Effect of dissolved oxygen and ammonia nitrogen on Culter alburnus: Physiology, biochemistry, and molecular analyses.

Culter alburnus (topmouth culter)is an economically valuable freshwater fish. However, its insufficient tolerance to dissolved oxygen (DO) and ammonia nitrogen (AN) hinders its industrialisation. 360 experimental fish (4.87 ± 1.10 g) were placed in breathing chambers (oxygen level was 0.70-6.50 mg/L) or water tanks (control AN, 0 mg/L; low AN, 8 mg/L; high AN, 16 mg/L). This study analysed the effects of DO and AN on C. alburnus at physiological, biochemical, and molecular levels. (1) Physiology level: the floating point, coma critical point, and coma point at 20 °C group were significantly higher than those at 30 °C. The oxygen consumption rate of C. alburnus at 20 °C, 25 °C, and 30 °C was (256.65 ± 25.87), (470.47 ± 83.84), and (520.87 ± 55.40) mg/kg.h. The LC50 of AN after 96 h was 24.13 mg/L, and the safe concentration was 2.41 mg/L. The survival rate in the high AN group was significantly lower than that in the other two groups. (2) Biochemistry level: The change curves of antioxidant enzyme activity in the liver tissue under hypoxic stress reached a maximum at 12 h and then decreased. In addition, the increase and decrease in enzyme activity (except malondialdehyde) in the high AN group was lower than that in the low AN group. (3) Molecular level: the angiotensin-converting enzyme and carboxypeptidase genes were the major differentially expressed genes (DEGs) in hypoxic stress, and the DEGs were mainly enriched in the ABC transporter signal transduction pathway. In addition, the serum/glucocorticoid-regulated kinase, stearoyl-CoA desaturase, and 3-hydroxy-3-methylglutaryl-coenzyme A reductase genes were among the major DEGs under high AN stress. The DEGs were mainly enriched in steroid biosynthesis or glycine, serine, and threonine metabolism transporter signal transduction pathways. In summary, it is necessary to focus on the DO and AN during C. alburnus breeding.

An unprecedented pair of Z/E isomeric pyridinium compound from the aqueous extract of Aspongopus chinensis Dallas / 药学学报

A novel pair of Z/E isomeric compounds with unprecedented carbon skeleton were isolated from an aqueous extract of Aspongopus chinensis Dallas by macroporous resin, silica gel, and semi-preparative high performance liquid chromatography (HPLC). Their structures were identified by nuclear magnetic resonance (NMR), Infrared spectroscopy (IR), Mass spectroscopy (MS) and other spectroscopic methods as (Z)-3-(but-1″-en-1″-yl)-1-(2ʹ-hydroxyethyl)-4-propylpyridin-1-ium, namely aspongopyridine A, and (E)-3-(but-1″-en-1″-yl)-1-(2ʹ-hydroxyethyl)-4-propylpyridin-1-ium, namely aspongopyridine B, respectively. Besides, the anti-inflammatory, anti-tumor, acetylcholinesterase inhibition and butyrylcholinesterase inhibition activities of the compounds 1 and 2 were evaluated. The results showed that compounds 1 and 2 have no anti-inflammatory, anti-tumor, and butyrylcholinesterase inhibition activities instead of weak acetylcholinesterase inhibition activity.

A Bilayer High-Temperature Dielectric Film with Superior Breakdown Strength and Energy Storage Density.

The further electrification of various fields in production and daily life makes it a topic worthy of exploration to improve the performance of capacitors for a long time, including thin-film capacitors. The discharge energy density of thin-film capacitors that serves as one of the important types directly depends on electric field strength and the dielectric constant of the insulation material. However, it has long been a great challenge to improve the breakdown strength and dielectric constant simultaneously. Considering that boron nitride nanosheets (BNNS) possess superior insulation and thermal conductivity owing to wide band gap and 2-dimensional structure, a bilayer polymer film is prepared via coating BNNS by solution casting on surface of polyethylene terephthalate (PET) films. By revealing the bandgap and insulating behavior with UV absorption spectrum, leakage current, and finite element calculation, it is manifested that nanocoating contributes to enhance the bandgap of polymer films, thereby suppressing the charge injection by redirecting their transport from electrodes. Worthy to note that an ultrahigh breakdown field strength (~ 736 MV m-1), an excellent discharge energy density (~ 8.77 J cm-3) and a prominent charge-discharge efficiency (~ 96.51%) are achieved concurrently, which is ascribed to the contribution of BNNS ultrathin layer. In addition, the modified PET films also have superior comprehensive performance at high temperatures (~ 120 °C). The materials and methods here selected are easily accessible and facile, which are suitable for large-scale roll-to-roll process production, and are of certain significance to explore the methods about film modification suitable for commercial promotion.

Culture of cerebrospinal fluid-contacting neurons from neonatal mouse spinal cord.

Cerebrospinal fluid-contacting neurons (CSF-cNs) act crucial role in chemosensory and mechanosensory function in spinal cord. Recently, CSF-cNs were found to be an immature neuron and may be involved in spinal cord injury recovery. But how to culture it and explore its function in vitro are not reported in previous research. Here, we first reported culture and identification of CSF-cNs in vitro. We first established a protocol for in vitro culture of CSF-cNs from the cervical spinal cord of mice within 24 h after birth. Polycystic kidney disease 2-like 1 (PKD2L1)+ cells were isolated by fluorescence-activated cell sorting and expressed the neuron marker ß-tubulin III and CSF-cNs marker GABA. Intriguingly, PKD2L1+ cells formed neurosphere and expressed neural stem cell markers Nestin, Sox2 and GFAP. Thus, our research provided culture and isolation of CSF-cNs and this facilitate the investigation the CSF-cNs function in vitro.

Clinical prospective study of Gallium 68 (68Ga)-labeled fibroblast-activation protein inhibitor PET/CT in the diagnosis of biliary tract carcinoma.

PURPOSE: This study is to investigate the [68Ga]Ga-DOTA-FAPI PET/CT diagnosis performance in biliary tract carcinoma (BTC) and analyze the association between [68Ga]Ga-DOTA-FAPI PET/CT and clinical indexes. METHODS: A prospective study (NCT05264688) was performed between January 2022 and July 2022. Fifty participants were scanned using [68Ga]Ga-DOTA-FAPI and [18F]FDG PET/CT and acquired pathological tissue. We employed the Wilcoxon signed-rank test to compare the uptake of [68Ga]Ga-DOTA-FAPI and [18F]FDG, and the McNemar test was used to compare the diagnostic efficacy between the two tracers. Spearman or Pearson correlation was used to assess the association between [68 Ga]Ga-DOTA-FAPI PET/CT and clinical indexes. RESULTS: In total, 47 participants (mean age 59.09 ± 10.98 [range 33-80 years]) were evaluated. The [68Ga]Ga-DOTA-FAPI detection rate was greater than [18F]FDG in primary tumors (97.62% vs. 85.71%), nodal metastases (90.05% vs. 87.06%), and distant metastases (100% vs. 83.67%). The uptake of [68Ga]Ga-DOTA-FAPI was higher than [18F]FDG in primary lesions (intrahepatic cholangiocarcinoma, 18.95 ± 7.47 vs. 11.86 ± 0.70, p = 0.001; extrahepatic cholangiocarcinoma, 14.57 ± 6.16 vs. 8.80 ± 4.74, p = 0.004), abdomen and pelvic cavity nodal metastases (6.91 ± 6.56 vs. 3.94 ± 2.83, p < 0.001), and distant metastases (pleural, peritoneum, omentum, and mesentery, 6.37 ± 4.21 vs. 4.50 ± 1.96, p = 0.01; bone, 12.15 ± 6.43 vs. 7.51 ± 4.54, p = 0.008). There was a significant correlation between [68Ga]Ga-DOTA-FAPI uptake and fibroblast-activation protein (FAP) expression (Spearman r = 0.432, p = 0.009), carcinoembryonic antigen (CEA) (Pearson r = 0.364, p = 0.012), and platelet (PLT) (Pearson r = 0.35, p = 0.016). Meanwhile, a significant relationship between [68Ga]Ga-DOTA-FAPI metabolic tumor volume and carbohydrate antigen199 (CA199) (Pearson r = 0.436, p = 0.002) was confirmed. CONCLUSION: [68Ga]Ga-DOTA-FAPI had a higher uptake and sensitivity than [18F]FDG in the diagnosis of BTC primary and metastatic lesions. The correlation between [68Ga]Ga-DOTA-FAPI PET/CT indexes and FAP expression, CEA, PLT, and CA199 were confirmed. TRIAL REGISTRATION: clinicaltrials.gov: NCT 05,264,688.

Z-scheme WOx/Cu-g-C3N4 heterojunction nanoarchitectonics with promoted charge separation and transfer towards efficient full solar-spectrum photocatalysis.

Construction of Z-scheme heterojunctions has been considered one superb method in promoting solar-assisted charge carrier separation of carbon-based materials to achieve efficient utilization of solar energy in hydrogen production and CO2 reduction. One interesting concept in nanofabrication that has become trend recent years is nanoarchitectonics. A heterostructure photocatalyst constructed based on the idea of nanoarchitectonics using the combination of g-C3N4, metal and an additional semiconducting nanocomposite is investigated in this paper. Z-scheme tungsten oxide incorporated copper modified graphitic carbon nitride (WOx/Cu-g-C3N4) heterostructures are fabricated via immobilization of WOx on Cu nanoparticles modified superior thin g-C3N4 nanosheets. Mechano-chemical pre-reaction and a two-step high-temperature thermal polymerization process are the keys in attaining homogeneous distribution of Cu nanoparticles in g-C3N4 nanosheets. The horizontal growth of homogeneously distributed WOx nanobelts on Cu modified g-C3N4 (Cu-g-C3N4) base via solvothermal synthesis is achieved. The photocatalytic performances of the heterostructures are evaluated through water splitting and CO2 photoreduction measurements in full solar spectrum irradiation condition. The presence of Cu nanoparticles in the composite system improves charge transport between g-C3N4 and WOx and thus enhances the photocatalytic performances (H2 generation and CO2 photoreduction) of the composite material, while the presence of WOx nanocomposites enhances light absorption of the composite material in the near infrared range. The synthesized heterostructure with optimized WOx to Cu-g-C3N4 ratio and in case of no co-catalyst addition exhibits enhanced photocatalytic H2 evolution (4560 µmolg-1h-1) as well as excellent CO2 reduction rate (5.89 µmolg-1h-1 for CO generation).

Association between pressure ulcers and the risk of postoperative infections in male adults with spinal cord injury.

OBJECTIVE: Data about postoperative infections in male adults with spinal cord injury are scarce. We aimed to evaluate the association between prior exposure to pressure ulcers (PU) and the risk of postoperative infections in male adults with spinal cord injury (SCI). METHODS: We conducted a prospective study of male adults receiving surgery of SCI from January 2007 to December 2019. Postoperative infection included septicemia, pneumonia, surgical incision infection and urinary tract infection. A logistic regression analysis was applied. Risk ratios (RRs) and their corresponding 95% confidence intervals (CIs) were calculated. RESULTS: There were 408 patients with SCI in this study, which comprised 204 patients with prior PU and 204 patients without. The rate of postoperative infections within 14 days in patients with PU was 23.5%, which was higher than that of patients without PU (6.9%). The amounts to a 4.18-folds elevated risk of any postoperative infections with 14 days in patients with PU (RR: 4.18, 95% CI: 2.30-7.60, p-value: <0.001). With respect to specific infections, positive associations in pneumonia (RR: 4.18, 95% CI: 2.30-7.60, p-value: <0.001), surgical incision infection (RR: 4.18, 95% CI: 2.30-7.60, p-value: <0.001), and urinary tract infection (RR: 4.18, 95% CI: 2.30-7.60, p-value: <0.001) were also statistically significant. These results did not materially alter adjustment for potential risk factors. CONCLUSIONS: The study suggests an elevated risk of postoperative infections after surgery for SCI in male patients with prior exposure to pressure ulcers.

Humulus lupulus L. extract and its active constituent xanthohumol attenuate oxidative stress and nerve injury induced by iron overload via activating AKT/GSK3ß and Nrf2/NQO1 pathways.

Hops, the dried female clusters from Humulus lupulus L., have traditionally been used as folk medicines for treating insomnia, neuralgia, and menopausal disorders. However, its pharmacological action on iron overload induced nerve damage has not been investigated. This study aims to evaluate the protective effects of hops extract (HLE) and its active constituent xanthohumol (XAN) on nerve injury induced by iron overload in vivo and in vitro, and to explore its underlying mechanism. The results showed that HLE and XAN significantly improved the memory impairment of iron overload mice, mainly manifested as shortened latency time, increased crossing platform times and spontaneous alternation ratio, and increased the expression of related proteins. Additionally, HLE and XAN significantly increased superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) activities, and remarkably decreased malondialdehyde (MDA) level in hippocampus. Also, HLE and XAN apparently reduced reactive oxygen species (ROS) content of PC12 cells induced by iron dextran (ID), and improved the oxidative stress level. Moreover, HLE and XAN significantly upregulated the expression of nuclear factor E2-related factor (Nrf2), NAD(P)H quinone oxidoreductase (NQO1), heme oxygenase-1 (HO-1), SOD, phosphorylated AKT (p-AKT), and phosphorylated GSK3ß (p-GSK3ß) both in hippocampus and PC12 cells. These findings demonstrated the protective effect of HLE and XAN against iron-induced memory impairment, which is attributed to its antioxidant profile by activation of AKT/GSK3ß and Nrf2/NQO1 pathways. Also, it was suggested that hops could be a potential candidate for iron overload-related neurological diseases treatment.

Acupuncture for chronic prostatitis/chronic pelvic pain syndrome: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the short-term efficacy, long-term efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).@*METHODS@#Forty-two patients with CP/CPPS were randomly divided into an acupuncture group (21 cases, 1 case dropped off) and a sham acupuncture group (21 cases). The patients in the acupuncture group were treated with acupuncture at bilateral Zhongliao (BL 33), Huiyang (BL 35), Shenshu (BL 23) and Sanyinjiao (SP 6); the needling depth of Zhongliao (BL 33) and Huiyang (BL 35) was 60 to 80 mm, while Shenshu (BL 23) and Sanyinjiao (SP 6) was directly punctured of 30 mm. The patients in the sham acupuncture group were treated with acupuncture at non-acupoints, including points 2 cm next to Shenshu (BL 23), Zhongliao (BL 33) and Huiyang (BL 35), and the midpoint of the connecting line between the spleen meridian and the kidney meridian. All the non-acupoints were treated with directly puncture of 2 to 3 mm. The needles were left for 30 min in both groups, once every other day in the first four weeks, three times a week, and twice a week in the next four weeks, totally 20 treatments. Before treatment, after treatment and in follow-up of 24 weeks after treatment completion, the National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) score and urinary flow rate were observed in both groups; the clinical efficacy and safety were evaluated.@*RESULTS@#Compared with those before treatment, the pain and discomfort scores, urination symptoms scores, quality of life scores and total scores of NIH-CPSI in both groups were reduced after treatment in the two groups (P<0.01), while each item score and total score of NIH-CPSI in the acupuncture group were reduced in follow-up (P<0.01, P<0.05). After treatment and in follow-up, each item score and total score of NIH-CPSI in the acupuncture group were lower than those in the sham acupuncture group (P<0.05, P<0.01). After treatment, the maximum and average urinary flow rates in the acupuncture group were higher than those before treatment (P<0.05), and the average urinary flow rate in the acupuncture group was higher than that in the sham acupuncture group (P<0.05). The total effective rate was 75.0% (15/20) in the acupuncture group, which was higher than 42.9% (9/21) in the sham acupuncture group (P<0.05). No significant adverse reactions were observed in the two groups, and there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).@*CONCLUSION@#Acupuncture could effectively alleviate the clinical symptoms, improve quality of life, and has a sustained, safe and reliable therapeutic effect in patients with CP/CPPS.

Visual analysis of social isolation studies on adolescents based on Web of Science / 上海预防医学

ObjectiveTo perform visual analysis of the literature in the field of adolescent social isolation in order to provide reference for research on social isolation of Chinese teenagers. MethodsLiterature related to adolescent social isolation was retrieved from the Web of Science core collection database from September 2013 to September 2022. CiteSpace 6.1.R3 software was used to conduct bibliometric analysis on publication volume， publication organization， keyword clustering， keyword salience， and time⁃line map of hot words. ResultsA total of 1 347 related articles were screened out， and the overall number of publications from 2013 showed an upward trend. The largest number of articles came from the United States with 521 （38.68%）， and China ranked 6th with 79 （5.86%）. The top three institutions were Columbia University in the United States （29 articles）， King's College London in the United Kingdom （28 articles） and the University of London in the United Kingdom （27 articles）. Research hotspots mainly focused on social isolation， physical and mental health， loneliness， quality of life and comprehensive interventions. ConclusionIn recent years， the problem of adolescent social isolation has attracted continuous attention from foreign scholars. Based on our national conditions， we should conduct relevant screening and preventive assessment for social isolation of special youth groups， so as to conduct early management and intervention.

Risk factors analysis of protein energy wasting in children with chronic kidney disease / 中华儿科杂志

Objective: To analyze the clinical characteristics and risk factors of protein energy wasting (PEW) in children with chronic kidney disease (CKD). Methods: Clinical data of 231 children with chronic kidney disease hospitalized in Beijing Children's Hospital affiliated to Capital Medical University from January 2018 to January 2023 were retrospectively analyzed to explore the incidence of PEW. According to the diagnostic criteria of CKDPEW, they were divided into a CKDPEW group and a non PEW group. The comparison between the groups was performed by independent-sample t test and Chi-squared test, and the risk factors were analyzed by multivariate Logistic regression. Results: Among the 231 children, there were 138 males and 93 females, with a visiting age of 9.9 (7.9, 16.0) years; 6 cases were in stage 1, 14 cases in stage 2, 51 cases in stage 3, 36 cases in stage 4, and 124 cases in stage 5. A total of 30 children (13.0%) with CKD PEW were diagnosed at the age of 7. 1 (3.8, 13.2) years, including 1 case in stage 1, 1 case in stage 2, 5 cases in stage 3, 5 cases in stage 4, and 18 cases in stage 5. There were a total of 201 cases (87.0%) in the non PEW group, diagnosed at the age of 11.8 (8.5, 12.2) years, including 5 cases in stage 1, 13 cases in stage 2, 46 cases in stage 3, 31 cases in stage 4, and 106 cases in stage 5. The Chi-squared test and t test showed that the systolic blood pressure, diastolic blood pressure, birth weight and carbon dioxide binding capacity of the CKD PEW group were lower than those of the non PEW group ((109±22) vs. (120±20) mmHg (1 mmHg=0.133 kPa), (72±19) vs. (79±16) mmHg, (2.9±0.5) vs. (3.2±0.6) kg, (17±4) vs. (19±4) mmol/L,t=2.85, 2.14, 0.67, 2.63, all P<0.05). Multivariate logistic regression analysis showed that carbon dioxide binding capacity and birth weight were independent protective factors of CKDPEW in children (OR=0.81 and 0.36, 95%CI=0.73-0.90 and 0.17-0.77, respectively; both P<0.01); the risk of PEW in CKD children decreased by 0.187 times for every 1 mmol/L increment in carbon dioxide binding capacity, and 0.638 times for every 1 kg increment in birth weight. Conclusions: The incidence of protein energy expenditure in children with chronic kidney disease is lower than that in the previous researches. PEW can appear in CKD 1-2 stage, and attention should be paid to it in the early stage of CKD in clinical practice. Low birth weight CKD children are susceptible to PEW, and actively correcting metabolic acidosis can reduce the risk of CKDPEW.

Pediatric Classic Prescription Xiaoruwan Based on Ancient Literature / 中国实验方剂学杂志

Xiaoruwan is one of the classic prescriptions included in the Catalogue of Ancient Classic Prescriptions （the Second Batch of Pediatrics） published by the National Administration of Traditional Chinese Medicine（TCM） in 2022 with definite clinical efficacy， but it has not been converted into Chinese patent medicine preparations. The authors collected 173 pieces of data based on ancient literature on Xiaoruwan by the method of bibliometrics and selected 99 pieces of effective data， involving 46 ancient books of TCM. The study analyzed the historical development origin， prescription names， formulation rules， dosage， drug origin， preparation method and usage， indications and functions， and other aspects of Xiaoruwan. The results showed that Xiaoruwan was presumably derived from Ying Hai Miao Jue Lun（《婴孩妙诀论》） written by TANG Minwang， a doctor in the Song Dynasty. In the records of ancient medical books， there are names such as Xiaoshiwan，Yangshi Xiaoruwan， and Kuaige Xiaoshiwan， but they are mainly recorded in the name of Xiaoruwan. The prescription was composed of Cyperi Rhizoma， Amomi Fructus， Citri Reticulatae Pericarpium， Massa Medicata Fermentata， Hordei Fructus Germinatus， and Glycyrrhizae Radix et Rhizoma. In terms of processing method， Cyperi Rhizoma， Massa Medicata Fermentata， and Hordei Fructus Germinatus are fried， Glycyrrhizae Radix et Rhizoma is processed， and raw materials of Amomi Fructus and Citri Reticulatae Pericarpium are used directly. In terms of function， it is effective in warming the middle， improving digestion， stopping vomiting， and digesting milk and food. The main indications include vomiting， diarrhea， night crying， and other diseases caused by milk and food stagnation. The dosage of the most used prescription in the records of ancient books is Cyperi Rhizoma 41.30 g， Amomi Fructus 20.65 g， Citri Reticulatae Pericarpium 20.65 g， Massa Medicata Fermentata 20.65 g， Hordei Fructus Germinatus 20.65 g， and Glycyrrhizae Radix et Rhizoma 20.65 g， which are prepared into pills. In the taking method， it is recommended to take it with warm boiled water or ginger soup after meals. The study summarized the historical evolution of Xiaoruwan and identified the key information， with a view to providing a reference for the modern development and research of Xiaoruwan.

Modification Effect of Nano-Clay on Mechanical Behavior of Composite Geomaterials: Cement, Nano-Silica and Coastal Soft Soil.

To study the modification effect of nano-clay and nano-SiO2 on cement-reinforced coastal soft soil, the effects of the nano-SiO2 and nano-clay on the mechanical properties of cement soil were studied through unconfined compressive and unconsolidated undrained shear tests, and the Duncan-Chang model was used to fit the test results. Results show that adding nano-clay and nano-SiO2 to cement soil improved its compressive and shear strength. The compressive strength and shear strength increased by 18-57% and 3-32%, respectively, with the increase in nano-clay content in a content range of 0-10%. Additionally, nano-clay can enhance the ductility of cement soil. Moreover, nano-clay and nano-SiO2 improve the shear strength by increasing the internal friction angle by 1°-2° and cohesion of 9-25%, and the cement-stabilized coastal soft soil enhanced by nano-SiO2 and nano-clay conforms to the Duncan-Chang model well.

The neural stem cell properties of Pkd2l1+ cerebrospinal fluid-contacting neurons in vivo.

The neural stem cells (NSCs) in the ventricular-subventricular zone of the adult mammalian spinal cord may be of great benefit for repairing spinal cord injuries. However, the sources of NSCs remain unclear. Previously, we have confirmed that cerebrospinal fluid-contacting neurons (CSF-cNs) have NSC potential in vitro. In this study, we verified the NSC properties of CSF-cNs in vivo. In mouse spinal cords, Pkd2l1+ CSF-cNs localized around the central canal express NSC markers. In vitro, Pkd2l1+ CSF-cNs form a neurosphere and express NSC markers. Activation and proliferation of CSF-cNs can be induced by injection of the neurotrophic factors basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) into the lateral ventricle. Spinal cord injury (SCI) also induces NSC activation and proliferation of CSF-cNs. Collectively, our results demonstrate that Pkd2l1+ CSF-cNs have NSC properties in vivo and may be involved in SCI recovery.

The feasibility study on the generalization of deep learning dose prediction model for volumetric modulated arc therapy of cervical cancer.

PURPOSE: To develop a 3D-Unet dose prediction model to predict the three-dimensional dose distribution of volumetric modulated arc therapy (VMAT) for cervical cancer and test the dose prediction performance of the model in endometrial cancer to explore the feasibility of model generalization. METHODS: One hundred and seventeen cases of cervical cancer and 20 cases of endometrial cancer treated with VMAT were used for the model training, validation, and test. The prescribed dose was 50.4 Gy in 28 fractions. Eight independent channels of contoured structures were input to the model, and the dose distribution was used as the output of the model. The 3D-Unet prediction model was trained and validated on the training set (n = 86) and validation set (n = 11), respectively. Then the model was tested on the test set (n = 20) of cervical cancer and endometrial cancer, respectively. The results between clinical dose distribution and predicted dose distribution were compared in the following aspects: (a) the mean absolute error (MAE) within the body, (b) the Dice similarity coefficients (DSCs) under different isodose volumes, (c) the dosimetric indexes including the mean dose (Dmean ), the received dose of 2 cm3 (D2cc) , the percentage volume of receiving 40 Gy dose of organs-at-risk (V40 ), planning target volume (PTV) D98% , and homogeneity index (HI), (d) dose-volume histograms (DVHs). RESULTS: The model can accurately predict the dose distribution of the VMAT plan for cervical cancer and endometrial cancer. The overall average MAE and maximum MAE for cervical cancer were 2.43 ± 3.17% and 3.16 ± 4.01% of the prescribed dose, respectively, and for endometrial cancer were 2.70 ± 3.54% and 3.85 ± 3.11%. The average DSCs under different isodose volumes is above 0.9. The predicted dosimetric indexes and DVHs are equivalent to the clinical dose for both cervical cancer and endometrial cancer, and there is no statistically significant difference. CONCLUSION: A 3D-Unet dose prediction model was developed for VMAT of cervical cancer, which can predict the dose distribution accurately for cervical cancer. The model can also be generalized for endometrial cancer with good performance.

Current status of unplanned readmission of neonates within 31 days after discharge from the neonatal intensive care unit and risk factors for readmission / 中国当代儿科杂志

OBJECTIVES@#To investigate the current status of unplanned readmission of neonates within 31 days after discharge from the neonatal intensive care unit (NICU) and risk factors for readmission.@*METHODS@#A retrospective analysis was performed on the medical data of 1 561 infants discharged from the NICU, among whom 52 infants who were readmitted within 31 days were enrolled as the case group, and 104 infants who were not readmitted after discharge during the same period of time were enrolled as the control group. Univariate analysis and multivariate logistic regression analysis were performed to identify the risk factors for readmission.@*RESULTS@#Among the 1 561 infants, a total of 63 readmissions occurred in 52 infants, with a readmission rate of 3.33%. hyperbilirubinemia and pneumonia were the main causes for readmission, accounting for 29% (18/63) and 24% (15/63) respectively. The multivariate logistic regression analysis showed that that gestational age <28 weeks, birth weight <1 500 g, multiple pregnancy, mechanical ventilation, and length of hospital stay <7 days were risk factors for readmission (OR=5.645, 5.750, 3.044, 3.331, and 1.718 respectively, P<0.05).@*CONCLUSIONS@#Neonates have a relatively high risk of readmission after discharge from the NICU. The medical staff should pay attention to risk factors for readmission and formulate targeted intervention measures, so as to reduce readmission and improve the quality of medical service.

Reconstruction of teaching mode of Human Parasitology among rural order-oriented medical students in the context of curriculum ideology and politics / 中国血吸虫病防治杂志

To set the cultivation goal with adaptation to rural order-oriented medical students, the teaching mode of Human Parasitology was reformed in the context of curriculum ideological and political education. The new teaching mode not only enables students to harvest medical knowledge during the school education stage, but also plays a guiding role in cultivation of humanistic qualities and professional spirit, which provides a basis for cultivating general practitioners serving for grassroots healthcare.

Study on ergonomic intervention to relieve work-related musculoskeletal disorders among assembly workers in a railway vehicle manufacturing enterprise / 环境与职业医学

Background Work-related musculoskeletal diseases (WMSDs) occur in a variety of occupational populations. Because of their various discomfort and serious disease burden, they have become an important issue worthy of attention in the field of occupational health. The prevention and control of WMSDs is one of the public health problems to be solved. Objective To evaluate the intervention effect on WMSDs among assembly workers in a railway vehicle manufacturing enterprise, so as to provide scientific basis for the prevention and control of WMSDs. Methods A total of 250 assembly workers in a railway vehicle manufacturing enterprise were selected using convenience sampling from August to December 2017. The Chinese Musculoskeletal Questionnaire was used for epidemiological investigation, and the Ergonomic Checkpoints was used for ergonomic inspection and worker interview. According to the above survey results, a six-month intervention plan including stepladder improvement and ergonomics training were implemented in the assembly workshop from September 2018 to February 2019. The intervention effects including the awareness of WMSDs, the exposure level of ergonomic load, and the occurrence of WMSDs symptoms were evaluated with relevant cross-sectional survey results before and after the intervention. The scores of WMSDs symptom intensity, symptom duration, and symptom frequency from low to high were 0-10, 1-4, and 1-5, respectively. Results After the intervention, the awareness rates of assembly workers on WMSDs types, affected body sites, influencing factors, preventive measures, and symptoms all increased from 52.3%, 51.9%, 25.5%, 19.1%, and 51.5% to 68.5%, 61.3%, 48.1%, 40.9%, and 61.3%, respectively (P<0.05). After the intervention, the proportion of assembly workers who "often" bend their head backwards frequently decreased from 34.6% to 21.8%, the proportion who "often" keep their trunk backward for a long time decreased from 26.6% to 15.0%, and the proportion who "never" raise their arms frequently increased from 3.4% to 9.0% (P<0.05). After the intervention, the scores of WMSDs symptom intensity in neck, shoulders, upper back, low back, elbows, hands/wrists, hips/thighs, knees, and ankles/feet all decreased, and the medians were mostly decreased from 6 to 3 (P<0.05); the scores of WMSDs symptom duration only decreased in neck (P<0.05) and there was no significant difference in the other body sites before and after the intervention; the median scores of WMSDs symptom frequency in low back, hands/wrists, and hips/thighs decreased from 3 to 2 (P<0.05). Conclusion The six-month intervention of stepladder improvement and ergonomics training among assembly workers in a railway vehicle manufacturing enterprise can improve workers' awareness of WMSDs, and reduce the exposure frequency of awkward postures and the intensity, duration, and frequency of WMSDs symptoms.

Influencing factors for work-related musculoskeletal disorders among assembly workers in four manufacturing enterprises / 环境与职业医学

Background The prevalence rate of work-related musculoskeletal disorders (WMSDs) among manufacturing workers is relatively high and has been widely concerned. However, research on the prevalence and risk factors of multi-site WMSDs is still insufficient. Objective To explore the prevalence and risk factors of multi-site WMSDs of assembly workers in four manufacturing enterprises. Methods The "Chinese Musculoskeletal Questionnaire" was used to conduct a cross-sectional survey among 1401 assembly workers selected by convenient sampling in four manufacturing enterprises, and their demographic characteristics, the prevalence of WMSDs in various body parts, and the information about biomechanical factors, work organizations, work environment, and psychosocial factor exposure were collected. The prevalence of WMSDs and multi-site WMSDs were estimated, Pearson χ2 test was used for univariate analysis of multi-site WMSDs risk factors, and logistic regression was used for multi-factor analysis. Results The total prevalence rate of WMSDs was 54.9% (769/1 401). The top three affected sites were neck (41.4%), shoulders (30.7%), and wrist/hand (25.1%). The prevalence rate of multi-site WMSDs was 41.9% (587/1 401). The prevalence rates of multi-site WMSDs in railway vehicle assembly and riveting workers were higher than those in electronic parts processing and glass manufacturing workers (P<0.001). The results of logistic regression analysis showed that individual factors such as female (OR=2.09, 95%CI: 1.48−2.97) and drinking (OR=1.52, 95%CI: 1.05−2.18), biomechanics factors such as keeping head down for a long time (OR=1.37, 95%CI: 1.22–1.53), keeping bending frequently (OR=1.18, 95%CI: 1.03–1.34), and keeping arms up for a long time (OR=1.25, 95%CI: 1.10–1.41), work organizational factors such as electronic parts processing, railway vehicle assembly, and riveting (OR values were 3.23, 5.70, and 13.83, respectively), environmental factors such as temperature a little cold (OR=4.84, 95%CI: 1.90–12.37), noise seriously affecting work (OR=2.25, 95%CI: 1.23–4.11), and psychosocial factors such as high job demands (OR=1.47, 95%CI: 1.04–2.08), fatigue after work (OR=1.92−2.61) were risk factors of multi-site WMSDs. Conclusion The prevalence rate of multi-site WMSDs in assembly workers is high, and the main influencing factors include individual factors, awkward work postures, environmental factors, and psychosocial factors.