@#One hundred individuals with Hb E disorders indicated by high performance liquid chromatography (HPLC) were subjected to genetic testing through multiple gap-PCR and reverse dot-blotting analysis.@*Results@#All patients were found to harbor a mutation to the 26th codon of the β-globin chain (HBB: c. 79G>A). Ninety patients were heterozygotes, and 10 co-inherited c. 79G>A and an α-thalassemia mutation (7 αα/-α3.7, 2 αα/--SEA and 1 -α3.7/-α3.7). Hematological characteristics of the heterozygotes were: Hb A2 (26.02±3.64)%, Hb F(1.35±1.25)%, MCV(78.83±4.68) fl, MCH(26±1.54) pg, MCHC (329.65±10.73) g/L, HGB (141.08±16.53) g/L, while that of the co-inherited cases was decided by the type of α-thalassemia mutation.@*Conclusion@#Hb E can be effectively detected by HPLC. The type of α-thalassemia mutations will determine hematological features of co-inherited cases. Hb E disorders may be missed by relying only on routine blood test upon prenatal screening.

Epidemic status of malaria and progress of malaria elimination in Henan Province, 2018 / 中国血吸虫病防治杂志

Objective To understand the epidemic status of malaria and progress of malaria elimination in Henan Province in 2018, so as to provide the scientific evidence for formulating the control strategy of malaria. Methods All data pertaining to the epidemic status of malaria and malaria case were captured from Henan Province in 2018, and the epidemic status of malaria and the diagnosis and treatment of malaria cases were analyzed using a descriptive epidemiological method. Results A total of 174 malaria cases were reported in Henan Province in 2018, with a male-to-female ratio of 33.8∶1. The cases were predominantly found at 30- and 40- years, and farmer was the highest-risk population. All cases were imported for overseas countries and 96.55% (168/174) were from Africa. The cases were reported across 17 cities of the province, and 63.22% (110 cases) were detected in 4 cities of Zhengzhou, Luoyang, Xuchang and Puyang. Both the median duration from onset to initial admission and the median time from the initial admission to definitive diagnosis were 1 d. There were 6 cases (3.45%) with more than 7 days to visit a doctor, and there were 13 cases (7.47%) with definitive diagnosis of over 7 days (delay in definitive diagnosis). All malaria cases were reported within 24 h, and 98.28% (171/174) completed case investigations within 3 d. All 18 cities had achieved malaria elimination by December 2018. Conclusions All malaria cases reported in Henan Province in 2018 are imported from overseas countries. Intensifying malaria surveillance among returnees from Africa and Southeast Asia and timely identification and treatment of imported malaria cases are required to prevent the development of secondary malaria cases, so as to ensure the achievement of malaria elimination in Henan Province on schedule.

Study on Chaihu Shugan Powder in the Adjunctive Treatment of Major Depressive Disorder Based on Network Pharmacology / 中国药房

OBJECTIVE：To explore the mo lecular mechanism of Chaihu shugan powder in the adjunctive treatment of major depressive disorder （MDD）. METHODS ：Network pharmacology was adopted. The microarray dataset GSE 76826 was downloaded from GEO common database ，and the limma package was used to screen the differently expressed genes in the samples of MDD patients. The active ingredients and corresponding targets of Chaihu shugan powder were screened out based on TCMSP platform. Through the online software venny 2.1.0，the differently expressed genes of MDD and the targets of Chaihu shugan powder were screened，and the common target genes of Chaihu shugan powder for MDD were obtained. The target genes were introduced into Cytoscape 3.6.1 software to construct the network diagram of “Chaihu shugan powder active ingredients-MDD target gene ”. Then ， BisoGenet plug-in was used to construct the PPI network ，analyze the topological structure and screen the core target gene. KEGG pathway analysis was conducted. RESULTS ：There were 139 active components of Chaihu shugan powder for the treatment of MDD，including quercetin ，kaempferol，luteolin，stigmasterol，etc. There were 8 core target genes ，including NR3C2，DPP4， ALOX5，GSTM1，CCND1，IGFBP3 and so on. They play an important role in the treatment of MDD via signaling pathway such as regulating cell receptor ，purine metabolism ，steroid biosynthesis ，aminoacyl biosynthesis ，etc. CONCLUSIONS ：Chaihu shugan powder can play a role in the adjunctive treatment of MDD through multiple targets and pathways ，which can provide a theoretical basis for the follow-up study of its mechanism.