Tailored wastewater surveillance framework uncovered the epidemics of key pathogens in a Northwestern city of China.

Wastewater surveillance enables rapid pathogen monitoring and community prevalence estimation. However, how to design an integrated and tailored wastewater surveillance framework to monitor major health threats in metropolises remains a major challenge. In this study, we first analyzed the historical clinical data of Xi'an city and designed a wastewater surveillance framework covering five key endemic viruses, namely, SARS-CoV-2, norovirus, influenza A virus (IAV), influenza B virus (IBV), respiratory syncytial virus (RSV), and hantavirus. Amplicon sequencing of SARS-CoV-2, norovirus and hantavirus was conducted biweekly to determine the prevalent community genotypes circulating in this region. The results showed that from April 2023 to August 2023, Xi'an experienced two waves of SARS-CoV-2 infection, which peaked in the middle of May-2023 and late August-2023. The sewage concentrations of IAV and RSV peaked in early March and early May 2023, respectively, while the sewage concentrations of norovirus fluctuated throughout the study period and peaked in late August. The dynamics of the sewage concentrations of SARS-CoV-2, norovirus, IAV, RSV, and hantavirus were in line with the trends in the sentinel hospital percent positivity data, indicating the role of wastewater surveillance in enhancing the understanding of epidemic trends. Amplicon sequencing of SARS-CoV-2 revealed a transition in the predominant genotype, which changed from DY.1 and FR.1.4 to the XBB and EG.5 subvariants. Amplicon sequencing also revealed that there was only one predominant hantavirus genotype in the local population, while highly diverse genotypes of norovirus GI and GII were found in the wastewater. In conclusion, this study provided valuable insights into the dynamics of infection trends and predominant genotypes of key pathogens in a city without sufficient clinical surveillance, highlighting the role of a tailored wastewater surveillance framework in addressing public health priorities. More importantly, our study provides the first evidence demonstrating the applicability of wastewater surveillance for hantavirus, which is a major health threat locally.

Highly stable and antifungal properties on the oilseed rape of Cu3(MoO4)2(OH)2 nanoflakes prepared by simple aqueous precipitation.

In the last few decades, nanoparticles have been a prominent topic in various fields, particularly in agriculture, due to their unique physicochemical properties. Herein, molybdenum copper lindgrenite Cu3(MoO4)2(OH)2 (CM) nanoflakes (NFs) are synthesized by a one-step reaction involving α-MoO3 and CuCO3⋅Cu(OH)2⋅xH2O solution at low temperature for large scale industrial production and developed as an effective antifungal agent for the oilseed rape. This synthetic method demonstrates great potential for industrial applications. Infrared spectroscopy and X-ray diffraction (XRD) results reveal that CM samples exhibit a pure monoclinic structure. TG and DSC results show the thermal stable properties. It can undergo a phase transition form copper molybdate (Cu3Mo2O9) at about 300 °C. Then Cu3Mo2O9 nanoparticles decompose into at CuO and MoO3 at 791 °C. The morphology of CM powder is mainly composed of uniformly distributed parallelogram-shaped nanoflakes with an average thickness of about 30 nm. Moreover, the binding energy of CM NFs is measured to be 2.8 eV. To assess the antifungal properties of these materials, both laboratory and outdoor experiments are conducted. In the pour plate test, the minimum inhibitory concentration (MIC) of CM NFs against Sclerotinia sclerotiorum (S. sclerotiorum) is determined to be 100 ppm, and the zone of inhibiting S. sclerotiorum is 14 mm. When the concentration is above 100 nm, the change rate of the hyphae circle slows down a little and begins to decrease until to 200 ppm. According to the aforementioned findings, the antifungal effects of a nano CM NFs solution are assessed at different concentrations (0 ppm (clear water), 40 ppm, and 80 ppm) on the growth of oilseed rape in an outdoor setting. The results indicate that the application of CM NFs led to significant inhibition of S. sclerotiorum. Specifically, when the nano CM solution was sprayed once at the initial flowering stage at a concentration of 80 ppm, S. sclerotiorum growth was inhibited by approximately 34%. Similarly, when the solution was sprayed once at the initial flowering stage and once at the rape pod stage, using a concentration of 40 ppm, a similar level of inhibition was achieved. These outcomes show that CM NFs possess the ability to bind with more metal ions due to their larger specific surface area. Additionally, their semiconductor physical properties enable the generation of reactive oxygen species (ROS). Therefore, CM NFs hold great potential for widespread application in antifungal products.

Decoding the Cell Atlas and Inflammatory Features of Human Intracranial Aneurysm Wall by Single-Cell RNA Sequencing.

BACKGROUND: Intracranial aneurysm (IA) is common and occasionally results in life-threatening hemorrhagic strokes. However, the cell architecture and inflammation in the IA dome remain less understood. METHODS AND RESULTS: Single-cell RNA sequencing was performed on ruptured and unruptured human IA domes for delineating the cell atlas, gene expression perturbations, and inflammation features. Two external bulk mRNA sequencing-based data sets and serological results of 126 patients were collected for validation. As a result, a total of 21 332 qualified cells were captured. Vascular cells, including endothelial cells, smooth muscle cells, fibroblasts, and pericytes, were assigned in extremely sparse numbers (4.84%), and were confirmed by immunofluorescence staining. Pericytes, characterized by ABCC9 and HIGD1B, were identified in the IA dome for the first time. Abundant immune cells were identified, with the proportion of monocytes/macrophages and neutrophils being remarkably higher in ruptured IA. The lymphocyte compartment was also thoroughly categorized. By leveraging external data sets and machine learning algorithms, macrophages were robustly associated with IA rupture, irrespective of their polarization status. The single nucleotide polymorphism rs2280543, which is identified in East Asian populations, was associated with macrophage metabolic reprogramming through regulating TALDO1 expression. CONCLUSIONS: This study provides insights into the cellular architecture and inflammatory features in the IA dome and may enlighten novel therapeutics for unruptured IA.

The Prevention and Treatment of Pulmonary Nodules “Nodule-cancer Transformation” Based on the View of “Disease with Latent Pathogen Induced by a New Pathogen” / 中医杂志

As one of the pathogenic mechanisms contained in The Inner Canon of Yellow Emperor （《黄帝内经》）， “disease with latent pathogen induced by a new pathogen” means that the induced new pathogen resulted to a combination of the latent previous pathogen and the new pathogen， which caused the disease. Based on this， it is believed that the change of “nodule-cancer transformation” of pulmonary nodules is actually based on the deficiency of original qi， and the new pathogen induces the latent pathogens like phlegm coagulation， qi stagnation， blood stasis， toxicity， so healthy qi can not drive the pathogens out， and the long-time detention generated into cancerous turbidity， and deve-loped into cancerous tumour at the end. Therefore， based on the three-stage treatment of unformed cancer， dense cancerous toxin， and developed cancer， the clinical practice applied six methods of clearing， expelling， dissipating， tonifying， harmonizing， and transforming， taking into account both the manifestation and root cause， moving the treatment window of pulmonary nodules forward， attacking the pathogens when the toxin was not yet overbearing， supporting the healthy qi before declining， delaying the process of nodules-cancer transformation， and providing ideas for the prevention and treatment of pulmonary nodules “nodule-cancer transformation” in traditional Chinese medicine.

Research progress in the diagnosis and treatment of neurotrophic keratitis / 国际眼科杂志(Guoji Yanke Zazhi)

Neurotrophic keratitis(NK)is a degenerative corneal disease caused by impairment of trigeminal innervations. It can lead to spontaneous corneal epithelial defects, corneal ulceration and perforation. Early diagnosis of NK is crucial and requires accurate investigation of clinical history and thorough examination of ocular surface to determine clinical stage. Treatment for NK needs to be divided into stages according to disease severity. In addition to conventional treatments including artificial tears, blepharorrhaphy, and amniotic membrane transplantation, there are also emerging treatments such as targeted drug therapy and corneal neurotization. This article summarized the epidemiology, clinical manifestations and classification, etiology, diagnosis, differential diagnosis and treatment of NK, aiming to provide reference for the early diagnosis and treatment of NK in the future.

Treatment of Inflammatory Bowel Disease by Targeting M1/M2 Macrophage Polarization Balance with Traditional Chinese Medicine and Active Components： A Review / 中国实验方剂学杂志

Inflammatory bowel disease （IBD）， consisting of ulcerative colitis and Crohn's disease， is a chronic relapsing inflammatory gastrointestinal disease closely associated with immune dysfunction. The pathogenesis of IBD is closely related to genetic susceptibility， immune system dysfunction， environmental change， and intestinal microbial dysbiosis. Modern research has found that macrophage polarization plays an important role in the development of IBD and can affect the level of inflammatory response， intestinal mucosal repair， and intestinal microbial balance， making it a potential target for IBD treatment. Increasing evidence suggests that traditional Chinese medicine and its active components can regulate macrophage polarization through multiple pathways and balance the M1/M2 macrophage ratio， thus inhibiting inflammatory response， promoting intestinal mucosal repair， and slowing down the progression of IBD. This article summarized the biological processes and targets involved in macrophage polarization and discussed its impact on IBD. It also provided a brief overview of the latest research on how traditional Chinese medicine and its active components can improve IBD by regulating macrophage polarization， so as to provide new directions and strategies for the clinical application of traditional Chinese medicine in IBD treatment.

Predictors of mortality in patients with isolated gastrointestinal perforation.

Gastrointestinal (GI) perforation is common in the emergency department and has a high mortality rate. The present study aimed to identify risk factors for mortality in patients with GI perforation. The objective was to assess and prognosticate the surgical outcomes of patients, aiming to ascertain the efficacy of the procedure for individual patients. A retrospective cohort study of patients with GI perforation who underwent surgery in a public tertiary hospital in China from January 2012 to June 2022 was performed. Demographics, clinical characteristics, laboratory and imaging results, and outcomes were collected from electronic medical records. The primary outcome measure was in-hospital mortality, and patients were divided into survivor and non-survivor groups based on this measure. Univariate and multivariable logistic regression analyses were performed to obtain independent factors associated with mortality. A total of 529 patients with GI perforation were eligible for inclusion. The in-hospital mortality rate after emergency surgery was 10.59%. The median age of the patients was 60 years (interquartile range, 44-72 years). Multivariable logistic regression analysis indicated that age, shock on admission, elevated serum creatinine (sCr) and white blood cell (WBC) count <3.5x109 or >20x109 cells/l were predictors of in-hospital mortality. In conclusion, advanced age, shock on admission, elevated sCr levels and significantly abnormal WBC count are associated with higher in-hospital mortality following emergency laparotomy.

Effects of intrinsic foot muscle strengthening on the medial longitudinal arch mobility and function: A systematic review.

OBJECTIVE: To Investigate the effects of intrinsic foot muscle (IFM) strengthening on foot's medial longitudinal arch (MLA) mobility and function in healthy individuals. We also identified exercise type and resistance training characteristics (series and repetitions). METHODS: Eight databases were searched, between October 2020 and February 2021 and updated in May 2021. We included randomized controlled trials involving IFM strengthening exercises compared with controls (no exercise or exercises not involving isolated intrinsic foot muscle strengthening). Methodological quality of the studies was assessed using PEDro scale and Cochrane Risk of Bias tool. Quality of evidence was evaluated using GRADE model (Grading of Recommendations, Assessment, Development and Evaluations). RESULTS: Four randomized controlled trials (RCT) were included. IFM strengthening did not change MLA mobility in the short-term (4 weeks); however, it promoted medium-term effects (8 weeks - low quality of evidence). IFM exercises improved function in the short and medium-term (low quality of evidence). Most studies used the short-foot exercise and the toe-towel curl exercise with contractions of 5 s and load progression from sitting to standing. CONCLUSION: IFM strengthening exercises change MLA mobility in the medium-term (8 weeks) and improve the dynamic balance of healthy individuals in short- (4 weeks) and medium-terms.

Surveillance, epidemiology, and impact of the coronavirus disease 2019 interventions on the incidence of enterovirus infections in Nanchang, China, 2010-2022.

Introduction: Pathogen spectrum of Hand, foot and mouth disease (HFMD) has substantially changed in the past decade in China. Growing evidence has indicated that anti-COVID-19 nonpharmaceutical interventions (NPIs) can support control of various infectious diseases, including intestinal diseases. Methods: In this study, HFMD cases were enrolled from sentinel hospitals of Nanchang, Jiangxi province, and enteroviruses were genotyped using specific real time RT-PCR. We systematically characterized the epidemiology of HFMD based on the continuous molecular surveillance and estimated the impact of COVID-19 intervention on HFMD incidence using seasonal autoregressive integrated moving average (ARIMA) models. Results: A total of 10247 HFMD cases were included during 2010-2022, of which 6121 enterovirus (EV)-positive cases (59.7%) were identified by real-time RT-PCR. Over 80% cases were associated with EV-A71 and coxsackievirus A16 (CVA16) during 2010-2012, while the type distribution significantly changed as CVA6 emerged to be dominant, accounting for 22.6%-59.6% during 2013-2022. It was observed that the prevalence patterns of EV-A71 and CVA16 were similar and both of them peaked in the second quarter and then leveled off. However, CVA6 was generally prevalent around the fourth quarter, demonstrating a staggered prevalence during 2010-2019. During the COVID-19 epidemic, the seasonal HFMD epidemic peak was restrained, and the ARIMA analysis indicated that the COVID-19 intervention had mitigated EV transmission during the first COVID-19 outbreak in early 2020. In addition, bivariate Spearman's cross-correlation coefficients were estimated for the major types CVA6, CVA16 and EV-A71. Our analyses indicated the possible existence of correlations among CVA6, CVA16 and EV-A71 prevalence in the epidemiological level. Discussion: Taken together, the type distribution of HFMD has substantially changed over the last decade and CVA6 and CVA16 are currently the most predominant types co-circulating in Nanchang. The anti-COVID-19 NPIs significantly reduced the incidence of EV infections.

Joint polarization detection and degradation mechanisms for underwater image enhancement.

Light absorption and scattering exist in the underwater environment, which can lead to blurring, reduced brightness, and color distortion in underwater images. Polarized images have the advantages of eliminating underwater scattering interference, enhancing contrast, and detecting material information of the object in underwater detection. In this paper, from the perspective of polarization imaging, different concentrations (0.15 g/ml, 0.30 g/ml, and 0.50 g/ml), different wave bands (red, green, and blue), different materials (copper, wood, high-density PVC, aluminum, cloth, foam, cloth sheet, low-density PVC, rubber, and porcelain tile), and different depths (10 cm, 20 cm, 30 cm, and 40 cm) are set up in a chamber for the experimental environment. By combining the degradation mechanism of underwater images and the analysis of polarization detection results, it is proved that the degree of polarization images have greater advantages than degree of linear polarization images, degree of circular polarization images, S1, S2, and S3 images, and visible images underwater. Finally, a fusion algorithm of underwater visible images and polarization images based on compressed sensing is proposed to enhance underwater degraded images. To improve the quality of fused images, we introduce orthogonal matching pursuit (OMP) in the high-frequency part to improve image sparsity and consistency detection in the low-frequency part to improve the image mutation phenomenon. The fusion results show that the peak SNR values of the fusion result maps using OMP in this paper are improved by 32.19% and 22.14% on average over those using backpropagation and subspace pursuit methods. With different materials and concentrations, the underwater image enhancement algorithm proposed in this paper improves information entropy, average gradient, and standard deviation by 7.76%, 18.12%, and 40.8%, respectively, on average over previous algorithms. The image NIQE value shows that the image quality obtained by this paper's algorithm is improved by about 69.26% over the original S0 image.

Assessment of potential ecological risk based on the vertical characteristics of potential toxic elements in sediments from a high-density cage culture reservoir in China.

The pollution of sediments around Lu Ban Island is a serious environmental issue that is threatening human health. The concentration of As, Cd, Cu, Cr, Hg, Ni, Pb, and Zn at 73 layer points were investigated, vertical distribution characteristics, correlation among potential toxic elements and potential ecological risks of sediments at different depth were analyzed. The following results were obtained, (1) the hypothesis that there was a linear relationship between concentration of potential toxic elements and the reciprocal of deep was reasonable. Based on hypothesis, the ultimate value of concentration by making depth go to infinity was regarded as the background concentration. The background concentration of As, Cd, Cu, Cr, Hg, Ni, Pb, and Zn are respectively 4.94 mg/kg, 0.20 mg/kg, 15.48 mg/kg, 58.41 mg/kg, 0.062 mg/kg, 26.96 mg/kg, 20.29 mg/kg, and 53.31 mg/kg. (2) But correlation between Ni and As was relatively weak, high degree of correlation among other potential toxic elements were found. Based on their correlation, eight potential toxic elements were classified into three groups. First group included Ni and Cr, mainly releasing by coal burning; Cu, Pb, Zn, Hg, and Cd were grouped together, possibly due to their shared source of fish cage culture; Arsenic with relatively weak correlation with other potential toxic elements was classified as a separate class, which was usually one important mineral resource associated with phosphate. (3) Potential ecological risk index (PERI) of sediment above - 0.40 m belonged to moderate risk, the PERI of sediment in - 0.10 m, - 0.20 m, and - 0.40 m were 289.06, 254.33, and 201.44, respectively. Sediment below - 0.40 m belonged to low risk with average PERI value 112.82, with no significant changes in PERI values. The order of contribution to PERI was Hg > Cd > As > Cu > Pb > Ni > Cr > Zn. (4) According to result of cluster analysis and potential ecological risk, the potential ecological risk of sediment above - 0.40 m mainly contributed by potential toxic elements of Cu, Cd, Hg, Pb, and Zn sharing source of fish cage culture.

Atrophic gastritis rather than Helicobacter pylori infection can be an independent risk factor of colorectal polyps: a retrospective study in China.

BACKGROUND: Colonoscopy is considered the most effective screening method for colorectal polyps. However, the longevity and complexity of the procedure makes it less desirable to screen for colorectal polyps in the general population. Therefore, it is essential to identify other independent risk factors. In this study, we explored the link between Hp infection, atrophic gastritis, and colorectal polyps to identify a new potential risk factors of colorectal polyps. METHODS: In this study, atrophic gastritis and intestinal polyps were diagnosed by endoscopy and pathology. All the 792 patients in this retrospective study were divided into sub-groups based on the presence of colorectal polyps. The correlation between polyps and atrophic gastritis was analyzed using the chi-square test and Kruskal-Wallis test. The receiver operating characteristic (ROC) curve was used to compare the predictive value for colorectal polyps between Hp infection and atrophic gastritis. Binary logistic regression was utilized to identify independent risk factors for colorectal polyps. RESULTS: Patients with colorectal polyps were primarily male with advanced age, and the number of patients with colorectal polyps had a higher association with smoking, alcohol drinking, and Hp infection than the control group. A positive correlation between the number of colorectal polyps and the severity of atrophic gastritis was observed. ROC analysis showed that atrophic gastritis was a better risk factors for colorectal polyps. Multivariate analysis identified atrophic gastritis as an independent risk factor for colorectal polyps (OR 2.294; 95% CI 1.597-3.296). CONCLUSIONS: Atrophic gastritis confirmed could be an independent risk factors for colorectal polyps.

Rapid quantification of the adulteration of pomegranate juices by Raman spectroscopy and chemometrics.

The juice drink industry has repeatedly been exposed to adulteration. Unscrupulous producers, for example, use cheap juice for substitution in the pursuit of more significant economic benefits, which presents a tremendous challenge for the control of the quality of drinks. The objective of this study was to apply Raman spectroscopy combined with chemometrics to rapidly quantify the adulteration concentration of apple juice or grape juice in pomegranate juice. Two supervised learning algorithms: partial least squares regression (PLSR) and support vector machine regression (SVR) were used to analyze the Raman spectra of 114 samples. The coefficient of determination (R2), root mean square error (RMSE), and residual prediction deviation (RPD) of the prediction set when using PLSR and SVR to predict the adulterated concentration of apple juice in pomegranate juice were 0.9357 and 0.9465, 6.446% and 5.974%, 3.945 and 4.322, respectively. The R2, RMSE, and RPD of the prediction set when using PLSR and SVR to predict the adulteration concentration of grape juice in pomegranate juice were 0.9501 and 0.9502, 6.334% and 5.571%, and 4.475 and 4.481, respectively. It was concluded that Raman spectroscopy combined with chemometrics has excellent potential for application as a rapid quantitative method to detect adulterated concentrations of pomegranate juice.

Ferroptosis in pancreatic diseases: potential opportunities and challenges that require attention.

The pancreas is an abdominal organ with both endocrine and exocrine functions, and patients with pancreatic diseases suffer tremendously. The regulated cell death of various cells in the pancreas is thought to play a key role in disease development. As one of the newly discovered regulated cell death modalities, ferroptosis has the potential for therapeutic applications in the study of multiple diseases. Ferroptosis has been observed in several pancreatic diseases, but its role in pancreatic diseases has not been systematically elucidated or reviewed. Understanding the occurrence of ferroptosis in various pancreatic diseases after damage to the different cell types is crucial in determining disease progression, evaluating targeted therapies, and predicting disease prognosis. Herein, we summarize the research progress associated with ferroptosis in four common pancreatic diseases, namely acute pancreatitis, chronic pancreatitis, pancreatic ductal adenocarcinoma, and diabetes mellitus. Furthermore, the elucidation of ferroptosis in rare pancreatic diseases may provide sociological benefits in the future.

Magnetic resonance imaging thicknesses and apparent diffusion coefficient values of the endometrium and junction zone in women of reproductive age.

BACKGROUND: The endometrium and uterine junction zone often change throughout the menstrual cycle. Some pathological conditions may appear normal in uterine imaging, which will lead to missed diagnosis and misdiagnosis. PURPOSE: To evaluate the changes in the thickness and apparent diffusion coefficient (ADC) values of the endometrium and uterine junction zone throughout the menstrual cycle in magnetic resonance imaging (MRI) of women of reproductive age. MATERIAL AND METHODS: Data were collected from 40 healthy women of reproductive age with regular menstrual cycles from January 2017 to April 2018. They underwent four total MRI sessions during the menstrual, proliferation, and early and late secretive phases. The main MRI sequences were T2-weighted (T2W) volume isotropic turbo spin echo acquisition (VISTA) spectral attenuated inversion recovery (SPAIR) and diffusion-weighted imaging (b = 0, 600, 800, 1000 s/mm2), which were used to measure the thicknesses and ADC values of endometrium and uterine junction zone. RESULTS: First, the endometrium was thinnest during the menstrual phase and thickest in the late secretive phase. Second, the uterine junction zone was thinnest in the late secretive phase and thickest in the menstrual phase. Third, the ADC values of the endometrium were lowest in the menstrual phase and peaked in the early secretive phase. Finally, the ADC values of the uterine junction zone were lowest in the menstrual phase and peaked in the late secretive phase. CONCLUSION: The endometrium and uterine junction zone showed cyclic changes. Radiologists should consider these changes in the thickness and ADC values when analyzing MRI images of the uterus.

Translation, cross-cultural adaptation, validity and reliability of the Brazilian Portuguese version of Activity Scale for Kids questionnaire.

BACKGROUND: The Activity Scale for Kids (ASK) assesses the physical disability of children (5 to 15 years old) with neurological, orthopaedic or rheumatic diseases. The objective of this study was to translate and cross-culturally adapt the ASK for Brazilian Portuguese and assess the validity and reliability of the instrument. METHODS: A total of 67 children and adolescents with musculoskeletal, neurological or rheumatic diseases participated in the study. We evaluated the comprehension of the pre-final version of the questionnaire in 24 participants and reliability and validity in the other 43 participants. The translation and adaptation of ASK to Brazilian Portuguese followed guidelines from previous studies. The validity of the Brazilian Portuguese version of the ASK was verified through Spearman's correlation with the Pediatric Quality of Life Inventory™ Version 4.0 (PedQL). Intraclass correlation coefficient verified inter- and intra-evaluator reliability, while internal consistency was assessed using Cronbach's alpha. Scores were used to assess the standard error of the mean and minimal detectable change. RESULTS: The Brazilian Portuguese version of the ASK presented excellent reliability, internal consistency, agreement and moderate correlation with PedsQL (0.522, P < 0.001) between ASK performance and PedsQL; 0.537, P < 0.001 between ASK capacity and PedsQL. CONCLUSION: The Brazilian Portuguese version of the ASK has good validity and reliability and may be used by professionals and researchers to assess the functioning of children and adolescents with disabilities.

Construction of risk factors for autologous arteriovenous fistula failure in 120 patients with chronic kidney disease stage 4 to 5 maintenance hemodialysis and prevention strategies / 中国医师进修杂志

Objective:To explore the risk factors and prevention strategies for autologous arteriovenous fistula failure in 120 maintenance hemodialysis (MHD) patients, and build a regression model.Methods:The clinical data of 120 patients received MHD treatment in Anji County People′s Hospital from January 2020 to February 2022 were retrospectively analyzed, and the selected patients were divided into the failure group (25 cases) and the patency group (95 cases) according to whether they had autologous arteriovenous fistula failure. The clinical data of the two groups were compared. Multivariate Logistic regression analysis method was used to analyze the risk factors of autologous arteriovenous fistula failure in MHD patients. And a Logistic regression model was established to analyze the predictive value.Results:The proportions of women, diabetes and temporary catheter dialysis patients in the failure group were higher than those in the patency group: 56.00% (14/25) vs. 33.68% (32/95), 44.00% (11/25) vs. 13.68% (13/95), 92.00% (23/25) vs. 65.26% (62/95); the time of catheterization, plasma parathyroid hormone, serum albumin (Alb), D-Dimer (D-D), fibrinogen (FIB) and phosphorus were higher than those in the patency group: (47.87 ± 18.43) d vs. (39.65 ± 16.58) d, (439.76 ± 23.45) ng/L vs. (354.54 ± 31.26) ng/L, (43.43 ± 2.54) g/L vs. (39.65 ± 2.31) g/L, (1.13 ± 0.32) mg/L vs. (0.23 ± 0.07) mg/L, (5.64 ± 2.14) g/L vs. (2.76 ± 0.76) g/L, (3.54 ± 1.02) mmol/L vs. (0.76 ± 0.05) mmol/L( P<0.05). The results of multivariate Logistic regression analysis showed that female, concomitant diabetes, temporary catheter dialysis, and high level of serum phosphorus were independent risk factors for autologous arteriovenous fistula failure in MHD patients ( OR = 2.654, 3.077, 3.721, 2.646; P<0.05). Regression equation model was: logit( P) = -12.763 + sex × 0.976 + diabetes × 1.124 + temporary catheter dialysis × 1.314 + level of blood phosphorus × 0.973. When Logistic ( P) > 18.542, the area under the curve (AUC) value for autologous arteriovenous fistula failure prediction in this model was 0.882 (95% CI from 0.811 to 0.934), and with sensitivity of 80.00%, and specificity of 83.16%. Conclusions:Female gender, diabetes mellitus, temporary catheter dialysis, and high blood phosphorus level were independent risk factors for autologous arteriovenous fistula failure in patients with MHD. The model had a good predictive value for failure of autologous arteriovenous fistula in patients with MHD. Corresponding treatment and intervention measures could be used for patients with the above conditions in order to reduce the risk of autologous arteriovenous fistula failure and improve the treatment effect.

Accuracy and stability of a smart wearable device for quantitative analysis of environmental risks related to myopia / 中华实验眼科杂志

Objective:To evaluate the accuracy and stability of Eye-Monitor, a smart wearable device, in quantifying environmental risks related to myopia.Methods:A diagnostic test study was conducted.Forty-two subjects aged 18-25 years old were recruited from Shandong University of Traditional Chinese Medicine in December 2021.Forty-two Eye-Monitors were selected from 80 devices using the simple random sampling method.Static and dynamic tests were carried out to compare environmental risks related to myopia.The static tests included measurements under different working distances, different head tilt angles when sitting, and different light intensities.The dynamic tests included measurements under different near-work time, different outdoor activity time, different time watching computers, and different phone viewing time.Eye-Monitor with the largest sum of absolute values of total relative error was selected, Spearman rank correlation analysis was used to analyze the correlation between the set values and Eye-Monitor measurements, and the accuracy of the objectively measured values was evaluated by Bland-Altman consistency analysis.The stability of the objectively measured values from Eye-Monitor was evaluated by the coefficient of variation.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (No.HEC-KS-2021005KY). Written informed consent was obtained from each subject.Results:There were significant correlations between the measured values and setting values in the working distance, head tilt angle when sitting, indoor light intensity, total near-work time, average continuous near-work time, outdoor activity time, time watching computers, and time viewing phones ( rs=0.999, 0.998, 0.999, 0.998, 0.976, 0.959, 0.992, 0.997; all at P<0.001), with the 95% limits of agreement (LoA) of-1.23-2.32 cm, -1.49-4.24°, -13.90-26.90 lx, -6.46-0.11 minutes, -4.50-1.20 minutes, -4.01-1.34 minutes, -2.54-1.94 minutes and-2.15-0.45 minutes, respectively.More than 95% of dots were within the clinically acceptable LoA.The coefficients of variation of the measured values ranged from 1.23%-2.99%, 2.39%-8.25%, 0.87%-8.03%, 1.49%-12.52%, 6.63%-13.59%, 0.00%-14.15%, 1.20%-8.33 and 1.49%-12.51%, respectively, showing good stability.Eye-Monitor had good accuracy in measuring outdoor light intensity (95% LoA: -336.50-130.00 lx). Conclusions:The smart wearable device Eye-Monitor can be used to objectively monitor working distance, head tilt angle when sitting, indoor light intensity, total near-work time, average continuous near-work time, outdoor activity time, time watching computers, and time watching phones, which are with good accuracy and stability.

Exploration in the medication law and core TCM prescriptions of Jia Yuejin in the treatment of coronary heart disease complicated with depression based on the "target-component-Chinese materia medica" and clinical data / 国际中医中药杂志

Objective:To explore the medication law and core TCM prescriptions of Jia Yuejin in the treatment of coronary heart disease (CHD) complicated with depressive disorder (DD) by analyzing target-based network and mining clinical data.Methods:The targets of CHD complicated with DD were obtained by GeneCards, OMIM, TTD and other databases, and then the protein-protein interaction network of the two disease targets was constructed and then screened out the core targets. The Metascape platform was used to perform GO and KEGG pathway enrichment analysis on the intersection targets respectively to analyze the mechanism of action of CHD complicated with DD. Then TCMSP was used to query the active components acting on the targets and the Chinese materia medica containing these active components, and the data were imported into Cytoscape 3.9.0 to construct the core target-active component-Chinese materia medica network for network topology analysis. The outpatient clinical data of Jia Yuejin from January 1, 2015 to January 1, 2021 were collected, and data mining was conducted by using the Ancient and Modern Medical Case Cloud Platform (V2.3.5) to obtain his commonly used prescriptions. The results were fitted with the core TCM prescriptions obtained by target network analysis, and the drugs in the core prescriptions were analyzed.Results:Totally 1 501 intersection targets were obtained by protein interaction network analysis of CHD complicated with DD, which could be divided into 4 core target clusters, including inflammation cause, subclass tumor cause, subclass lipid metabolism factor, and fibrosis factor; a total of 480 active components were obtained by TCMSP, which belonged to 181 types of Chinese materia medica, including 8 core components: quercetin, kaempferol, luteolin, carotene, beta-carotene, acacetin, formononetin and ellagic acid. GO enrichment analysis yielded 61 results, mainly including positive regulation of protein phosphorylation, signal receptor agonist activity, side of membrane , etc.; KEGG pathway enrichment analysis yielded a total of 20 results, mainly including cancer pathways, lipid and atherosclerosis, JAK-STAT signaling pathway, etc. Clinical data mining included 120 cases and 148 prescriptions, including 135 types of Chinese materia medica; the properties were mainly mild, warm, slightly cold and cold; the tastes were mainly sweet, bitter and light, and the medicine mainly belongs to the lung, spleen, liver, heart, stomach, kidney and other meridians; drug association analysis, cluster analysis and complex network analysis were used to synthesize common prescriptions. The core TCM prescriptions obtained from common prescription and target network analysis were fitted: Pinelliae Rhizoma, Glycyrrhizae Radixet Rhizoma, Bupleuri Radix, Cyperi Rhizoma, Salviea Miltiorrhizae Radix et Rhizoma, Corydalis Rhizoma, Codonopsis Radix, Astragali Radix, Acori Tatarinowii Rhizoma. Conclusion:The medication law of Jia Yuejin in the treatment of CHD complicated with DD is in accordance with core TCM prescriptions. This study can provide guidance for clinical treatment and further research of CHD complicated with DD.