[Investigate of the etiology and prevention status of liver cirrhosis].

Objective: To investigate the etiology, prevention and treatment status, and their corresponding regional differences of the patients with liver cirrhosis in China, in order to provide scientific basis for the development of diagnosis and control strategies in China. Methods: Clinical data of patients diagnosed with liver cirrhosis for the first time through January 1, 2018 to December 31, 2020 from 50 hospitals in seven different regions of China were collected and analyzed retrospectively, and the difference of etiology, treatment, and their differences in various regions were analyzed. Results: A total of 11 861 cases with liver cirrhosis were included in the study. Thereinto, 5 093 cases (42.94%) were diagnosed as compensated cirrhosis, and 6 768 cases (57.06%) had decompensated cirrhosis. Notably, 8 439 cases (71.15%) were determined as chronic hepatitis B-caused cirrhosis, 1 337 cases (11.27%) were alcoholic liver disease, 963 cases (8.12%) were chronic hepatitis C, 698 cases (5.88%) were autoimmune liver disease, 367 cases (3.09%) were schistosomiasis, 177 cases (1.49%) were nonalcoholic fatty liver, and 743 cases (6.26%) of other types of liver disease. There were significant differences in the incidence of chronic hepatitis B, chronic hepatitis C, alcoholic liver disease, fatty liver, schistosomiasis liver disease, and autoimmune liver disease among the seven regions (P<0.001). Only 1 139 cases (9.60%) underwent endoscopic therapy, thereinto, 718 cases (6.05%) underwent surgical therapy, and 456 cases (3.84%) underwent interventional therapy treatment. In patients with compensated liver cirrhosis, 60 cases (0.51%) underwent non-selective ß receptor blockers(NSBB), including 59 cases (0.50%) underwent propranolol and 1 case (0.01%) underwent carvedilol treatment. In patients with decompensated liver cirrhosis, 310 cases (2.61%) underwent NSBB treatment, including 303 cases (2.55%) underwent propranolol treatment and 7 cases (0.06%) underwent carvedilol treatment. Interestingly, there were significant differences in receiving endoscopic therapy, interventional therapy, NSBB therapy, splenectomy and other surgical treatments among the seven regions (P<0.001). Conclusion: Currently, chronic hepatitis B is the main cause (71.15%) of liver cirrhosis in several regions of China, and alcoholic liver disease has become the second cause (11.27%) of liver cirrhosis in China. The three-level prevention and control of cirrhosis in China should be further strengthened.

[Progress of research on evaluation indicators and standards about high-speed train comfort].

The rapid development of high-speed railway in China has proposed higher requests for the comfort level of high-speed trains. However, there is no internationally unified evaluation criterion for high-speed train comfort currently, which therefore substantially affects the comparability and standardization of research results for high-speed train comfort. This paper systematically reviews the research literature about evaluation indicators and standards related to high-speed train comfort, and finds that there is currently no unified definition, evaluation indicators, as well as evaluation criterion for high-speed train comfort. Most current evaluation criteria are based on a single indicator. Some indicators are simultaneously developed by different apartments and differ between each other, and there is no comprehensive indicator or criteria for high-speed train comfort, restricting the comparison of high-speed train comfort across regions. It is recommended that the administrative department of high-speed railroad in China should organize experts to establish a unified definition of high-speed train comfort, comprehensive evaluation indicators and relevant judgment criteria for high-speed train comfort, in face of the rapid development and globalization of high-speed trains.

[Prediction on the cardio-cerebrovascular death and probability of premature death caused by common risk factors in China in 2030].

Objective: Predictive models were used to evaluate the impact of common risk factors on the number of cardio-cerebrovascular deaths and the probability of premature death. Methods: Using the data for China estimated by the Global Burden of Disease study 2015 (GBD 2015), we calculated the population attribution fraction (PAF) of risk factors. The proportional change model was used to estimate the number of unattributable deaths by 2030, and to predict the number of deaths, mortality, standardized mortality and probability of premature death by 2030. Results: According to the natural change trend of risk factors from 1990 to 2015, the number of deaths and mortality would reach 6.12 million and 428.53/100 000 by 2030, with an increase of 59.92% and 52.87%. By 2030, the probability of premature death from cardio-cerebrovascular diseases among Chinese aged 30-70 years old would continue to decline, from 11.43% to 11.28% for men, and from 5.79% to 4.43% for women. If the goals of all included risk factors were reached by 2030, 2 289 200 cardio-cerebrovascular deaths would be avoided. If only the exposure to a single risk factor was achieved by 2030, blood pressure, total cholesterol, and fine particulate matter exposure were the three most important factors affecting cardio-cerebrovascular deaths, which would reduce 1 332 800, 609 100 and 306 800 deaths, respectively. Among the involved risk factors, the control of blood pressure would mostly decrease the number of deaths due to ischemic heart disease and hemorrhagic stroke, about 677 300 and 391 100 deaths, accordingly. Conclusion: The control of risk factors is of great significance in reducing deaths and probability of premature death due to cardio-cerebrovascular diseases. If the control targets of all risk factors could be achieved by 2030, the burden of cardio-cerebrovascular diseases would be reduced greatly.

[Using multiple measure to promote injury prevention and control rapidly in China].

This paper highlights the grand significance of enhancing injury prevention and control through multiple measures currently, briefly summarizes the achievements, challenges of Chinese injury prevention and control in the past few decades and the core contents of current issue, and puts forward some suggestions, combined with the current challenges, to promote the development of injury prevention and control in China.

[Progress in cohort studies related to injury].

Objective: To summarize the progress of injury cohort studies over the world. Methods: Relevant information of injury cohort publications published before December 2017 were retrieved from PubMed, WanFang and China National Knowledge Infrastructure (CNKI) databases, consisting of the starting year, category of injury, study population, sample size, countries, follow-up duration, main exposure variables, outcome variables and method of data collection, and statistical methods. Results: A total of 295 studies were included in the analysis. The overall number of injury cohort studies increased with a peak in 2000, and then decreased. The top three countries that most frequently published cohort studies were the United States (52), Sweden (46) and the United Kingdom (37). A total of 29 published injury cohorts were identified in China, about 3, 23 and 3 cohort studies from the mainland of China, Taiwan Province, and Hong Kong Specific Administrative Region, respectively. The majority of cohort studies involved a single injury cause (93.6%); the most common injury causes included suicide/self-harm (46.1%), falls (17.3%) and road traffic injuries (14.6%). For the published cohort studies, exposure variables and outcome events varied with injury causes, primarily being collected through data registration system, national survey data, questionnaire survey, telephone interviews, and other means. Conclusion: A number of injury cohorts have been established worldwide, and few in the mainland of China. The existed cohort studies could offer important references for the design of large-scale, multi-center and high-quality injury cohort in China in the future.

[Surgical management of elderly patients with medial wall pyriform sinus cancer].

Objective: To investigate the clinical efficacy of preoperative-, postoperative-radiotherapy and surgery for preserving laryngeal function in patient over 70 years of age with medial wall pyriform sinus cancer. Methods: Clinical data of 48 patients over 70 years of age with medial wall pyriform sinus cancer who received surgical treatment from January 2001 to December 2010 were retrospectively analyzed. Among them, 21 cases were given preoperative radiotherapy and surgery (R+ S). The radiation therapy dose was 45 Gy. And 14 cases' larynx is preserved. In addition, 27 cases were given postoperative radiotherapy and surgery (S+ R). The radiation therapy dose was 65 Gy. And 10 cases had preserved laryngeal function. Survival rates were analyzed by the Kaplan-Meier method. Chi-square test was used to compare complications between two groups. Results: The larynx preservation rate in R+ S group [66.7% (14/21)] was significantly higher than that in S+ R group [37.0% (10/27), P<0.05]. The complication rate and decannulation rate in R+ S group were 42.9% (9/21) and 64.3% (9/14), respectively, showing no difference compared with those in S+ R group [37.0% (10/27) and 50.0% (5/10), respectively] (all P>0.05). The complication rates of patients with and without larynx preservation were 41.7% (10/24) and 37.5% (9/24), respectively, showing no difference between two groups (P>0.05). The overall 3-years and 5-years survival rates for all patients were 54.2% (26/48) and 35.4% (17/48), respectively. There was no significant difference in survival rates between R+ S [38.1% (8/21)] group and S+ R group [33.3% (9/27), P>0.05)]. In the R+ S group, the survival rates in patients with and without larynx preservation were 40.0% (4/10) and 29.4% (5/17), respectively, showing no significant difference between two groups (P>0.05). Conclusions: It is secure and effective to choose the operation with laryngeal preservation for patient over 70 years of age with medial wall pyriform sinus cancer based on their physical conditions and the tumor extension. The preoperative- and postoperative-radiotherapy have the similar effect. Preoperative radiotherapy and surgery increases the laryngeal preservation rate.

[Efficacy of the treatment of pharyngeal fistula through pectoralis major myocutaneous flap combined with fistula local skin inversion in 20 cases].

OBJECTIVE: To sum up the efficacy of treatment of pharyngeal fistula through pectoralis major myocutaneous flap combined with fistula local skin inversion in 20 patients. METHODS: A retrospective analysis of the therapeutic efficacy in 20 cases of laryngeal and laryngopharyngeal cancer with postoperative pharyngeal fistula, to whom double-deck repairing were operated on through pectoralis major myocutaneous island flap combined with inversion of skin around fistula from January 2010 to December 2013. RESULTS: 20 patients were treated by improved pharyngeal fistula inverting suture of pectoralis major myocutaneous flap combined with the skin around the pharyngeal fistula. Flap around the fistula were sutured without tension formation. The pectoralis major myocutaneous flaps were sutured without tension formation covering the inner flanging flap wound. 20 patients were on a nasogastric liquid diet after operation for one week and received antibiotics to prevent infection. Then they all took liquid diet after one week, and had extubation safely later. Stitches were removed 10 more days later. All the twenty patients were recovered successfully, among them, 16 cases recovered in stage Ⅰ and left the hospital 10 days later, 4 cases recovered in stage Ⅱ and left the hospital 20 days later. All the 4 cases recovered in stage Ⅱ were treated with radiotherapy. Fistulas less than 1 cm occurred near their anastomotic stomas at 7 to 14 days after operation. They were healed well by dressing change and pressure dressing. No recurrence was observed during the six months follow-up. CONCLUSIONS: Pectoralis major myocutaneous flap combined with fistula local skin inversion is a good way to repair pharyngeal fistula, and it is suitable for the laryngeal and laryngopharynx cancer patients with postoperative throat fistula in an internal diameter larger than 2 cm.

[Forecasting the burden of disease from diabetes under the scenarios of specific risk factors control in China in 2030].

Objective: To forecast mortality, age-standardized mortality, and probability of premature mortality from diabetes, and to simulate the impact of controlling risk factors by 2030 in China. Methods: We simulated the burden of disease from diabetes in six scenarios according to the development goals of risk factors control by the WHO and Chinese government. Based on the theory of comparative risk assessment and the estimates of the burden of disease for China from the Global Burden of Disease Study 2015, we used the proportional change model to project the number of deaths, age-standardized mortality, and probability of premature mortality from diabetes under different scenarios of risk factors control in 2030. Results: If the trends in exposures to risk factors from 1990 to 2015 continued. Mortality, age-standardized mortality, and probability of premature mortality from diabetes would increase to 32.57/100 000, 17.32/100 000, and 0.84% by 2030, respectively. During that time, mortality, age-standardized mortality and probability of premature mortality for males would all be higher than for females. If the goals of controlling risk factors were all achieved, the number of deaths from diabetes in 2030 would decrease by 62.10% compared to the predicted numbers based on the historical trends in exposure to risk factors, and the probability of premature mortality would drop to 0.29%. If only the exposure to a single risk factor were achieved by 2030, high fasting plasma glucose control would have the greatest impact on diabetes, resulting in a 56.00% reduction in deaths compared to the predicted numbers based on the historical trends, followed by high BMI (4.92%), smoking (0.65%), and low physical activity (0.53%). Conclusions: Risk factors control plays an important role in reducing the number of deaths, age-standardized mortality rate, and probability of premature mortality from diabetes. We suggest taking comprehensive measures to control relevant risk factors for certain populations and regions, to achieve the goal of reducing the burden of disease from diabetes as expected.

[Progress on epidemiological characteristics and interventions of pedestrian distraction].

Pedestrian distraction is one of the important risk factors of road injury. This review summarized the epidemiological characteristics, influencing factors, safety implications, and the published intervention measures. The review found that: a) the prevalence of pedestrian distraction poses a serious threat to pedestrian safety, but most epidemiological studies on pedestrian distraction focus on mobile phone use, and the incidence of pedestrian distraction varied greatly across studies using various research methods and from different countries; b) demographic characteristics, social psychology, and environment are the three main influencing factors of pedestrian distraction; c) distraction differently affected physiology, cognition, motion control, efficiency and behavior of pedestrian's street-crossing to some degrees, threatening the safety of pedestrian; d) engineering interventions and education were the most common interventions to prevent pedestrian distraction currently, but the effectiveness of most measures was not assessed rigorously. In the future, multidisciplinary and systematic epidemiological studies are recommended to design interventions purposely and evaluate the effectiveness of interventions through rigorous designs, providing scientific evidence for reducing pedestrian distraction and improving road safety of pedestrians.

[Comparison of training models for master of public health between China and other countries].

With the accelerating globalization and the implementation of "Belt and Road" initiative proposed by our government, communication and exchanges between China and foreign countries have become more and more frequent than before, and much more international students have chosen to study in China's universities as candidates of master of public health (MPH). However, because China only launched the MPH program in recent years, with the training models being highly similar to the program of master of science in China but quite different from those of main international MPH programs, hindering China's MPH program to become an international one. This paper systematically evaluated existing training models of MPH programs both at home and abroad through literature review and identified major differences and deficiencies of China's MPH program compared to those from other countries: (1) requirement for medical background only; (2) comparatively longer period to complete the program; (3) incomplete curriculum; (4) overemphasizing scientific research competencies but somewhat neglecting practical abilities; and (5) limited career choices, and put forward some suggestions to improve the MPH program of China, including removing requirement for medical background only, shortening the period of MPH program, improving the curriculum of MPH program, and enhancing the training of practical abilities.

[Progress in research of burden of disease attributed to population ageing].

Objective: To summarize recent progress in research of burden of disease attributed to population ageing and provide reference for relevant research in the future. Methods: We conducted a systematic literature review of quantitative studies about the impact of population ageing on burden of disease published from 2009 to 2019 according to the inclusion and exclusion criteria through PubMed, Web of Science, Embase, Cochrane Library, Wangfang database and China National Knowledge Infrastructure (CNKI) databases and extracted basic information and key results of the searched literature. Results: A total of 65 studies were included in the analysis, in which 29 (44.6%) studies used death number or mortality rate as outcome measures, 43 (66.2%) studies focused on a single country, such as China, United Kingdom and United States, 39 (60.0%) studies quantified the impact of population ageing on single disease, such as diabetes, lung cancer and coronary heart disease, 44 (67.7%) studies used decomposition methods to quantify the impact of population ageing, and 10 (15.4%) studies evaluated the effect of interventions on alleviating the impact of population ageing. Most studies found that population ageing increased the burden of some diseases, such as cancer, cardiovascular disease and dementia, while a few studies reported that population ageing decreased the burden of some diseases, such as neonatal disease and malaria. Various decomposition methods were adopted in 65 included studies, but several common methods were sensitive to the preconditions that were assumed, the decomposition order of three factors (population size, age structure, and age-specific rate) and the choice of control group, resulting incomparable and unstable results. Conclusions: The published decomposition studies adopted various methods and only evaluated the impact of population ageing in very limited countries and for several diseases. Therefore, a systematic evaluation using robust decomposition method is very necessary to evaluate the impact of population aging on disease burden across countries and diseases.

[Review on the progress regarding the intervention mapping protocol].

Along with the significant development on both theory and practice of health promotion programs, the application of behavioral and social science theories has also been advanced in the fields of design and evaluation regarding the intervention-related studies. Intervention mapping is a new planning protocol, efficiently used to develop, implement, and evaluate health promotion related intervention programs. In this article, we are briefly introducing the basic concepts, implementation steps, specific requirements, as well as reviewing the current progress in methodologies, application that are related to intervention mapping, so as to provide reference for health intervention research studies, domestically.

Impact Factors and Attitudes Toward Organ Donation Among Transplantation Patients and Their Caregivers in China.

PURPOSE: This study's purpose was to investigate the attitudes toward organ donation among renal transplantation patients and their caregivers. In addition, we sought to explore the impact factors that affect their attitudes toward deceased organ donation. DESIGN AND METHODS: A self-administrated questionnaire was used, which consisted of two parts: 1) demographic data, and 2) transplantation and donation-related data. This study was conducted in three transplantation follow-up centers in three hospitals using a cross-sectional approach. SPSS 17.0 software was used to analysis descriptive and inferential statistics for data. The responses were analyzed using descriptive statistics and logistic regression analysis. RESULTS: We received 426 effective questionnaires. The renal transplantation patients' mean age was 40.84 years. Among these patients, 67.8% were willing to accept the organ transplantation surgery for their relatives, 67.4% were willing to donate a living kidney to a close relative, 62.7% were willing to donate organs after death, 53.5% were willing to register in the national organ donation system, and 51.4% were willing to sign the organ donation consent when facing their relatives becoming a potential organ donor. Age, marriage status, education level, understanding of transplantation procedures and understanding of donation procedures had statistical significance in the difference of the attitudes toward donate their organs after death (P < .05). CONCLUSIONS: Renal transplantation patients in our study are more willing to donate organs after death than their caregivers, but both their attitudes toward deceased donation were not very optimistic. There is a significant relationship between participants' willingness and knowledge of organ donation; patients with more understanding of the transplantation and donation procedure were more willing to donate organs after death. Affected by traditional values such as Confucianism, many people still cannot accept registering in the national organ donation system or sign the organ donation consent when facing their relatives becoming potential organ donors. CLINICAL RELEVANCE: There is a need to give adequate training regarding donation to increase donation rates. The government must provide education from the perspective of scientific knowledge to change the traditional views of the public, which may then increase the donation rate in China.

[Progress in research of mobile health intervention].

With the rapid development of mobile communication technology and the growing popularity of smartphones worldwide, mobile health has become an extension of e-Health and Tele-Health, and is of value in the research and practice of public health. In this paper, we systematically assessed research literature of mobile health' s application on disease prevention and control as well as health promotion. Based on the characteristics of current literature, this paper focused on the application of mobile health in maternal health promotion, chronic disease management, and communicable disease prevention and control to provide reference for the mobile health intervention research in China.

AIM2 contributes to the maintenance of intestinal integrity via Akt and protects against Salmonella mucosal infection.

The mechanism regulating the gastrointestinal epithelial barrier remains poorly understood. We herein demonstrate that Absent in melanoma-2 (AIM2) contributes to the maintenance of intestinal barrier integrity and defense against bacterial infection. AIM2-deficient mice displayed an increased susceptibility to mucosal but not systemic infection by Salmonella typhimurium, indicating a protective role for AIM2 in the gastrointestinal tract. In a Salmonella colitis model, compared with wild-type mice, AIM2(-/-) mice exhibited more severe body weight loss, intestinal damage, intestinal inflammation, and disruption of basal and activated epithelial cell turnover. In vivo and in vitro data showed that AIM2 restricted the early epithelial paracellular invasion of Salmonella and decreased epithelial permeability. The decreased epithelial barrier in AIM2(-/-) mice might be attributed to the altered expression of tight junction proteins that contribute to epithelial integrity. AIM2 promoted the expression of tight junction proteins through Akt activation. Together, these results suggest that AIM2 is required for maintaining the integrity of the epithelial barrier.

Study of carbon nanotube modified biosensor for monitoring total cholesterol in blood.

A carbon nanotube modified biosensor for monitoring total cholesterol in blood was studied. This sensor consists of a carbon working electrode and a reference electrode screen-printed on a polycarbonate substrate. Cholesterol esterase, cholesterol oxidase, peroxidase and potassium ferrocyanide were immobilized on the screen-printed carbon electrodes. Multi-walled carbon nanotubes (MWCN) were added to prompt electron transfer. Experimental results show that the carbon nanotube modified biosensor offers a reliable calibration profile and stable electrochemical properties.

Some efficient strategies for improving the eigenstructure method in synthesis of feedback neural networks.

Two efficient strategies are proposed for improving the eigenstructure method from the best approximation projector point of view. Interpreted as two complementary best approximation projectors, the method is reformulated in a much more simplified form. We develop a new synthesis procedure through constructing the related best approximation projectors by using a simple recursive formula, which improves on the existing eigenstructure method not only in the significant reduction of the computational complexity but also in the incorporation of the learning capability comparable to the outer product method. The networks designed by the present procedure outperform those designed by some other known methods. We also propose a new forgetting algorithm for deleting any specific existing memories in a synthesized network. The algorithm performs efficiently and reliably, which particularly eliminates the overforgetting drawback of the Yen-Michel algorithm (1991, 1992). The feasibility and effectiveness of the algorithm are supported by theoretical analysis and computer simulations.

Compact, magneto-optic Q-switched, neodymium-doped bismuth germinate crystal (Nd:BGO) laser pumped by a laser diode.

The magneto-optic Q-switched operation of a neodymium-doped bismuth germinate crystal (Nd:BGO) laser that is end pumped by a cw 500-mW laser diode is reported. The crystal is a new host for Nd lasers. Here it acts as a magneto-optic modulator as well as a laser medium. A pulse energy of 2 µJ with a FWHM of 100 ns has been obtained. The device operates at a repetition rate of 1 kHz, and the fluctuation of the shot-to-shot intensity is less than ±1%.